Teresa H. Caraway, PhD, CCC-SLP, LSLS Cert. AVT
WREIC 2017
“The real voyage
of discovery consists
not in seeking new
landscapes, but in
having new eyes.”
SERVE AND RETURN
STRATEGIES FOR ITTY BITTYS
Teresa H. Caraway, PhD, CCC-SLP, LSLS Cert. AVT
CEO, Hearing First
-
Marcel Proust
[email protected]
PG 1
PG 2
PG 3
Brain Power: From Neurons to Networks Video: http://youtu.be/zLp-edwiGUU
PG 4
NEW…BETTER…DIFFERENT
TOPICS FOR OUR TIME TOGETHER
Exchange Thoughts:
•
•
What surprised you about the
video?
What do you want to learn from
our time together?
PG 5
•
What is Served… Must be Returned
•
LSL (AV) Strategies keep the Serve & Return LSL Volley Going
•
Serve & Return with Babies
•
Serve & Return with Toddlers
•
Mindsets for Serve & Return
PG 6
1
Teresa H. Caraway, PhD, CCC-SLP, LSLS Cert. AVT
WREIC 2017
SERVE & RETURN INTERACTION SHAPES BRAIN CIRCUITRY
ARCHITECTURE DETERMINED
BY STIMULATION RECEIVED
http://developingchild.harvard.edu/resources/serve-return-interaction-shapes-brain-circuitry/
PG 7
SERVE & RETURN
PG 8
THE SCIENCE OF EARLY CHILDHOOD DEVELOPMENT
WHAT DO WE ALREADY
KNOW ABOUT
WHAT IT TAKES
FOR BABIES WITH
HEARING LOSS TO
DEVELOP LISTENING
AND SPOKEN LANGUAGE?
1
Plasticity, or the ability for the brain to reorganize and adapt,
is greatest in the first years of life and decreases with age.
2
The interactive influences of genes and experience
shape the developing brain.
3
Supportive relationships and positive learning experiences
begin at home. Babies’ brains require stable, caring, interactive
relationships with adults.
PG 9
WHAT THE RESEARCH SAYS ABOUT EARLY LITERACY
1
Early language skills, the foundation for reading ability and school readiness,
are based primarily on language exposure – resulting from parent and other
results talking to young children.
2
The more words parents use when speaking to an 8 month old infant, the
greater the size of their child’s vocabulary at age 3. The landmark Hart-Risley
study on language development documented that children from low-income
families hear as many as 30 million fewer words than their more affluent peers
before age 4.
3
4
PG 10
WHAT IS SERVED… MUST BE RETURNED
•
Serve and Return is critical to develop
•
Serve & Return is
by hearing loss and the child’s
developing listening and language skills.
Reading difficulty contributes to school failure, which increases the risk of
absenteeism, leaving school, juvenile delinquency, substance abuse, and
teenage pregnancy – all of which perpetuate the cycles of poverty and
dependency.
•
AV Strategies provide
for the child to be successful
A child's reading proficiency at the end of third grade is one of the most
powerful indicators of future academic success.
Annie E. Casey Foundation Grade Level Reading Campaign
PG 11
PG 12
http://gradelevelreading.net/wp-content/uploads/2012/08/FACE-Research.pdf
2
Teresa H. Caraway, PhD, CCC-SLP, LSLS Cert. AVT
WREIC 2017
It’s NOT JUST about
Serve & Return
It’s About the Volley
LSL Strategies
to Up Level the Game
Jim Trelease
PG 13
PG 14
“ MUDDY IN ….MUDDY OUT”
I ASKED YOU TO PLAY ROMEO…NOT RODEO
One letter changes the meaning of everything!
Children must have access to audible and intelligible speech
PG 15
PG 16
LSL Strategies
provide support
for the child and
parent to be
successful serving
and returning.
Today it’s about a professional/ parent partnership.
The goal is for the parent to be the child’s primary teacher.
