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Facilitating spoken language development in the regular classroom

Facilitating spoken language development in the regular classroom. September 28 th & 29 th Winnipeg, MB Petra Smith M.Sc. Aud (C) Audiologist/Certified Auditory Verbal Therapist. AV PRINCIPLES AND THE AV SESSION.

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Facilitating spoken language development in the regular classroom

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  1. Facilitating spoken language development in the regular classroom September 28th & 29th Winnipeg, MB Petra Smith M.Sc. Aud (C) Audiologist/Certified Auditory Verbal Therapist

  2. AV PRINCIPLES AND THE AV SESSION How the auditory verbal therapist works with the children, their families and other professionals

  3. Auditory Verbal Services in Manitoba: • Located at the Central Speech & Hearing Clinic • Audiology Services & Family Centered Intervention • AVT for families with children using hearing aids or cochlear implants • Cochlear Implant Candidacy Evaluations & Device Programming • Aural rehabilitation for older students & adults with cochlear implants • Professional Development & Mentoring • Education Petra Smith M.Sc. Aud (C) Sept 28/29 2009

  4. Auditory Verbal Therapy (AVT) Who can deliver AVT? Auditory Verbal Therapists are practising professionals in Speech & language Therapy, Audiology, or Education of the Deaf who have received specialised training Petra Smith M.Sc. Aud (C) Sept 28/29 2009

  5. Auditory Verbal Therapist – experience & training • SPEECH LANGUAGE PATHOLOGIST • EDUCATOR of children who are deaf or hard of hearing • AUDIOLOGIST • Certified by A G Bell: Listening and Spoken Language Specialist www.agbellacademy.org Petra Smith M.Sc. Aud (C) Sept 28/29 2009

  6. Standardized Curriculum for Trainee Therapists: • History & Philosophy • Hearing & Audiology • Spoken Language Development • Parent Guidance • Cochlear Implants • Education in the mainstream • Auditory Verbal Practice Petra Smith M.Sc. Aud (C) Sept 28/29 2009

  7. Auditory Verbal Therapy (AVT) What is AVT? An individualised, auditory, developmental programme, implemented by the child’s family in close collaboration with a therapist, with the goal of achieving age appropriate spoken language ability, and full social participation throughout childhood and beyond. Petra Smith M.Sc. Aud (C) Sept 28/29 2009

  8. Auditory Verbal Therapy.. …..is part of the Auditory Verbal Approach Petra Smith M.Sc. Aud (C) Sept 28/29 2009

  9. THE AUDITORY VERBAL APPROACH“The auditory verbal approach is a mindset of expectations” (Pam Talbot, AVT) • Hearing and audiology • Parental involvement • Spoken Language Development • Education Petra Smith M.Sc. Aud (C) Sept 28/29 2009

  10. Ten Principles of AVT • Adapted from the principles developed by Doreen Pollack, 1970 • Adapted by the A G Bell Academy for Listening & Spoken Language, 2006 www.agbellacademy.org Petra Smith M.Sc. Aud (C) Sept 28/29 2009

  11. AV Principle #1 “ Promote early diagnosis of hearing loss in newborns, infants, toddlers and children, followed by immediate audiologic management and auditory verbal therapy” Petra Smith M.Sc. Aud (C) Sept 28/29 2009

  12. Hearing vs Listening(Flexer, 2005) • Hearing is acoustic access to the brain. It includes improving the signal to noise ratio by managing the environment and utilizing hearing technology. • Listening is attending to acoustic events with intentionality. Petra Smith M.Sc. Aud (C) Sept 28/29 2009

  13. Hearing loss • Hearing loss is not about the ears; it is about the brain. • Hearing aids, FM systems and cochlear implants are not about the ears; they are about the brain • (Flexer, 2005) Petra Smith M.Sc. Aud (C) Sept 28/29 2009

  14. Functional impact of hearing loss:distance hearing Flexer 1999 Petra Smith M.Sc. Aud (C) Sept 28/29 2009

  15. Functional impact of hearing loss: incidental learning Petra Smith M.Sc. Aud (C) Sept 28/29 2009 Flexer 1999

  16. Hearing loss = auditory deprivation If caregivers want their child/ren to develop spoken language, early identification and optimal amplification = “ a neurodevelopmental emergency” (Flexer, 2005) ..due to the impact of auditory deprivation Petra Smith M.Sc. Aud (C) Sept 28/29 2009

  17. Neuroplasticity • Greatest in the first three and a half years • The younger the infant, the greater the neuroplasticity • Rapid infant brain growth requires prompt intervention • No sound = reorganization of brain to receive other sensory information • No sound reduces auditory neural capacity Petra Smith M.Sc. Aud (C) Sept 28/29 2009

  18. Typical Language Development Means.. • Optimal use of the brain for skills human beings are pre-disposed to acquire – ie: spoken language • Best opportunity to achieve success in areas which must be taught – ie: reading Petra Smith M.Sc. Aud (C) Sept 28/29 2009

  19. Implications for Intervention Developmental approach …instead of…. Remedial approach Petra Smith M.Sc. Aud (C) Sept 28/29 2009

  20. GOAL: Universal Newborn Hearing Screening Petra Smith M.Sc. Aud (C) Sept 28/29 2009

  21. Goal – at identification • Support families in making their decisions about: • Language of choice • Communication approaches Petra Smith M.Sc. Aud (C) Sept 28/29 2009

