Overview

In this day and age, we are dealing with a vastly different population of children with hearing loss, a population that never before in history have we had. With this new population, whose hearing loss is identified at birth, we can now prevent the developmental and communicative effects of hearing loss that were so common just a few years ago. With these babies and young children, we can now work primarily from a developmental and preventive perspective rather than from a remedial, corrective one. What has happened in the field of hearing loss is revolutionary.

This second edition of Developing Listening and Talking, Birth to Six remains a dynamic compilation of crucially important information for the facilitation of auditorally-based spoken language for today's infants and young children with hearing loss.

This text is intended for graduate level training programs for professionals who work with children who have hearing loss and their families (teachers, therapists, speech-language pathologists, and audiologists.) In addition, the book will be of great interest to undergraduate speech-language-hearing programs, early childhood education and intervention programs, and parents of children who have hearing loss. Responding to the crucial need for a comprehensive text, this book provides a framework for the skills and knowledge necessary to help parents promote listening and spoken language development.

This second edition covers current and up-to-date information about hearing, listening, auditory technology, auditory development, spoken language development, and intervention for young children with hearing loss whose parents have chosen to have them learn to listen and talk. Additions include updated information about hearing instruments and cochlear implants and about ways that professionals can support parents in promoting their children’s language and listening development. Information about preschool program selection and management has been included. The text also features a revised auditory development checklist.

A new appendix provides an important and useful tool for professionals who are interested in AG Bell Academy's Listening and Spoken Language Specialist Certification Program (LSLS) -- LSLS Cert. AVT and LSLS Cert. AVEd. This appendix lists the competencies required for the LSLS, and references each chapter of the book with regard to those requirements.

This book is unique in its scholarly, yet thoroughly readable style. Numerous illustrations, charts, and graphs illuminate key ideas. This second edition should be the foundation of the personal and professional libraries of students, clinicians, and parents who are interested in listening and spoken language outcomes for children with hearing loss.

Reviews

• Sarah Holden, M.S., George Washington University, Doody's Review Service, (February 2011):
  "Topics range from neurological foundations of listening, the auditory system, and diagnosis of hearing loss to key intervention issues and strategies. The book is a quick reference for students/parents to support interpretation of testing, but provides greater detail in the area of intervention and ways to promote listening and talking through interactions. The information is presented in a way that is easy to understand and that would be useful to students and parents. Overall, this book provides a solid overview of key issues related to developing listening and spoken language skills in children with hearing loss for parents and students. Basic information in a broad range of areas relevant to the topic is presented in a way that is easy to read and understand."

• Mary Pat Moeller, PhD, Director, Center for Childhood Deafness, Boys Town National Research Hospital, Boys Town National Research Hospital, (May 2011):
  "I want to commend the authors for developing this wonderful resource! In my opinion, parents, educators and clinicians will find very helpful guidance from this book. I especially appreciated the integration of child language concepts and the integrated approach to listening development. This is a must-read."

• Rachel Millward, Speech-Language Therapist,, Speech & Language Therapy in Practice, (Winter 2011):
  ""This detailed book looks at the skills and knowledge needed to promote the development of spoken language through listening in young children and babies with a hearing loss. Despite its length it is very readable. Each chapter's 'key points' give a clear and concise explanation of the information to come. The comprehensive contents page makes it quick and easy to look up specific information. Early chapters provide a good overview of hearing loss, with information on terminology, technology, the structure and function of the ear, and causes. It includes data on good language learning environments and early language development. Later chapters look at intervention and are more practical, exploring strategies and activities for working with families. The appendices provide some interesting frameworks and checklists. Whilst the book refers to American terms and systems, the information is still useful. In places it is slightly repetitive (for example, the importance of goo early hearing technology) and would benefit from more therapy suggestions, examples and sample sessions. However, I would recommend it as a detailed reference for students, a good resource for those new to the field and a refresher for more experienced clinicians, particulary with its discussion around recent research. I certainly enjoyed reading it and will dip into it again.""