PG 17
PG 18
3
Teresa H. Caraway, PhD, CCC-SLP, LSLS Cert. AVT
WREIC 2017
BECAUSE OF EHDI,
HEARING TECHNOLOGY, AND BRAIN NEUROPLASTICITY
When clear programmatic alternatives are available, the choices made
by parents of children who are DHH have changed dramatically over
time.
o In 1995: 40% chose spoken language outcome, compared to 60%
who chose sign-language outcomes
o In 2005: 85% chose spoken language outcomes, compared to 15%
who chose sign-language outcomes. Brown, C. (2006)
o In 2012: Beginnings in North Carolina reporting 89% chose spoken
language; Hearts for Hearing 95%
PG 19
CHANGING PARADIGM…
PG 20
AG BELL ACADEMY
OF LISTENING AND SPOKEN LANGUAGE
Today’s Best Practice for Listening and Spoken Language
Outcomes
• Now Listening and Spoken Language rather than traditionally known
as Auditory Oral and Auditory-Verbal
• Creating an auditory accessible world filled with auditory
• Creation of certification in Listening and Spoken Language
o LSLS Cert. AVEd
o LSLS Cert. AVT
• Partnering with parents and instructional team members
To learn more about LSLS Certification from
the AG Bell Academy for Listening and
Spoken Language: www.agbellacademy.org
living
PG 21
PG 22
LSL
STRATEGIES
& TECHNIQUES
PG 23
PG 24
4
Teresa H. Caraway, PhD, CCC-SLP, LSLS Cert. AVT
WREIC 2017
A WORD ABOUT
PROGRESS
PG 25
PG 26
DIRECT THE CHILD TO LISTEN
Say “Listen!” to your child
whenever you hear a sound or a
person talking, or before you
start talking to them. This
provides the child with an
opportunity to detect and pay
attention to the sounds and
speech around them.
PG 27
POINT OUT SOUND AND NAME IT
PG 28
USE AUDITION FIRST
Say, “I hear a [name of sound].” Then imitate the
sound, and name it again.
Example: “Listen! I hear an airplane.” (Pause and
point towards the airplane.) “Ahhhhhh!” (Imitate the
sound.) “The airplane is flying.” (Add a comment: use
the word in a simple sentence.) “It’s an airplane!”
(Use the word again at the end of a short sentence.)
When you direct your child to listen, point out the
sound, name it, and talk about it, they learn that
sound and speech are important. It helps your child
begin to understand the meaning of sound and
spoken language.
PG 29
Let your child hear a sound before you show
it to them. This provides ear contact before
eye contact, which is critical to grow your
baby’s brain for auditory skills. So talk
about an object before you show it to them,
start a song or fingerplay before beginning
the motions, or talk about the page in a
book before you turn the page. This will
provide lots of opportunities for your baby
to learn to listen throughout the day.
PG 30
5
Teresa H. Caraway, PhD, CCC-SLP, LSLS Cert. AVT
WREIC 2017
DESCRIBE ACTIONS AND THOUGHTS
KEEP THE SERVE AND RETURN GOING
Practice by expecting a response from your
baby. Use pausing, waiting, and leaning in with
an expectant look to encourage a response
from your baby. This teaches them the power of
turn-taking in conversations. For older children,
use another person to model the answer to a
question or provide the opportunity for the
child to fill in a missing word. When a child
engages in serve and return, the connections in
the brain grow and become stronger, which is
critical for listening, spoken language, and
reading.
Much like a sports announcer, describing
the play-by-play action of what your baby
experiences every day will help them grow
their listening and language skills. This
self-talk provides your baby with the
opportunity to hear lots of words so they
can reach hearing 40 million words by age
4. As your child gets older, continuing to
talk out loud about your thoughts helps
them learn that others may have thoughts
and feelings different from their own.
