Aural Rehabilitation Final

redundant cues

Using ________ provided by both auditory and visual input, FISH is easier than FORK.

front articulators

Consonants produced with ______ are easiest to produce in terms of place but not manner.

lip rounding

Vowels are easiest when _______ is greatly different.

/s/

In Deaf speech,________ is often produced as a /t/or omitted entirely.

Visual

comfortable, bright lighting that illuminates face of the communication partner; optional viewing angle, and distance 3- 6ft from partner are all examples of what kind of communication strategy?

Homophones

words or phrases that look alike on the lips.

Words from ___ neighborhoods are recognized more quickly than words from ___ neighborhoods

Sparser; Denser

Visual distinctions between vowels

lip rounding (spread vs rounded) and jaw height (high vs low)

McGurk Effect

speech sounds are often miscategorized when auditory cues in the stimulus conflict with the visual cues from the speakers face.

Topic Related Sentences

Clinician presents a phrase or sentence about the agreed upon topic in the condition or manner appropriate for current goals (visual /auditory /both). Client has no printed information but knows the topic

For Deaf speakers,________ may be normal for non speech activities, but inefficient for speech.

respiration

Candidates for communication strategies

all clients with elevated hearing who use spoken language.

Cause of nasalization for Deaf speakers

VP port is not a visible articulator, accurate VP port manipulation is different without auditory feedback.

Effects of lack of eavesdropping

can affect pragmatics.

Vowels of deaf speakers are often

prolonged

Tongue body

________ does not move forward and back as much as typically hearing speakers.

Visual discrimination is easier when

place differs greatly.

Recorded stimuli advantages

more consistent baseline and post Tx measures, client can work at own pace, independently, or at home.

Initial consonant discrimination _____ than medial or final

easier

Vowels of Deaf speakers

may be neutralized or dipthongized.

Consonant Visemes

phonemes with the same place of articulation (voicing /manner differences)

Auditory Communication Strategies

reduce background noise, reduce reverberation, HoH sit facing wall in noisy place.

Vowels

________ are more intelligible because they are easier to produce, hear, and more acceptance of different vowel productions by listeners.

Speechreading tests for children

test of child speech reading (ToCS), Gist Test, Childrens Audio Visual Enhancement Test (CAVET)

Speechreading tests for adults

CUNY sentences, UTLey sentence test, Denver Quick Test, recorded materials

Live stimuli advantages

more personal, therapist can adjust level of difficulty on the spot, therapist can monitor interest and frustration

Recorded stimuli advantages

more consistent baseline and post Tx measures, client can work at own pace, independently, or at home

Homophones

words or phrases that look alike on the lips

McGurk Effect

speech sounds are often miscategorized when auditory cues in the stimulus conflict with the visual cues from the speakers face

Goal

compensate for the effects of elevated hearing on interpersonal communication

Candidates

all clients with elevated hearing who use spoken language

Informal

unstructured conversion or with patient alone or with significant other or HoH individual

Quantify Mean Length of Turn (MLU)

count of words or amount of time both conversational partners speak/ of turns

Formal

structured communication assessments and questionnaires

Visual

comfortable, bright lighting that illuminates face of the communcation partner; optional viewing angle, distance 3-6ft from partner

Auditory

reduce background noise, reduce reverberation, HoH sit facing wall in noisy place

Physical Comfort

find a comfortable place that will not add stress

Respiration

Basis of all speech production

Vocal Pitch of Deaf Speakers

failure to maintain even pitch, abnormally high pitch

Intensity of Deaf speech

too loud or too soft, inability to adjust level for different noise conduction

Pauses in Deaf speech

due to need for air or effortful articulation, rather than to add information

Rate of Deaf speech

often slower, more effortful

Stress of Deaf speech

poor or no use. May be from unfamiliarity bc it is mostly an auditory event

Eavesdropping

incidental learning

Speech as a visual phenomenon

therapy with speechreading; informal imagery and visual cues

Speech as a physical phenomenon

tactile, kinesthetic feedback

Tactile way to distinguish voiced vs voiceless

hand on throat

Tactile way to distinguish Nasals

finger on side of nose

Tactile way to introduce production of stops vs constituents

difference of breath

Addition of background noise

makes any task more difficult

How can we use context to manipulate the hierarchy of difficulty?

