Learning to Listen with Hearing

Technologies: An Interdisciplinary

Perspective on Aural Rehabilitation

Learning to Listen Again: Aural

Rehabilitation for Teens & Adults

- John Henry MS, CCC-SLP

Outline

• Role of an Aural Rehabilitation Specialist

• Auditory Development

• It’s all about the BRAIN

• Neuroplasticity

• Adult/Teen Resources

Objective

• After this session, the participant will be able to discuss the variety

of audiological options available for individuals who have hearing

loss, whether the hearing loss is mild, profound, unilateral or

bilateral.

• After this session, the participant will be able to list 3

resources for evaluation and intervention of children or

adults with hearing loss who are learning to listen with

hearing technologies.

• After this session, the participant will be able to list 3 key

principals in evaluation and intervention for children with hearing

loss who are learning to listen and use spoken language, weather

an infant starting an IFSP or an elementary-aged child who has

nearly met all IEP goals.

What is an Aural Rehabilitation Specialist? Therapy provided by a speech-language pathologist with

skills and knowledge in:

• Listening and spoken language milestones and red flags for children

with hearing loss.

• National standards for intervention (e.g., guidelines provided by the

Joint Committee on Infant Hearing)

• Comfort troubleshooting hearing technologies

• Process of guiding a child and family through auditory development

• Focus on family education and coaching for speech & language

development

• Requires close collaboration with child’s audiologist and educational

team.

Role of an Aural Rehabilitation Specialist

• Provide ongoing information to Audiologist

regarding perception/production for

programming purposes

• Evaluate auditory, speech, language, oral

motor skills, pre- and post-implant.

• Ongoing intervention – connecting meaning

to sound

• Incorporate listening into daily life (home,

school, work, etc.)

Adult vs. Pediatric Aural Rehab

• Aural Rehabilitation for individuals with post

lingual hearing loss (older children, teens &

adults) looks very different than Aural

Rehabilitation for individuals with pre-lingual

hearing loss.

• HOWEVER…..

Auditory Development

• Regardless of whether we are conducting

Aural Habilitation or Aural Rehabilitation,

the auditory development process remains

the same.

Auditory Development

Detection – Was there a

sound?

Discrimination – Is this

sound different from

another sound?

Identification – What do

you hear?

Comprehension – Is

there meaning to this

sound?

The Science of Speech

The Ling Six (7) Sound Check…

• AH, OO, EE, MM,

SH, SS, No Sound

• Need to test Ling

under ALL conditions

• Left, Right, Bilateral,

Unilateral HA, FM,

Quite/Noise, 1’, 3’, 6’,

9’, 12’, 40’, Phone, etc.

Hearing Loss & Literacy

• Listening and Talking are sensory partners of

reading and writing

• Listening and reading are subsets of receptive

language ability

• Talking and writing are subsets of expressive

language ability.

-Source – Cochlear Americas, HOPE Conference, 2010

It’s all about the BRAIN -Carol Flexer, Ph.D., CCC-A; LSLS Cert. AVT

• An audiologist will work to make sure hearing

loss technology provides the best access to

sound. Focus on maximizing quality of input.

• Aural Rehabilitation specialist will focus on

what your brain does with that

information/input.

From the Beginning…

• The inner ear is fully

developed by the 20th

week of gestation.

• Auditory neural

development begins at

that moment.

Auditory Cortex

Auditory Memory-Music Study

Neuroplasticity

• The brain's ability to reorganize itself by

forming new neural connections to meet

demands throughout life.

Neuroplasticity

• Greatest in the first 3½ years of life

• The brain is wired for hearing and without

early auditory input, the brain will reorganize

itself to receive input from other senses,

primarily vision.

• This reduces auditory neural capacity

especially as children age.

• Early auditory intervention synchronizes

activity in the cortical layers.

Auditory Cognitive Closure

• “Aoccdrnig to a rscheearch at Cmabrigde

Uinervtisy, it deosn't mttaer in waht oredr the

ltteers in a wrod are, the olny iprmoatnt tihng

is taht the frist and lsat ltteers be at the rghit

pclae. The rset can be a toatl mses and you

can sitll raed it wouthit porbelm. Tihs is

bcuseae the huamn mnid deos not raed ervey

lteter by istlef, but the wrod as a wlohe”

Adult/Teen Therapy Resources

• Angel Sounds - http://angelsound.tigerspeech.com

• The Listening Room (www.hearingjourney.com)

• Tools for Schools

• Making the Connection (Young Adults/Adults)

• Med-El Soundscape - http://www.medel.com/us/soundscape/

Adult/Teen Therapy Resources

• Sound & Way Beyond (Cochlear)

Apps: SoundAMP R, Cochlear Hope Words,

Rehabilitation Game, L2-Learning to Listen,

Ling 6 Sound Application, Ear Trainer, Hear

Coach

Social Media (Hear Peers)-Many online

resources for patients/families to connect.

General Resources • www.advancedbionics.com

• www.cochlear.com

• www.medel.com

• Hearing Loss Association of America -

http://www.hearingloss.org

• Alexander Gram Bell Academy for Listening

and Spoken Language (2012). Principles of

LSLS/Aud-Verbal Therapy – www.agbell.org

• Cochlear – Online HOPE Resources

References • American Speech-Language-Hearing Association (2012). Adult aural /audiologic

rehabilitation.

Retrieved from http://www.asha.org/public/hearing/Adult-Aural-

Rehabilitation/

• Daniel, L., Daniloff, R., Schuckers, G. (1999) ALPS: A Language Rehabilitation

Program for Childr Cochlear Implants. The Journal of Louisiana Allied Health

Professions, Vol. II., Summer, pp. 36-44.

• Sorkin, D. L., Caleffe-Schenck, N., ( ). Cochlear implant rehabilitation: It’s not

just for kids.

• Tye-Murray, N. (2009). Foundations of aural rehabilitation: Children, adults, and

their family members (3rd ed.). Clifton Park, NY: Delmar, Cengage Learning.

• Neuman, A. C., (2005). Central auditory system plasticity and aural rehabilitation

of adults. Journal of Rehabilitation Research and Development. Volume 42 (4),

169-186.

References Cont… • Connolly JL, Carron JD, Roark SD. Universal newborn

hearing screening: are we achieving the Joint Committee on Infant Hearing (JCIH) objectives?. Laryngoscope. Feb 2005;115(2):232-6.

• Kristina M. Blaiser, Ph.D., CCC-SLP

• Carol Flexer, Ph.D., CCC-A; LSLS Cert. AVT www.carolflexer.com

• Donald Goldberg, Ph.D., CCC-SLP/A: LSLS Cert. AVT

• Opening Doors – Hearing Loss Resources - http://www2.ed.gov/about/offices/list/osers/products/opening_doors/index.html

Learning to Listen…

• “We as clinicians are

only as good as we are

able to teach parents

and families how to

work with their kids.”

FM Systems