AURAL HAB AX

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36 Terms

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Assessment of listening skills

  •  In the context of Diagnostic therapy

  • When dealing with children with HL in aural habilitation, we continuously assess. 

    • One of the areas we assess is listening skills

    • Focus on assessing listening skills while doing therapy through questionnaires, models, checklists and the likes.

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getting to know the child and the family

  • Evaluation is _____?

  • Even if it's in the context diagnostic, this is still diagnostic.

  • The sole purpose: GET TO KNOW THE CHILD in terms of their strengths, interests in terms of what makes them listen more, participate in sessions, baseline skills, what they need to learn.

  • What makes Aural Hab unique is that we firmly stress family participation.

    • Realize that we really need to teach the family (esp. in AVT)

    • Getting to know what the parents know and their skill sets could help us in setting expectations for parent coaching and plan out how to coach and guide the parents along with the whole family. 

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Process of using assessment tools/strategies to arrive at a diagnosis

  • Evaluation is the _____?

  • During diagnostic therapy, we don't usually diagnose. We plot the skills.

    • During the therapy sessions, [we note] at what level the patient current functioning or what listening skills does the patient actually exhibit? Is that typical for their age?

  • This will guide us in what to target next and curate the entire long term plan.

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An ongoing process

  • Evaluation is _____?

  • Ongoing process esp. in aural habilitation for children.

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Knowledge of norms, Knowledge of testing strategies, Observational skills, Empathy, Scrutinising all aspects of behavior

Evaluation requires (6)

  1. No need to memorize but have to know the key points in terms of listening; e.g. When detection starts, identification starts.

  2. We all have good share of experience with patients requiring strategies in order to have the child participate in certain tasks and tests

  3. Most important: very good observational skills

  • In CLASP, they usually record sessions in video to see if they are doing it correctly in terms of also looking at the skills of the patient.

  • This is something that is developed over time.

  • At least when you go back to your videos (us), we should be able to pinpoint the skills, identify difficulties, and how to plot it well in the checklist and curriculums.

  1. Speech and Language is not black and white that you touch and manipulate. Hence, it requires some level of inferencing. We won't be imagining skills out of the blue. But if the child was able to perform a certain skill, then most likely they could also do the pre-requisite skill.

  2. Know how to put yourself in our patient's shoes since it's knowing the families and the child. If we could place ourselves in their shoes, we could know them better. 

  3. Although we are not behaviour specialists, it refers to the behavior exhibited by the patient. 

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Developmental model, Auditory processing model, Combined model

  • The assessment of auditory skills or listening skills are grouped into models

  • 3 Models are…?

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Developmental model

  • The word developmental it could be inferred that this is based on development

  • This is an assessment where you would ask yourself “At what age is my patient performing at?”

    • Because you are going to compare the skills that you observe in the sessions to the skills that are normally exhibited by a certain age level

  • Based on ages and stages of typical development of listening and spoken language comprehension

  • Often applied for use with children who are ideal aural habilitation candidates

    • Those who are fitted early, identified early, and intervened early

  • These are the patients who don’t usually fall far from the chronological age

  • This is applicable to the children who are still in the trajectory of normal development

    • You can compare it to those with delays only, rather than disorders

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Developmental model strategy 1

  • You have to be familiar with typical auditory development and receptive language benchmarks

  • The end goal of the hierarchy listening function is the development of comprehension

  • There are a lot of checklists and references that interchange listening and receptive language

    • Can be seen for example in PLS, the earlier skill listed in auditory comprehension are some form of listening skills

  • You cannot do the developmental auditory assessment if you do not have an idea of typical auditory development and receptive language benchmarks

  • It is very hard to memorize, so we are thankful to AVTs who have developed the scales that we know of and the different milestones that we can use in assessment.