PG 31
MAKE IT EASIER TO LISTEN
PG 32
EXPECT A RESPONSE OR ANSWER
Control the listening environment and place emphasis on
sounds and words. As a new listener, your baby needs a
quieter environment with background noises at a
minimum. Because your baby hasn’t fully developed their
spoken language skills yet, they aren’t able to fill in any
missing sounds or words. You can emphasize sounds and
make words easier to hear by whispering, becoming a
“drama momma” or “dramatic daddy” by using a voice
rich in tone and melody, or by using acoustic highlighting,
which means making a sound longer than normal in a
word or saying a word in a singsong way. After
emphasizing a sound or word in any of these ways and
following the child’s response, reinforce the learning by
saying it again as you normally would.
Help your child learn to answer questions by
changing your questions from open-set
questions, such as “How many crackers do you
want?”, to a closed-set question that has a
limited choice of answers, like “How many
crackers do you want: one or two?” Providing
choices helps a child with limited vocabulary and
spoken language skills. These techniques help
your child gain confidence in their skills. The goal
is to continually raise the bar as they learn and
grow their listening and talking skills.
PG 33
PG 34
EXPAND AND EXTEND
YOUR CHILD’S UTTERANCES
CREATE AN AUDITORY SANDWICH
Create an auditory sandwich when you speak to
your child and you don’t think they understand. You
can do other things to help reinforce the spoken
word such as pointing, gesturing, or another visual
cue to help them then put it back into listening by
saying it again without the visual help. This will help
your child improve their ability to understand
spoken language through listening.
Add your words to their comments to expand and model more
complex language or extend the comment by talking about past or
future experiences. For example, if your baby says, “Ball,” you could
expand their utterance by saying, “Yes, you have a big ball. Roll the
ball.” As your child learns more words, keep raising the bar by using
new words that mean the same thing. This will help to continue
growing their vocabulary instead of getting stuck in a rut and only
using words that you know the child can understand, which stifles
vocabulary growth. For example, once your baby is saying, “Bye-bye,”
begin to extend their vocabulary and understanding by adding new
words and phrases that mean the same thing, such as “See you later,”
or “So long!”
An auditory sandwich is made in three simple steps:
Step 1 – Listen
Step 2 - Add More
Step 3 - Listen
PG 35
PG 36
6
Teresa H. Caraway, PhD, CCC-SLP, LSLS Cert. AVT
WREIC 2017
ASK “WHAT DID YOU HEAR?”
Encourage your child to listen the first time something is said
or asked of them. Children with hearing loss can often develop
a habit of asking “Huh?” or “What?” Asking “What did you
hear?” can break this habit, teach them to listen the first time,
and build their confidence in their listening skills. For example,
if you ask “Where do you want to go for lunch?” and your child
replies “Huh?”, follow up by asking “What did you hear?” If your
child responds “Lunch?”, say “Good for you. Where do you
want to go for lunch?” Using “What did you hear?” is also a
diagnostic tool to learn if your child is consistently missing part
of a message. This will inform you and your LSL interventionist
about your child’s auditory skill development.
LSL STRATEGIES
BABIES
TODDLERS
PG 37
PG 38
LISTENING AND LEARNING: BUILT IN “CURRICULUM”
Daily Routines
• Acts of care-giving; they happen no
matter what the day is like
SERVE & RETURN
WITH BABIES
Play Routines
• Use of age appropriate objects, phrases
that support parent-infant interactions
Social Routines
• Incidental interactions that occur in the
life of the family
School Routines
• Informal curriculum of the classroom
that occurs during the school day
PG 39
LISTENING AND LEARNING: BUILT IN “CURRICULUM”
LISTENING AND LEARNING: BUILT IN “CURRICULUM”
PLAY ROUTINES
DAILY ROUTINES
•
•
•
•
•
PG 40
Use play routines to teach listening:
• Blowing Bubbles
Diaper changing
Feeding
Bathing
Dressing
Rocking and Singing
• Knocking and entering doors
• Calling Games: I’m gonna get you!