Audience

Primary Subject: Pediatrics
Secondary Subject: Audiology / Pediatrics
Secondary Subject: Speech and Language Pathology / Pediatrics
Audience Level: Textbook - Desk Copy

• Neurological Foundations of Listening and Talking
  Key Points Presented in the Chapter
  Introduction
  Typical Infants: Listening and Language Development
  Auditory Neural Development
  Multiple Definitions for the Terms: New Context for the Word “Deaf”
  Hearing Versus Listening
  A Model of Hearing Loss: The Invisible Acoustic Filter Effect
  Summary: The Question That Drives Technological and Intervention Recommendations
• The Auditory System
  Key Points Presented in the Chapter
  The Nature of Sound
  • Unconscious Function
  • Signal Warning Function
  • Spoken Communication Function
    Acoustics
  • Audibility versus Intelligibility of Speech
  • The Ling 6-7 Sound Test: Acoustic Basis and Description
    Ear Mechanisms
  • Data Input Analogy
  • Outer and Middle Ear
  • Inner Ear to the Brain
• Hearing and Hearing Loss in Infants and Children
  Key Points Presented in the Chapter
  Introduction
  Classifications
  • Degree (Severity)—Minimal to Profound
  • Timing—Congenital or Acquired
  • General Causes—Endogenous, Exogenous, or Multifactorial
    Genetics, Syndromes, and Dysplasias
  • Connexin 26
  • Syndromes
  • Inner Ear Dysplasias
    Medical Aspects of Hearing Loss
  • Conductive Pathologies and Hearing Loss
  • Sensorineural Pathologies and Hearing Loss
  • Mixed, Progressive, Functional, and Central Hearing Losses
  • Synergistic and Multifactorial Effects
  • Auditory Neuropathy/Dyssynchrony (AN/AD)
    Summary
• Diagnosing Hearing Loss
  Key Points Presented in the Chapter
  Introduction
  Newborn Hearing Screening and EHDI Programs
  Test Equipment and Test Environment
  Audiologic Diagnostic Assessment of Infants and Children
  • Test Protocols
  • Pediatric Behavioral Tests: BOA, VRA, CPA, Speech Perception Testing
  • Electrophysiologic Tests: OAE, ABR/ASSR, and Immittance
    The Audiogram
  • Configuration (Pattern) of Thresholds on the Audiogram
    Formulating a Differential Diagnosis
  • Sensory Deprivation
  • Ambiguity of Hearing Loss
    Measuring Distance Hearing
    Summary
• Hearing Aids, Cochlear Implants, and FM Systems
  Key Points Presented in the Chapter
  Introduction
  For Intervention, First Things First: Optimize Detection of the Complete Acoustic Spectrum
  • Listening and Learning Environments
  • Distance Hearing/Incidental Learning and S/N Ratio
  • ANSI S12.6-2002 Acoustical Guidelines
  • Talker and Listener Physical Positioning
    Amplification
  • Hearing Aids/Hearing Instruments
  • Bone Anchored Hearing Aid (Baha)
  • Assistive Listening Devices (ALDs): Personal-Worn FM and Sound Field FM and IR (Classroom Amplification) Systems
  • Wireless Connectivity
  • Cochlear Implants
    Measuring Efficacy of Fitting and Use of Technology
  • Equipment Efficacy for the School System
    Conclusion
• Intervention Issues
  Key Points Presented in the Chapter
  Basic Premises
  Differentiating Dimensions Among Intervention Programs
  • Educational Options for Children with Hearing Loss, Ages 3 to 6
  • Challenges to the Process of Learning Spoken Language
• Auditory “Work”
  Key Points Presented in the Chapter
  Introduction
  The Primacy of Audition
  The Acoustics-Speech Connection
  • Intensity/Loudness
  • Frequency/Pitch
  • Duration
    The Effect of Hearing Loss on the Reception of Speech
    A Historical Look at the Use of Residual Hearing
  • The Concept of Listening Age
    Auditory “Skills” and Auditory Processing Models
  • Theory of Mind and Executive Functions
    How to Help a Child Learn to Listen in Ordinary, Everyday Ways
    Two Examples of Auditory Teaching and Learning
  • Scene I: Tony
  • Scene II: Tamara
    Targets for Auditory/Linguistic Learning
    A Last Word
• Spoken Language Learning
  Key Points Presented in the Chapter
  Introduction
  What’s Involved in “Talking”?
  How Does a Child Learn to Talk?
  Relevance for Intervention Decisions
  How Should Intervention Be Organized?
• Constructing Meaningful Communication
  Key Points Presented in the Chapter
  Introduction
  The Affective Relationship
  The Child’s Development of Interactional Abilities
  • Joint Reference
  • Turn-Taking Conventions
  • Signaling of Intention
    Characteristics of Caregiver Talk
  • 1. Content: What Gets Talked About?
  • 2. Phonology: What Does Motherese Sound Like?
  • 3. Semantics and Syntax: What about Complexity?
  • 4. Repetition: Say It or Play It Again
  • 5. Negotiation of Meaning: Huh?
  • 6. Participation-Elicitors: Let’s (Keep) Talk(ing)
  • 7. Responsiveness
    Issues about Motherese
  • How Long Is Motherese Used?
  • Motherese: Why?
  • Motherese: Immaterial or Facilitative?
• Interacting in Ways that Promote Listening and Talking: Parents, Therapists, and Teachers
  Key Points Presented in the Chapter
  Introduction
  The Emotional Impact of a Child’s Hearing Loss on the Family
  What Parents Need to Learn
  Components of Intervention for Babies and Young Children with Hearing Loss
  When to Talk with Your Child and What to Talk About
  A Framework for Maximizing Caregiver Effectiveness in Promoting Auditory/Linguistic Development in Children with Hearing Loss
  • Background and Rationale
  • Structure of the Framework
  • Getting a Representative Sample of Interacting
  • Discussing the Framework with Parents
  • Ways of Addressing Parent-Chosen Targets
    Teaching through Incidental and Embellished Interacting
  • Teaching Through Incidental Interacting
  • Teaching Through Embellished Interacting
    Parent Guidance Sessions or Auditory-Verbal Therapy Sessions
  • Components to Be Accomplished in a Typical Preplanned Session
  • Sample Preplanned Scenario
  • Substructure
  • About the Benefits and Limitations of Preplanned Teaching
• Appendix 1: How to Grow Your Baby’s/Child’s Brain
• Appendix 2: Application and Instructions for the Ling 6-7 Sound Test
• Appendix 3: Targets for Auditory/Verbal Learning
• Appendix 4: Explanation for Items on the Framework for Maximizing Caregiver Effectiveness
• Appendix 5: Checklist for Evaluating Preschool Group Settings
• Appendix 6: Selected Resources
• Appendix 7: Description and Practice of Listening and Spoken Language Specialists: LSLS Cert. AVT and LSLS Cert. AVEd.
• Appendix 8: Principles of LSLS Practice
• Appendix 9: Knowledge and Competencies Needed by Listening and Spoken Language Specialists (LSLS)
• Appendix 10: Listening and Spoken Language Domains Addressed in This Book
• References
• Glossary of Terms
• Index