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Doreen Pollack’s hearing and speech scale

  • Doreen Pollack is one of the one who published the development of listening function where she divided it into 3

    • First 3 months

    • Second 3 Months

    • Third 3 Months

  • Basically you observe the patient and tick the skills that you have observed

  • You can see that the skills are arranged according to ages

  • If most of the ticks fall under the first 3 months category, most likely the patient is performing at that level

  • The next goals will be the remaining skills in that bracket or the ones in the next bracket

<ul><li><p><span style="background-color: transparent;">Doreen Pollack is one of the one who published the development of listening function where she divided it into 3</span></p><ul><li><p><span style="background-color: transparent;">First 3 months</span></p></li><li><p><span style="background-color: transparent;">Second 3 Months</span></p></li><li><p><span style="background-color: transparent;">Third 3 Months</span></p></li></ul></li><li><p><span style="background-color: transparent;">Basically you observe the patient and tick the skills that you have observed</span></p></li><li><p><span style="background-color: transparent;">You can see that the skills are arranged according to ages</span></p></li><li><p><span style="background-color: transparent;">If most of the ticks fall under the first 3 months category, most likely the patient is performing at that level</span></p></li><li><p><span style="background-color: transparent;">The next goals will be the remaining skills in that bracket or the ones in the next bracket</span></p></li></ul><p></p>
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Hierarchy of Early Auditory Responses (HEAR) Chart

  • This is developed by the DHSS

    • An institution that caters to children who are deaf and hard of hearing

  • This describes the benchmarks in listening behaviors of typically developing children from birth to 18 months

  • If your hearing age falls within that range then you can use this

  • Similar to how you mark a bloom and lahey grid

    • You check it across categories and those with complete marks are checked in that range then that is the level that child is performing at. 

<ul><li><p><span style="background-color: transparent;">This is developed by the DHSS</span></p><ul><li><p><span style="background-color: transparent;">An institution that caters to children who are deaf and hard of hearing</span></p></li></ul></li><li><p><span style="background-color: transparent;">This describes the benchmarks in listening behaviors of typically developing children from birth to 18 months</span></p></li><li><p><span style="background-color: transparent;">If your hearing age falls within that range then you can use this</span></p></li><li><p><span style="background-color: transparent;">Similar to how you mark a bloom and lahey grid</span></p><ul><li><p><span style="background-color: transparent;">You check it across categories and those with complete marks are checked in that range then that is the level that child is performing at.&nbsp;</span></p></li></ul></li></ul><p></p>
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Auditory Language Comprehension (ALC) Benchmarks

  • Based on various curricula and developed by Morrison.

  • This tool allows you to observe the patient and tick off the skills you have observed.  

  • You can also elicit some of the skills that haven't been demonstrated. 

  • This helps you determine the child's current age level and identify the next goals to target. 

<ul><li><p><span style="background-color: transparent;">Based on various curricula and developed by Morrison.</span></p></li><li><p><span style="background-color: transparent;">This tool allows you to observe the patient and tick off the skills you have observed.&nbsp;&nbsp;</span></p></li><li><p><span style="background-color: transparent;">You can also elicit some of the skills that haven't been demonstrated.&nbsp;</span></p></li><li><p><span style="background-color: transparent;">This helps you determine the child's current age level and identify the next goals to target.&nbsp;</span></p></li></ul><p></p>
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Integrated Scales of Development

  • Developed by Cochlear Corporation, this tool allows you to simply tick off the skills that are present. 

  • If 70% of the skills in one section are ticked, that is considered the mastered level.  

  • This is made for children from birth to 4 years of age across different domains including social communication and cognition, not just listening.

<ul><li><p><span style="background-color: transparent;">Developed by Cochlear Corporation, this tool allows you to simply tick off the skills that are present.&nbsp;</span></p></li><li><p><span style="background-color: transparent;">If 70% of the skills in one section are ticked, that is considered the mastered level.&nbsp;&nbsp;</span></p></li><li><p><span style="background-color: transparent;">This is made for children from birth to 4 years of age across different domains including social communication and cognition, not just listening.</span></p></li></ul><p></p>
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Developmental model strategy 2

  • Use informal checklists and questionnaires that compare a child’s listening skills to typically developing peers

  • There are numerous checklists and questionnaires available, and you can use one or a combination of them. 

    • Some questionnaires may differ in administration and tend to have different coverage.

Is the child an infant or preschooler? 

  • Will give you an idea for the age.

  • For example, this questionnaire is only meant for this age. It can help you choose. 

Is an informal checklist with a parent's report a better way to obtain information than formal testing?

  • If the answer is yes, then you should use a checklist. 

  • Unlike other cases, we usually start with children with HL very young. We could start therapy even at six months of age. 

    • This is why we rely on parent reports early on. 

  • It is very difficult to elicit skills below 1 year old even so at 2 years old it is still difficult. We utilize many evidence-based questionnaires for parents that require a parent report. 

