Introduction to Aural Rehabilitation

Lisa Bowers, Ph.D. CCC-SLP

Audiologic Rehabilitation
Services in the School Setting
Chapter Eight

Creation of an Individual(ized) Education

Plan (IEP)

Not all children with hearing loss receive an IEP

504 Plan

Child does not need specialized instruction or support

Child needs accommodations to have access to education

Modification vs. Accommodations

Individualized Education Plan (IEP)

Should include the following:

Familys preferred mode of communication

Childs current level of performance
Childs strengths
Childs linguistic needs
Academic progress
Social/emotional needs
Appropriate accommodations to ensure learning

Outline of an IEP

List of things that should be included in a formal IEP

1) Statement of present level of performance

2) Statement of annual goals
3) Short-term instructional objectives
4) Special Education and related services to be
provided
5) Extent of participation in the regular
educational program
6) Projected date for services to begin
7) Anticipated duration of services
8) Appropriate criteria to determine if objectives
are
achieved

9) Evaluation procedures to determine if

objectives are achieved
10) Schedules for review
11) Assessment information
12) Placement justification statement
13) Statement of how special education
services are tied to the regular education
program

Example IEP -

includes current status, annual

goals and short-term objectives
Domain

Status

Annual Goal

Short-term
Objective

Audiologic

Can discriminate two

utterances that differ in
syllable length and
intonation, such as
Hello from How are
you?

To achieve closed-set
identification of
monosyllabic everyday
words

Will correctly identify a spoken

word when presented in the
context of four then six
alternatives with 80%
accuracy

Language

Does not use bound

morphemes such as ed
or -ing

To establish consistent
use of word endings in
expressive and written
communication

Will demonstrate use of past

tense endings in 80% of
written samples and in 70% of
spontaneous and spoken
language samples

Speech

Neutralizes vowels and

omits final word
consonants

To improve speech
intelligibility

Will distinguish between /i/,

/a/, and /u/ in imitated speech
tasks with 80% accuracy, and
produce final consonants in at
least 50% of words spoken
during a spontaneous speech
task

Psychosocial

Does not follow

classroom rules

To demonstrate gradeappropriate classroom

behavior

Will receive positive

reinforcements for adhering to
classroom regulations, and
accumulate 100 pts during 3
mo period

Goals and Objectives

REMEMBER, Goal is the desired aim or

outcome and objective is a measurable result
expected within a particular time period

Role of the Audiologist

Test hearing and speech.

Maintain listening device and ALDs.
Assess central auditory function.
Assess classroom acoustics and make
recommendations.
Provide direct speech perception training.
Consult with multidisciplinary team.
Serve as educational audiologist in school system.

Educators Role
Provide academic instruction
Provide assessment and diagnosis
May or may not have background in
deaf education
Make modifications to regular education
curricula
Manage learning environment
Manage student behavior and social
skills

SLPs role

Teach the teacher

Strategies for optimal learning

How to use technology

Keep teacher updated on progress and goals

School and classroom placement

Equipment every school SLP needs:

1) Hearing aid stethoscope for listening check

2) Hearing Aid Battery tester
3) Air blower to remove moisture and wax
from tubing
4)Extra supplies (batteries)
Hearing aids/Cis need to be checked on a
daily basis

Strategies Teachers can use with HI

children in classroom:

Use visual aids

Get students attention before speaking
Encourage all students to help minimize the
noise level in the classroom
Face student when talking and avoid covering
mouth
Providing handouts to provide context cues
Preferential seating

Segmental Errors with Significant Hearing

Loss

Vowels errors

Neutralization and nasalization

Substitutions
Prolongations

Consonants errors

Voiced/Voiceless confusions
Substitutions, omissions, and distortions
Consonant cluster errors
Visible consonants produced better

Assessment of Hearing Impaired Children

Areas of testing by SLP:

Speech Assessment

Collect speech sample

Evaluate intelligibility

Method of measuring speech influences

intelligibility

Articulation/Phonology
Articulation:
GFTA-2
(GoldmanFristoe Test of
Articulation)
-CAAP(Clinical
Assessment of
Articulation and
Phonology)
-Arizona 3
-CID Phonetic
Inventory

Phonology:
KLPA-2(Khan-Lewis Phonological
Analysis, Second Edition)
HAPP-3 (Hodson Assessment of
Phonological Patterns)

Language Assessment

Language tests according to form, content, or

pragmatics

Form= Test for Auditory Comprehension of Lang (TACL) or Oral

and Written Lang skills (OWL)
Content= Peabody Picture Test
Function= Pragmatic Content Analysis
SKI-HI Language Development Scale
The Clinical Evaluation of Language Fundamentals (CELF-4)

Obtain language sample and analysis

Type-Token Ratio (TTR)

# of total words used compared to different words

Mean Sentence Length (MSL)

Mean # of words per sentence

Reading Skill Assessment

Develop instructional goals and
objectives
Few assessments designed for hearing
loss

May be different for HI students

Difficult to compare how doing compared to peers

Grade levels compared to hearing

children
Examine pre-literacy skills

Reading readiness

Reading and language comprehension

Phonology, syntax, semantics
Decoding

Auditory Tests

Tests that focus on use of audition in

language:

TACL (Test for Auditory Comprehension of Language)

TARPS (Test of Auditory Reasoning and Processing Skills)
TAPS-R and TAPS-UL (Test of Auditory Processing Skills)
APT-HI (Auditory Perception Test for the Hearing Impaired)
MUSS (Meaningful Use of Speech Scale )
TAC(Test of Auditory Comprehension)

Examples of Speech Therapy goals with HI

child:

Increase awareness suprasegmental

aspects of speech.
Improve speech intelligibility in
spontaneous communication
Increase vocalizations that have
appropriate speech characteristics.
Will imitate the suprasegmental
variables of loudness, duration, and
pitch/intonational contours.

Language Therapy

content, form and pragmatics are addressed in development of language

intervention plan

Increase or improve the following:

Parent-child communication
Comprehension of complex concepts
Vocabulary
World knowledge and self-expression
Use of syntax and pragmatics
Narrative skills