Learning to Listen with Hearing Technologies: An Interdisciplinary Perspective on Aural Rehabilitation

Learning to Listen with Hearing

Technologies: An Interdisciplinary

Perspective on Aural Rehabilitation

Learning to Listen Again: Aural

Rehabilitation for Teens & Adults

Outline

• Role of an Aural Rehabilitation Specialist • Auditory Development

• It’s all about the BRAIN • Neuroplasticity

Objective

• After this session, the participant will be able to discuss the variety of audiological options available for individuals who have hearing loss, whether the hearing loss is mild, profound, unilateral or

bilateral.

• After this session, the participant will be able to list 3 resources for evaluation and intervention of children or adults with hearing loss who are learning to listen with hearing technologies.

• After this session, the participant will be able to list 3 key

principals in evaluation and intervention for children with hearing loss who are learning to listen and use spoken language, weather an infant starting an IFSP or an elementary-aged child who has nearly met all IEP goals.

What is an Aural Rehabilitation Specialist?

Therapy provided by a speech-language pathologist with skills and knowledge in:

• Listening and spoken language milestones and red flags for children with hearing loss.

• National standards for intervention (e.g., guidelines provided by the Joint Committee on Infant Hearing)

• Comfort troubleshooting hearing technologies

• Process of guiding a child and family through auditory development • Focus on family education and coaching for speech & language

development

• Requires close collaboration with child’s audiologist and educational team.

Role of an Aural Rehabilitation Specialist

• Provide ongoing information to Audiologist regarding perception/production for

programming purposes

• Evaluate auditory, speech, language, oral motor skills, pre- and post-implant.

• Ongoing intervention – connecting meaning to sound

• Incorporate listening into daily life (home, school, work, etc.)

Adult vs. Pediatric Aural Rehab

• Aural Rehabilitation for individuals with post lingual hearing loss (older children, teens & adults) looks very different than Aural

Rehabilitation for individuals with pre-lingual hearing loss.

Auditory Development

• Regardless of whether we are conducting Aural Habilitation or Aural Rehabilitation, the auditory development process remains the same.

Auditory Development

Detection – Was there a sound?

Discrimination – Is this sound different from

another sound?

Identification – What do you hear?

Comprehension – Is there meaning to this sound?

The Ling Six (7) Sound Check…

• AH, OO, EE, MM, SH, SS, No Sound • Need to test Ling

under ALL conditions • Left, Right, Bilateral,

Unilateral HA, FM, Quite/Noise, 1’, 3’, 6’, 9’, 12’, 40’, Phone, etc.

Hearing Loss & Literacy

• Listening and Talking are sensory partners of reading and writing

• Listening and reading are subsets of receptive language ability

• Talking and writing are subsets of expressive language ability.

It’s all about the BRAIN

• An audiologist will work to make sure hearing loss technology provides the best access to

sound. Focus on maximizing quality of input. • Aural Rehabilitation specialist will focus on

what your brain does with that information/input.

From the Beginning…

• The inner ear is fully developed by the 20th

week of gestation. • Auditory neural

development begins at that moment.

Auditory Cortex

Neuroplasticity

• The brain's ability to reorganize itself by forming new neural connections to meet demands throughout life.

Neuroplasticity

• Greatest in the first 3½ years of life

• The brain is wired for hearing and without early auditory input, the brain will reorganize itself to receive input from other senses,

primarily vision.

• This reduces auditory neural capacity especially as children age.

• Early auditory intervention synchronizes activity in the cortical layers.

Auditory Cognitive Closure

• “Aoccdrnig to a rscheearch at Cmabrigde

Uinervtisy, it deosn't mttaer in waht oredr the ltteers in a wrod are, the olny iprmoatnt tihng is taht the frist and lsat ltteers be at the rghit pclae. The rset can be a toatl mses and you can sitll raed it wouthit porbelm. Tihs is

bcuseae the huamn mnid deos not raed ervey lteter by istlef, but the wrod as a wlohe”

Adult/Teen Therapy Resources

• Angel Sounds -

http://angelsound.tigerspeech.com

• The Listening Room

(www.hearingjourney.com) • Tools for Schools

• Making the Connection (Young Adults/Adults)

• Med-El Soundscape -

Adult/Teen Therapy Resources

• Sound & Way Beyond (Cochlear)

Apps: SoundAMP R, Cochlear Hope Words, Rehabilitation Game, L2-Learning to Listen, Ling 6 Sound Application, Ear Trainer, Hear Coach

Social Media (Hear Peers)-Many online

General Resources

• www.advancedbionics.com

• www.cochlear.com

• www.medel.com

• Hearing Loss Association of America -

http://www.hearingloss.org

• Alexander Gram Bell Academy for Listening and Spoken Language (2012). Principles of LSLS/Aud-Verbal Therapy – www.agbell.org

References

• American Speech-Language-Hearing Association (2012). Adult aural /audiologic rehabilitation.

Retrieved from http://www.asha.org/public/hearing/Adult-Aural-Rehabilitation/

• Daniel, L., Daniloff, R., Schuckers, G. (1999) ALPS: A Language Rehabilitation Program for Childr Cochlear Implants. The Journal of Louisiana Allied Health Professions, Vol. II., Summer, pp. 36-44.

• Sorkin, D. L., Caleffe-Schenck, N., ( ). Cochlear implant rehabilitation: It’s not just for kids.

• Tye-Murray, N. (2009). Foundations of aural rehabilitation: Children, adults, and their family members (3rd ed.). Clifton Park, NY: Delmar, Cengage Learning. • Neuman, A. C., (2005). Central auditory system plasticity and aural rehabilitation

of adults. Journal of Rehabilitation Research and Development. Volume 42 (4), 169-186.

References Cont…

• Connolly JL, Carron JD, Roark SD. Universal newborn

hearing screening: are we achieving the Joint Committee on Infant Hearing (JCIH) objectives?. Laryngoscope. Feb

2005;115(2):232-6.

• Kristina M. Blaiser, Ph.D., CCC-SLP

• Carol Flexer, Ph.D., CCC-A; LSLS Cert. AVT

www.carolflexer.com

• Donald Goldberg, Ph.D., CCC-SLP/A: LSLS Cert. AVT • Opening Doors – Hearing Loss Resources -

http://www2.ed.gov/about/offices/list/osers/products/op ening_doors/index.html

Learning to Listen…

• “We as clinicians are only as good as we are able to teach parents and families how to work with their kids.”