CSD 5400REHABILITATION

PROCEDURES FOR THE HARD OF HEARING

Auditory Training

Auditory Training

This can be a child’s or an adult’s major component to an aural (re)habilitation program

What is it??

Some Definitions ofAuditory Training

Goldstein (1939)Auditory training involves a development and/or

improvement in the ability to discriminate various properties of speech and nonspeech sounds

Carhart (1960)Auditory training is a process of teaching hearing

impaired listeners to take full advantage of all available auditory cues

Erber (1982)Auditory training is helping kids to acquire many of

the auditory perception abilities that normal hearing kids acquire naturally without intervention

Primary Objectives of Auditory Training

Learning to maximize the use of acoustic cues available for speech perception

Adjusting to and making maximum use of amplification

These objectives are especially critical with cochlear implant recipients

Some Additional Comments…

Auditory training is not designed to change sensitivity, but rather to make maximal use of audible sounds

Accurate assessment of speech understanding is importantAdults

NST, CCT, W-22, NU-6, SPIN, SIN, CID Everyday SentencesKids

WIPI, PB-50, NU-CHIPS, Sound Effects Recognition Test

Ling Six Sound TestProcedure using the 6 sounds /a/, /u/, /i/, /sh/, /s/, /m/

Some Additional Comments…

Specific goals and procedures may vary depending on whether the client is an adult or child, but these three things are common to all1. Appropriate amplification is basic to the

process2. Residual hearing is maximized, either as a

primary means of reception or as a supplement to visual communication

3. Auditory training must involve the use of meaningful dialogue representative of the messages the client will encounter in their academic, work, home, and social environment

Auditory Skill Development in Children

Most traditional approaches to auditory training use this hierarchy of auditory skill developmentAwareness--is a sound

present?Discrimination-are sounds

the same?Identification-recognizing

and identifying soundsComprehension-

understanding the message on a cognitive and linguistic level

Auditory Training Activities for Children

Auditory training activities that are appropriate for each stage of auditory skill development

Popular and Current Auditory Training Approaches for Kids

DASL IISKI-HISPICE

DASL II (1994)

Developmental Approach to Successful Listening (II)Sequential, highly structured auditory

training programCan be used with any age

Most often used with preschool and school-age kids using hearing aids or cochlear implants

Auditory Hierarchyof the DASL II

Sound awarenessBasic skills (detection, discrimination) of both

environmental and speech sounds

Phonetic listeningExposure to the fundamental aspects of speech

perceptionDuration, intensity, pitch, rate

Discrimination and identification of vowels and consonants in isolation and in words

Auditory ComprehensionDiscrimination of common words to the

comprehension of complex verbal messages in everyday settings

SKI-HI (1985)

SKI-HI is a comprehensive identification and home intervention treatment plan for hearing impaired infants and young children and their families

Many SLPs and audiologists use the developmentally based auditory stimulation and training program that is included in the treatment plan

SKI-HI The program moves

the child through these eleven auditory skills in four phasesNotice that as you

move through the different skill levels, the auditory behavior becomes more complex

Sample SKI-HI Lesson

Here’s a sample lesson plan for Skill 3, recognizing objects and events from a sound source

Speech Perception Instructional Curriculum and

Evaluation

Goals and Objectives for:Detection

Awareness and responsiveness to speech

Suprasegmental perceptionGross variations in duration, stress,

intonation

Vowel and consonant perceptionConnected Speech

Activities include combined auditory and visual cues and auditory cues alone

Popular as a cochlear implant auditory training program

Summary Remarks of Auditory Training with Children

Auditory training philosophies and methodologies have enjoyed a resurgence through the advancement of conventional hearing aids and cochlear implants

Before implementing any one plan, you need to consider the child’s language development stage and characteristics of their hearing loss (audibility)

This should be a multi-sensory approachVisual cues should be emphasized as well as

auditory cues

Auditory TrainingWith Adults

Major difference in goalsAuditory training with kids has a

developmental goalAuditory training goal for adults is

remediation

Two general types of activitiesDrill on auditory or auditory/visual stimuliAdjustment to use of amplification

Activities for Reinforcing Auditory Discrimination

Minimal pairs-- sets of words that differ by only one phonemeDiscriminating (same or different)Identifying (pointing)Producing (saying aloud)

Auditory memory drillsClosed-set lists (numbers, days of the week, months of

the year, names)

Exercises in intonation“when will it open”Adjust the accent word and talk about any change in

meaning

Listening ExperiencesWith Hearing Aids

It’s useful to proceed gradually in adjusting to hearing aid use and to discuss with your clients their ability to assess the relative complexity of everyday listening situations using this kind of hierarchy

Guidelines for Adjustingto Hearing Aid Use

The adjustment period should take 2-4 weeks