Speech and Language
Therapist Resource Page
Wayne
A. Foster, PhD, CCC-Sp/A
SECTION ONE - Auditory Training Paradigm
Listening in Noise
Introduction: One major goal
for many hearing impaired is to process speech signals with greater clarity in
the presence of background noise. Here are some assumptions that I accept in my
efforts to assist children in their speech/language and hearing development:
- Hearing and understanding speech in
noise is a skill that develops over time. Normal hearing individuals must
develop this ability. Those with hearing loss must also develop this skill
set.
- Understanding speech in noise is not
completely a function of having the perfect hearing aid. A hearing aid that
brings an individual’s hearing to a normal level is not sufficient for
processing speech in noise. The individual still must develop the skill of
suppressing background noise.
- Children with hearing loss are at a
disadvantage in developing this skill. The prudent speech/language
pathologist and/or audiologist will assess the necessity of augmenting poorly
developed skills through the utilization of an assistive listening device.
- If a child is to ultimately develop
the ability to ‘listen through noise’ they must be challenged to do so. This
means that providing opportunities to systematically enhance listening
capabilities is important.
Preparing
for treatment:
- Obtain samples of background noise.
Here is what I did:
- Using a single tape recorder that I
use for all purposes, I obtained 2 minute samples of noise in the cafeteria
(speech noise), next to an air conditioner, and in a high traffic area. (Of
course you can obtain noise samples from any common environment to add to
your ‘collection.’)
- Tape record using different tapes
for each type of noise so that you do not have to fast forward or backward
with the tape. (If you have the capability to obtain samples in a digital
fashion – so much the better.)
- Develop lists of words and
sentences. These are listed from easiest to hardest.
- Familiar words/familiar
sentences: 4-8 word sentences using familiar words. In these sentences
poorly heard words may be deduced by the context.
i.
The dog chewed the bone.
ii.
We had hamburgers for dinner.
- Familiar words/unfamiliar
sentences: 4-8 word sentences where the words are familiar but the
context is more challenging. Explain to the student that some of the
sentences may sound ‘odd.’
i.
I see a squirrel in the chair.
ii.
Elephants live in small homes.
- Word contrasts A: The
student must either repeat the words or tell whether they are the
same/different.
i.
Strong – Chain
ii.
Book – Stay
- Word contrasts B: Select
words that are very close acoustically. The student must either repeat the
words or state whether they are the same or different.
i.
Fly – Flea
ii.
Men – Meant
- Sentence tracking: This is a
task that was recommended during the early FDA cochlear implant trials. A
grade level text is used.
- The clinician reads the text
sentence by sentence (or phrase) and the student must repeat it EXACTLY.
Keep going over the sentence or phrase until the student gets it.
Speech-reading is allowed.
- Read for one minute.
- Calculate the correct words per
minute and use this as your gauge for progress.
- Repeat the process without
speech-reading cues.
- Conversation A: Closed Topic
- Select a topic for which the
student has high interest and/or high knowledge.
- Engage in conversation regarding
the topic with visual cues allowed.
- Determine the percentage of
appropriate versus inappropriate responses/comments or answers to fact
questions about the topic. The idea is to grossly assess whether the
individual is correctly hearing the speaker.
- Engage in a conversation regarding
the topic with the mouth covered so that the individual does not have visual
cues (lip/speech reading information)
- Determine the percentage of correct
versus incorrect responses to fact questions.
- Conversation B: Open Topic
- Select a topic for which the
student’s background knowledge is known to be limited.
- “Teach” a short (1-3 minute) lesson
on the information with the student allowed to use speech-reading cues.
- Determine the percentage of correct
versus correct responses to fact questions regarding the topic.
- Repeat with a new passage. This
time the student is not allowed to have visual cues.
Notes on Treatment
·
In most cases individuals with normal hearing will perform nearly
the same with and without speech-reading cues.
·
If the score with speech-reading cues (on any task) is
significantly better than without – aim your therapy to close the gap between
the two modes of communication in each task and in each listening condition
·
Move from task to task starting with speech-reading cues and then
to non-speech-reading in the following manner:
o
Task in Quiet
o
Task in Non-Speech Noise (low intensity level)
o
Task in Non-Speech Noise (higher intensity level)
o
Task in Speech Noise (low intensity level)
o
Task in Speech Noise (higher intensity level)
The final step is to perform the conversation
level tasks in real environments, e.g., classroom, cafeteria.
If you have any questions contact Wayne Foster at
pider@netpath.net
SECTION TWO: Information from Speech/language Symposium at the 2008
Exceptional Children's Conference
November 21, 2008
I want you all to know that I enjoyed our day and a half
together at the North Carolina EC Speech/Language Institute. I hope you
came away with some new information and a few new viewpoints. Here is some
of the 'stuff' I promised to you. By the way, I have changed the web link
for the book: 'For the love of words'. It has come to my attention that I
left an 's' out of the web address. Sorry about that.
Thanks for the MANY emails! I am going to put together
some of the goals and objectives that I use on IEPs for you to review. As
I said several times during the session, I am still struggling with how best to
capture what I really want to do on an IEP and I'm not always happy with what I
write.
Wayne
************
Contact Information:
Wayne A. Foster, PhD, CCC-Sp/A
pider@netpath.net