  22. Communication Options: Petra Smith M.Sc. Aud (C) Sept 28/29 2009

  23. Manual Oral Sign Spoken Language Language (ASL) (English/French etc) --------------------------------------------------------------------- Bi-bi Auditory Verbal Signed Exact English Aural-oral Total Communication Cued Speech Petra Smith M.Sc. Aud (C) Sept 28/29 2009

  24. AV therapist offers • Time to reflect, question, feel, grieve • Information – re: • Technology • Hearing • Spoken language development • General developmental issues • Action – what to do! • Contact with other families Petra Smith M.Sc. Aud (C) Sept 28/29 2009

  25. AV Principle # 2 “ Recommend immediate assessment and use of appropriate, state of the art hearing technology to obtain maximum benefits of auditory stimulation” Petra Smith M.Sc. Aud (C) Sept 28/29 2009

  26. A good acoustic signal is needed for auditory stimulation Petra Smith M.Sc. Aud (C) Sept 28/29 2009

  27. Amplification – improves quantity and quality of acoustic signal Petra Smith M.Sc. Aud (C) Sept 28/29 2009

  28. Good audiological support Early identification of hearing loss Accurate diagnosis Optimal amplification Early intervention Petra Smith M.Sc. Aud (C) Sept 28/29 2009

  29. Early amplification • Research shows that children who are identified with a hearing loss by six months of age, provided with optimal amplification and family based intervention, have the potential of entering kindergarten on a par with hearing peers. Ref: Yoshinaga Itano Petra Smith M.Sc. Aud (C) Sept 28/29 2009

  30. Amplification Hearing aids Cochlear implants All require optimal fitting to allow access to spoken language. Petra Smith M.Sc. Aud (C) Sept 28/29 2009

  31. Advanced Bionics 90k Implant Petra Smith M.Sc. Aud (C) Sept 28/29 2009

  32. Speech Processors from Advanced Bionics Petra Smith M.Sc. Aud (C) Sept 28/29 2009

  33. Wireless FM with iConnect earhook Petra Smith M.Sc. Aud (C) Sept 28/29 2009

  34. Freedom Speech Processors from Cochlear Corporation Petra Smith M.Sc. Aud (C) Sept 28/29 2009

  35. MicroLink Freedom for the BTE • Seamlessly integrated into the BTE case • FM receiver can be left in place all the time Petra Smith M.Sc. Aud (C) Sept 28/29 2009

  36. AV Principle # 3 “ Guide & coach parents to help their child use hearing as the primary sense modality in developing spoken language without the use of sign language or emphasis on lipreading” Petra Smith M.Sc. Aud (C) Sept 28/29 2009

  37. A person who really listens • Is motivated • Has time and opportunity • Is attentive Petra Smith M.Sc. Aud (C) Sept 28/29 2009

  38. Auditory Skills Development The auditory verbal approach seeks to maximize the use of audition in the development of spoken language. Levels of auditory skills: detection -> discrimination -> COMPREHENSION Petra Smith M.Sc. Aud (C) Sept 28/29 2009

  39. AV Goals – infants & toddlers Supporting families in hearing aid fitting and evaluation by: • Facilitating use of amplification all waking hours • Monitoring prelinguistic vocalizations • Collaborating with audiologists - comparing hearing tests with functional measures of benefit Petra Smith M.Sc. Aud (C) Sept 28/29 2009

  40. Assess, monitor & facilitate: • Auditory development: awareness of sound attaching meaning to sound vocalizations • Eye gaze & joint attention • Development of natural gesture • Play Petra Smith M.Sc. Aud (C) Sept 28/29 2009

  41. AV Principle # 4 “ Guide and coach parents to become the primary facilitators of their child’s listening and spoken language development through active consistent participation in individualized AV therapy.” Petra Smith M.Sc. Aud (C) Sept 28/29 2009

  42. Parental Involvement Parents are the child’s: • Primary language models • First teacher • Playmate • Advocate Petra Smith M.Sc. Aud (C) Sept 28/29 2009

  43. Play as the engine of language development “In the early stages it is the playful behaviours of the adult and the child that generate the language. By the time they are into fully fledged socio dramatic play, the language shapes reality. “I ‘m ‘tending this is a snake. By the way it is a snake” From Play by Catherine Garvey Fontana/Open Books 1977 Petra Smith M.Sc. Aud (C) Sept 28/29 2009

  44. Why individualized therapy? Petra Smith M.Sc. Aud (C) Sept 28/29 2009

  45. Why do children need language? • CONVERSATION • Social interaction • Problem solving and thinking • Negotiation and sharing • Story telling • Joint imaginary play Petra Smith M.Sc. Aud (C) Sept 28/29 2009

  46. A CONVERSATION IS.. …A SERIES OF TURNS …A SHARED ACTIVITY …GOVERNED BY RULES WHICH ARE LEARNED IN INFANCY …EASIER FOR ADULTS THAN FOR CHILDREN Petra Smith M.Sc. Aud (C) Sept 28/29 2009

  47. CONVERSATION “Informal exchange of ideas by spoken words” Concise Oxford Dictionary 1982 so…one of our aims is: ..give the words to the child.. Petra Smith M.Sc. Aud (C) Sept 28/29 2009

  48. How hard can it be? Petra Smith M.Sc. Aud (C) Sept 28/29 2009

  49. A bad conversation.. Think of someone you would gladly cross the street to avoid, rather than have a conversation with them. Why would you rather avoid them? Petra Smith M.Sc. Aud (C) Sept 28/29 2009

  50. Petra Smith M.Sc. Aud (C) Sept 28/29 2009

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