AR final

- similar vocalization patterns (coo, squeal, babble)
- fewer consonant-like sounds
- delayed reduplicated babbling (11-25 months vs. 6-10 months)

- inverse relationship between degree of HL and intelligibility (70dBHL)
- effects on intelligibility related to onset of HL, intervention strategy used, and family attitudes

- sounds produced are commonly low intensity, high freq., short duration
- articulation problems with fricatives, affricates, and consonant blends
- final consonant omission and distortion

- can use regular tests since speech errors are similar as hearing children
- may have issue with vocab

- early amplification
- standard therapy techniques with some modifications
- use more visual, tactile, kinesthetic cues
- co articulation, move quickly to words/phrases

- select sequence targets based on normal development
- maximize optimal residual hearing
- have parents/child work on goals during activities of daily living

- average intelligibility (20%)
- problems with vowel, consonant, diphthong, voice quality, suprasegmentals

- lose more air due to delay in adduction of VFs
- fundamental frequency is higher with reduced range
- variable intensity

- both hypo and hyper nasality
- can be taught to use auditory cues

- vowel substitutions and neutralization
- diphthongalization
- diphthong distortion
- nasalization

- voicing errors
- omission and distortion
- omission of blends
- nasalization

- reduced intelligibility
- slower rate, more pauses
- intonation has excessive variation

- assess intelligibility, articulation, phonology, voice, suprasegmentals
- standard artic tests, speech sampls, acoustic analysis (visiptich)

- amplification
- whole language approach
- co-articulatory focus
- visual cues/stimulation/feedback

- gradual speech deterioration
- typical errors: final consonant deletion, voice, loudness, rhythm
- may have no "deaf speech"
- huge range of intelligibility scores

- degree of loss
- age of onset
- presence of concomitant disorders (30% incidence of secondary disabilities in children)

- increase in nonverbal communication from 6-36 months
- stabilizes or increases when words/signs are acquired

- mothers dominate conversation and respond less to child's initiation
- limited schema due to less auditory or visual (non-signing parent)

- generally equal with hearing children
- look at partner more
- imitate more
- use less wh questions
- use touch to initiate conversational turns

- total communication had more signs than oral only
- 158 words deaf 4 year old vs 2000 words hearing 4 year old

- reduced vocab
- no difference in types or complexity of semantic relationships
- delays approx. 1 year for mod HL and 3+ years for severe HL

- more problems than with vocab
- over use of nouns and verbs
- omission of function words
- overuse of subject-verb-object sentence structure
- receptive syntax rarely exceeds 5-7 years equivalent

- leveling off at 11 to 13 years in children with severe HL
- also seen in children with less severe HL
- some evidence that syntactic skills improve after leaving formal education

- drill and practice
- natural/experiential approach

traditional: stress first syntax and vocab, then pragmatics and communication effectiveness
- whole language: expose to all rule systems simultaneously rather than drills, development of written language through recognition and skill developement

- instead of lists of word definitions, replace with learning words in semantically rich contexts

- recasting: correct child's inappropriate/incomplete utterances
- conversational encouragers: naturally reinforce child's utterances
- develop schema: plan experiential learning events or role-play
- saboteur strategies: encourage child to protest, request or comment using already established language by violating already established routines

- provide opportunities through labels, traffic signs, drawing pictures, tracing letters, story reading and retelling

- Johnson, Liddell and Erting
- use ASL for academic instruction and interpersonal communication in classroom
- English skills taught through written language with explanations given in ASL

- communication checklists
- formal language tests
- communication/language sample analyses

- difficult to determine whether hearing vs. comprehension problem or reading vs. language problem
- iconicity of signs may interfere with results
- doesn't measure conversational skills

- sensory devices checked for proper function
- environment optimized by reducing noise and distractions
- allow full access to speech reading cues
- administrators must be proficient in primary mode of communication

- free appropriate public education
- mandate that requires access to special education and related services without charge
- must be provided in LRA
- documented with IEP

- least restrictive environment
- learning environment in which child has most access to academic, social and emotional support

- Individualized Education Program
- written report describing child's current level of performance, goals, and procedures to meet goals

- individualized family service plan
- IEP for children ages birth to 3 years
- focused on needs of child within context of family

- emphasizes communication, optimal use of amplified residual hearing, and development of speech-reading
- discourages use of sign
- auditory-verbal approach is variation that removes visual cues
- used by 30% schoolchildren

- uses sign, speech, listening, speech reading and nonverbal communication
- uses ASL, SEE or Pidgin
- used by 66% of classroom instruction

- visual support system for speech reading
- hand shapes made close to face
- only used in 1% of classroom instruction

- bilingual-bicultural
- sign only method
- 1%

- screening and assessment
- management of amplification
- direct instruction and indirect consultation
- hearing conservation
- evaluation and modification of classroom acoustics
- transition planning to post-secondary placements

- noise level
- reverberation
- distance between teacher and student

- full time regular education classroom
- regular education with in-class support
- regular education with pull-out sessions
- part time regular ed, part time special ed
- full time special ed at school facility
- full time special ed at separate facility
- residential school

- shock
- denial
- depression
- acceptance/resignation

- coping strategies for life, decision making and current problems

- help patients tell their story
- help patients clarify their problems
- help patients take responsibility for their listening problems
- help patients establish goals
- develop action plan
- implement plan
- conduct ongoing evaluation