AR exam 2

• awareness (detect presence/absence of sound): child must learn to pay attention to sound & to respond when sound is present. Detection capacity is determined by the integrity of the peripheral auditory system (detection performance may be poorer than detection capacity) Ex: peek-a-boo, noise makers, musical chairs
• discrimination (differentiate same/diff or pattern perception): pattern perception- discrimination based on number of syllables. Discrimination capacity is determined by the integrity of the cochlea. Ex: animal sounds, same/diff games.
• identification (label some auditory info & suprasegmentals): involves suprasegmentals (prosodic elements) & segmentals (individual speech elements.) identification capacity is determined by the neural system. Ex: labeling body parts, animals, colors; play Candyland & listen to the name of colors; play Go Fish & listen for the numbers. 
• comprehension (understanding of spoken lang): following oral directions, answering questions about a story, giving the opposite of a word, communicating appropriately. Comprehension necessitates the skills of auditory memory & sequencing. Ex: I Spy, stories, songs.

• analytic training: focuses on segments of speech (phonemes & syllables); emphasizes recognition of acoustic cues; bottom up- building blocks of speech sounds (% correct phonemes/words
• Vowels: more intensity in lower freq, thus more audible to most; vowels formants
• Consonants: focus on place, manner, & voicing. 
• Objectives: goal (desired outcome); objective (measured outcome); establishment sound awareness; discrimination of suprasegmental aspects (stress, tone, intonation, length); recognition of vowels & consonants. 
• synthetic training: recognizes meaning of whole message (may not comprehend all isolated sounds); top down- higher order processing (% correct sentences). Individuals learn to recognize the meaning of an utterance even if they don’t recognize every word (sentence comprehension in story format.) discriminate b/w a declarative & interrogative sentence (how are you; you are fine;) will carry on a conversation; can follow the instructions of simple commands. 
• Objectives: awareness of suprasegmentals, discrimination of suprasegmentals, identification of syllable number, progression from single-word to multi-word utterances, closed-set comprehension activities, open-set comprehension activities.

• formal training: structured individual or group; usually 1-on-1. Guidelines- training stimuli should become more challenging over time; a variety of talkers should speak training items; many training items should be presented during a relatively short period of time; non-speech stimuli should only be used with young students for a short period of time or prelingual CI adults.
• informal training: incorporated into everyday situations (daily routines.) fostering listening skills within the context of meaningful communication (especially appropriate for babies & young children;) methods to consider- minimize background noise in home; use lang & speech that is repetitive, melodic, expressive & rhythmic.

• vary set size: closed set (person knows the stimuli prior to activity. Ex numbers, colors); limited (defined by context cues. Ex holidays, sports, farm animals); open (person not familiar with stimuli prior to activity (sentence tests not previously used for training)
• vary stimulus unit: words, phrases, sentences
• vary stimulus similarity: begin with acoustically dissimilar stimuli & work towards acoustically similar stimuli. Dissimilar (easier)- hi vs good morning. Similar- good morning vs good evening. 
• Vary amount of stimulus context: stimuli high in environmental or linguistic context easier to recognize. Low context- nonsense sentences & words. High context- the big bad wolf huffed & puffed after reading the 3 little pigs. 
• Vary stimuli by using structured vs spontaneous tasks: drills vs milieu learning. Structured- card matching & labeling. Spontaneous- spontaneous conversation while person is engaged in an unrelated activity. 
• Vary the listening environment: ex- speech-in-noise tests with varying SNRs. (15, 10, 5dB)

• auditory skill level
• stimuli units
• activity type
• difficulty level

awareness, discrimination, identification, comprehension

Consonants: easiest- voicing cues, manner cues. Difficulty- place features

uses a moderately loud conversational level; is characterize by precise but not exaggerated articulation; pauses at appropriate linguistic boundaries; uses a somewhat slow speaking rate. 

Easier/harder: closed/open stimulus set; words/sentences stimulus unit; not/very stimulus similarity; high/low context; structured/spontaneous task; good/poor S/N ratio.

Learning & comm. Enhancement (LACE) results in improved performance on listening tasks. 

• Lipreading: person relies on only the visual signal provided by the talker’s face for speech recognition
• Speechreading: person relies on both visual & auditory cues provided by a talker for speech recognition (also includes other cues such as expressions, gestures, context.)

• consonants more visible: bilabial closure (p, b, m); fricative (f, v); labiodental (th)
• consonants least visible: inside mouth (k, g, t, n)
• vowels not highly visible. May or may not be distinguished by spread of lips, tongue/jaw height, lip rounding. 

• Visemes: groups of speech sounds that appear identical on the lips
• Homophones: words that look identical on the mouth; may vary. 

