Listening and Spoken Language Therapy for Children With Hearing Loss: A Practical Auditory-Based Guide

Sylvia Rotfleisch, MSc(A), CCC/A, BSc(OT), LSLS Cert, AVT, is a certified Auditory-Verbal therapist, educator, and audiologist. She has devoted her career to providing therapy to families with children with hearing loss and teaching and mentoring other professionals. Trained at McGill University with Dr. Daniel Ling, Ms. Rotfleisch worked at Montreal Oral School for the Deaf, House Ear Institute, and Echo Horizon School before starting Hear to Talk (hear2talk.com), her own private practice. In addition to working with hundreds of families over more than 35 years, Ms. Rotfleisch has taught at University of Southern California, California Lutheran University, and led international master classes. She lectures, consults and mentors for school districts, helping to update their professional staff and mentors for LSL certification. She has presented at a wide variety of workshops and conferences. Ms. Rotfleisch has also served a variety of committees, including for AG Bell Academy for Listening and Spoken Language (R) and the task Force on Principles of Auditory-Verbal Therapy. ***** Maura Martindale, EdD, LSL Cert. AVEd, is a certified Auditory Verbal Educator. She received her doctorate in Educational Leadership from the University of Southern California in 1999. She is the founder and director of the Master's Degree of Science in the Education of the Deaf and Credential Program, and is an Associate Professor, at California Lutheran University in Thousand Oaks, California. She has provided guidance and support to families of children with hearing loss in listening and spoken language at No Limits for Deaf Children centers in Southern California for over 15 years. Throughout her 40-plus years teaching at numerous universities, Dr. Martindale has prepared hundreds of teachers of the deaf for schools and programs throughout the US. She was a teacher and Director of Educational Services at the John Tracy Clinic in Los Angeles California for 26 years.

Introduction
Acknowledgements
Reviewers

Chapter 1. Speech Acoustics: The Gold at the End of the Rainbow Audiogram
Sylvia Rotfleisch

Why Do We Need to Understand Speech Acoustics?
Section I. Basics of Sound
Key Points
Basics of Sound
Audiogram
A Sound Basis Through Application

Hearing Loss and Detection
Modifying the Signal
Ear Shot/Speech Bubble
Background Noise and Noise Clutter
Audible Versus Intelligible
The 6-dB Significance
The 6-dB Rule

Sounds of Speech

The Basics
Applications

Discussion Questions
Section II. Speech Features
Key Points
Speech Features and Acoustic Correlates

The Basics

The Applications Related to Speech Features

Suprasegmentals, Vowels and Diphthongs
Consonants

Discussion Questions
Section III. Speech Acoustic Tools and Applications
Key Points
Ling Six-Sound Test

Purpose and Administration
Applications of the Ling Six Sounds
Interpretation of the Ling Six Sounds

The Rainbow Audiogram

Applications of the Rainbow Audiogram

Functional Audiogram
Error Analysis to Determine Perception and Error Patterns
Case Study Application of Speech Acoustic Tools
Speech Acoustics and Hearing Loss Configurations
Speech Acoustics and the Impact on Speech Production
Speech Acoustics and Language Development

Case Study Application of Speech Acoustics for Speech and Language Development

The Gold at the End of the Rainbow Audiogram: Applications for Speech Acoustics
Discussion Questions
References

Chapter 2. Guiding and Supporting Parents/Caregivers.
Key Points
Why are Parents Included in Auditory Sessions?
Getting Started - Planning
Emotional Supports for Families
Teaching Parents and Caregivers: Why Are They Part of Every Session?
Family Life: Activities of Daily Living (ADL) as the FOundation of Every Session
Engaging Families in Sessions

Cultural Considerations
Screen Time

Speech Acoustics and Parents
Summary
Discussion Questions
References

Chapter 3. Stages Not Ages Model
Sylvia Rotfleisch and Maura Martindale

Key Points
Stages/Sequence of Development (Flow Chart)
Determining Child's Level
Expectations for Growth
Brain Functions of Audition

Auditory Processes

Typical Development

Language
Speech

Theory of Mind
Self-Advocacy
Higher-Order Thinking
Summary
Discussion Questions
Cases

Case 1
Case 2
Case 3

References

Chapter 4. Assessment of English Language, Speech and Listening
Maura Martindale

Key Points
Terms and Definitions
General Tips for Assessment of Children
Formal, Standardized Tests for Assessment
Checklists, Observations, and Questionnaires
Brain Functions for Listening and Spoken Language
Assessing Spoken Language

Spoken Vocabulary/Semantics
Language Sampling
Mean Length of Utterance (MLU)
Pragmatic Functions

Speech Assessment (Phonetic and Phonologic)
How to Align Assessment Data with the Proposed Therapy Model

Prelinguistic Stage
Single-Word Stage
Emerging Word Combinations Stage
Communication with Childlike Errors Stage
Competent Communicator Stage
Advanced Communicator Stage

Reporting Your Findings
Goal Setting Based on Data Gathered and Analyzed
Summary
Discussion Questions
References

Chapter 5. Therapy Basics
Sylvia Rotfleisch and Maura Martindale

Key Points
What Should Therapy Look Like? Fun!
The Chocolate Chip Cookie Theory
General Tips for the Sessions
Tools, Strategies, Building Materials

Turn Taking or Serve and Return
Infant- and Child-Directed Speech (IDS, CDS)
Narrating
The Expectant Pause
Waiting, Waiting, and Sometimes ... More Waiting ...
Blah Blah, Blah Ginger
Joint Attention
Auditory Closure
Auditory Sandwich
Listening Hoop
Enhancing Perception
Acoustic Highlighting
Life in Slow Motion
The Three-Act Play
Expansion
Upping the Ante

Vocabulary Expansion
Discussion Questions
References

Chapter 6. Prelinguistic Stage
Sylvia Rotfleisch
Key Points
Basic Characteristics at the Prelinguistic Stage

Listening
Language
Speech

Goals for the Prelinguistic Stage

Developing an Appropriate Therapy Plan by Addressing Strengths and Aread of Need
Typical Goals for the Prelinguistic Stage
How Do We Work on These Goals?