About The Authors

Elizabeth Cole, Ed.D.

Elizabeth Cole, EdD, is the Director of Soundbridge, a statewide public school program that provides a wide variety of services to approximately 600 children (birth through secondary school) who are learning spoken language through listening. She is also an Adjunct Professor at the University of Hartford, and for the First Years program at the University of North Carolina. Prior to coming to Connecticut in 1996, Dr. Cole was a professor at McGill University in Montreal for 16 years, where she taught acoustic phonetics, language, speech, and aural habilitation courses to students in the Auditory-Oral (Re-)Habilitation and Education of Hearing-Impaired Children (AORE) program, as well as to audiology and speech-language pathology students. Most of her published articles, chapters, and books have been focused on how to foster listening and spoken language development in young hearing-impaired children.

Dr. Cole has credentials and experience as an audiologist, Auditory-Verbal Therapist, teacher of the hearing-impaired, French teacher, reading teacher, educational administrator, and professor. She has been working with children who have hearing loss in one capacity or another since 1973. Presently she is the Director of CREC Soundbridge, a statewide program that provides a wide array of services to approximately 600 children who have hearing loss and are users of spoken language. She is also closely involved as an Adjunct professor with the University of Hartford Master’s degree program in Aural Habilitation, and with the First Years program. Dr. Cole has published numerous articles, chapters, and two books, all related to helping children who have hearing loss learn to listen and talk.

---

Carol Flexer, Ph.D.

Carol Flexer received her doctorate in audiology from Kent State University in 1982. She was at the University of Akron for 25 years as a distinguished professor of audiology in the School of Speech-Language Pathology and Audiology. Special areas of expertise include pediatric and educational audiology. She continues to lecture extensively nationally and internationally and has authored more than 150 publications. She has co-edited four books: How the Student with Hearing Loss Can Succeed in College, 1st and 2nd ed., and Sound-Field Amplification: Theory and Practical Applications, 1st and 2nd ed. She also has authored Facilitating Hearing and Listening in Young Children, 1st and 2nd ed. She is a past president of the Educational Audiology Association, a past board member of Auditory-Verbal International (Cert.Avt), and a past president of the American Academy of Audiology. Currently, she is a board member of the American Academy of Audiology Foundation, and president of the Alexander Graham Bell Association for the Deaf and Hard of Hearing Academy for Listening and Spoken Language. For her research and advocacy for children with hearing loss, Dr. Flexer received the Volta Award, the most prestigious award conferred by The Alexander Graham Bell Association for the Deaf and Hard of Hearing. Dr. Flexer also is a Certified Laughter Leader.

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