1. Chapter 5 Auditory Only Training
Perry C. Hanavan, Au.D.

2. ???????
“You have to hear what you don’t hear to know what you don’t want to hear.”

3. Factoid
40% of 170 pediatric SNHL in study had structural peripheral auditory abnormalities diagnosed with MRI
May not have complete audibility even with best hearing aids
50% had mal-functioning issues with hearing aids
Battery
Earmold
FM connection

4. 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

5. The Early Auditory Experience Hart and Risley, 1995
Welfare
Working Class
Professional
Words heard per hour
616
1,251
2,153
Words heard per week
62,000
125,000
215,000
Words heard per year
3.2 million
6.5 million
11.2 million
Words heard by age 4
45 million

6. Words Understood Age No. of Words 2 years 300 2.5 years 500 3 years
900
4 years
1,500 to 2,000
5 years
2,500 to 2,800
6 years
13,000
7 years
20,000 to 26,000
Note: Between ages 5 and 6, children are learning about 28 words a day

7. Hart & Risely Study (1995)

8. The More Parents Talk to Child

9. Average IQ & Levels of Talk

10. 30 Million Word Gap Initiative

11. LENA

12. LENA: Average Words Per Hour

13. LENA: Word & Turn Taking

14. LENA: TV Time & Media

15. Hearing Loss Impact on Phonological Processes
Vowel substitutions
Deletion of unstressed syllable – “di(na)sour”
Deletion of initial syllable of word – (e)lephant
Vowel insertion - “cuppa” for “cup”
Cluster reduction – “fower” for “flower”
Final consonant sound deletion – “cu” for “cup”

16. At-Risk Language Components in Children with Hearing Loss
Plurals
Sounds like “s” (cats)
Sounds like “z” (dogs)
Sounds like “es” (horses)
Suffixes and Prefixes
Friendly, happiness
Widest, toxic
Disable, misbehave

17. At-risk Language Components, Cont.
Past tense
Sounds like “t” (walked)
Sounds like “d” (bobbed)
Sounds like “ed” (beaded)
Possessives
The cat’s mitten
The truck’s wheel

18. At-risk Language Components, Cont.
Copulas/Connecting words Is Of
Have If
Present progressive
Going
Swimming
Pronouns and 3rd person
He, his
She, her It
Vocabulary!

19. Question Which of the following is NOT an auditory skill level?
Detection
Discrimination
Recognition
Comprehension
Transformation

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

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

22. Question Analytic works on the— Phoneme level Sentence level
Paragraph level
None of the above

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

24. Question The analytic approach typically begins with: Consonants
Vowels
Diphthongs
Syllables
Words

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

26. Vowel Formants

28. Question The first 2 formants are all below: 1000 Hz 2000 Hz 3000 Hz

29. Analytic Auditory Assessment
Non-speech
Phoneme
Syllable
Word
Supra-segmental
Detection
Discrimination
Identification
Comprehension

30. Audibility Assessment
UWO Plurals Test
Phonak Logatom Test
Mr. Potato Head Test
PBK
BKB-SIN
Cincinnati Auditory Test
CHAPS
SIFTER
FLE
LENA
CAEP

31. Auditory Assessment Examples
Segmental-word: Early Speech Perception
Segmental-vowel: Early Speech Perception, Ling
Segmental-consonant: Minimal Pairs Test, Ling
Connected Speech – Mr. Potato Head Test, Common Phrase Tests (synthetic)

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

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

35. Nancy Tye-Murray: Auditory Training

36. LACE Auditory Training
LACE Auditory Training: a key to hearing better in noise

37. Keira's therapy part 1

38. Auditory Oral School of NY

39. Brain Plasticity
Ability of brain to change
Learning possible

40. Plasticity
Physiological changes in the CNS (and PNS – auditory nerve) that occurs from sensory experiences
Brain’s ability to reorganize space
Benefit from HA, CI, HATs may need to be measured at later date
Brain may continue to acclimate for several years following HA, CI, HAT, therapy

41. Auditory Reorganization/Plasticity
Cochlear dead regions
Brain reorganization will occur with damage to regions of the cochlea

42. Dr. Nina Kraus

43. Dr. Patricia Kuhl

44. Top Down Bottom Up

45. 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)

46. 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?

