SLHS 1150 Spring 2014.1. Communication Optionsa. Oralists v manualists approach Oralists - Emphasis on speech- Amplification is necessary for residual hearing - Adjustment is made to fit into hearing world- Cornerstone of this approach: maximize whatever hearing is left/residual hearing that the person may have o Pro hearing aids/cochlear implants Manualists - Signs and finger spelling- Allows children with HL to communicate more readily- Capital D Deaf Cultureo Deafness isn’t a disabilityo Promotes acceptance- Family centered: what kinds of parents choose this? Most likely signers themselves- Visual language (ASL) is the natural language for the deafWhat would happen to a child born deaf to two hearing parents? o Sooo many tests, gets the child ready for amplification, but this is hard with babies! o This is LOST TIME in the language learning window32% of people with hearing loss have other issues too, such as learning, reading, and behavior disorders/disabilities b. 4 different approaches ( Auditory/Oral, Auditory/Verbal, Total Communication, Bilingual/ Bicultural) Auditory-Oral (Aural/Oral) Approacho Acquiring both receptibe and expressive spoken language is realistic goal for children with hearing losso Oral, visual, and auditory clues help promote language understanding and language useo Parental involvement, appropriate amplification, consistent quality speech trainingo LIP READING!!!!!!o Use every possible means to increase the person’s residual hearingo Maximize ability to hear o Spoken English using residual hearing, lip readingo HIGH level of parent involvement, appropriate amplification, consistent and RIGOROUS quality speech trainingo What are some benefits to the aural/oral approach?o Ability to communicate with hearing individualso Proficiency with spoken language and good speech intelligibility o Limitations?o Not all kids are successful!o Need for motivation, attentiono Some kids might have additional language disorders!Take into account RESOURCES!Where does the patient live? City vs RuralWho chooses the approach?? Parents are the final decision makers, but its up to the doctors and the SLPs to present all of the options to the parentsAuditory-Verbalo Goal: individuals with hearing loss to become independent, participating, and contributing citizenso Children grow up in “typical” learning and living environments o NO LIPREADINGo Oral and Auditory clueso Speaking lips, smiles, facial expressions, not reading the lips!!o Principles of auditory/verbalo Earliest identification of HL as possibleo Best medical treatment and technological amplification as possibleo Auditory verbal centers, therapists, very intense training, hours each day, high level of parent involvement o Not often accessible in rural/remote areas Cued speecho Sound based hand supplements to learn ASLo 8 hand shapes representing groups of consonants are placed in four positions around the face that indicate groups of vowel soundso benefits:o ability to see sound based units of speecho increase literacy levelso improve residual hearing/use of cochlear implanto adds to the phonology of a wordo tools for learning languageo helps ASL users to learn English as a second languageTotal CommunicationPhilosophy, not a methodo may include one or many methods of communication, depending on a child’s needso manual, oral, auditory, writteno helped to bridge the gap between oral only programs and sign language onlyo of kids who are hard of hearing or deaf, 36% use both speech and signo kids who use this with cochlear implants develop language with a delayo “putting your eggs in too many basketso these methods need intense training… repetition is the mother of all skillBENEFITSo can open multiple avenues of communicationo increase number of people a deaf individual can communicate witho parent-child relationship may deepenLIMITATIONSo problems arise from difference in spoken or visual modeso limits the number of communication methods that can be used by one speaker at a timeo children with cochlear implants who use total communication tend to develop language with a delay Bilingual/Biculturalo 2 languages, 2 cultureso assumes ASL is the natural language for deaf children, and that English should be taught as a second languageo ultimate goal: proficiency in ASL and written English (written English so that the child can have access to the reading system)o works best with deaf parents who already know ASLo why? Bc of the early language exposureBENEFITSo children allowed to utilize highly accessible languageo strong association/identification with the deaf cultureo kids don’t feel isolated (as they may in mainstream schools) LIMITATIONSo heard for hearing parents to find a language modelo bi-bi approach is most common at res. Schools for the Deafo **Separate but equal is counter cultural**o2. Fluency Disorders: speech disorder characterized by high rates of stoppage/interruptions that disrupt flow of speech (3 SLDs/100 words) and significantly interferes with communicationa. Definitions of termsFluency= rhythm, smoothness, flow of speech productionRate= how fast/slow you speakRhythm= smoothness/ease of articulatory productionEffortAutomaticity= how quickly speech comes to youDis-fluency= disruption of flow of speech o typically speech is littered with dis-fluencieso kids there is a level of fluency developmental delay, this is normal!!!o You have to be able to pick up on this when it becomes atypical!b. Core/primary & secondary features of stutteringCORE (primary) FEATURESo Monosyllabic whole word repetitionso One syllable words repeated again and again “I I I I want it.”o Part word repetitions o Sound: c c c c cano Syllable bu bu bu butterfly, can can can cannoto Sound prolongationso Holding the sound Can be audible or inaudible- Audible= you can hear the sound being held out the whole timeo “I sssssee the water.”- Inaudible: “I …………….see the water.” o This is called a block (an inaudible prolongation) o Posture is held, there is tension in the articulators, can’t get the sound out, voice box is closed ** there can also be a struggle with a certain sound all the time! SECONDARY BEHAVIORS o Psychosocial behaviors (emotional reactions)o Avoidance of words/sounds/situationso Passivity in conversation, avoids talkingo Fear, embarrassment, shameo How can this affect daily life?? In EVERYway!! (think about sports, auditions, relationships, social situations!)o Physical