Auditory-Verbal Therapy- Hearing, Listening, Talking, Thinking

Warren_Estabrooks

 

 

By Warren Estabrooks, M.Ed., Dip. Ed. Deaf, LSLS Cert. AVT, co-author of Auditory-Verbal Therapy: For Young Children with Hearing Loss and Their Families, and the Practitioners Who Guide Them

 

 

Globally, there is a great shift towards listening and spoken language for children who are deaf and hard of hearing.

Amazing auditory options, state-of-the-art hearing aids, and a variety of implantable hearing devices and the pursuit of excellent (re)habilitation by highly qualified practitioners working in partnerships with families, will hopefully become the standard of international health care and educational intervention for children with hearing loss around the world.

It is the work of therapists, teachers, audiologists, surgeons, social workers, and allied practitioners in health care and education to guide, navigate, and coach parents on their search for the treasure chest of spoken communication—to help them help their children discover the valued jewels of hearing, listening, and spoken conversation.  Practitioners everywhere form alliances of hope and trust with parents, and together we polish these precious gems until they sparkle and dance with life.

Why would one ever consider compromising when so much is possible?

We hope that one day we will look back and see an abundance of evidence-based outcomes, all barriers to equitable service gone, and a global focus on literacy with a deep understanding of powerful auditory access to the brain provided by state-of-the-art hearing technologies.

Renaissance man and mentor of many of today’s auditory-verbal practitioners, Dr. Daniel Ling, wrote that “auditory-verbal therapy… developed as a result of the natural outcomes of advances in knowledge, skills and technology.  As such advances occurred, new treatment strategies were devised to maximize their applications”.

Auditory-Verbal Therapy is now widely accepted because more children are acquiring, or have already acquired, the abilities to use spoken language, to interact more freely with other members of society, to obtain higher levels of academic education, and to have a more extensive range of careers, a greater security of employment and fewer limitations on the personal and social aspects of their lives” (Estabrooks, 2006).

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Managing the Expectations of the Common Core State Standards

Lissa_Power-deFur      PowerdeFur_CCSS

By Lissa A. Power-deFur, author of Common Core State Standards and the Speech-Language Pathologist: Standards-Based Intervention for Special Population

Speech-language pathologists (SLPs) in school districts across the country have returned to school, often with the new (or renewed) obligation of addressing the “Common Core” (or the “Career and College Readiness Standards” as the Common Core State Standards [CCSS] is referred to in some states.) The SLPs’ reactions are likely to include the following:

  • With all the students on my caseload, how can I possibly do something else?
  • This is just another education fad; it’ll pass in a couple of years.
  • From what I hear about these standards, they aren’t applicable to the students on my caseload.
  • I’m focusing on the IEP goals, they are most important for my students.

These are common reactions, reflecting the current challenges and pressures of working as an SLP in the schools. However, it is important that all SLPs working with children, whether in schools or other settings, understand that the CCSS is now the lens through which educators must view the achievement of all students, including students with speech-language impairments. The education standards movement has been in place for over two decades, with states first adopting their own standards and developing assessments to measure student achievement of those standards. More recently, the National Governors’ Association (NGA) and the Council of Chief State School Officers (CCSSO), with funding from the Bill and Melinda Gates Foundation, used teams of educators, business professionals, and policy-makers to develop the Common Core State Standards. Released in 2010, 43 states have adopted the CCSS. The Standards serve as the basis for state assessments developed by two consortiums, the Partnership for Assessment of Readiness for College and Careers (PARCC), and the Smarter Balanced Assessment Consortium.

As SLPs study the CCSS, they will find that the Standards encompass a hierarchy of language skills from phonological awareness to the ability to understanding diverse perspectives, from comprehension of discipline-specific vocabulary to syntactic complexity in speech and text. The CCSS emphasize oral language and phonological awareness in the primary grades, as kindergarteners must demonstrate skills in counting, pronouncing, blending, and segmenting syllables in spoken words. The CCSS expect secondary students to use oral communication effectively to present findings and support their evidence clearly and concisely using a style appropriate to the audience and task. In the vocabulary area, students must demonstrate such diverse skills as mastery of morphology for understanding meaning to becoming adept at understanding euphemisms, hyperbole, and paradox. Students’ skills in the conventions of Standard English develop from early skills in using nouns, verbs, adjectives, and adverbs to secondary level skills in using parallel structure in their oral and written communication.