• Nursery Rhymes and Songs
• Reading to baby
• Using age-appropriate toys
• Play routines: Peek-a-boo;
• How big is baby? Sooo big; Tickling
PG 41
PG 42
7
Teresa H. Caraway, PhD, CCC-SLP, LSLS Cert. AVT
WREIC 2017
LISTENING AND LEARNING: BUILT IN “CURRICULUM”
LISTENING AND LEARNING: BUILT IN “CURRICULUM”
BEGINNING PLAY ROUTINES
•
•
•
•
•
•
•
•
•
•
Listening Walks
Peek-a-Boo
Wake Up Game
Where Are You?
Knock-Knock Game
Freeze Dance
I’m Gonna Get You!
Don’t Bite!
Bubbles
Give You Kisses
SOCIAL ROUTINES
Use social routines to teach
listening and encourage
incidental learning:
• Greetings
• Going places
• Family gatherings
PG 43
SERVE & RETURN WITH BABIES
MAKING THE MOST OF DAILY
ROUTINES
•
What would you say to explain
serve & return to a parent partner?
•
What are child goals in that
routine?
•
What strategies do you do in those
routines?
•
How do you make sure the parent
can use serve & return and explain
it to others? What do you want the
parent to take away?
PG 44
REFLECTION & ACTION PLAN
HOW WILL YOU
CHANGE YOUR PRACTICE WITH
BABIES AND THEIR FAMILIES?
PG 45
PG 46
SERVE & RETURN WITH TODDLERS
Don’t Bite!
SERVE & RETURN
WITH TODDLERS
When playing with toy animal, you pretend that
it has bitten your finger by holding finger close
to animal. Pull finger back saying, “Ouch!” Scold
the animal, saying “No no, Frog! Don’t bite.”
Take turns with this game. The child usually
begins to initiate the animal biting the parent’s
finger.
Modified from Listening Games for Littles,
Dave Sindrey, LSLS Cert. AVT, Word Play
Publications, 1997
PG 47
PG 48
8
Teresa H. Caraway, PhD, CCC-SLP, LSLS Cert. AVT
WREIC 2017
OPEN A BOOK…
SERVE & RETURN WITH TODDLERS
Wake-Up Game
A fun game for encouraging a child to use a
loud and soft voice is the Wake-Up game.
Pretend to be sleeping or pretend that a doll
is sleeping. Use a quiet voice as you pretend
that the doll is sleeping. Then use a loud
voice to wake up the baby.
http://hope.cochlearamericas.com
Hope Series Getting Started Brochure
….FALL INTO A CONVERSATION
PG 49
FACILITATING LISTENING AND TALKING
PG 50
NEW THINKING TO MAXIMIZE SERVE & RETURN
• Avoid “the rut”
Rethinking
• Avoid “the hot seat”
1.
• Avoid “test questions”
2. Narrate
New Thinking
Follow the child’s lead
the child’s actions
3. Demonstrate
routines
structured play
4. “Therapized” Voice
PG 51
1.
Be responsive to the child’s serve
2. Comment,
serve
pause to expect a return or
3. Parent
initiate play routines –
build on how they play with their child
4. Use natural
conversational voice
PG 52
REFLECTION & ACTION PLAN
HOW WILL YOU
CHANGE YOUR PRACTICE WITH
TODDLERS AND THEIR FAMILIES?
PG 53
PG 54
9
Teresa H. Caraway, PhD, CCC-SLP, LSLS Cert. AVT
WREIC 2017
MINDSETS FOR SERVE & RETURN
•
Expect a return and serve
•
Keep the volley going - Use LSL (AV) Strategies
•
Use multiple strategies to up-level the volley
•
Focus on the “true” serve and return players – the
parent and the child
•
Use questions that inspire critical thinking,
problem solving and Theory of Mind (ToM)
What is clearer to you
about Serve & Return?
PG 55
JOIN US AT HEARING FIRST
PG 56
WHAT WE DO
www.hearingfirst.org
Awareness
Education
Communities
PG 57
PG 58
FAMILY SUPPORT COMMUNITY
Four forums to
focus
participation
PG 59
PG 60
10
Teresa H. Caraway, PhD, CCC-SLP, LSLS Cert. AVT
WREIC 2017
Member Profile
Page aides
connections and
story telling.
