Children with Hearing Loss


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Neurological Foundations of Listening and Talking Key Points Presented in the Chapter Introduction Typical Infants: Listening and Language Development Auditory Neural Development Multiple Definitions for the Terms: New Context for the Word "Deaf" Hearing Versus Listening A Model of Hearing Loss: The Invisible Acoustic Filter Effect Summary: The Question That Drives Technological and Intervention Recommendations The Auditory System Key Points Presented in the Chapter The Nature of Sound Unconscious Function Signal Warning Function Spoken Communication Function Acoustics Audibility versus Intelligibility of Speech The Ling 6-7 Sound Test: Acoustic Basis and Description Ear Mechanisms Data Input Analogy Outer and Middle Ear Inner Ear to the Brain Hearing and Hearing Loss in Infants and Children Key Points Presented in the Chapter Introduction Classifications Degree (Severity) - Minimal to Profound Timing - Congenital or Acquired General Causes - Endogenous, Exogenous, or Multifactorial Genetics, Syndromes, and Dysplasias Connexin 26 Syndromes Inner Ear Dysplasias Medical Aspects of Hearing Loss Conductive Pathologies and Hearing Loss Sensorineural Pathologies and Hearing Loss Mixed, Progressive, Functional, and Central Hearing Losses Synergistic and Multifactorial Effects Auditory Neuropathy/Dyssynchrony (AN/AD) Summary Diagnosing Hearing Loss Key Points Presented in the Chapter Introduction Newborn Hearing Screening and EHDI Programs Test Equipment and Test Environment Audiologic Diagnostic Assessment of Infants and Children Test Protocols Pediatric Behavioral Tests: BOA, VRA, CPA, Speech Perception Testing Electrophysiologic Tests: OAE, ABR/ASSR, and Immittance The Audiogram Configuration (Pattern) of Thresholds on the Audiogram Formulating a Differential Diagnosis Sensory Deprivation Ambiguity of Hearing Loss Measuring Distance Hearing Summary Hearing Aids, Cochlear Implants, and FM Systems Key Points Presented in the Chapter Introduction For Intervention, First Things First: Optimize Detection of the Complete Acoustic Spectrum Listening and Learning Environments Distance Hearing/Incidental Learning and S/N Ratio ANSI S12.6-2002 Acoustical Guidelines Talker and Listener Physical Positioning Amplification Hearing Aids/Hearing Instruments Bone Anchored Hearing Aid (Baha) Assistive Listening Devices (ALDs): Personal-Worn FM and Sound Field FM and IR (Classroom Amplification) Systems Wireless Connectivity Cochlear Implants Measuring Efficacy of Fitting and Use of Technology Equipment Efficacy for the School System Conclusion Intervention Issues Key Points Presented in the Chapter Basic Premises Differentiating Dimensions Among Intervention Programs Educational Options for Children with Hearing Loss, Ages 3 to 6 Challenges to the Process of Learning Spoken Language Auditory "Work" Key Points Presented in the Chapter Introduction The Primacy of Audition The Acoustics-Speech Connection Intensity/Loudness Frequency/Pitch Duration The Effect of Hearing Loss on the Reception of Speech A Historical Look at the Use of Residual Hearing The Concept of Listening Age Auditory "Skills" and Auditory Processing Models Theory of Mind and Executive Functions How to Help a Child Learn to Listen in Ordinary, Everyday Ways Two Examples of Auditory Teaching and Learning Scene I: Tony Scene II: Tamara Targets for Auditory/Linguistic Learning A Last Word Spoken Language Learning Key Points Presented in the Chapter Introduction What's Involved in "Talking"? How Does a Child Learn to Talk? Relevance for Intervention Decisions How Should Intervention Be Organized? Constructing Meaningful Communication Key Points Presented in the Chapter Introduction The Affective Relationship The Child's Development of Interactional Abilities Joint Reference Turn-Taking Conventions Signaling of Intention Characteristics of Caregiver Talk 1. Content: What Gets Talked About? 2. Phonology: What Does Motherese Sound Like? 3. Semantics and Syntax: What about Complexity? 4. Repetition: Say It or Play It Again 5. Negotiation of Meaning: Huh? 6. Participation-Elicitors: Let's (Keep) Talk(ing) 7. Responsiveness Issues about Motherese How Long Is Motherese Used? Motherese: Why? Motherese: Immaterial or Facilitative? Interacting in Ways that Promote Listening and Talking: Parents, Therapists, and Teachers Key Points Presented in the Chapter Introduction The Emotional Impact of a Child's Hearing Loss on the Family What Parents Need to Learn Components of Intervention for Babies and Young Children with Hearing Loss When to Talk with Your Child and What to Talk About A Framework for Maximizing Caregiver Effectiveness in Promoting Auditory/Linguistic Development in Children with Hearing Loss Background and Rationale Structure of the Framework Getting a Representative Sample of Interacting Discussing the Framework with Parents Ways of Addressing Parent-Chosen Targets Teaching through Incidental and Embellished Interacting Teaching Through Incidental Interacting Teaching Through Embellished Interacting Parent Guidance Sessions or Auditory-Verbal Therapy Sessions Components to Be Accomplished in a Typical Preplanned Session Sample Preplanned Scenario Substructure About the Benefits and Limitations of Preplanned Teaching Appendix 1: How to Grow Your Baby's/Child's Brain Appendix 2: Application and Instructions for the Ling 6-7 Sound Test Appendix 3: Targets for Auditory/Verbal Learning Appendix 4: Explanation for Items on the Framework for Maximizing Caregiver Effectiveness Appendix 5: Checklist for Evaluating Preschool Group Settings Appendix 6: Selected Resources Appendix 7: Description and Practice of Listening and Spoken Language Specialists: LSLS Cert. AVT and LSLS Cert. AVEd. Appendix 8: Principles of LSLS Practice Appendix 9: Knowledge and Competencies Needed by Listening and Spoken Language Specialists (LSLS) Appendix 10: Listening and Spoken Language Domains Addressed in This Book References Glossary of Terms Index

