Chapter 8 Auditory Training Perry C. Hanavan, Au.D.

??????? “You have to hear what you don’t hear to know what you don’t want to hear.”

Auditory Training Utilize residual hearing Emphasizing that the primary therapeutic goal is training the mind to be aware of, attend to, and use sound. Speech and language activities are founded in this mental training. To help integrate listening into one’s development of communication and social skills To help monitor one’s own voices and the voices of others in order to enhance the intelligibility of spoken language Utilize residual hearing with amplification and/or cochlear implant, and hearing assistance technologies

Four Design Principles 1.Auditory Skill –Awareness, detection –Discrimination –Identification –Comprehension 2.Stimuli –Phonetic level –Sentence level 3.Activity Type –Formal –Informal 4.Difficulty Level –Response type Closed, limited, open –Stimulus unit Words, phrases, sentences –Stimulus similarity –Contextual support –Task structure Highly structured, spontaneous –Listening conditions

1. Auditory Skill Level Detection –Presence/absence of sound Discrimination –Same/different Identification –Recognition/labeling Comprehension –Understanding/meaning detection discrimination identification comprehension

2. Stimulus Units Analytic –Phoneme, syllable, word Individual auditory cues Synthetic –Sentence, communication discourse Meaning of utterance analytic synthetic

Analytic Auditory Approach Two primary objectives often targeted in analytic approach 1.Vowels More intensity in lower frequencies, thus more audible to most Vowel formants: back, front, central, high, mid, low 2.Consonants Focus on place, manner and voicing characteristics

Vowel Formants

3. Activity Kind Informal Training –Occurs as part of the daily routine –Often incorporated into other activities Formal –Highly structured –Usually one-on-one training formal informal

4. Difficulty Level Stimulus set Stimulus unit Stimulus similarity Context Task SNR closed limited open phoneme syllable word sentence dissimilar similar high low good poor easy hard structured spontaneous

Hierarchy of Listening Tasks Familiar expressions/common phrases Single directions/two directions Classroom instructions Sequencing three directions Multielement directions Sequencing three events in a story Answering questions about a story Comprehension activities/exercises in noisy environs Onomatopoeic words –(Estabrooks, 1994)

Friday Morning Appointment The audiologist has just completed an audiologic evaluation and referred them for AR or you are an educator of the deaf or speech language pathologist? What audiologic tests measure detection? What audiologic tests measure identification?

Analytic to Synthetic Non- speech PhonemeSyllableWordSentenceDiscourse Detection Discrimination Identification Comprehension

Analytic Will discriminate vowels that differ in first formant information Will discriminate vowels that differ in second formant information (e.g. beet, bit; boot, but) Will discriminate words that have vowels with similar first and second formant information (e.g., “meet, mat”; boot, bought) Will identify words with different vowels, using a four-item response set (e.g., beet from beet, boot, bat, and bet) Will identify words with different vowels, from an open set of vocabulary

Synthetic Will discriminate between a declarative and interrogative sentence (How are you? ;You are fine) Will carry on a conversation Can follow the instructions of simple commands (Go to the chalkboard; write your name on the board; jump three times, etc.

Analytic to Synthetic Non- speech PhonemeSyllableWordSentenceDiscourse Detection Discrimination Identification Comprehension Analytic Synthetic

Context Non- speech PhonemeSyllableWordSentenceDiscourse Detection Discrimination Identification Comprehension Low High

Stimulus Unit Non- speech PhonemeSyllableWordSentenceDiscourse Detection Discrimination Identification Comprehension Non-speech Discourse

Audiologic Evaluation Non- speech PhonemeSyllableWordSentenceDiscourse Detection Pure toneLing 6SAT Discrimination Larson Identification Ling 6 WIPI NU-6 CAT SRT Isophonemic DSI QuickSIN HINT BKB-SIN Comprehension TOPICON

AR Evaluation (Auditory) Non- speech PhonemeSyllableWordSentenceDiscourse Detection Ling Discrimination Larson Identification SPAC Ling SPAC NU-CHIPS WIPI CAT BKB CUNY Quick-SIN BKB-SIN Comprehension TOPICON

AR Training(Auditory) Non- speech PhonemeSyllableWordSentenceDiscourse Detection Ling Vowel Consonant Syllable forms monosyllabic NU-6 Monosyllabic trochees Spondees multisyllabic Discrimination Pitch Loudness Duration Rate Identification noise makers everyday noises BKB CID Tracking Comprehension Discussion TOPICON

10 am Appointment Early childhood program has identified a 3 year old child with profound loss which was recently fitted. Child has accepted the hearing aids and is responding to sound. Develop 6 analytic auditory objectives from the paradigm that will encourage continued growth in exploring sound

Cycling Reviewing or practicing tasks already accomplished or demonstrated –e.g., student is struggling with identification of words—you review or practice at a simpler level of discrimination by comparing two words –e.g., student is struggling with hearing comprehending sentences— you practice at a word level before returning to work with sentences

11 am Appointment The student now 8 years of age has worn a cochlear implant since 2 and has been successfully integrated for the past three years in a regular classroom Develop 6 synthetic objectives from the paradigm that will help the child succeed