PROFESSIONAL LEARNING COMMUNITY
LSL Friend Finder to
make individual
connections
PG 62
PG 61
EDUCATION
INTEGRATION OF COMMUNITY & LEARNING EXPERIENCES
• Implementing learning events within the community since January, 2017
• Developing discussions based on monthly LSL theme
• Developing integrated Learning Experiences in the community space such as
– Subject specific discussions facilitated by community members with that expertise
– Highlight new LSL texts or research for discussion facilitated by authors
– Brown Bag lunches (online content that teams can implement on your own site
and share back)
– Video hangouts on specific topics with some report backs in community
– Podcast interviews
– Discussions around an intervention video clip
– Community participation/private group for collaborative learning
PG 63
LEARNING EXPERIENCES: FALL 2017
3 Video
Observation
Experiences for
Professionals and
Families
1 Journal Club
Monthly for
Professionals and
Families
64
LEARNING EXPERIENCES: FALL 2017
Blended learning
experiences:
AG Bell
After the LE
webinars for
Professionals &
Families
1 LSL Study
Group Monthly
for Professionals
65
1 Explode the App
monthly for
Professionals and
Families
1 Mentoring Group: PLC
2 Mentoring Groups: C & M
1 Mentor Group: C & M
66
11
Teresa H. Caraway, PhD, CCC-SLP, LSLS Cert. AVT
WREIC 2017
Education Now in the Community
Coming Soon
Strengths Based Coaching discussion
Mythbusters
1-2 discussions around monthly theme
Resource Round Up
Best Bets
Weekly digest
Embedding LSL strategies/techniques in
play discussion
Interviews with authors and post-discussion
(not book specific)
Member interviews on monthly theme
Resource Repository
Shared Resources
Explode the App: learning experience solely
implemented in the community space
More in-depth community discussions on
LSL content
Ongoing infusion of how to learn online
Hearing First Happenings from the CEO blog
Audiology discussions
Discussion on how professionals have used
specific resource
Lessons learned from the trenches member
interview/discussion
September 2017: Course on Strength Based
Coaching and Mentoring
Community Mentor Group
SEE YOU ONLINE IN THE HEARING FIRST COMMUNITY!
PG 67
PG 68
A FEW RESOURCES FOR INFANTS AND TODDLERS
A FEW RESOURCES FOR INFANTS AND TODDLERS
Resource and downloadables to use to support families in their LSL
journey:
http://www.hearingfirst.org
Website and also has an app:
www.joinvroom.org
Forty lessons for the first year:
http://www.cochlear.com/au/sound-foundation-course-babies
Learn to Talk Around the Clock: Monthly newsletters by K. Rossi
http://www.learntotalkaroundtheclock.com
HOPE Series Getting Started Brochure:
http://hope.cochlearamericas.com
The Learn to Listen Sounds: Listen-Up & E. Rhoades
http://www.listen-up.org/dnload/listen.pdf
PG 69
SELECTED RESOURCES: TIPS BY AGE GROUP IN 11 LANGUAGES!
PG 71
PG 70
SELECTED REFERENCES
•
Shlain,Tiffany. Brain Power: Neurons to Networks. Retrieved 11/14/2014.
https://www.youtube.com/watch?v=zLp-edwiGUU.
•
Center on the Developing Child, Harvard University. Serve & Return Interaction Shapes Brain
Circuitry. Retrieved 11/14/2014. http://developingchild.harvard.edu/resources/serve-returninteraction-shapes-brain-circuitry/
•
Co-Production of Paramount Pictures and Nickelodeon Movies. Imagine That. Release 2009
•
Baby Talking To Mom, https://www.youtube.com/watch?v=BABrm1ie5tg: Retrieved 11/14/2014
•
LSL Strategies and Techniques: http://hearingfirst.org/learning-growing-lsl/lsl-strategiestechniques
•
Sindrey, Dave. LSL Strategy Activities for Babies and Toddlers: Listening Games for Littles.