Do you wish to supplement formal testing with observation and parent report? 

  • Do you want to be able to compare the child’s performance with typically developing children? 

    • Not all questionnaires are meant to compare to typically developing children. 

Is it important to you that there be statistically valid normative data for comparison? 

  • Essentially the questionnaire that you will be using should be:

    • Appropriate for the child’s age 

    • Yield the kinds of scores that you need 

    • Assesses the listening behaviors and RL aspects that you want 

      • It should be valid. 

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LittleEars Auditory Questionnaire (LEAQ)

  • By Med-El, one of the providers of CI in the Philippines  

  • A questionnaire that is self-administered by the parents.  

    • Comes in English and has a Tagalog version as well.  

How to complete?

  • All questions are to be answered by checking either YES or NO.

    • YES: If you have already observed the behavior in your child at least once.

    • NO: If you have never observed the behavior in your child, or if you are not sure how to answer the question.

  • If you answer 6 questions with “NO” for children with normal hearing, you do not need to continue the questionnaire.

  • Further questions will then be regarded as “NO” answers.

  • For children with CI(s) or HA(s), all questions should be answered, since they may show auditory behavior covered by later questions. 

Sample:

  • You will calculate it at the end. 

    • How many yes and how many nos were answered.  

    • Then you will come up with the score. 

      • The score will be plotted on the score sheet.

Scoring:

  • For example, during the assessment the child scored 2 and the hearing age is at 20 months then you plot it there. (↑)

  • If the dot is within the graph ( line), then it is considered to be typical.  

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Track a Listening Child

  • Developed by Cochlear: Cheryl Dickson and Nancy Calleffe Schenck

    • Another cochlear implant company that is available in the Philippines

  • A companion for the Integrated Skills of Development

    • There are some similarities

  • Audition and receptive language are sometimes joint together or interchanged

  • You just have to check the skills present

  • Areas you need in order to plan sessions for these patients:

    • Audition/Receptive Language

    • Expressive Language

    • Speech

    • Pragmatics

    • Cognition

  • Just tick and you would know where the patient is actually performing at and what next skill to target

<ul><li><p><span style="background-color: transparent;">Developed by Cochlear: Cheryl Dickson and Nancy Calleffe Schenck</span></p><ul><li><p><span style="background-color: transparent;">Another cochlear implant company that is available in the Philippines</span></p></li></ul></li><li><p><span style="background-color: transparent;">A companion for the Integrated Skills of Development</span></p><ul><li><p><span style="background-color: transparent;">There are some similarities</span></p></li></ul></li><li><p><span style="background-color: transparent;">Audition and receptive language are sometimes joint together or interchanged</span></p></li><li><p><span style="background-color: transparent;">You just have to check the skills present</span></p></li><li><p><span style="background-color: transparent;">Areas you need in order to plan sessions for these patients:</span></p><ul><li><p><span style="background-color: transparent;">Audition/Receptive Language</span></p></li><li><p><span style="background-color: transparent;">Expressive Language</span></p></li><li><p><span style="background-color: transparent;">Speech</span></p></li><li><p><span style="background-color: transparent;">Pragmatics</span></p></li><li><p><span style="background-color: transparent;">Cognition</span></p></li></ul></li><li><p><span style="background-color: transparent;">Just tick and you would know where the patient is actually performing at and what next skill to target</span></p></li></ul><p></p>
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Developmental model strategy 3

  • Use standardized assessments that are normed with typically-developing children

    • global assessments of RL

    • specific assessments of RL

    • global assessments about specific language domains

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Developmental model strategy 4

  • Use the child’s chronological age and hearing age to interpret performance

  • You have to know how to interpret the skills you observed and plotted on the different checklists

  • You interpret it by comparing the skills to the child’s chronological age and hearing age

  • Hearing age: The date at which the child begins to learn to listen

    • The child’s hearing birthday

    • You might want to consider this date as the date at which a child is wearing his hearing aid or other technology full-time

      • Should be hearing aids or technology that are appropriate

    • The length of time that the child has been listening with this technology full-time is the child’s hearing age

      • Ex. A child who is 4 years old who has been listening full-time with an appropriate hearing aid since 18 months, has a chronological age of 4 years but a hearing age of 2.5 years

How to determine

  • Record Review: Determine when a child achieved full-time use of hearing technology