The CCSS provide an excellent vehicle for SLPs to use to support collaboration with their education partners. As SLPs communicate with teachers, the CCSS provides a common vocabulary to describe student expectations and performance, thereby facilitating the education team’s focus on needed language and communication skills. A typical child on the SLP’s caseload will have difficulty acquiring standards from prior grade levels. The CCSS can serve as a resource SLPs can use in explaining the effect of children’s speech-language impairments on their ability to master specific standards. By using the language of the CCSS in describing students’ performance, the SLP’s ability to communicate with teachers and administrators about the challenges the child is and will be facing is enhanced.

SLPs will find that an analysis model facilitates their ability to integrate the standards into their intervention planning. A 5-step model builds upon SLPs’ extensive knowledge of the language and metalinguistic skills and leads to development of collaborative direct and classroom-based intervention activities. In step 1, SLPs work collaboratively to identify the standards needed for success. SLPs will analyze the CCSS, identifying the specific expectations that will rely on the student’s language and communication skills. Due to the magnitude of the CCSS, this task quickly becomes overwhelming. Therefore, SLPs are urged to follow the practice of their education partners—creating teams to review the standards. By working with colleagues, SLPs can focus on the areas that relate to their expertise. For example, SLPs with specialization in fluency can review the standards for expectations for oral communication and presentations. SLPs with a passion for literacy can focus on these standards. Another approach would be for SLPs to focus on all standards or the grade levels they serve (or the grade levels their students have just left and will be moving into). Not only does teamwork minimize the workload, it enables the creative generation ideas that flow from a collaborative group of professionals. The Plural book, Common Core State Standards and the Speech-Language Pathologist:  Standards-based Interventions for Special Populations, provides SLPs with examples of the language and communication expectations of the standards.

The model’s second step focuses on detailed identification of the language and communication skills needed for success. This analysis addresses phonology, morpho-syntactic, semantic, and pragmatic and metalinguistic skills. The SLPs will find standards that require competency in speech sound production and fluency as well. This is another task completed well by a team of SLPs, reducing the workload and facilitating the brainstorming and analysis. The result will be a comprehensive understanding of the standards.

Step 3 shifts the attention from the standards to individual students. The SLP will complete a thorough analysis of a student’s current skills and needs. Data sources include standardized assessments, observations of the child in the classroom, classroom work samples (e.g., narratives, spelling tests), and probes of specific skills. Many of these items will be found in the Present Level of Academic Achievement and Functional Performance (PLAAFP) of the child’s Individualized Education Program (IEP). However, SLPs will find that they will want to generate skill-specific probes to understand the nuances of the child’s needs as they plan for intervention.

At this point, the SLP’s focus shifts to consideration of the expectations in the child’s classroom. The SLP will use information from observations to identify the language of the classroom communications, especially directions, texts, and instructional activities. A specific focus on morphological-syntactic constructions and vocabulary will enable the SLP to focus on specific skills the child will need for success. If multiple SLPs have children in this same classroom, this can be a joint activity.

The final step is to design intervention. Children’s academic success relies on their ability to apply the language and communication skills developed under the guidance of the SLP into real-world settings (i.e., the classroom). Therefore, the intervention should be a combination of direct intervention and collaborative classroom-based intervention. This combination of approaches allows for a specific focus on skill attainment, followed by application of that skill. The SLP may find it particularly valuable to participate in classroom center activities, working with specific children and facilitating their mastery of skills through collaboration with other students. This step relies on a collegial working relationship with the child’s classroom teacher(s), with time for planning to enable both professionals to identify which skills they will focus on and the nature of interventions.

The use of a stepwise model for analyzing the standards and applying this information to the strengths and needs of a specific child enables the SLP to tailor intervention to what matters for children—academic success. It is only through the SLP’s comprehensive knowledge of the academic standards and analysis of the specific linguistic expectations of the standards that students with language and communication difficulties can successfully meet the academic demands of 21st century schools.

