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HI and ALI > HI 3: Families > Flashcards

HI 3: Families Flashcards

1
Q

Old policy + new

A

OLD
Distraction test, pre-2006
- sound made (e.g. rattle). look for response.
- done 6 mo post birth
- few reliably diagnosed before 2 years => huge impact on language

NEW
Newborn hearing screening programme (NHSP)
- 4-5 wks w/in birth
- objective

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2
Q

Tests in Newborn hearing screening programme (NHSP)

A

OTOACOUSTIC EMISSION SCREEN (AOE)

  • sound presented thro ear canal via tube
  • tests inner ear; HC sensitivity
  • should result in echo generated
  • AOE usually followed up by AABR

AUTOMATED AUDITORY BRAINSTEM RESPONSE

  • various tones played thro ear canal
  • electrodes on mastoid monitors brain’s response
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3
Q

Effects of pre lingual deafness on language development?

A
  • prelingual deafness effects lang acq.

HERMAN ET AL - deaf children have

  • smaller lexicons
  • weaker connections btw word meanings
  • lower reading vocab
  • slower growth rate
  • profit less from opp to acquire new words (convos)
  • poor speech intell => phonological skills (important for lexical development)
  • Poor lang =impacts=> working memory, ToM, social skills
  • Non-verbal skills not usually impaired (compensatory strat)
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4
Q

Why is language important for brain development?

A

LANGUAGE STIMULATES BRAIN DEVELOPMENT

  • FLEXER => hearing neccessary pre-quisite for developing spoken communication
  • CAMPBELL => hearing speech stimulates specific regions of brain development but studies of deaf signers brains show similar levels of act when signing
  • lack of stimulation at 2 yrs (critical period) = nueral degeneration
  • children exp to sign lang from birth => better outcomes than deaf children in hearing fams (MAYBERRY)
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5
Q

IMPACT OF DEAFNESS OF LANGUAGE

Snowball effect of deafness

A
  1. delayed + degraded speech perception
  2. incomplete phonological representations, unintelligible speech
  3. Poor vocab + syntax, diff w compreh.
  4. limited social skills + interaction
  5. Delayed literacy skills + academic attainment + employability

GOES ON

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6
Q

Sign lang dev vs spoken. Best outcomes.

A

LEDERBERY ET AL - sign lang development parallels spoken.

  • good models + early expos ess for cogn development, identity +mental health
  • deaf children still gotta know some spoken words => comm w hearing ppl
  • SINGING + ORAL BEST OUTCOME
    - gr8st access to vocab
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7
Q

Cochlear implants - when offered? benefits?

A
  • offered to profoundly deaf by age 3.
  • SHARMA => Chw CIs @ 1 yrs gr8r nueroplasticity than hearing aid users
  • ROBBINS => some CIs acq auditory skills same as hearing peers
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8
Q

CI cotreverdy

A
  • fear it will eradicate Deaf culture + sign
  • ethics of invasive surgery for non-life threatening condition — few deaf families would opt for it
  • CIs dont make person hearing (still deaf)
  • failures rarely reported
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9
Q

What 5 areas should intervention target acc to RCSLT?

A
  1. empowering parents by providing info + support w/in team
  2. est effective comm w/in family
  3. develop + monitor child’s comm skills
  4. Maximise use of residual hearing + speech
  5. Develop child’s self-esteem and identity
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10
Q
  1. SUPPORT AND INFORMATION
A

Early Support Programme – govt funded initiative. Prov parents w information:

  • Professionals and services they may need, encounter, use. (charities, education, social se.)
  • Info on hearing – hearing tests, aids and CIs, improving listening environm
  • Infos on comm options + ways to support development
  • Info on education

Coordinated services, key prof encountered: teacher of deaf, SLT, audiologist, docs, Deaf staff, volunt org

Role of Deaf staff – role model, facilitating interact, help w parent’s acceptance, promot sign comm, prov info on Deaf culture.

Helping to inform choices re comm opt: meeting w range of families, expl of interventions;implications;evidence, making changes to child comm plan, making arrangements w fam + local auth.

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11
Q
  1. EST EFFECTIVE COMMUNICATION

- PCI

A

Working on parent-child interaction as this is disrupted by childhood deafness due to mismatch of modalities. Early int => high quality interaction est

PCI:
- Parent filmed interacting w child. Watch video back with SLT + evaluate own interaction

  • Focus on positives => change 1 thing
  • Videos measure of before + after
  • Interaction profile of parent – ability to gain child’s attention, linguistic input, consideration of child’s perspective
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12
Q
  1. EST EFFECTIVE COMMUNICATION

- Facilitating interaction: child needs…

A
  • Full access to auditory and visual comm
  • Attention strategies so child knows what comm is taking place
  • Needs to switch attention from parent to referent (joint attention)
  • Quality of comm important

Making communication accessible: Gaining eye contact, moving into LOV, facial exp + gesture; developing JA => gain att and present sign, point + child shifts gaze

Modifying content of parental language: parentese in speech and sign (access to app sign classes??), amount of lang (less + simple, few questions, more naming)

NDCS Family sign curriculum = aimed @ fams of deaf children who want to use BSL.