  • Calculate an estimation of hearing age

  • Look at behaviours expected for your child’s HA and CA

  • Administer a developmental checklist

  • Administer a standardized test

  • Sometimes it’s hard to calculate for the hearing age because you wouldn’t know when was the full-time use or if it is the appropriate hearing aids

    • Have an alternate hearing age

      • Consider the age fitted in the calculation

      • Indicate that it is calculated in the premise that you don’t know when is the full-time use of the technology

    • Others say that the hearing age and CI age are different

      • Up to you on what you want to use

  • Essentially, if the child is wearing hearing aids and they are not benefitting, it’s not good to calculate for the hearing age during that time

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Auditory Processing Model

  • Also known as Model of Auditory Assessment which is more remedial

  • Also hierarchical, orderly, and sequential, but the skills and sequences are guided by how listeners process a signal to comprehend it

  • Based on characteristics of the spoken language stimulus and hierarchy of responses that listeners can make to that stimulus

  • Based on Erber’s hierarchy of auditory skills

  • Frequently described as a remedial model

Recommended for children who begin listening later in life

  • Such children may be substantially delayed in listening and spoken language development

  • May be transitioning from using dependence on visual cues to using audition as the primary sensory modality

  • Many assessment and intervention materials that were created for deaf children, prior to the advent of newborn hearing identification and early fitting with technology, utilized an auditory processing model and merit a closer examination when we are considering intervention for today’s children with hearing loss

  • It is essential to monitor how well a child uses his hearing to ensure that he is developing auditory skills optimally

  • Auditory skills hierarchies provide framework for breaking down listening into smaller subskills that can be targeted by parents and professionals, and learned by the child

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Erber model

  • Auditory responses cannot take place without stimuli

  • Erber pointed out that we must pay attention to the stimuli that are presented to a child

    • Including systematically assessing by stimulus type

  • He also pointed out that the listener may exhibit different levels of response, depending on the stimulus

    • He included the following table in his 1982 book

  • The Erber model suggests that a syllable is a lower level stimulus than the sentence because the syllable is less complex than a sentence

  • It’s possible, however, to work with the stimulus hierarchy from the opposite direction as well

    • For example, it may be difficult for a child to recognize the word “fizzy” when presented in isolation, but when it appears in the sentence “fizzy soda pop tickles my nose”, there is a semantic context and syntactic information as well

    • These multiple cues provide redundancy in the signal and various meanings for the understanding of the word “fizzy”

<ul><li><p><span style="background-color: transparent;">Auditory responses cannot take place without stimuli</span></p></li><li><p><span style="background-color: transparent;">Erber pointed out that we must pay attention to the stimuli that are presented to a child</span></p><ul><li><p><span style="background-color: transparent;">Including systematically assessing by stimulus type</span></p></li></ul></li><li><p><span style="background-color: transparent;">He also pointed out that the listener may exhibit different levels of response, depending on the stimulus</span></p><ul><li><p><span style="background-color: transparent;">He included the following table in his 1982 book</span></p></li></ul></li><li><p><span style="background-color: transparent;">The Erber model suggests that a syllable is a lower level stimulus than the sentence because the syllable is less complex than a sentence</span></p></li><li><p><span style="background-color: transparent;">It’s possible, however, to work with the stimulus hierarchy from the opposite direction as well</span></p><ul><li><p><span style="background-color: transparent;">For example, it may be difficult for a child to recognize the word “fizzy” when presented in isolation, but when it appears in the sentence “fizzy soda pop tickles my nose”, there is a semantic context and syntactic information as well</span></p></li><li><p><span style="background-color: transparent;">These multiple cues provide redundancy in the signal and various meanings for the understanding of the word “fizzy”</span></p></li></ul></li></ul><p></p>
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Auditory processing model strategy 1

  • Assess auditory skill levels

  • Auditory skills hierarchy has provided a model for assessment and intervention for decades

  • Prior to universal newborn hearing screening, the development of cochlear implants, and the early fitting with hearing technology, audition was far less likely to develop with other developmental domains

    • A child’s auditory skills developed more slowly and often required specific teaching that targeted small steps

  • The Erber hierarchy and others that were based on Erber’s model, enabled us to monitor progress and set specific listening goals

  • We have not stopped with Erber’s basic hierarchy, you will find expansions of Dr. Erber’s hierarchy to include skills that have been proposed as essential to the comprehension of spoken language

