By Dan Schwartz and Anne S, with an extensive comment by Jane R Madell, PhD
February 24, 2012 Update: Added free pediatric resources from John Tracy Clinic, with corrected links~
Often, the missing ingredient for many hearing impaired people is auditory therapy, or (re)habilitation (AR), especially for those who are sold hearing aids for mild to moderately severe hearing loss. AR is typically given along with speech therapy for hearing impaired children, and is especially important in the first three years as the regions of the brain that process auditory and visual information overlap: With a hearing impaired child, the natural tendency is for them to use the “easier” means of visual and manual communication — sign language — which will “crowd out” auditory development.
For teens & adults, AR is also sometimes included at some of the 250 CI centers in the US (you pay your dues and you take your chances); and at all 21 CI centres in the UK.
• The John Tracy Clinic, one of the finest pediatric audiology centers in the world, now has three free Distance Learning for Parents Courses, which can be taken mail or now turbocharged by the Internet, online anywhere in the world.
- Mini Course: Designed for use by families in the first few years after identification of their child’s hearing loss, this course summarizes initial information, provides considerations for decision making and gives suggestions on support. It has separate sections about hearing loss, communication and parent roles. Extended learning ideas help parents recognize what they know, consider how they feel and identify steps they wish to take.
- Baby Course: Geared toward infants and toddlers (i.e., birth to two), this course discusses early hearing loss, infant-toddler development, parent-child communication and learning through play. Suggestions are given for emphasizing communication through natural routines. Parents can choose specific ideas to encourage beginning language and auditory learning.
- Preschool Course: Developed with preschoolers in mind (i.e., ages two to five), this course provides parents with tools to foster language growth and facilitate family interactions. Modules discuss communication, thinking and social development. Suggestions are given for activities to encourage language, listening and speech. Parents choose ideas that fit their child’s developmental level and their family’s current concerns.
These self-paced lessons are available at no cost to parents; and are available online or through the mail. Parents receive family friendly information with fun activities; and then submit report forms with their comments. Also, individualized encouragement and personalized correspondence from experienced parent educators is sent by the Clinic via web or mail. We at The Hearing Blog recommend these courses for grandparents & caregivers; and strongly recommend them for both parents of hearing impaired infants and children: Click this link right now to register. Now, not tomorrow or later today: It’s that important.
• Well-respected University of California-San Francisco (UCSF) audiology professor Robert Sweetow has the very good Neurotone LACE Listening Program AR (auditory therapy) DVD and Web based program with many dozens of exercises. I have received good reports on LACE from audiologists, including one who dispenses hearing aids and includes it in her package. There are samples of each of the exercises you can download on the Neurotone website;
- Advanced Bionics has The Listening Room as part of their “Hearing Journey” website, with a number of environmental sound, speech, and music exercises. Although they may seem simple for people with mild to moderately severe hearing loss, they still nonetheless can be quite helpful as a “reality check;”
- MedEl has a number of AR packages available for both purchase, and also complimentary web-based and downloadable SoundScape exercises. Download the Bridge PDF catalog for an entire listing of their AR pacages & materials for all ages;
- Cochlear Americas has their extensive HOPE program which consists of their Sound and WAY Beyond and HOPE Notes software. To see how HOPE Notes was created by Providence RI musician Richard Reed, click here to read an interview of him by AudiologyOnline Editor Carolyn Smaka. If you are .NOT. in the Americas, i.e. in the EuroZone, Australia, or elsewhere, please click here and select your region and country from the map. Also, your CI centre may supply you the Sound and WAY Beyond &∓/or HOPE Notes software to supplement your auditory (re)habilitation program, as this will vary by country — Some — Like UK — provide much better post-implant rehab services than we receive here in America.
If you don’t believe me that it can really suck here in the US, see the next item…
• Underscoring the importance of what happens when AR is not done, one need only watch the superb and touching HBO documentary Hear and Now, as filmmaker Irene Taylor Brodsky accidentally documents what happened when her parents did .NOT. get the AR they needed. From my detailed Movie Review on the Amazon.com Hear and Now page:
I strongly recommend this movie for anyone who already has a cochlear implants, prospective CI candidates or parents of kids with CI’s; and also all Audiologists, whether practicing or are studying to become one, as filmmaker Irene Taylor Brodsky accidentally documented two avoidable CI failures, with Sally’s worse than Paul’s.
Watch the movie twice: The first time, just sit back and enjoy the story with your entire family, as any member of the viewing public would do so, as that alone rates a good Four Stars. But then, watch the second half again, from the implant surgery forward through 1st stim and subsequent MAP’s to the end.
Notice something missing?! HINT: Sally Taylor has personally told me this is the most common question asked at film screenings.
—> WHERE IS THE FOLLOWUP AUDITORY THERAPY? <—
That’s right, Paul and (especially) Sally were victimized by their CI center, with poor quality 1st stim, followup MAPs, and the total *lack* of auditory (re)habilitation. This is a superb documentary of an absolute, miserable #FAIL by the Audiology profession, *especially* in Rochester, NY, which has 90,000 deaf residents — The highest concentration in the world. In fact, both Sally and Paul are retirees from NTID (National Technical Institute for the Deaf; one of eight Colleges at RIT), so it’s not like deafness is an unknown quantity among the healthcare profession in the area.
