Transcript APD Presentation

Auditory Processing
Teaching
“When the Brain Can’t Hear”
(Bellis, 2002)
Michelle Redman
Auditory Processing
Is a foundational skill
COMPREHENSION
DECODING &
SPELLING
PHONICS
PHONOLOGICAL
AWARENESS
ORAL
LANGUAGE
AUDITORY
PROCESSING
WOW!! How do these kids learn?
Descriptors
• Central Auditory Processing Disorder (CAP) or
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Auditory Processing Disorder (APD) is a
communication disorder
There are deficits in the information processing
of audible signals NOT attributed to hearing
impairment or to intellectual impairment
CAP involves the Perceptual, Cognitive, and
Linguistic functions
What does this look like?
• Difficulty attending
• Difficulty discriminating and identifying acoustic signals
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(vocal, snaps, claps, accents, telephone, recordings)
Disruption in their ability to transmit information through
both peripheral and central nervous system… what does
that mean? That means that the information being
received by the auditory nerves (Peripheral nervous
system) is disrupted, incomplete or inaccurately
transmitted to the brain (Central nervous system) so the
brain is unsure how to process or react to the provided
stimuli without added information
What else does it mean?
• Conceptual knowledge can have gaps as the
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Perceptual information from the senses has not
been complete, meaning often a student with
APD has trouble drawing on background
knowledge and experiences
Learners with APD have difficulty with working
memory: storing and retrieving information
efficiently or completely
There’s more!!
• Learners may have trouble understanding
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speech in noisy environments… like a classroom
They may have difficulty following directions
Similar sounding speech patterns may present
difficulty when trying to discriminate between
the two
The learner may often ask for repetition or
clarification
They may have trouble spelling and reading
And even more!
• Students with APD may act as if they have hearing loss
• They may have trouble understanding lectures and
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information presented verbally
Learner’s with APD have difficulty with auditory
sequencing (Have you listed verbal directions with more
than one step in your class?)
A student with APD may have language delays due to
insufficient information reaching and being interpreted
by the Central nervous system
A learner with APD will usually do better when they are
clear on what is expected of them
How is APD assessed?
• Assessment CAN NOT be completed by a
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screening survey
Evaluation is completed by an audiologist to
evaluate the learner’s hearing and identify
possible auditory perception problems
Evaluation by a speech-language pathologist to
evaluate a learner’s perception of speech and
his/her receptive and expressive language use
follows the audiologist’s examination
What does the audiologist do?
• The audiologist administers a series of tests in a
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sound-treated room. These tests require
listeners to attend to a variety of signals and to
respond to them via repetition, pushing a
button, or in some other way.
There may be other tests to check an individual’s
auditory system's physiologic responses to
sound may also be administered.
Children are typically not assessed for APD
before age 7/8
(Bellis, 2015)
How does that affect a Learner’s
Reading and Writing?
Difficulty discriminating
and categorizing speech
sounds
Difficulty decoding
Failure to recognize
which sounds are
important to
meaning
Delayed phonemic
awareness
Weak spelling
•Inability to discriminate
between letter sounds
Delayed reading
development
•Increased anxiety
•Difficulty performing
invented spelling
•Non phonetic
Weak listening skills
Weak auditory attention
Poor auditory memory
General academic
difficulties
Delay in oral language
Rhyming, songs,
nursery rhymes
Weak comprehension
What about socially?
• Learner’s with APD experience mixed success
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socially
Their inability to follow an interaction with
background noise, or with distractions
surrounding them, creates difficulty building
relationships with classmates
Often on a playground, miscommunications may
occur as the student either misinterprets or does
not respond the way others think they should in
the situation… all because the student with APD
really isn’t aware of the situation!
(Bellis, 2015)
More social effects!
• Inability or difficulty initiating and
maintaining conversation
• Difficulty or miscommunication with turn
taking
• Difficulty interpreting inflection, emotion,
and vocal cues
• Anxiety, frustration, withdrawal or
conversely, acting out physically
How to support learners with
APD
through a three prong
approach
(Campbell, 2011)
1.Enhancing the Acoustic Signal and the
Listening Environment
• Reduce unnecessary noise
• Seating location
– Provide a study carol
– Preferential seating
• (least affected ear to centre of
class)
• Sound absorbing materials in a
classroom aid in reducing
background noise levels
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Carpets
Tennis balls on chair legs
Double glazed windows
Partitions
Draperies
Closed doors
Seals on doors
(Campbell, 2011) (Bellis, 2008) (PaulBrown, 2003)
• Teacher/speaker adaptations
– Use clear speech
– Give simple, brief instructions
– Embed sequencing words (such as:
first, then, next, finally)
– Incorporate gestures
– Alter pacing
– Emphasis on segmentation of their
speech without over exaggeration
– Frequent checks for understanding
• A pictorial cue system or signal to
reduce attention and focus on the
student and build trust
• Sound Amp
– Transforms an ipod, ipad, or itouch
into an interactive listening device
– Also allows replay for the last 30
seconds
• Assisted FM listening systems
– As children with APD typically have
normal hearing, it is important to
use systems designed for normal
hearing
2. Auditory Training
There are many computer based auditory
training tools and programs
recommended by Professionals,
researchers and educators. Some
examples include:
a.