    • When a child begins understanding sentences, and longer stretches of conversation, including following directions or telling stories, he is utilizing memory and sequencing ability

    • If a child is making slow progress understanding spoken language, assessment of memory and sequencing may be helpful to identify a difficulty in general cognitive ability or executive functioning beyond the effects of hearing loss

    • We can go further and consider the auditory skills necessary to make sense and learn from conversation, and verbal instruction

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Functional Assessments and Checklists

  • These checklists employ auditory hierarchy and most closely follow the Erber hierarchy

    • You will find that as the level of auditory processing increases, there is more specification with regard to the language that is being processed

    • Integrating receptive language acquisition and auditory comprehension

  • Parent questionnaires

  • Caleffe-Schenck and Anderson Auditory Skills Checklists

  • Functional Auditory Performance Indicators

  • St. Gabriel’s Checklists

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IT-MAIS

  • Infant-Toddler Meaningful Auditory Integration Scale by Zimmerman-Phillips, Robbins, and Osberger

  • Adaptation of the meaningful auditory integration scale

  • Both are parent interviews that were developed as a means of tracking a child’s responses to auditory stimuli pre- and post- cochlear implantation

  • IT-MAIS is more commonly in use because children typically receive cochlear implants in infancy or toddlerhood today

  • LEAQ vs IT-MAIS 

    • Both auditory questionnaires meant for parents

    • LEAQ: self administered questionnaire yes or no questions

    • IT-MAIS: interview, open-ended questions then write in verbatim what the parent answered then the clinician will rate based on the answer of the parent

  • 10 questions (0-4)

    • Responses of the parents are actually recorded in verbatim and then later on scored from 0 to 4 by the clinician

    • 0 = never, 1 = rarely, 2 = occasionally, 3 = frequently, 4 = always

  • 3 Main Areas: Vocalization, Alerting to Sound, Deriving Meaning From Sounds

    • Age Equivalence*

      • Was derived from a study using the  IT-MAIS

  • Score Sheet used to summarize the responses of the parents

    • Under the parent report column, the verbatim responses of the parent should be listed there and then later on the score should be encircled per question and then the total score will be computed as well

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Cincinnati Auditory Skills Checklist

  • Auditory Processing Model Parent Questionnaire

  • questionnaire designed to track a child’s auditory responsiveness over time

  • The items are classified according to the response levels in the Erber hierarchy:

    • Detection

    • Discrimination

    • Identification

    • Comprehension

  • The checklist allows for a more refined look at a child’s progress over time rather than answering yes/no questions

  • Each question is answered according to this scale:

    • S (often)

    • E (sometimes)

    • D (never/rarely)

  • Each response receives a different point value 

  • The total points give a measure of the child’s responsiveness

  • Authors recommend that the assessment be administered every 3 months

  • Results can be supplemented by observation

  • The point system assigned to each of the responses are 0,1, or 2 

  • Performance is scored in terms of the total amount of points out of the possible 70 and also by the change in scores over time

  • Nancy Calleffe-Schenck (1992)

    • First to create the auditory skills checklist 

There are 27 items that each describe an auditory behavior preceding from auditory awareness, detection, and finishing with listening on the telephone and background noise

  • It should be rated as none, sometimes, often, always

  • Karen Anderson (2004)

    • Checklist was re-organized into 10 levels

    • Response was modified into 

      • Emerging

      • Inconsistent

      • Acquired

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Functional Auditory Performance Indicators (FAPI)

  • The profile of the child’s functional auditory skills is generated after administering all the items in the profile

  • The 7 categories are hierarchical, in addition, auditory performance indicators in each category are listed also in hierarchical order.

    • Note that while the scale is hierarchical, it is appropriate for the child to be working on the skills at the same time.

    • Approximately, 4-8 skills can be addressed simultaneously

  • By working on multiple skills from different categories, the child will be learning an integrated approach to an auditory skill development

  • Each category has several stimulus probes

  • The performance on each probe is elicited in 3 presentation conditions:

    • With visual cues

    • At close range (within 3 ft.) 