About the Author 

Lissa A. Power-deFur, PhD, CCC-SLP, ASHA-F, is a professor in the communication sciences and disorders program at Longwood University in Virginia. Among the courses she teaches is public school methods, which focuses on supporting children’s mastery of the language expectations of the Common Core State Standards. In her clinical role at Longwood, she has collaborated with local school districts for service delivery. She received her bachelor’s, master’s, and doctoral degrees in speech-language pathology at the University of Virginia. She is a Fellow of the American Speech-Language-Hearing Association (ASHA) and the Speech-Language-Hearing Association of Virginia, and regularly volunteers for the profession. Dr. Power-deFur has served as a state education advocacy leader and as a member of numerous education-related committees at ASHA. She is the ASHA 2014–2016 vice president of standards and ethics in speech-language pathology. Additionally, she received The ASHA Leader Outstanding Service Award for her 2011 article on special education eligibility.

 

 

The Art and Science of Laryngology

Plural has several great titles that delve into the art and science of laryngology (click here to see them). One such title is the forthcoming Techniques of Botulinum Toxin Injections in the Head and Neck.

 

This title provides you with all the information you need to perfect your technique, illuminated with outstanding graphics, across a range of procedures – from cosmetics, through headache, to neurologic and functional disorders – order it now to ensure your get your copy immediately on publication by clicking here.

Hearing Loss in Older Adulthood

Raymond Hull’s new book, Hearing and Aging, is coming soon!

 

 

It is the first book dedicated solely to hearing loss in older adulthood, and importantly, the processes involved in serving the special needs of the aging population.

Order Raymond Hull’s book and other audiology titles here!

 

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New Book in the Here’s How Series

We’ve got an exciting new book in the ‘Here’s How’ series coming out in time for this year’s ASHA meeting, to be held in our hometown of San Diego. 

Here’s How to Do Early Intervention for Speech and Language:
Empowering Parents

By Karyn Searcy-Bair, M.A., CCC-SLP

The book includes a DVD with video interviews with parents and examples of specific therapy techniques effective for children under the age of 24 months, and the impact that empowering parents has on their ability to engage their children. To learn more and pre-order, click here.

New Surgical Instrument Guide Coming Soon!

The pocket partner to Pasha’s Otolaryngology-Head and Neck Surgery is coming soon! Releasing this Fall, Otolaryngology Surgical Instrument Guide serves as a handy reference of more than 200 of the most frequently used surgical instruments in otolaryngology. Organized by surgical subspecialty, this pocket guide features professional photographs of the instruments, their formal name, their aliases and details on how to set up equipment. Order your copy here.

May is Better Hearing and Speech Month!

May is Better Hearing and Speech Month! In celebration, we would like to announce our forthcoming speech and language pathology resources for 2011! From topics on organization of school programs to stuttering therapy, Plural provides a variety of resources for your every need.

Check out Plural’s forthcoming speech and language pathology releases for 2011!
Here’s How Children Learn Speech and Language:
A Text on Different Learning Strategies

Margo Kinzer Courter, MA, CCC-SLP
Here’s How to Do Early Intervention for Speech and Language: Empowering Parents
Karyn Searcy-Bair, MA, CCC-SLP
Here’s How to Do Respiratory Muscle Strength Training:
Theory and Practice

Christine Sapienza, PhD
Here’s How to Do Stuttering Therapy
Gary Rentschler, PhD
Handbook of Voice Assessments
Estella P.-M. Ma, PhD
Edwin M.-L. Yiu, PhD
Handbook of Augmentative and Alternative Communication
Carolyn Higdon, PhD, CCC-SLP
School Programs in Speech-Language Pathology:
Organization and Service Delivery, FIFTH EDITION

Jean Blosser, EdD, CCC-SLP
Scholarship of Teaching and Learning in Speech-Language
Pathology and Audiology: Evidence-Based Education

Sarah Ginsberg, EdD, CCC-SLP
Jennifer Friberg, EdD, CCC-SLP/BRS-CL
Colleen Visconti, PhD, CCC-SLP
Movement Disorders in Neurologic Disease:
Effects on Communication and Swallowing

Leonard LaPointe, PhD
Bruce Murdoch, PhD

New Book on Stuttering Therapy

We are pleased to announce that Here’s How to do Stuttering Therapy by Gary Rentschler, PhD, will be published in August.

The uniqueness of this book is the focus on applied practice and functional applications. While other books present theory and structure of therapeutic approaches, Rentschler’s offers a hands-on, eclectic approach centered on the needs of the client, rather than the structure of any specific treatment program. Pre-order your copy today!