Teaches signs + phrases meaningful to child.

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13
Q
  1. MONITOR COMMUNICATION
A

Early Support Developmental Journals:National monitoring protocol for deaf babies and children

Need to track areas potentially at risk due to deafness 0-3 years:
- comm, A+L, vocalising, social + emo dev, play, physical dev

  • Each area divided into 11 baby (B) stages of development – early years have narrow ranges than later years, each stage has descriptors of what parent can expect.
  • Encourages parents to obs child’s development.
    Monitor early lexical development: MacArthur
  • Communicative Inventor ==> Parent report tool incl vocab checklist.
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14
Q
  1. MAXIMISING RESIDUAL HEARING AND SPEECH

describe continuum of auditory skills development

A

Easiest to hardest:

sound detection/awareness (presence/absence),

Discrimination (same/diff),

identification (labelling),

comprehension (understanding naming).

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15
Q
  1. MAXIMISING RESIDUAL HEARING AND SPEECH

How can residual hearing be maximised?

A

work on activities focusing on sound awareness and discrimination (minimal pairs etc).

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16
Q
  1. MAXIMISING RESIDUAL HEARING AND SPEECH

Describe Learning through listening

A

Yoshinaga-Itano –

Use of parent training that involves:
• Effective use of amplification
• Looking for/encouraging child’s response to environ sounds
• Child’s reaction to Ling sounds
• Encouraging adult imitation of child production + vice versa

Encouraging vocalisation and vocal play –

  • Copying child sounds
  • Playing w noise act toys
  • Exposing to diff sounds
  • Varying intonation patterns
  • Singing – anticipating rhymes
  • Books
17
Q
  1. MAXIMISING RESIDUAL HEARING AND SPEECH

What asx monitors children’s hearing for speech?

A

Infant-toddler meaningful auditory integration scale (IT-MAIS), Zimmerman and Phillips

Structure of interviews to asx child’s spontaneous responses to sounds based on 3 criteria –

  1. Vocalisation behaviour
  2. Alerting to sounds
  3. Deriving meaning from sound
18
Q
  1. MAXIMISING RESIDUAL HEARING AND SPEECH

Describe trajectory for speech production

A

Yoshinaga-Itano:

0-12 mo: All deaf children have similar vocal prod diff to age-matched hearing peers

1-2 yrs: Speech production differ by severity of HL. Less = more phonetic inventory + rising vocal inflection

2-5;06 yrs: Diff trajectory for profoundly deaf; speech prod depends on exp lang

3 years: ChwMILDHL sign. delayed in speech production

19
Q
  1. MAXIMISING RESIDUAL HEARING AND SPEECH

Assessment to track speech in chwCIs

A

Profiles of Actual Speech Skills, P.A.S.S. (Osberger et al.):

  • Assesses pre-speech vocalisations – designed to measure vocal changes in early months after Cis.
  • Based on 6 min sample of spontaneous speech taken in play situation w child’s parent/caregiver
  • Vocalisations classified by frequency of occurrences of each category is calculated
  • Periodic reassessment enables monitoring of change

PASS CATEGORY + DESCRIPTION

SPEECH ==> Recognisable/reasonable approximation of phonemes of English. Describe broadly.

NON-SPEECH ==> Sounds don’t represent speech e.g. lip smacking, raspberries

SPEECH-LIKE ==> Utterances had vocalic, nasal quality, produced on a glottal fry

OTHER ==> Artic movements should be eliminated such as exaggerated jaw movements

20
Q

Predicted outcomes for chwHL?

A

Outcomes for deaf children (Yoshinaga-Itano): The severity of a HL will impact the number of consonants in a child’s repertoire + exp lang vocab.

MODE OF COMMUNICATION (Yoshinaga-Itano??):

~ Chw mild HL – mainly use oral comm + more intelligible speech

~ Severe -prof deaf – if educated w sign + orally (bilingual), achieved intelligible speech

~ Prof deaf chwCIs – age of implantation important for transfer from sign to speech (18 mo = 100% VS 18-3- mo = 50%)

~ Parents changed comm strats during infant/toddler period

~ Est lang in sign is facilitated by subsequently by dev of spoken lan (piggy back effect)

21
Q

Significant factors in optimising outcomes

A 
children do well where:
•	Programmes are parent centred
•	Strong counselling component
•	Careful monitoring of child’s progress
•	Parent-professional partnership
•	Parents fully informed
•	Access to role models

HI and ALI (10 decks)

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