Targeting and Incorporating Goals

Auditory Attention, Detection, Memory and Discrimination
Auditory Feedback and Development of the Speech
Production System; Auditory Retrieval and Expressive Communication
Language Comprehension Development of Auditory Recognition, Sequencing, and Comprehension

Putting It All Together: Case History

Auditory Processes for Using Sound Meaningfully
Auditory Processes for Learning to Talk
Auditory Processes for Leaning Language
The Intervention Session

Summary
Discussion Questions
References

Chapter 7. Single-Word Communication Stage
Sylvia Rotfleisch

Key Points
Basic Characteristics at the Single-Word Stage of Communication

Listening
Language
Speech

Goals for the Single-Word Stage

Developing an Appropriate Therapy Plan By Addressing Strengths and Areas of Need
Typical Goals for the Single-Word Communication Stage
How Do We Work on These Goals?

Targeting and Incorporating Goals

Auditory Attention, Detection, Memory, Discrimination, Auditory Recognition, Sequencing, and Comprehension
Auditory Feedback and Speech Production Development of the Speech Production System, Auditory Retrieval, and Expressive Communication

Putting It All Together: Case History

Auditory Process for Using Sound Meaningfully
Auditory Process for Learning to Talk
Auditory Process for Learning Language
The Intervention Session

Summary
Discussion Questions
References

Chapter 8. Emerging Word Combinations Stage.
Sylvia Rotfleisch

Key Points
Basic Characteristics of the Child With Emerging Words Combinations

Listening
Language
Speech

Goals for the Emerging Words Combinations Stage

Developing an Appropriate Therapy Plan by Addressing Strengths and Areas of Need
Typical Goals for the Emerging Word Combinations Stage
How Do We Work on These Goals?

Targeting and Incorporating Goals

Auditory Attention, Detection, Memory, Discrimination, Auditory Recognition, Sequencing, and Comprehension
Targeting and Meeting Goals for Development of the Speech Production System: Auditory Retrieval and Expressive Communication

Putting It All Together: Case History

Auditory Process for Using Sound Meaningfully
Auditory Process for Learning to Talk
Auditory Process for Learning Language
The Intervention Session
Summary
The Intervention Session

Summary
Discussion Questions
References

Chapter 9. Communication with Typical Childlike Errors Stage
Sylvia Rotfleisch

Key Points
Basic Characteristics at the Communication with Errors Stage

Listening
Language
Speech

Goals for the Stage of Communication with Errors

Developing an Appropriate Therapy Plan by Addressing Strengths and Areas of Need
Typical Goals for the Communication with Errors Stage
How Do We Work on These Goals?

Targeting and Incorporating Goals

Auditory attention, Detection, Memory, Discrimination, Auditory Recognition, Sequencing, and Comprehension

Auditory Feedback and Expressive Communication
Putting It All Together: Case History

Auditory Process for Using Sound Meaningfully
Auditory Process for Learning to Talk
Auditory Process for Learning Language
Diagnostic Therapy and Informal Assessment
Progress in AVT Sessions
Summary
The Intervention Session

Summary
Discussion Questions
References

Chapter 10. Competent Communicator Stage
Key Points
Basic Characteristics of a Competent Communicator Stage

Listening
Language
Speech

Goals for the Competent Communicator Stage

Developing an Appropriate Therapy Plan by Addressing Strengths and Areas of Need
Typical Goals for the Stage Competent Communicator
How Do We Work on These Goals?

Targeting and Incorporating Goals

Auditory Attention, Detection, Memory, Discrimination, Auditory Recognition, Sequencing, and Comprehension
Auditory Retrieval and Expressive Communication

Putting It All Together: Case History

Auditory Process for Using Sound Meaningfully
Auditory Process for Learning to Talk
Auditory Process for Learning Language
Summary
The Intervention Session

Summary
Discussion Questions
References

Chapter 11. Advanced Communicator Stage
Sylvia Rotfleisch

Key Points
Basic Characteristics of an Advanced Communicator Stage

Listening
Language
Speech

Goals for the Advanced Communicator

Developing an Appropriate Therapy Plan by Addressing Strengths and Areas of Need
Typical Goals for the Advanced Communicator Stage
How Do We Work on These Goals?

Targeting and Incorporating Goals

Auditory Attention, Selection, Memory, Discrimination, Auditory Recognition, Sequencing, and Comprehension
Auditory Retrieval and Expressive Communication

Putting It All Together: Case History

Auditory Process for Using Sound Meaningfully
Auditory Process for Learning to Talk
Auditory Process for Learning Language
Summary
Progress Over Time With Intervention
The Intervention Session

Summary
Discussion Questions
References

Index