Building Auditory Skills in Children Who Sign Audiologists bring specific knowledge to teams working on auditory skill development in children who use sign language. All Ears on Audiology
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All Ears on Audiology  |   May 01, 2017
Building Auditory Skills in Children Who Sign
Author Notes
  • Katie Brennan, MS, CCC-SLP, is a clinical supervisor and lecturer at the University of Nebraska–Lincoln. Brennan has worked on cochlear implant teams and as an auditory consultant, providing training and coaching for school agencies nationally to support students with hearing loss. She is an affiliate of ASHA Special Interest Group 9, Hearing and Hearing Disorders in Childhood. katie.brennan@unl.edu
    Katie Brennan, MS, CCC-SLP, is a clinical supervisor and lecturer at the University of Nebraska–Lincoln. Brennan has worked on cochlear implant teams and as an auditory consultant, providing training and coaching for school agencies nationally to support students with hearing loss. She is an affiliate of ASHA Special Interest Group 9, Hearing and Hearing Disorders in Childhood. katie.brennan@unl.edu×
Article Information
Development / Audiologic / Aural Rehabilitation / Augmentative & Alternative Communication / All Ears on Audiology
All Ears on Audiology   |   May 01, 2017
Building Auditory Skills in Children Who Sign
The ASHA Leader, May 2017, Vol. 22, 14-16. doi:10.1044/leader.AEA.22052017.14
The ASHA Leader, May 2017, Vol. 22, 14-16. doi:10.1044/leader.AEA.22052017.14
Children who use hearing technology can benefit from a focus on auditory skill development— but juggling priorities for different communication areas, including for children who use sign language, can be a challenge that takes teamwork to solve.
Around 33 percent of U.S. children who are deaf or hard of hearing use sign language only, sign-supported spoken language, or a communication method other than spoken language as a primary communication mode for learning, according to a 2011–2012 survey by the Gallaudet Research Institute, and audiologists in all settings likely work with children who use signing to communicate. Optimizing auditory outcomes for children who use sign is a team effort involving caregivers, educators, audiologists and speech-language pathologists.
Collaboration is key because each team member has unique expertise and a different perspective to share with the team. Audiologists can help determine appropriate auditory learning objectives, while SLPs can continue targeting language, reading and spoken-language development with sign supports.
Working together, team members can foster a child’s auditory development without sacrificing language and academic progress. For example, they can encourage listening-only opportunities during well-established routines (such as farewell routines and familiar games) in which language and conversational exchanges are very predictable. Meanwhile, they can opt not to remove sign supports when introducing new concepts or unfamiliar experiences (such as a first trip to an amusement park).

Working together, team members can foster a child’s auditory development without sacrificing language and academic progress.

How does the child use sign?
First, teams must determine how a child uses sign. Children can use sign in many different ways, from their primary communication method to a supplement for learning. Teams can base decisions about how children use sign on the child’s need and family choice, and determining the child’s type of sign use can help teams guide recommendations for auditory skill development and expected outcomes.
Children may fall into one of four groups (identified by Mary Pat Moeller):
  1. Foundational user: Short-term use of sign; transitions to spoken language after appropriately fit with hearing technology.

  2. Transitional user: Uses sign as a bridge between new auditory skills and language knowledge, shifting toward spoken language as primary communication method.

  3. Strategic user: Uses sign as supplement to spoken language and in difficult communication contexts (for example, noisy environments).

  4. Dominant user: Uses sign as primary communication method.

Children who continue to use sign as part of their communication systems need teams who can approach auditory development strategically so that the appropriate approach is used to support participation in learning and conversational exchanges. Children should never experience a negative consequence because the communication approach or strategy was a poor match for the context. Auditory skills should not be challenged in a setting where the auditory focus could impede a child from participating like their peers.
Team discussions for transitional and strategic users may focus on when or where use of sign is appropriate for meeting a child’s listening and language goals. Discussions for dominant users could focus on creating meaningful listening opportunities in daily routines (for example, identifying the school bell as an indicator to transition between classes, or alerting to their name).

Children should never experience a negative consequence because the communication approach or strategy was a poor match for the context.

Audiologists and SLPs team up
The team’s SLP provides valuable information in areas including language abilities, articulation skills and auditory skill performance across settings. The team’s audiologist shares critical information in several areas to inform intervention approaches:
  • Audibility: Knowing what the hearing technology can and cannot do for individual children is key in determining the appropriate intervention strategy. Share specifics about audibility—avoid reporting vague statements such as, “Hearing aids provide good audibility.” For example, if the SLP knows a child cannot access /s/ with his hearing aids, the /s/ phoneme can be taught through visual and tactile methods. Educators know that plural and possessive /s/ need to be emphasized with visual supports.

  • Speech-perception performance: Performance on speech-perception measures may confirm skills observed in educational or therapeutic settings; however, a child may demonstrate different skills in a situation where the demands on listening are greater than daily expectations. The child may know their job with the audiologist is to listen, and that the SLP, teacher or parent can sign to them to confirm or clarify a message. Speech-perception results can help guide development for treatment objectives.

  • Device-use data logging: Data logging helps guide education and counseling about device use and possible barriers to consistent device use, especially regarding intervention modifications if a child’s auditory skills do not progress as expected. The team may evaluate whether the current approach is appropriate in intensity and frequency of services and could later find out through data logging that a child wears her hearing aids an average of two hours per day. This information could shift the team’s focus to working toward full-time use before changing the intervention strategies.

  • Technology: Technology changes constantly, and keeping up with those changes can be challenging for SLPs and educators. Audiologists can share information that could affect daily functioning; for example, warning indicators (device blinks green in response to speech, whereas an older device displayed a steady red light in the same situation), troubleshooting guides, and strengths and/or limitations of the new technology. Send a website link so the team can research the new product.

  • Follow-up recommendations: Audiologists should share follow-up recommendations with the team. Each member can help caregivers with necessary steps to comply with those recommendations.

When working with children with hearing loss, audiologists and SLPs have a prime opportunity to combine their specialties for children’s benefit. Ongoing communication and collaboration are key to helping the treatment team forge the most optimal treatment path.
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May 2017
Volume 22, Issue 5