If you already watched the edited version on HBO, buy the DVD anyway as it has an additional 20 minutes that didn’t make the cut, mostly of booth testing… But it’s worth it to those to both groups — Hearing healthcare professionals and hearing impaired patients & their families.
I very strongly recommend this film for any and all in the hearing healthcare industry, as it clearly demonstrates how auditory rehab is critical to patient success; and what happens when professionals #FAIL to provide adequate followup care.
I also strongly recommend this film to any and all members of the hearing impaired (hard-of-hearing, deaf and Deaf) community, as well as to their families.
Please see my detailed review on the Amazon.com Hear and Now page for a more extensive discussion of the importance of Auditory Therapy
• The John Tracy Clinic also offers intensive three-week On Site Family Summer Sessions for children with hearing loss 2 through 5 years old and their families worldwide are offered at the John Tracy Clinic (JTC) campus in Los Angeles. Children attend a spoken language preschool designed to identify their strengths and needs. Parents participate in an education program to learn about hearing loss, auditory-verbal techniques, emotional support for families and educational services for their children.Specialists provide audiology, counseling and consultation services to children and families. Summer sessions include a(n):
- Auditory-oral preschool program
- Comprehensive audiological services
- Daily intensive parent education classes
- In-depth speech-language assessments
- Parent support groups led by trained counselors
- Recreation programs for brothers and sisters, grades 1st through 6th
Summer services are offered free of charge as are all other family services at John Tracy Clinic. To learn more, read the Overview page, read a first-hand account written by a parent, or download a one-page informational PDF. Enrollment applications and answers to general inquiries can be obtained by calling 1-800-522-4582 or emailing firstname.lastname@example.org. ~Dan Schwartz, Editor
Some of the listening practice stuff that I do… I have worked 1-on-1 with the CI program audiologist for an hour every week for most of the past 3 years; but many of what I’ve done are exercises you can do on websites like some of the ones that I have listed below, and some things with a friend or family member… And you don’t need a special sound-proof booth to do these. People often ask how I have improved so much with my level of comprehension of speech with my ABI, and I usually say that I’ve practiced a lot; but people say, “what do you mean by that?” How do you practice listening?” With the ABI [Ed.: Auditory Brainstem Implant], it’s kind of like you have to learn how to hear again, because as a baby you learned how to hear naturally, but now I needed to learn those sounds are not the same as they were before, and fit things together like its a big puzzle. I don’t understand everything with the ABI, but I do understand a lot. [The other day, I talked to my mom on my cell phone for 15 minutes and understood mostly everything she said!]
Here are some of the things I use for listening practice, for my fellow ABI user friends…. (I tried to only tag people who’ve gotten ABI or CI in the past few years, or might be getting one soon… And people who just think that robot ears are awesome!)
SUGGESTION: Keep a record of scores on the online listening quizzes and games, then do the same one in a few months or next week and see if you can improve your scores;
LISTENING STORY/CONVERSATION ACTIVITY: Get a family or friend to try to talk with you while holding a piece of paper (or thin fabric, which works better) in front of their face. It can be challenging but when I started doing that, it was just sounds really. I’ve progressed to being able to have pretty clear conversation, or repeat back person reading a story — Read a sentence, pause, listener repeats… etc.)
PHONE ACTIVITY WITH SOMEONE: Practice talking on the phone by calling a friend or family member (whom you know the voice of well) while they are in another room of the same house/apt/building. Try planning the call by making a list of what you will talk about. Example: You ask them a question about what they did this weekend, and they answer, then you confirm if that was what they said. Strategies include: Ask for spelling of words that you get stuck on (and I found it helpful to sometimes try using the military code alphabet letter list which you can switch some around on or make your own but you need 2 copies of same thing. A = Alpha, B = Bravo, C = Charlie… so if the word you didn’t understand was, for example dog, they can say “D – Delta, O- oscar, G-golf”), ask for something that is unclear to be rephrased, or repeated (but if 3 repeats don’t work, try spelling or rephrasing).
PHONE ACTIVITY ALONE: And try listening to the words and stories on here: 1-800-458-4999 – Cochlear Practice telephone recordings, which can be viewed here. There are new recordings every day. If you get bored of the fairy-tales, there is some pretty interesting different ones, usually on the weekends, like such as the time line of Abe Lincoln, Dr Martin Luther King Jr’s “I have a dream” speech, Robert Frost poems, Cochlear Implantee success stories, and more.)
OTHER ACTIVITIES: Lots of great stuff from the home page of the ManyThings.org links here and here. Play around and find what you like. The “minimal pairs” sound comparisons are great; or go to the home page of this site and try the “easy activities/games for beginners.”
- www.elllo.org has a lot of listening activities at various levels here, here, here, and here. Most of them are geared at foreign students learning English, but its a great site.
- There are also a large number of listening practice selections available through the TalkEnglish.com website
- Free music online at www.GrooveShark.com , LOL. [Editor's note: This website uses the very latest browser plug-ins, which can at times cause computer lockups and crashes.]
- The Grammar Girl: Listen, and you can read it too, but this one is really boring, I thought. My audiologist said she thinks this changes each week, but this particular link is new to me, so I’m not sure yet.
~Anne S., Auditory Brainstem Implant user
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