• Spoken words activate internal lexical candidates (lexical neighborhood); one of the members of the neighborhood matches/completes the incoming stimulus; acoustic lexical neighborhood (comprised of words that sound alike with the exception of a single phoneme) 
• Auditory only: top-down processing- members of neighborhood are activated with onset of spoken word & candidates are eliminated as word unfolds until only 1 candidate remains. 
• Visual lexical neighborhoods: groups of words that look alike on the face & have approx the same freq of occurance. 

• Analytic & synthetic training objectives.
• Computerized: computer assisted speech training (CAST)- for CI, mainly children. Sound & way beyond (cochlear corp) 
• Efficacy: difficult to compare; many studies report training improves performance, but not all; many report marginal or no improvement; reported results often inconclusive or present contradictory findings; some show practice effects. 

talker, message, environment, person with hearing loss

Instructional strategies: people with hearing loss use to influence comm. partner’s speaking behaviors; a person asks a talker to change the delivery of the message. Person with HL must ID behaviors that impede their speech understanding, & be able to instruct comm. partner how to change the behavior.

• Message-tailoring strategies: influence the way someone constructs a message; a way of phrasing one’s remarks to constrain the response of a comm. Partner; how to best say something in order to get the desired response.
• Acknowledgment gesture: made in response to a remark from a comm. Partner who is familiar with that sort of signaling; could be a nod or head shake; can lead to bluffing. 

Constructive strategy: tactic designed for optimizing listening environment for comm. 

• Adaptive strategies: methods of counteracting maladaptive behaviors that stem from HL. Ex: every time you bluff, put a dollar in jar; social withdrawal- meditation; ask others to repeat. 
• Anticipatory strategies: methods of preparing for a comm. interaction. Ex: go to new restaurant, expect noisy background & you get mad when you cant hear what the server is saying- look up menu online before hand. 
• Maladaptive strategies: inappropriate behavioral mechanism for coping with the conversation difficulties caused by HL. Sometimes yield short-term benefits, but have long term costs. Bluffing, social withdrawal, dominating conversations, anger, hostility, self-pity.  

• Specific: provide explicit instructions to comm. partner about how to repair conversation breakdown.
• Non-specific: indicate lack of understanding

• Receptive: utilized when recipient of message does not understand the meaning (specific or nonspecific) 
• Expressive: used when talker (person w/HL) sends an unintelligible message & comm. partner cannot understand it; often children & prelingually deafened. 

Be able to identify different stages and courses of action in communication breakdown including repairs (i.e., topic shading, non-specific repair, rephrasing,  verbatim repetition etc.)

• Passive: person tends to withdraw from conversations & social interactions rather than attempt to repair conversations. Tend to bluff, speak with quiet tone, use little eye contact.
• Aggressive: protect their rights at expense of others; need to win the conversation. Tend to blame others for misunderstandings; display hostility; shouting/soapbox speech; excessive body gestures; intimidating- inappropriate body gesture, eye contact. 
• Passive-aggressive: aggression is expressed in indirect ways. Tend to use sarcasm, behave passively face-to-face then aggressively behind one’s back; exhibit sullenness, stubbornness, procrastination
• Assertive: takes responsibility for managing comm. difficulties in a way that is considerate of comm. partners. Tend to be respectful, use appropriate eye contact/body lang, acknowledge comm. partner’s efforts to promote good comm. 

• MLT: average number of words spoken during set of conversational turns
• MLT ratio: add up number of words each talker says. Divide by number of turns. Divide by the two talkers. 

• Self efficacy: the confidence that one has for successfully performing a particular task, activity or challenge. How well person thinks they can manage difficult comm. situations.
• Mastery experience: direct experience in a successful comm. interaction
• Vicarious experience: person sees other people with HL succeed
• Verbal persuasion: clinician or AR professional tells they can succeed & gives tools to assist
• Emotional arousal: relaxation or breathing techniques to reduce stress 

develop curriculum, gather materials, set ground rules

individuals are provided with info about various types of comm strategies & appropriate listening & speaking behaviors. Try to involve group discussion opportunities to avoid boredom. 

attendees use comm. strategies in controlled, structured setting. Can consist of modeling, role play, analysis of scenarios, computer-based interactions, continuous discourse tracking 

individuals perform new comm. strategy, skill, behavior in an everyday environment. Includes activities that have previously been performed with success in the classroom; require them to comm. & interact in a highly motivating setting. 

• Materials approach: providing printed & recorded materials
• Short tutorial: do not always result in significant changes in comm. strategies/ conversational fluency, comm. in general 

Children: older children can benefit from comm. strategies training; can use formal instruction, real world learning, or combo of both. Training should focus on effective listening behaviors; teach kids how to ask for clarity if they did not understand or hear a message; teach kids other ways to comm. if they cannot verbalize what they want to say, or is what they are verbalizing is not understood. Begin with formal instruction/ guided learning then transfer to real world training.