Aural Rehab Test #3 Part 2

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  1. A fetus can hear speech by _____________ weeks
  2. By six months, babies have learned to ___________ the sounds of their native language.
  3. If identification and management is reached by six months, they will have developed normal speech by age ____
  4. For NH childrehn, sound sequences
    • Crying and vegetative sounds (burp, cough, sneeze)
    • Cooing and laughing
    • Reduplicated babbling (same CV string; bababababa)
    • Variegated babbling (change CV string; badabadaba)
  5. Early vocalizations for hearing impaired children
    • Coo, squeal, babble, etc
    • Similar vowel positionsm but with greater velar-back consonants at 12-15 months
    • Similar in place of articulation of consonants and in frequency and babbling
    • Fewer consonant-like sounds from 6-10 months
    • Reduplicated babbling around 11-25 months with fewer instances than normal hearing babies
  6. Speech intelligibility
    The proportion of speech understood by the listener
  7. Speech intelligibility Evaluation
    involves recording the HOH individual and then further evaluating word identification and overall intelligibility (no visual cues of face to face interaction and context of the real world situation)
  8. Factors influencing scoring of intelligibility
    • Experience of the listener with deaf speech
    • Difficulty level of the vocabulary and sentence structure for the speaker
  9. Other factors of speech intelligibility
    • Effects daily conversation and others perceptions of a speaker's cognitive competence and personality
    • Speakers with at least moderately good intelligibility are perceived much more positively than speakers with poor intelligibility.
  10. Degree of intelligibility is __________ to hearing loss up to 90 dB HL
    directly related
  11. more residual hearing = ________________
    better intelligibility
  12. Potential causes for intelligibility for AV over TC
    • More intensive speech training
    • Teacher in TVC did not have expertise in speech training
    • Higher expectations set by teachers and parents (all they've ever known was speech)
    • Peer use of speech
  13. There is no evidence that the use of sign language itself detracts from speech intelligibility.

    True or false?
  14. Some TC programs may emphasize _____ more than __________ so this could cause the decrease in intelligibility.
    sign, oral communication
  15. Prelingual HL

    Mild to Moderately Severe (less than 70 dB HL)

    Speech characteristics
    Errors: misarticulation of single consonants and consonant blends.

    Most common sound errors are affricates, fricatives, and blends. Most common error types are substitutions (57%), distortions (29%), and omissions (14%).

    These errors resemble the errors made by younger children with NH sensitivity.
  16. Prelingual mild to moderately severe HL

    Due to a usual sloping HL configuration, most errors for speech sounds are...
    • Low intensity (loudness)
    • High frequency (pitch related)
    • Short duration (less acoustical cues)

    Suprasegmentals are HIGH frequency.
  17. Prelingual Mild to Mod. Severe HL

    Speech Assessment
    Speech errors comparable to NH children with artic or phonological delays.
  18. Prelingual Mild to Mod Severe HL

    Speech Management. Therapy is directed towards:
    articulation and/or phonological treatment.

    Consider: Use of visual and tactile cues to aid in speech distrinction. Familiar with the child's AIDED thresholds to identify the speech sounds that are in the child's audible range. Awareness of the impact of co-articulation, due to the change of sounds as they are paired with different speech sounds.
  19. Prelingual Mild to Mod. Severe HL

    Speech management

    Movement from ______________ to __________ and __________ is vital for this population.
    Single phoneme isolation, meaningful words and phrases.

    • Maximize and ensure optimal residual hearing
    • Parent/clinician goals for spoken language in everyday activities.
  20. Prelingual severe to profound HL

    Speech Characteristics.

    The average intelligibility for this type of HL is approximately _____%.

    The errors in their speech are usually complex and interrelated.
  21. Prelingual severe to profound HL

    Respiration: may speak only a few syllables on a single exhalation of air, can't self monitor so this is difficult.

    Resonance: vibration of air in the throat, oral cavity, and/or nasal cavity. (problems with hypernasality and hyponasality)
  22. Prelingual severe to profound HL

    Phonation issues
    • Vowel production may involve inadequate vocal fold adduction.
    • Voiceless phonemes will be voiced because they can hear them when they're voiced.
    • Incomplete closure=breathy voice quality.
    • Decreased control of the fundmental frequency of the voice.
    • Varied speech intensity. (May relate to breathiness and low lung volume)
  23. Prelingual severe to profound HL

    Articulation and phonology errors
    Patterns of consonant and vowel errors can be identified.

    Consonant misarticulation is more common than vowel and diphthong misarticulation.

    • Vowel neutralization-vowels resemble neutral schwa
    • Diphthong and vowel confusions
    • Nasalization of vowels.

    • Voicing errors
    • Omission and distortion of consonants
    • Omission of consonants in blends
    • Nasalization of consonants
  24. Prelingual severe to profound HL

    What is palatometry?
    Palatometry: fit to the patients palate and contains 96 electrodes for recording tongue to palate placement.

    Reduction is related to slower and less precise movement of the tongue.
  25. Prelingual severe to profound HL

    Suprasegmental Aspects are important bc they _______________________.
    communicate an individual's emotional intent, urgency of message and linguistic stress.

    They include: changes in duration, intensity, fundamental frequency actoss syllables in an utterance.
  26. Prelingual severe to profound HL

    Suprasegmental Aspects

    Speak at an overall rate of 1.5 to 2 times _____________than speakers with NH.

    (prolongation of individual phonemes and lengthy pauses within an utterance. slower speaking rates may serve as a compensatory adjustment.)

