CSD 5400
REHABILITATION
PROCEDURES FOR THE
HARD OF HEARING
Auditory Training
Auditory Training
This can be a child’s or
an adult’s major
component to an
aural (re)habilitation
program
What is it??
Some Definitions of
Auditory Training
Goldstein (1939)
Auditory training involves a development and/or
improvement in the ability to discriminate various
properties of speech and nonspeech sounds
Carhart (1960)
Auditory training is a process of teaching hearing
impaired listeners to take full advantage of all
available auditory cues
Erber (1982)
Auditory training is helping kids to acquire many of
the auditory perception abilities that normal
hearing kids acquire naturally without
intervention
Primary Objectives of
Auditory Training
Learning to maximize the use of
acoustic cues available for speech
perception
Adjusting to and making maximum use
of amplification
These objectives are especially critical
with cochlear implant recipients
Some Additional
Comments…
Auditory training is not designed to change
sensitivity, but rather to make maximal use of
audible sounds
Accurate assessment of speech understanding is
important
Adults
NST, CCT, W-22, NU-6, SPIN, SIN, CID Everyday Sentences
Kids
WIPI, PB-50, NU-CHIPS, Sound Effects Recognition Test
Ling Six Sound Test
Procedure using the 6 sounds /a/, /u/, /i/, /sh/, /s/, /m/
Some Additional
Comments…
Specific goals and procedures may vary depending on
whether the client is an adult or child, but these
three things are common to all
1. Appropriate amplification is basic to the
process
2. Residual hearing is maximized, either as a
primary means of reception or as a supplement
to visual communication
3. Auditory training must involve the use of
meaningful dialogue representative of the
messages the client will encounter in their
academic, work, home, and social environment
Auditory Skill Development
in Children
Most traditional
approaches to auditory
training use this
hierarchy of auditory
skill development
Awareness--is a sound
present?
Discrimination-are sounds
the same?
Identification-recognizing
and identifying sounds
Comprehensionunderstanding the
message on a cognitive
and linguistic level
Auditory Training Activities
for Children
Auditory training
activities that are
appropriate for
each stage of
auditory skill
development
Popular and Current Auditory
Training Approaches for Kids
DASL II
SKI-HI
SPICE
DASL II (1994)
Developmental Approach to Successful
Listening (II)
Sequential, highly structured auditory
training program
Can be used with any age
Most often used with preschool and school-age
kids using hearing aids or cochlear implants
Auditory Hierarchy
of the DASL II
Sound awareness
Basic skills (detection, discrimination) of both
environmental and speech sounds
Phonetic listening
Exposure to the fundamental aspects of speech
perception
Duration, intensity, pitch, rate
Discrimination and identification of vowels and
consonants in isolation and in words
Auditory Comprehension
Discrimination of common words to the
comprehension of complex verbal messages in
everyday settings
SKI-HI (1985)
SKI-HI is a comprehensive identification
and home intervention treatment plan
for hearing impaired infants and
young children and their families
Many SLPs and audiologists use the
developmentally based auditory
stimulation and training program that
is included in the treatment plan
SKI-HI
The program moves
the child through
these eleven
auditory skills in
four phases
Notice that as you
move through the
different skill levels,
the auditory
behavior becomes
more complex
Sample SKI-HI Lesson
Here’s a sample
lesson plan for Skill
3, recognizing
objects and events
from a sound
source
Speech Perception Instructional
Curriculum and Evaluation
Goals and Objectives for:
Detection
Awareness and responsiveness to speech
Suprasegmental perception
Gross variations in duration, stress, intonation
Vowel and consonant perception
Connected Speech
Activities include combined auditory and
visual cues and auditory cues alone
Popular as a cochlear implant auditory
training program
Summary Remarks of Auditory
Training with Children
Auditory training philosophies and
methodologies have enjoyed a resurgence
through the advancement of conventional
hearing aids and cochlear implants
Before implementing any one plan, you need
to consider the child’s language
development stage and characteristics of
their hearing loss (audibility)
This should be a multi-sensory approach
Visual cues should be emphasized as well as
auditory cues
Auditory Training
With Adults
Major difference in goals
Auditory training with kids has a
developmental goal
Auditory training goal for adults is
remediation
Two general types of activities
Drill on auditory or auditory/visual stimuli
Adjustment to use of amplification
Activities for Reinforcing
Auditory Discrimination
Minimal pairs-- sets of words that differ by
only one phoneme
Discriminating (same or different)
Identifying (pointing)
Producing (saying aloud)
Auditory memory drills
Closed-set lists (numbers, days of the week,
months of the year, names)
Exercises in intonation
“when will it open”
Adjust the accent word and talk about any change
in meaning
Listening Experiences
With Hearing Aids
It’s useful to proceed
gradually in adjusting
to hearing aid use and
to discuss with your
clients their ability to
assess the relative
complexity of everyday
listening situations
using this kind of
hierarchy
Guidelines for Adjusting
to Hearing Aid Use
The adjustment
period should take
2-4 weeks