47. Auditory Training Apps
AB CLIX free (iOS)
AB Listening Adventures $1.99 (iOS)
Auditory Verbal $3.99 (iOS)
VocAB Scenes $1.99 (iOS)
Hear Coach (Starkey) free (iOS, Android)
Hope Words LITE (Cochlear Ltd) free (iOS)
Hope Words (Cochlear Ltd) $2.99 (iOS)
Hope Words HD (Cochlear Ltd) $2.99 (iOS)
i-Angel Sound free (iOS)
iHear That free (iOS) (Ling 6 Sound Game)
Oceans & Continents (MED-EL) free (iOS, Android)
Rehabilitation Game (Oticon) free (iOS)
Siemens Hearing Test free (iOS)
Sound Match free (iOS)

48. Analytic Auditory Training (bottom-up)
Non-speech
Phoneme
Syllable
Word
Supra-segmental
Detection
Discrimination
Identification
Comprehension

49. Analytic: Vowel I e i a o u tu/ti/ta tube e vs. o tu vs. ta
Non-speech
Phoneme
Syllable
Word
Detection
I e i a o u
tu/ti/ta
tube
Discrimination
e vs. o
tu vs. ta
tub vs. tube
Identification
i, u o, a ti tu to
Tom
Tim
Tam
Comprehension
Explain or show understanding

50. More Analytic Strategies
quiet vs. noise
noise vs. quiet
various types of noise
near vs. far...various distances

51. More Analytic Strategies
Ling 6 sounds
CAT words
PBK word lists
UWO Plurals Test
Phonak Phoneme Test
WIPI lists

52. Analytic Strategy

53. Analytic Strategy

54. Auditory Training: Analytic
Phonemes – common consonant confusions

55. 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

56. Auditory Training Apps
HOPE Words
iBaldi
ListenListen
Melody Match
Siemens Hearing Test
Word Magic
Starkey Hear Coach
Auditory Verbal
Sound Match
Mr. Potato Head
Oticon Medical-Neurelec Rehabilitation Game
Minimal Pairs

57. CI Resources Cochlear Americas Advanced Bionics Med-el
HOPE
School Age
Advanced Bionics
School Tools
Listening Room
Med-el
Bridge to Better Communication
Oticon Medical - Neurelec
Rehabilitation

58. Question Which is not synthetic? Sentences Discourse Phonemes
Paragraphs

59. Synthetic (top-down)
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.

60. Auditory Training: Synthetic
Topic of Conversation
Sentence Matrix
Continents Listening Tasks

61. Analytic to Synthetic Analytic Synthetic Non-speech Phoneme Syllable
Word
Sentence
Discourse
Detection
Discrimination
Identification
Comprehension
Analytic Synthetic

62. Context Low High Non-speech Phoneme Syllable Word Sentence Discourse
Detection
Discrimination
Identification
Comprehension
Low High

63. Stimulus Unit Non-speech Discourse Non-speech Phoneme Syllable Word
Sentence
Discourse
Detection
Discrimination
Identification
Comprehension
Non-speech Discourse

64. Audiologic Evaluation
Non-speech
Phoneme
Syllable
Word
Sentence
Discourse
Detection
Pure tone
Ling 6
SAT
Discrimination
Larson
UWO Plurals
Identification
Phonak Logatome
Iowa Vowel
Iowa Consonant
WIPI
NU-6
W-22
CAT
SRT
Isophonemic
DSI
HINT
QuickSIN
BKB-SIN
Comprehension
TOPICON

65. AR Evaluation (Auditory)
Non-speech
Phoneme
Syllable
Word
Sentence
Discourse
Detection
Ling 6
Discrimination
Larson
Identification
SPAC
NU-CHIPS
WIPI
CAT
BKB
CUNY
Quick-SIN
BKB-SIN
Comprehension
TOPICON

66. AR Training(Auditory)
Non-speech
Phoneme
Syllable
Word
Sentence
Discourse
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

67. 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

70. Tongue Position for Vowels

73. Question What is cycling? Washing clothes in wash machine
Separating trash into separate bins
Repeating
Reviewing a task already accomplished
Riding a bicycle

74. 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

75. 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

78. KidTrax

79. KidTrax

80. KidTrax and TesTrax

81. Loudness Scales

82. Computer Programs

83. LACE Listening Demo Click on the LACE Listening Demo

84. SPATS

85. CAST Free from Angel Sound

86. Mobile Apps App OS Child/Adult Comments AB Listening Adventures iOS C
For HA or CI users, listening for word differences in both quiet & noise
AB MAIS
Assess young child’s response to sound with hearing technology
Oticon Medical Neurelec Rehabilitation Game
A/C
Practice listening to environmental sounds, detecting sounds and listening for different between speech sounds (like ba pa)
Starkey Hear Coach
iOS/A A
Interactive listening games designed to challenge cognitive and auditory skills, helping improve ability to listen in noise
Cochlear HOPE Words
Created to expose children to speech sounds in the English language
Auditory Verbal
 Ling 6 sound discrimination

87. Music Training with HA & CI
Rhythm
Pitch
Melody
Timbre
Instrument identification
Name that tune