Aural re/habilitation

Transcription

1 Aural re/habilitation speech and language re/habilitation Phonology problems Sound production influenced by: Speech sound visibility /f/ vs /k/ Acoustic characteristics Duration, db, Hz Speech characteristics sheet 1

2 Resonance & voice problems Resonance disorder Hypernasality Lack of auditory feedback Voice disorder Pitch Excessive laryngeal tension Audio control rather than laryngeal dysfunction 2

3 Language problems Syntax Grammatical markers he showed me Word endings the cat s got the mouse Articles he got a lolly from the lady Mismatch between language systems Written language provides an estimate of language structure Re/habilitation approaches Speech reading Cued speech Oral/aural approach Auditory verbal vs auditory oral Manual approach Simultaneous communication approach (SimCom) 3

4 Speech reading Sometimes called lip reading Uses lips, gestures, facial expression and visual cues 30% of consonants and vowels clearly visible Distinguishing between these is another matter Often used in conjunction with other strategies Residual hearing/ amplification 4

5 Cued speech Sound-related hand shapes Removes the guesswork from speech reading Phonemically based 8 shapes at 4 different locations Lack of transfer Oral/aural approach Focuses on improving both speech and hearing Combination of hearing aids, speech reading and spoken language output of the hearing impaired child 5

6 Auditory oral vs Auditory verbal approach Auditory oral use all visual cue (e.g., speech reading) to develop spoken language Auditory verbal (AVT) - Use listening only to develop spoken language MUST consider what the child can hear Auditory-verbal therapy strategies Hand cue C6w Benefits and overuse Encouraging listening ear cue YAWM Learning to listen sounds Attaching meaning to sound from smaller to larger units 6

7 AVT progression of auditory skills Detection: the ability to determine the absence or presence of sound Discrimination: the ability to perceive differences between sounds Identification: the ability to label what has been heard by repeating, by pointing to or picking up the object representing the word or words, sentence, or environmental sound perceived Comprehension: the ability to understand the meaning of connected language An aside: Cochlear implants in post-lingually deaf adults Prioritization for implants Lower than children due to critical period for language development Adaptation to new sound Rehabilitation for adults with CIs 7

8 Manual approach Belief that language in any form is more important than speech Sign language Movements of hands, body, face and head to represent words Finger spelling Represent sounds Often used in conjunction with SL to convey novel words Lack of transfer Simultaneous communication approach (SimCom) Spoken language and manual variant of that language are used simultaneously Idea seems ideal Problems The 2 languages very rarely translate exactly One is often stronger meaning lack of consistency for learners 8

9 Total communication Combination of a number of communication modes Spoken language, sign, finger spelling, speech reading, amplification, writing, natural gestures Belief that child will pick up form/s that is best suited to their needs Re/habilitation for the deaf and blind person Tadoma method Named after the first children (Tad, Oma) who were deaf and blind to be taught the method (1920 s). A method in which the person places his hand on the speaker s face to feel the movements of speech. 9

10 Medical vs cultural model of deafness Medical Seen as a disability and something that isolates people from functioning in society. Treated with interventions Cultural Members of a minority culture. No impairment. Deaf vs deaf Directions of aural rehabilitation Frequency transposition in HAs 10

11 Directions of aural rehabilitation Brain imaging after cochlea implants Once implanted, parts of the brain are activated that have never before received sensation Monitoring any change in these regions more objective measure than perception and production measures of language Directions of aural rehabilitation Possibility of a new objective screening assessment Post-auricular muscle response 11