auditory processing presented by kimberly klein. early interest in cap in children concept was...
TRANSCRIPT
Auditory Processing
Presented by Kimberly Klein
Early interest in CAP in children
Concept was described by Myklebust, 1954
Interest expanded in 1970s
ASHA Consensus Conference on CAPD: Central auditory processes are
mechanisms and processes responsible for the following phenomena:
Sound localization and lateralization
Auditory discrimination
Auditory pattern recognition
Auditory performance decrements with degraded acoustic signals
Temporal aspects of audition, including temporal resolution, masking, integration, and ordering
Auditory performance decrements with competing acoustic signals (ASHA, 1996)
CAP Disorders can be defined as:
Observed deficiency in one or more behaviors described in ASHA Consensus Statement
Auditory specific (disorder of coding and transformation of auditory input or perception) or part of a larger general information processing deficit
Children with CAP
Lack skills to process/carry out multi-step directions
Pass pure-tone hearing tests
Great visual learners
Inability to learn to read with the phonetic approach
Difficulty learning where noise level is high
Children with CAP
Become followers socially & behaviorally
Can be withdrawn, confused, distracted, frustrated
Develop compensatory strategies
Develop listening skills
Reading Blocks
Primarily visual
Phonics
Rhyming words
Sequencing sounds into words
Dividing words into syllables
Retaining sounds
Auditory Skills
Sequential memory
Auditory discrimination
Sound blending
Auditory association
Sound blending
Obstacles
The brain’s inability to process all information correctly at a given time
Common Behaviors of CAP Children
Poor listener
Poor attention (short span)
Easily distracted
Misunderstands
Trouble following verbal instructions
Frustration
Poor speech discrimination
Poor ability to organize information
Seemingly poor memory
Common Behaviors of CAP Children
Doesn’t complete tasks
Daydreams
Hyperactive or hypoactive
Hostility
A “loner” often plays by self
Prefers company of younger friends or adults
“Soft” if any neurological signs
Common Behaviors of CAP children
DisruptiveWithdrawal“Clings” to parents (young children in an active environmentSeeks quiet or structured environment
Researchers say
Willeford & Burleigh noted that “such behaviors are not surprising if the child has failed to understand the teacher’s instructions.”
Toman reports that “70% of the talking in the classroom is done by teachers.”
Children with CAP
Trying hard to process what is being said and often are undiagnosed
Lack the skills necessary to process and carry out multi-step directions
Useful Resources
Fisher’s Auditory Problems Checklist
Willeford and Burleigh’s Behavior Rating Scale for Central Auditory Processing
Corpus Callosum
“The corpus callosum is primarily responsible for communication and integration of information from two cerebral hemispheres
Auditory Function Language
Rapid sequences of auditory stimuli and analysis dominate left hemisphere
While music perception, acoustic contour recognition and perception of gestalt dominates right hemisphere
Time will tell
If a child will outgrow CAP with the neuromaturation of his/her temporal processing abilities.
Skills continue to improve until age 12
Tests Used for selective attention, memory and
performance in sound blending include:Peabody Picture Vocabulary Test-Revised
Clinical Evaluation of Language Fundamentals-Revised
Test of Language Competency
Test of Adolescent Language
Test of Language Development Primary
Other subtests can be used
Interventions
Assistive listening devices--FM systems
Mnemonics
Chunking
Maximization of auditory & visual information
Speaking slower with more pauses
Brain Plasticity
Can take over and help a person compensate for this auditory deficit or disorder
Occurs quicker in younger children
Helps stroke victims who are musically inclined, as the music compensates for the CAP
Competing Sentence Test
Uses dichotically presented sentences that are the same length.Primary message, “My brother is a tall boy,” in right ear at 35 dBCompeting message, “Your mother is a good cook,” in left ear at 50 dBChild is asked to listen/repeat primary message and ignore louder message
Filtered Speech Test
Contains two fifty-word lists presented to each ear.
Words such as “tone, phone, root, tire” are given but are filtered
Child must say word given to testing ear
Each ear is tested with different set of words
Binaural Fusion Test
Gives the same word such as “bagpipe” to both ears simultaneouslyOne ear receives word in a low-pass signal/other receives in a high pass filtered stimuliWhen 2 frequencies played separately: unintelligible. Together the child understands “bagpipe”Testing ear receives low frequency
Alternating Speech Test
Phonemes of sentences are shifted such as “put a dozen apples in the sack”
Give to each ear in short bursts
20 alternating sentences
Test shows which ear is dominant and which is weak
Recommendations
Made on individual basis
If child has dominant right ear…then child’s right ear should be in center of room
Child has better opportunity of distinguishing sounds and processing information
Recommendations
Preferential seating
Implement buddy system: clarify auditory information
Position child away form “busy” areas
Earplugs or earmuffs worn during desk activities
Testing sessions in a quiet room
Rephrase or crosscheck instructions/concept
Teaching Approach
Pre-teach, teach and post-teach format of learning.
Coordinate this approach with parent and resource room teacher
Pre-teach—resource room—presenting new concepts prior to full class instruction
Teaching Approach
Classes relying heavily on auditory transmission of information should be scheduled in initial part of the morning or afternoon.
Re-Teach---parent or tutor revisits the concept for a third time
Creating Learning Environment
Lightly touch child’s shoulder or call child’s name prior to auditory information given
Visual supplements and “hands-on” approach
Use computer for classroom work
Phonics approach should be emphasized
Other students speak in softer voice; reduces strain of listening
Leads to?
Learning becomes fun and exciting rather than an arduous task that is compounded by confusion and frustration.
Activating poor memory
Use chunking, verbal chaining, rehearsal, paraphrasing, and summarizing
Activate right hemisphere through drawing and imagery
Use external aids—calendars, notebooks
Strategy for poor listening comprehension
Induce formal scheme to aid organization, integration and prediction through recognition and explanation of connective (furthermore) patterns of parallelism and co-relative pairs (not only/but also neither/nor
Maximize visual and auditory summation by substituting note taking
Sequencing: first, second, then, next, finally
Which direction does my brain follow?
Teacher trained
To provide classroom that child can thrive and succeed
To practice listening skills then child learns in effective manner
To become aware and talk slowly, emphasizing key words or phrasesTo wear lipstick as the focus becomes on the spoken word of the teacher and not her physical features
If teacher educated in CAP
Does the child need an assistive listening device (FM system)?
Does the teacher’s classroom provide good acoustics?
Does the teacher speak slowly when emphasizing key words or introducing new concepts?
Due to limited resources
Teachers must often compensate
Child is entitled to education regardless of needs
School district is to provide an education that teaches, challenges and meets the needs of its students
Parent should advocate for his/her child providing necessary research and information
Dedication
To the audiologists, research scientists, speech therapists, case managers, psychologists, resource teachers, staff and teachers who have provided knowledge, techniques, and explanations of working, teaching, raising a successful child with CAP