Word Play Publications, 1997
•
Hearing First.org. Serve and Return. Hearing First Blog published March 8, 2016.
http://hearingfirst.org/blog/2016/03/08/Serve%20and%20Return
PG 72
12
Teresa H. Caraway, PhD, CCC-SLP, LSLS Cert. AVT
WREIC 2017
SELECTED REFERENCES
SELECTED REFERENCES
• Cole, E. & Flexer, C. (2010). Children with hearing loss: Developing listening and talking—birth
to six. 2nd Edition. San Diego, CA: Plural Publishing.
• Brown, C. (2006). Early intervention: Strategies for public and private sector collaboration.
Paper presented at the 2006 Convention of the Alexander Graham Bell Association for the
Deaf and Hard of Hearing. Pittsburgh PA.
• Dehaene, S. (2009). Reading in the brain: The science and evolution of a human invention.
New York: Penguin Group.
• Caraway, T. & Madell, J. (Produced by ASHA). (2012). Current Trends in Pediatric Cochlear
Implantation: Creating Auditory Opportunities [Web Workshop]. Workshop submitted for
publication.
• Doidge, N (2007) The Brain that Changes Itself; Penguin Books NY
• Estabrooks, W. (2006). Auditory-verbal therapy and practice. (2006). Washington, DC: A.G.
Bell Association for the Deaf and Hard of Hearing.
• Caraway, T. (2010). Lend Me Your Ears: Auditory-Verbal Strategies and Techniques. A short
course presented at the 2010 Convention of the Alexander Graham Bell Association for the
Deaf and Hard of Hearing. Orlando, FL.
• Hart, B and Risley, T. R. (1999). The social world of children learning to talk. Baltimore, Brookes.
• Howard, P. (2000). The Owners’ Manual for the Brain: Everyday Applications from Mind-Brain
Research (2nd Edition). Austin, TX: Bard Press
• Caraway, T. (2008). Facilitating Conversational Competency through Auditory-Verbal
Strategies and Techniques. Cochlear HOPE workshops.
• Moeller, M.P. & Schick, B. (2006). Relations between maternal input and theory of
understanding in deaf children. Child Development, 77, 751-766.
• Caraway, T., Smith, J., & Clemmons, K. (2004). Open a Book – Fall Into a Conversation. A short
course at AG Bell International Convention, Anaheim, CA
• Sharma, A., Nash, A., and Dorman, M (2009) Cortical development, plasticity, and reorganization in children with cochlear implants. Journal of Communication Disorders, 42(4),
272-279.
PG 73
SELECTED REFERENCES
• Cole, E. & Flexer, C. (2015). Children with hearing loss: Developing listening and talking—birth to
six. 3rd Edition. San Diego, CA: Plural Publishing.
• Dehaene, S. (2009). Reading in the brain: The science and evolution of a human invention. New
York: Penguin Group.
• Doidge, N (2007) The Brain that Changes Itself; Penguin Books NY
• Estabrooks, W. (2016). Auditory-Verbal Therapy for Young Children with Hearing Loss and Their
Families, and the Practitioners Who Guide Them. San Diego, CA: Plural Publishing.
PG 74
LET’S CONNECT
Teresa H. Caraway, PhD, CCC-SLP, LSLS Cert. AVT
[email protected]
@CarawayTeresa
• Hart, B and Risley, T. R. (1999). The social world of children learning to talk. Baltimore, Brookes.
• Howard, P. (2000). The Owners’ Manual for the Brain: Everyday Applications from Mind-Brain
Research (2nd Edition). Austin, TX: Bard Press
• Moeller, M.P. & Schick, B. (2006). Relations between maternal input and theory of understanding
in deaf children. Child Development, 77, 751-766.
• Sharma, A., Nash, A., and Dorman, M (2009) Cortical development, plasticity, and reorganization in children with cochlear implants. Journal of Communication Disorders, 42(4), 272279.
PG 75
PG 76
13