    • At a distance 

  • The child’s response to the probe is scored along the four levels of attainment

    • Not present

    • Emerging

    • In process

    • Acquired

  • By dividing the earned scores or the total numbers of possible points, the child receives percentage score for this category

  • In this example, the earned score is 58 points which is divided by the total possible score of 72 points (58/72) 

    • The child receives a percentage of 80.5 for this category

  • Once the category score is determined, this score would be filled out in the performance profile:

  • After shading the appropriate cells that corresponds to the scores, we will note which of the 7 categories are already acquired, in process, emerging, or not present

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Sound awareness, Sound is meaningful, Auditory feedback, Localisation, Auditory discrimination, Short term auditory memory, Linguistic auditory processing

Functional Auditory Performance Indicators (FAPI)

  1. Where we look into how the child is aware that an auditory stimulus is present; The child may demonstrate awareness of loud environmental sounds, noisemakers, music, and/or speech

  2. Would test if child can attend to sounds and associate a variety of stimuli with their sound source

    • Loud environmental sounds, noisemakers, music, vocalizations, and speech stimuli

    • A child may simply attend to a sound which is relatively easy or the child may match the sound with its sound source which is a more difficult skill

  3. We look into if the child can monitor the sound he/she hears

  • A child may demonstrate this skill when responding to sound when amplification is turned on, by vocalizing in order to monitor whether amplification is working, and/or by noticing his/her own vocalizations

  1. The child searches for and refines the auditory stimulus. Searching is a prerequisite for localizing. Children with hearing in only one year may not be able to localize to the sound source that is why this is not applicable to them

  2. Looks into how a child distinguishes the different characteristics of different sounds including environmental sounds, suprasegmental characteristics of speech, non true words, and true words

  3. Looks into how the child can hear, remember or repeat and recall a series of numbers. This scale is developmentally appropriate who are 2 years of age or older. Numbers are used in order to isolate the skill which is auditory memory

  4. The child is observed if he/she can utilize auditory information to process language. This category measures the ways in which audition is used to sequence language, learn and use morphemes, to learn and use syntactic information, and to understand spoken language

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St. Gabriel’s Checklist

  • Checklist across multiple developmental domains

    • Commonly associated with the auditory memory domain 

    • However, it also consists of multiple developmental domains

  • Most domains: referenced to the age at attainment by typically developing children

    • In this checklist, each of the item is categorized according to the auditory skills hierarchy

  • Auditory memory domain: increasing complexity

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St. Gabriel’s checklist - strategy 1

  • Before administering any assessment: 

    • Check equipment to be sure it is working optimally

    • Conduct Ling 6 sound test to ensure that the child listening at his best

  • Select tool appropriate to a child’s developmental age

    • The assessments and checklists described here vary with regard to ages targeted and the thoroughness that age levels are described

    • We may need to read through an assessment or checklist to determine if it’s appropriate for your child or patient

  • What skill do you like to assess?

    • Does the assessment yield information that you could use for planning for this particular child?

    • Some assess very early awareness and identification skills, while others assess response to scores and some higher listening skills

  • Is the language level that is assessed appropriate for the child under consideration? 

    • Look over the checklist to get a sense of the stimuli that are assessed

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St. Gabriel’s checklist - strategy 2

  • Assess discrimination/identification

    • In this context, discrimination and identification is used interchangeably 

    • Discrimination: common task in listening assessments and training curriculum developed for children with hearing loss

      • To find out what the child was able to hear

      • What the child was able to hear with hearing technology

      • To find out whether child is attending to speech auditorily or inordinately dependent on visual cues 

  • Hearing technology may not allow the child to hear all the important differences between speech sounds that separate them as phonemes in the child’s language

    • We need to know what the child can discriminate easily and what presents a challenge

  • Discrimination assessment can identify the speech contrasts that require more focus input and practice so that the child can actually perform well

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Informal assessment, Picture identification, Syllable identification, Information from audiological speech perception testing, Open set tasks

Tasks that Examine a Child’s Ability to Discriminate and Identify Speech Sounds (5)

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Informal assessment

  • Tasks that Examine a Child’s Ability to Discriminate and Identify Speech Sounds

  • By noting what the child understands or fails to understand in conversations or in play

  • Particularly useful for young children

  • E.g. Parents and professionals can set up the environment and have the child help clean up, naming toys for the child to pick up, and taking note of any confusion that the child might make when identifying toys that an adult names

  • For example: Asking the child to pick up the car, pick up the bubbles, pick up the ball

    • In this sense, you’re observing if the child is identifying the words that you are saying through auditory alone

