Lecture 14 School-Age Children

At preschool a child:

• is age 3-4

• Typically had early intervention service, which has equipped them for school-readiness.

• Likely to use a listening device

• Continue to use their communication mode

Children Who Have Mild Or Moderate Hearing Loss Or Unilateral Hearing Loss

• May have difficulty listening in noisy and reverberant classrooms

• May miss out on incidental learning when good ear is turned away

• May exhibit inattentive listening and may be accused of “selective listening”

• May fatigue more quickly

• May have academic delay

• May be at risk for language delay and mild articulation errors

• Will benefit from favorable seating

• May benefit from amplification and a soundfield FM system

Unilateral hearing loss

• One in 40 children

• May not receive an IEP

• Only about half try some for amplification or FM system

• Higher likelihood of receiving speech-language therapy and special education

• Higher incidence of behavioral problems

Mild hearing loss

• About 15% of children in the USA

• Thanks to newborn screening, they are being identified at an earlier age than in previous decades

• Many receive hearing aids

• Many receive an IEP

School-age Population

Develop the following items:

• Education plan

• Multidisciplinary team: a group of professionals with different expertise who contribute to the assessment, intervention, and management of a child (e.g., audiologist, speech-language pathologist, classroom teacher, psychologist)

• Aural rehabilitation intervention strategy

IEP’s include:

• Anticipated duration of services

• Criteria to determine if objectives are achieved

• Procedures to determine if objectives achieved

• Schedules for review

• Assessment information

• Placement justification statement

The Multidisciplinary Team

• All professionals providing expertise to IEP conduct evaluation, intervention, and management

• Professionals include:

  • Audiologist

  • Speech-language pathologist

  • School personnel, including teacher, itinerate teacher, psychologist, resource room teacher, interpreter

  • Parents

The Audiologist

Roles

• Test hearing and speech

• Maintain the listening device and ALDs

• Assess central auditory function

• Assess classroom acoustics and make recommendations

• Provide auditory and speechreading training

• Consultation

• Possibly, sign language instruction

The Speech-language Pathologist

Roles

• An ASHA survey revealed that 46% of school-based SLPs service children with hearing loss and have around three children with hearing loss on their caseload.

• Assessment speech, language, literacy, and speechreading skills

• Possess knowledge of listening devices and ALDs

• Provide direct speech-language and speech perception therapy, and auditory training

• Consultation with parents, teachers, and other team members

• Potentially, instruction for sign language or other modes of communication

• Recommend printed or video resources (Purpose of digital therapeutic presentation)

Classroom Acoustics

• Background noise muffles and distorts speech

• Reverberation

  • Signal reflected from walls, floor, or ceiling

  • Impacts speech recognition

  • Magnifies noise

  • Inverse Square Law

  • Decrease of 6dB every doubling of distance (typically 3 feet)

Strategies for reducing classroom noise

• Carpeting

• Rubber tips on chair and desk legs

• Acoustical panels, flannel, etc. on walls

• Window treatments

• HVAC modifications

• Reduced overall room size

• Low ceilings

Listening Devices

• FM devices are typical in classroom settings

• Personal microphones

  • teacher wears microphone and student wears receiver

• Environmental microphones (whole classroom)

• Audiologist serves as resource for teacher to ensure comfort with system

Other services could include:

• Class in-service

• School in-service

• Psychosocial support

• Communication strategies training for both parent and child