About the Author

Elizabeth Cole, EdD, is the Director of Soundbridge, a statewide public school program that provides a wide variety of services to approximately 600 children (birth through secondary school) who are learning spoken language through listening. She is also an Adjunct Professor at the University of Hartford, and for the First Years program at the University of North Carolina. Prior to coming to Connecticut in 1996, Dr. Cole was a professor at McGill University in Montreal for 16 years, where she taught acoustic phonetics, language, speech, and aural habilitation courses to students in the Auditory-Oral (Re-)Habilitation and Education of Hearing-Impaired Children (AORE) program, as well as to audiology and speech-language pathology students. Most of her published articles, chapters, and books have been focused on how to foster listening and spoken language development in young hearing-impaired children. Carol Flexer received her doctorate in audiology from Kent State University in 1982. She was at the University of Akron for 25 years as a distinguished professor of audiology in the School of Speech-Language Pathology and Audiology. Special areas of expertise include pediatric and educational audiology. She continues to lecture extensively nationally and internationally and has authored more than 150 publications. She has co-edited four books: How the Student with Hearing Loss Can Succeed in College, 1st and 2nd ed., and Sound-Field Amplification: Theory and Practical Applications, 1st and 2nd ed. She also has authored Facilitating Hearing and Listening in Young Children, 1st and 2nd ed. She is a past president of the Educational Audiology Association, a past board member of Auditory-Verbal International (Cert.Avt), and a past president of the American Academy of Audiology. Currently, she is a board member of the American Academy of Audiology Foundation, and president of the Alexander Graham Bell Association for the Deaf and Hard of Hearing Academy for Listening and Spoken Language. For her research and advocacy for children with hearing loss, Dr. Flexer received the Volta Award, the most prestigious award conferred by The Alexander Graham Bell Association for the Deaf and Hard of Hearing. Dr. Flexer also is a Certified Laughter Leader.