Reduce contextual redundancy in order to encourage client to rely more on bottom up auditory or visual skills

Clear speech can improve speech reception by

11 to 34%

What does the McGurk Effect demonstrate?

Audiovisual integration, redundant cues in speech perception, and top down processing

What are the goals of communication strategy assessment?

to determine the need by assessing conversational fluency and style and to determine need for counseling to determine level of impact of elevated hearing on individual’s life

Mean Length of Turn

Number of words or amount of time for both conversational partner/# of turns

What is patient-centered facilitative communication strategies?

Using counseling techniques to help client develop self-confidence and physical wellbeing by preparing for communication strategies, learning to advertise, and encouraging patients to discuss and role play possible outcomes

What does WATCH stand for?

Watch the talker’s mouth, Ask for clarification, Talk about your hearing loss, Change the situation, and Healthcare knowledge (or helpful gestures)

Receptive Repair Strategies

Rephrasing, Elaborating, Requesting Topic, and Confirmation

What are maladaptive communication strategies?

dominating conversations to avoid communication breakdowns, withdrawing from conversations, bluffing (pretending to understand)

Respiration problems in Deaf speakers

poor biomechanical resistance at larynx and at supralaryngeal articulators and unintended extraneous emissions of air/sound

What are consonant errors associated with Deaf speech?

Plosives are often explosive, contributing to wasting of air; back consonants /g,k,h/ are hard to see, /r/ is often distorted, /s/ is often produced as a /t/ or is omitted

Common form errors in Deaf langauge

overuse of subject-verb-object structure, limited use of complex sentences, adverbs, prepositions, unusual word order, omission of articles, omission of plural markers, tense problems

Common content errors in Deaf language

concrete, restricted vocabulary, restricted use and understanding of idioms

Common pragmatic issues in Deaf language

Difficulties with turn taking and topic maintenance, lack of eavesdropping, difficulty with cultural style

What reading level do many Deaf children maintain?

4th

Why do Deaf children attain a low reading level?

Limited phonological awareness, less early exposure to books and reading, limited eavesdropping leading to reduced word knowledge and limited exposure to idioms, all due to over emphasis on spoken language in schools

Writing deficits in Deaf individuals

same as form and content of spoken language are common

Speech production formal tests

imitate words or short phrases, read a passage at appropriate reading level, relate a story from a set of pictures, spontaneous speech sample

How to evaluate speech from a recorded sample

Phonetically transcribe results and catalog errors or have naive or familiar others listen and determine rate of intelligibility, write what they hear, or phonetically transcribe what they hear

Speech therapy for Deaf speakers

breath control exercises, articulation practice with breath control, production of child’s name, maintain high but realistic expectations for “correct” pronunciations

How to work on speech production when there is little or no hearing

work on speech as a visual or physical phenomenon

Fill in the blank phrases

* Practice speech perception (task can be auditory, visual, or both)
* Client has printed sentences, clinician produces entire sentence, client must fill in missing words

Gap Sentences

* Client has printed materials
* Clinician produces the entire sentence
* Client must fill in the blank
* Harder than fill in the blank bc less information is provided

Discourse Tracking

* Clinician reads aloud from material that is appropriate for client’s age and interests, one phrase or sentence at a time
* Client must repeat verbatim

How is progressed tracked during discourse tracking

percent correct or time spent to accomplish repetition

_____ is easier than gap sentences

fill in the blank

_____ is easier than topic related sentences

gap sentences

discourse tracking is harder than

topic related sentences

Sabotage

purposefully setting up a difficulty condition for client to encourage use of desired communicative act or strategy