  • in informal assessment, you could also use some of the information in the checklist to have an idea of whether the child can start discriminating already

  • in the IT-MAIS, you can see the items/test questions that look into discriminating speakers voice or speech vs. non-speech sounds

  • in the Cincinnati Auditory Skills Checklist, there are a number of discriminations that are listed there as well

  • Same goes with the anderson auditory skills checklist

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Picture Identification

  • Tasks that Examine a Child’s Ability to Discriminate and Identify Speech Sounds

  • Something very familiar to us

  • This task is used for children who are ready for more structured assessment

  • A group of pictures or objects are placed before the child, the names of the items differ in speech feature that would be discriminated

  • For example: in order to evaluate a child’s ability to discriminate vowels, the child can be asked to point a to a specific picture between bed, beede, bad, and bug, the clinician names a picture, and the child selects a picture corresponding to the word that he hears

  • In order for this task to be valid, the child must know the names of all the objects or pictures before him

  • It is important therefore to preview the items on an assessment to make sure that it is appropriate for the child

  • In the case of discrimination testing, it is okay to pre-teach the words on the assessment because you are not testing vocabulary, you are evaluating whether or not a child can hear the differences among words

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Syllable identification

  • Tasks that Examine a Child’s Ability to Discriminate and Identify Speech Sounds

  • Some assessments have the child select from non-sense syllables that vary in speech feature being evaluated

  • For example: there might be 4 cards with the syllable printed on each card, cha, ta, sa, and sha

  • The teacher or the clinician reviews each card with the child or maybe if the child can read, the child can read each card aloud prior to testing to ensure the child understands what is represented in each card, this requires the child to have some reading ability

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Information from audiological speech perception testing

  • Tasks that Examine a Child’s Ability to Discriminate and Identify Speech Sounds

  • Audiological assessment of speech recognition can yield useful information about the child’s ability to discriminate speech

  • When speech recognition is assessed, it is assessed audiologically, and when it is assessed audiologically, children repeat words or point to pictures in response to speech delivered at an intensity equivalent to conversational levels

  • Ordinarily, the audiologist will report the speech recognition score in percentage form, if the audiologist receives a request in advance he or she may be able to provide the list of words that were presented and any errors the child gave

  • a comparison of the stimulus and the child’s error enables us to discover what sorts of discriminations provide a challenge to the child

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Open set tasks

  • Tasks that Examine a Child’s Ability to Discriminate and Identify Speech Sounds

  • means there are no choices

  • in here the child is just listening without any choices

  • this can be as simple as repeating the actual word that is heard 

  • we could actually give them a list of words of different phonetically balanced words that each of the child will have to repeat 

  • it can also be a sentence list as well

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Early Speech Perception Test, Compass Test of Auditory Discrimination, Word Intelligibility by Picture Identification, Glendonald Auditory Screening Procedure

Types of Picture Identification (4)

  1. very popular that we use

  2. Is also something that we can use for testing for identification

  3. Once the child performs wells with the ESP or GASP, the word intelligibility by picture identification test is utilized

  4. Early speech perception test followed by GASP

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Auditory processing model - strategy 2

  • Device check, ling 6 sound test

  • Pay attention to how a child responds to your input as early as the start of the ax period

    • what do you notice? are there any misperceptions? can you identify whether a child has confused one word for another? if so, what speech sounds have been confused? is there a misperception of syllable number?

    • these observations may help indicate whether you might want to engage in a more specific assessment of discrimination

  • Consider use of functional ax/checklists

    • consider using one of the functional assessments or checklists that include discrimination among the skills considered

    • do any include discriminations that are of interest to your assessment of your particular child? and are age appropriate? if so, then maybe you can use it to further your assessment

  • Consider structured assessment

    • are these relevant to the child? 

    • look over the words used and determine whether the vocabulary is appropriate or if training is needed prior to the administration of the test

    • these assessments are not particularly interesting for a child

    • it is a listen point, listen point, again and again and again

    • none of these structured assessments are standardized, so you can be a bit flexible in the administration

      • break the assessment into short episodes over several sessions if necessary and monitor the child for boredom

  • Refer back to the audiologist?

    • depending on the results of your assessment, you could refer back to the audiologists


  • We only have two strategies for remedial model for assessment

  • We are going to look at the specific picture identification tests that are necessary for us to study in order for us to use for our child