    Use more and longer pauses in addition to within phrase pauses during utterances.
  27. Prelingual severe to profound HL

    Suprasegmental Aspects

    Differences in intonation have been related to __________________________.
    reduced speech intelligibility.


    excessive pitch variation and less than normal pitch variation have been observed.
  28. Prelingual severe to profound HL

    suprasegmental aspects

    They have difficulty with adjusting ____________, __________, and ___________ within an utterance.
    duration, intensity, and intonation.
  29. Prelingual severe to profound HL

    Speech assessment

    Should include measures of:
    intelligibility, articulation and phonology, suprasegmental features and voice characteristics.
  30. Prelingual severe to profound HL

    Speech assessment

    Variables include: (4 variables)
    • Complexity of vocab and sentences spoken
    • Presence/absence of contestual cues
    • Presence/absence of visual and speechreading cues
    • Listener experience with deaf speech
  31. Prelingual severe to profound HL

    Speech Assessment

    Articulation and Phonology

    They ____________ their articulation

    Tests are not normed for children with HL but do show substitutions, distortions and omissions.

    Tell if the child is able to produce speech sounds through imitation or in conversational speech.

    They may imitate or spontaneously produce a large range of speech sounds but not use them contrastively to produce words in ongoing speech.
  32. Prelingual severe to profound HL

    Speech Management

    There is an extreme variability in error patterns among individuals.

    Speech traing should focus on _________
    making it as meaningful as possible. No lengthy motor drills of sounds in meaningless syllables. Focus on training of the use of meaningful words.
  33. Prelingual severe to profound HL

    Speech Management

    4 approaches to Enhance speech training
    • Early and consistent use of hearing devices to optimize residual hearing
    • Anatomic and pictorial monitoring (Anatomic charts, mobile articulations and pictures of the tongue shape-make sure these are age appropriate.)
    • Visual cues-usually involves a mirror
    • Use of complex feedback aids-uses devices to provide visual mmonitoring of acoustic features of speech. ex: observing the fundamental frequency of the voice and looking at the intensity.
  34. Maximize the use of residual hearing. It is the primary and best means for ____________________
    providing feedback for the development of speech. If you doubt audibility, have the child scheduled for an audiological evaluation.
  35. Postlingual Profound Loss

    This type usually produces a ________ ________ of speech
    gradual deterioration
  36. Postlingual Profound Loss

    A wide variation in speech production is related to:
    • Primarily the age of onset
    • Degree of HL
    • Hearing aid history
  37. Postlingual Profound Loss

    Who is responsible for intervention?
    Audiologist and SLP
  38. AVT

    What is the most common birth defect among children born on Earth?
    Hearing loss
  39. How many deaf or HOH children will be born on earth in the next 10 years?
    77 million
  40. AVT definition
    Auditory-Verbal Therapy is the application and management of technology strategies, techniques and procedures to enable children who are hearing impaired to learn to listen and understand spoken language in order to communicate through speech.
  41. Principles of A-V Practice
    Promote early diagnosis of HL in newborns, infants, toddlers, and young children, followed by immediate audiologic management and A-V therapy.

    Recommend immediate assessment and use of appropriate, state-of-the-art hearing technology to obtain maximum benefits of auditory stimulation.

    Guide and coach parents to help their chidl use hearing as the primary sensory modality in developing spoken language without the use of sign language or emphasis on lip reading.
  42. Average age of diagnosis in the US
    • 13 months for babies with severe loss
    • 22 months for those with mild to moderate loss
  43. Auditory Skill Development

    4 levels
    • Detection
    • Discrimination
    • Identification
    • Comprehension
  44. Ling 6 sound test
    Diagnostic test-start with detection then move to identification. They should imitate all by 2 years old.

    ah, sh, oo, ee, mm, ss

    (has sounds from the bottom to the top fo the spectrum)
  45. Factors Influencing Auditory Skill Development
    • Age of child
    • Duration of deafness
    • Age at implantation
    • Thresholds with cochlear implant
    • Wear time
    • Family support
    • Educational environment
    • Mode of communication
    • Implant function
    • Cognitive abilities
    • Language abilities
    • Social skills
    • Additional diagnoses
    • Presence of a second language in the home
    • Motivation
    • Learning Style
  46. Auditory skills must be taught in conjunction with speech, language, and cognitive goals.

    Goals must be ___________.
    integrated within one activity rather than taught in isolation.
  47. Instead of yelling (which distorts the signal),
    decrease the distance
  48. The listening environment is enhanced by:
    Parents and/or therapist sitting beside the child on the side of the better ear.

    Speaking close to the hearing aid or CI mic

    Speaking at a regular volume

    Minimizing background noise

    Using speech that is repetitive and rich in melody, expression and rhythm
  49. Acoustic highlighting techniques
    (like singing) is used to enhance the audibility of the spoken message.
  50. Guide and coach parents to:
    • Use natural developmental patterns
    • Help their child self monitor
    • Promote education in regular schools with peers wtho have typical haering and with appropriate services WHEN APPROPRIATE.

    Create environments that support listening for the acquisition of spoken language throughout the child's daily activities

    Help their child integrate listening and spoken language into all aspects of their life.
  51. AVT

    "What did you hear?" teaches children ___________.
  52. AVT

    The ultimate goal with familiar and unfamiliar listeners is :
    conversation competency-developing exceptional conversational skills involving social, cognition and higher order language, resasoning and thinking skills.
  53. AVT

    Teaching techniques and Strategies
    Be a birddog. Point out sound. "I hear that!"

    Be a director. Direct the child to LISTEN!

    Hear it before you see it. Audition first. Direct attention toward the object. Use a subtle handcue.
  54. AVT

    Teaching techniques and Strategies (more)
    Add meaningful language.

    Expect a response from the child. Pause and wait. Look expectantly, lean in.

    Play dumb. Use others to model.
Card Set
Aural Rehab Test #3 Part 2
AR test
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