Sarah Holden, M.S., George Washington University, Doody's Review Service, (February 2011): "Topics range from neurological foundations of listening, the auditory system, and diagnosis of hearing loss to key intervention issues and strategies. The book is a quick reference for students/parents to support interpretation of testing, but provides greater detail in the area of intervention and ways to promote listening and talking through interactions. The information is presented in a way that is easy to understand and that would be useful to students and parents. Overall, this book provides a solid overview of key issues related to developing listening and spoken language skills in children with hearing loss for parents and students. Basic information in a broad range of areas relevant to the topic is presented in a way that is easy to read and understand." Mary Pat Moeller, PhD, Director, Center for Childhood Deafness, Boys Town National Research Hospital, Boys Town National Research Hospital, (May 2011): "I want to commend the authors for developing this wonderful resource! In my opinion, parents, educators and clinicians will find very helpful guidance from this book. I especially appreciated the integration of child language concepts and the integrated approach to listening development. This is a must-read." Rachel Millward, Speech-Language Therapist, Speech & Language Therapy in Practice, (Winter 2011): "This detailed book looks at the skills and knowledge needed to promote the development of spoken language through listening in young children and babies with a hearing loss. Despite its length it is very readable. Each chapter's 'key points' give a clear and concise explanation of the information to come. The comprehensive contents page makes it quick and easy to look up specific information. Early chapters provide a good overview of hearing loss, with information on terminology, technology, the structure and function of the ear, and causes. It includes data on good language learning environments and early language development. Later chapters look at intervention and are more practical, exploring strategies and activities for working with families. The appendices provide some interesting frameworks and checklists. Whilst the book refers to American terms and systems, the information is still useful. ...I would recommend it as a detailed reference for students, a good resource for those new to the field and a refresher for more experienced clinicians, particularly with its discussion around recent research. I certainly enjoyed reading it and will dip into it again." Bjorn Lyxell, International Journal of Audiology 2011, (2011): "This is a timely and a much needed textbook on a new population of children with hearing loss where our level of knowledge, at least in some areas, is relatively low and where we need to increase our understanding in order to promote the best possible conditions for the development of auditorily-based spoken language. It is a textbook that is easy to read also for those outside the field of aural rehabilitation. The intended audience of the book is graduate students in training programs or professionals who work with children. The book is a valuable resource for this group of students and it will also be of great interest to undergraduate students, particularly in psychology and speech-language-hearing programs." Kelly S. Teegardin, M.S.,CCC-SLP, LSLS Cert AVT, Ear & Hearing (Vol. 34, No. 2), 2013: "In the world of audiology and speech language pathology, there is seldom an area of practice that brings the two careers together as the aural habilitation of infants, toddlers, and children who are deaf and hard of hearing. Children With Hearing Loss: Developing Listening and Talking, Birth to Six by Elizabeth Cole and Carol Flexer offers a comprehensive overview of the auditory system, the importance of early identification and diagnosis, amplification, and intervention. The authors have divided their book into two areas that benefit both audiologists and speech language pathologists. In the world of listening and spoken language habilitation, the audiologist is the gatekeeper of auditory access. To develop competent spoken language, a child must have adequate hearing technology. Without aggressive and appropriate auditory technology, the listening and spoken language interventionist will not be able to facilitate optimal outcomes for child. Chapters 1 through 5 focus on the hearing mechanism, types of hearing impairments, and the diagnosis of hearing impairment. Chapters 6 through 10 focus on intervention issues. The authors provide three informative appendices addressing required knowledge and competences for those professionals seeking certification as a listening and spoken language specialist. The authors' use of charts, lists, examples, and appendices makes this a practical text to use in any audiology or listening and spoken language practice. In Chapter 1, the authors explain the issue of neuroplasticity and the increasing body of evidence that normal hearing infants have amazing auditory skills. The chapter highlights the issue of the intensive listening and its link to effective spoken language and eventually literacy skills. The text offers an extensive explanation of auditory neural development and a model of hearing loss as an invisible acoustic filter, which changes the reception and perception of sound by the brain."

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