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Chapter 5 Auditory Only Training

Chapter 5 Auditory Only Training. Perry C. Hanavan, Au.D. ???????. “You have to hear what you don’t hear to know what you don’t want to hear.”. Factoid. 40% of 170 pediatric SNHL in study had structural peripheral auditory abnormalities diagnosed with MRI

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Chapter 5 Auditory Only Training

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  1. Chapter 5Auditory Only Training Perry C. Hanavan, Au.D.

  2. ??????? “You have to hear what you don’t hear to know what you don’t want to hear.”

  3. Factoid • 40% of 170 pediatric SNHL in study had structural peripheral auditory abnormalities diagnosed with MRI • May not have complete audibility even with best hearing aids • 50% had mal-functioning issues with hearing aids • Battery • Earmold • FM connection

  4. Auditory Training • Utilize residual hearing • Emphasizing that the primary therapeutic goal is training the mind to be aware of, attend to, and use sound. • Speech and language activities are founded in this mental training. • To help integrate listening into one’s development of communication and social skills • To help monitor one’s own voices and the voices of others in order to enhance the intelligibility of spoken language • Utilize residual hearing with amplification and/or cochlear implant, and hearing assistance technologies

  5. The Early Auditory ExperienceHart and Risley, 1995

  6. Words Understood Note: Between ages 5 and 6, children are learning about 28 words a day

  7. Hart & Risely Study (1995)

  8. The More Parents Talk to Child

  9. Average IQ & Levels of Talk

  10. 30 Million Word Gap Initiative

  11. LENA

  12. LENA: Average Words Per Hour

  13. LENA: Word & Turn Taking

  14. LENA: TV Time & Media

  15. Hearing Loss Impact on Phonological Processes • Vowel substitutions • Deletion of unstressed syllable – “di(na)sour” • Deletion of initial syllable of word – (e)lephant • Vowel insertion - “cuppa” for “cup” • Cluster reduction – “fower” for “flower” • Final consonant sound deletion – “cu” for “cup”

  16. Plurals Sounds like “s” (cats) Sounds like “z” (dogs) Sounds like “es” (horses) Suffixes and Prefixes Friendly, happiness Widest, toxic Disable, misbehave At-Risk Language Components in Children with Hearing Loss

  17. Past tense Sounds like “t” (walked) Sounds like “d” (bobbed) Sounds like “ed” (beaded) Possessives The cat’s mitten The truck’s wheel At-risk Language Components, Cont.

  18. Copulas/Connecting words Is Of Have If Present progressive Going Swimming Pronouns and 3rd person He, his She, her It Vocabulary! At-risk Language Components, Cont.

  19. Question Which of the following is NOT an auditory skill level? • Detection • Discrimination • Recognition • Comprehension • Transformation

  20. Auditory Skill Awareness, detection Discrimination Identification Comprehension Stimuli Phonetic level Sentence level Activity Type Formal Informal Difficulty Level Response type Closed, limited, open Stimulus unit Words, phrases, sentences Stimulus similarity Contextual support Task structure Highly structured, spontaneous Listening conditions Four Design Principles

  21. 1. Auditory Skill Level • Awareness/Detection • Presence/absence of sound • Discrimination • Same/different • Identification • Recognition/labeling • Comprehension • Understanding/meaning detection discrimination identification comprehension

  22. Question Analytic works on the— • Phoneme level • Sentence level • Paragraph level • None of the above

  23. 2. Stimulus Units • Analytic • Phoneme, syllable, word • Individual auditory cues • Synthetic • Sentence, communication discourse • Meaning of utterance analytic synthetic

  24. Question The analytic approach typically begins with: • Consonants • Vowels • Diphthongs • Syllables • Words

  25. Analytic Auditory Approach Two primary objectives often targeted in analytic approach • Vowels • More intensity in lower frequencies, thus more audible to most • Vowel formants: back, front, central, high, mid, low • Consonants • Focus on place, manner and voicing characteristics

  26. Vowel Formants

  27. Question The first 2 formants are all below: • 1000 Hz • 2000 Hz • 3000 Hz • 500 Hz • 250 Hz

  28. Analytic Auditory Assessment

  29. Audibility Assessment UWO Plurals Test Phonak Logatom Test Mr. Potato Head Test PBK BKB-SIN Cincinnati Auditory Test CHAPS SIFTER FLE LENA CAEP

  30. Auditory Assessment Examples • Segmental-word: Early Speech Perception • Segmental-vowel: Early Speech Perception, Ling • Segmental-consonant: Minimal Pairs Test, Ling • Connected Speech – Mr. Potato Head Test, Common Phrase Tests (synthetic)

  31. 3. Activity Kind • Informal Training • Occurs as part of the daily routine • Often incorporated into other activities • Formal • Highly structured • Usually one-on-one training formal informal

  32. 4. Difficulty Level easy hard • Stimulus set • Stimulus unit • Stimulus similarity • Context • Task • SNR closed limited open phoneme syllable word sentence dissimilar similar high low structured spontaneous good poor

  33. Nancy Tye-Murray: Auditory Training • clEAR Online Game-based Auditory Training

  34. LACE Auditory Training LACE Auditory Training: a key to hearing better in noise

  35. Keira's therapy part 1

  36. Auditory Oral School of NY

  37. Brain Plasticity • Ability of brain to change • Learning possible

  38. Plasticity • Physiological changes in the CNS (and PNS – auditory nerve) that occurs from sensory experiences • Brain’s ability to reorganize space • Benefit from HA, CI, HATs may need to be measured at later date • Brain may continue to acclimate for several years following HA, CI, HAT, therapy

  39. Auditory Reorganization/Plasticity Cochlear dead regions Brain reorganization will occur with damage to regions of the cochlea

  40. Dr. Nina Kraus

  41. Dr. Patricia Kuhl

  42. Top Down Bottom Up

  43. Hierarchy of Listening Tasks • Familiar expressions/common phrases • Single directions/two directions • Classroom instructions • Sequencing three directions • Multielement directions • Sequencing three events in a story • Answering questions about a story • Comprehension activities/exercises in noisy environs • Onomatopoeic words • (Estabrooks, 1994)

  44. Friday Morning Appointment The audiologist has just completed an audiologic evaluation and referred them for AR or you are an educator of the deaf or speech language pathologist? • What audiologic tests measure detection? • What audiologic tests measure identification?

  45. Auditory Training Apps • AB CLIX free (iOS) • AB Listening Adventures $1.99 (iOS) • Auditory Verbal $3.99 (iOS) • VocAB Scenes $1.99 (iOS) • Hear Coach (Starkey) free (iOS, Android) • Hope Words LITE (Cochlear Ltd) free (iOS) • Hope Words (Cochlear Ltd) $2.99 (iOS) • Hope Words HD (Cochlear Ltd) $2.99 (iOS) • i-Angel Sound free (iOS) • iHear That free (iOS) (Ling 6 Sound Game) • Oceans & Continents (MED-EL) free (iOS, Android) • Rehabilitation Game (Oticon) free (iOS) • Siemens Hearing Test free (iOS) • Sound Match free (iOS)

  46. Analytic Auditory Training (bottom-up)

  47. Analytic: Vowel

  48. More Analytic Strategies • quiet vs. noise • noise vs. quiet • various types of noise • near vs. far...various distances

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