1. Introduction to Aural Rehabilitation Lisa Bowers, Ph.D. CCC-SLP

2.  NIDCD NIDCD  Statistics reported as of December 2012  324,200 registered devices have been implanted worldwide  In the United States - 58,000 adults & 38,000 children  1.4 million school-age children in US with hearing loss

3. Language of the Deaf and Hard of Hearing Chapter Six (pages 211-229)

4. Communication modalities  What does this mean to you?  Different ways to speak/communicate  Overall goal is communication  Modalities is the way to get there

5.  Major decision parents will have make …  Communication option(s)!

6.  www.ncbegin.org www.ncbegin.org  Communication options Communication options  Video Video

7. The Great Divide

8.  The “Great Divide” is not the divide it once used to be …  BUT – the communication modality choice can be confusing and very overwhelming to parents  It is very important to understand all of the options and terminology as a professional

9. Koch, 2002

11. Sign Languages Sim - Com Signed Exact English Cued Speech Auditory- Oral Auditory Verbal Communication Modalities Auditory only Visual/ Auditory Manual/Visual/Auditory Manual

12. American Sign Language (ASL)  ASL is a full and complete language, using visual-spatial information to communicate thoughts and ideas.  ASL is not a manual form of spoken English, it has an entirely different grammar and syntax from English.  ASL has it’s own unique linguistic properties; however, there is no official written form of ASL.  ASL use is not associated with a specific geographic location or region.

13. Differences in Languages ASL Gloss English Translation  DOG BROWN I HAVE.  TWO CATS I HAVE. NAME BILLY. BOB.  WOW. YOUR BIKE RED ME LIKE.  STORE I GO.  TENNIS I LIKE PLAY WHY? FUN  I have a brown dog.  I have two cats and they are named Billy and Bob.  I really like your red bike!  I go to the store.  I like to play tennis, because it is fun.

14. Cued Speech Signed Exact English ASL Sim- Com Pidgin Signed English ASL makes use of spatial relationships, racial expressions, and body positioning The other forms of manual communication are linear and use the vocabulary, syntax and pragmatics of English, and are generally thought to support the reception of speech. ASL as a language Match English Exactly Not “true” language

15. Bilingual / Bicultural Approach  Children learn 2 languages  ASL and English  ASL is typically considered the “first” or “primary” language  Bi-Bi differs between families  Some use no spoken language, ASL to communicate, English for reading/writing  Some use ASL and spoken English to communicate as well as English for literacy

16. Manual / Visual Systems that support English Signed Exact English Pidgin Signed English Sim - Com Cued Speech

17. Manually Coded English forms  Simultaneous Communication (Sim-Com)  Manually coded English and spoken English at the same time  Typically uses ASL signs only  Does not use the signs for the verb “to be” or morphological endings (e.g., “ed”) that are part of SEE  Used often in school environments  Idea is to “support” spoken English with signs while speaking  Unfortunately, the reality is children do not get a full representation of either language (ASL or English)

18. Manually Coded English forms  Pidgin Signed English (PSE) (contact sign) –  Combination of ASL signed with English syntax  What you often see non native ASL signers use  Deaf individuals are very adapt at using PSE with hearing individuals

19. Manually Coded English Forms  Signed Exact English –  Is the direct translation of English using signs  Is not another language, but a way to represent English visually  includes things like pronouns, plurals, possession, and the verb "to be”  often used in school environments

20. Manually Coded English forms  Cued Speech  Uses mouth and handshapes to visually differentiate phonemes of a spoken language  cues represent the phonemes of English language  “Full visual access to spoken language”  Can learn in a 2 day workshop (12 -15 hours estimate)  cued speech cued speech  (see handouts in Additional & supplemental readings)

21. Total Communication (TC)  A communication philosophy that incorporates all means of communication  formal signs  natural gestures  fingerspelling  body language  listening,  lipreading  speech