Exam # 3 Study Guide Lectures: 5-10Chapter 5: Pages 177-190Assessment of Speechreading AbilityBecause of the complexities associated with the process, accurate evaluation is difficult. Formal tests → tests are presented either in vision-only conditions without acoustic cues or in a combined visual-auditory test condition in which the stimuli are both seen and heard by the speechreader. Are sometimes presented in a prerecorded fashion (videotape, CD, DVD) but are often administered in a live, face to face situation, where the clinician presents the test stimuli. Informal tests → developed by the clinician who selects stimulus materials of her or his choosing. Contents should vary as a function of the client's age and the info sought by the rehabilitationist. Visual Assessment and Speechreading EvaluationIt is important that assessment of speechreading skills be preceded by a measure of visual acuity. Evidence indicates that the incidence of ocular anomalies among hearing-impaired students is greater than for normally hearing children of the same age. Audiovisual integration: has been used to describe info obtained from speech that is seen. Traditional Speechreading Methods and HistorySpeechreading was initially developed in Europe as a method to teach speech production to young children with hearing loss. Until the 1890's, it was limited to children and characterized by a vision-only (unisensory) approach. 4 lipreading methods were introduced into the US → -Mueller-Walle (Martha Bruhn)-Nitchie (Edward Nitchie)-Kinzie (Rose and Cora Mae Kinzie)-Jena (Anna Bunger) During the early 1900's, 4 methods of teaching speechreading were popularized in the US. 3 of these methods were nurtured by individuals who has normal hearing until adulthood, at which time they acquired significant hearing losses. Analytic approach: based on the concept that, before an entire word, sentence or phrase can  SHS 451 1st Editionbe identified, it is necessary to perceive visually each of its basic parts. That is, because a word is constructed by placing phonemes in a given sequential order and sentences (thoughts) are constructed by correctly ordering words, it is essential that the viewer initially identify phonemes visually in isolation before attempting to perceive words. Likewise, we must be able to identify individual words before attempting to recognize strings of words. It centers around visually perceiving the details found in speech. Bruhn and Jena methods.Training objectives → Will discriminate words with /i/ and /u/ (beet/boot), will discriminate words with /i/ and /a/ (eat/saw), will discriminate words with /u/ and /a/ (boot, bought), will identify words with /i/, /u/, and /a/. Consonant training has to do with manner, place, voicing. Place= visible AND audible, Manner and voicing= NOT visible, but audible. Objectives would include discriminating consonant pairs that differ in place of production and share either voice or manner (pill/chill), identify consonants that share manner of production, using a 4 item response set, etc. Synthetic approach: the perception of the whole is paramount regardless of which of its parts isperceived visually. Consequently, the speechreader is encouraged to comprehend the general meaning of oral utterances, rather than concentrating on accurately identifying each component within the oral message. Involves grasping the general thought of the speaker through intuitive thinking. Nitchie and Kinzie methods. Training objectives → Follow simple directions using a closed set response, identify a sentence illustration from a set of four dissimilar pictures, spreechread a paragraph-long narrative, then answer questions. Continuous Discourse Training (CDT): requires the hard of hearing listener to speechread verbatim passages presented by the clinician either in vision-only or in a combined auditory-visual manner. Newer lipreading approaches are eclectic (modification or combinations of earlier approaches)-When BOTH auditory and visual info is available, individuals with hearing loss tend to do better on communication tasks. Example (auditory + vision): Speech Recognition score (AO)= 50%Lipreading Score (VO)= 20% SHS 451 1st EditionCombined (AV)= 90%Speechreading enhancement (AV-VO)=70%Developing Speechreading Skills1) Consideration of the processing2) Reflect on habits and skills3) Identify difficult listening situations and formulate solutions4) Formal speechreading lessonsRepeat-Rephrase-Speak Louder-Speak Slower-Spell key word-Add gesture-Write-Sign/FingerspellEfficacy of TrainingPost-treatment gains from speechreading training are modest ~15% Some individuals demonstrate significant gains. Limited data are reported for children.Repeated testing experience may be as beneficial as structured practice. Initial changes may be due to non-sensory factors (increased familiarity with the task). Following long periods of practice speechreaders learn the visual phonetic characteristics of specific talkers. Speechreading skills appear to improve in the first few hours of training but afterwords, there is very little additional improvement. Chapter 6: Language and Speech of the Deaf and Hard of HearingLanguage: a broad term to describe a system of symbols used as a social tool for the exchange of information. Family-centered intervention: involves shared responsibility with the parents for the child's intervention, with the family retaining the ultimate decision making regarding intervention goalsand services. A major goal is to strengthen family functioning, thus empowering the family to capitalize on its unique strengths when addressing the needs of the child with hearing loss. Communication Options for Families of Children with Hearing Loss-It is important that families are provided with non-biased information related to their communication options. The website for BEGINNINGS for Parents of Children Who Are Deaf or Hard of Hearing (ncbegin.org) offers a summary of communication options and brief videos.  SHS 451 1st EditionSome communication options focus on developing spoken language as the child's first language by maximizing audition through hearing technology. -Today “auditory-verbal” and “auditory-oral” techniques are often combined under the label of “Listening and Spoken Language” (LSL). In contrast to auditory based modalities, American Sign Language/English as a Second Language focuses on developing ASL, a visual