‘What’s that Sound’ Itunes app,
compatible with ipad, ipod, itouch,
iphone
b.
‘Lumpty.com’ pitch pattern
sequencing, available free on Google
Play or itunes app
c.
‘Simon Sings’ melody matching,
available on all IOS products
d.
‘Fastforword’ www.innovativetherapies.com phonemic awareness,
auditory memory, sequencing skills
(Strait et al, 2009) (Tallal et al, 2006)
(Campbell, 2011)
Additional auditory training
tools/techniques
a. Speech-Language Therapist
training
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b.
Listening centres
a.
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Dichotic listening training
(different signal to each ear
received simultaneously)
Cloze procedures to complete
missing word from the tape
Punctuation cloze procedure
a.
Learner listens to a recording,
following along on a print copy
and fills in missing punctuation
Musical training
a.
b.
c.
There are many studies
completed and on-going into the
positive effects of musical
training for learners with APD
Evidence of improved auditory
attention and perception
“Lower level sound processing
can be shaped by musical
training” (D.L.Strait et al, 2010)
3. Metacognitive and Metalinguistic Strategies
• Explicitly teach self-regulation to develop attention, persist in activities,
manage our emotions, regulate our behaviour
– Model self-regulation, model respect, model balance
– Instruct in strategies
• Cognitive – recognize personal patterns of behaviour, try alternative strategies,
incorporate student strengths and implement alternative tools to best support student
in cognitive efforts
• Emotional – recognize emotional changes as clues, label emotions, use visuals, take
responsibility for emotions, find appropriate ways to express honest emotions
• Physical (low level thinking) – recognize physical changes happening in own body as
clues, use repetitive movements, breathing, stretching, change of physical position, to
effect higher level thinking
– Coach Use hints and cues (visual)
– Offer correction/re-direction
• Debrief what happened (verbally if able, pictorially or with use of symbols)
• Ask specific questions “what was missing just now? Patience? Kindness? Use of visual
aid? “ “how will you act differently?”
– Acknowledge efforts and express belief in student abilities
• “Thank you for your patience”
• “I appreciate your use of the signal”
(Chapin, 2011)
Metacognitive and Metalinguistic continued
• Reciprocal teaching
• Metamemory strategies
– Implement use of
mnemonics (memory
devices like acronyms),
mind mapping (visual
organizer), pictorial
presentation, and graphic
organizers in classroom
– Utilize verbal rehearsal
• Explicitly teach organizational
skills
– Use of a daily planner
– Following class schedule
(posted clearly)
– Utilizing a mobile device for
calendar and schedule items
• Shared reading
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– Everyday, every child
– Incorporate specific
phonological and phonemic
skills into authentic reading
and textual frameworks
Incorporate reauditorization
– Paraphrasing
– Repetition
– Summarizing
– Tape record lectures to provide
permanent record for repetitive
listening
Explicitly teach problem solving
skills
• Identify the problem
• Structure the problem
• Look for possible solutions
• Make a decision
• Implement
• Monitor/seek feedback
What about the associated
behaviour?
• Define and teach pro-social behaviour
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– Role play
Teach visual cues or actions
Adapt environments to reduce problem behaviour
Identify helpers for social situations
Build classroom scripts for participation in discussions,
turn-taking, listening
Relaxation strategies
– Breathing
– Stretching
– Change of physical position
Bibliography
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American Speech-Language-Hearing Association. (2002). Appropriate
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http://www.asha.org/policy/TR2002-00236.htm
American Speech-Language-Hearing Association. (1993). Definitions of
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school facilities for students with speech-language-hearing
disorders [Technical Report]. Available from
communication disorders and variations [relevant paper]. Retrieved
from http://www.asha.org/policy/RP1993-00208.htm
American Speech-Language-Hearing Association. (2003). Let’s talk…
for people with special communication needs. Retrieved from
http://www.asha.org/uploadedFiles/aud/LetsTalkAuditoryProcessing.p
df
Bellis, Teri James. PhD. CCC-A. (2015). Understanding auditory
processing disorders in children. Retrieved from
http://www.asha.org/public/hearing/Understanding-AuditoryProcessing-Disorders-in-Children/
Bibel, B. (2003). When the brain can't hear: Unraveling the mystery of
auditory processing disorder. New York: Retrieved from
http://search.proquest.com.ezproxy.library.ubc.ca/docview/19681060
0?pq-origsite=summon&accountid=14656
Campbell. N. (2011). Supporting children with auditory processing
disorder. British Journal of Nursing, 6(6), 273-277. Retrieved from
http://search.ebscohost.com.ezproxy.library.ubc.ca/login.aspx?direct=
true&db=ccm&AN=2011230133&site=ehost-live&scope=site
Bibliography
• Chapin, Brad. LCP. LLMP. (2011, July 1). Engaging strategies for social,
emotional and behavioural issues. [weblog message]. Retrieved from
http://www.slideshare.net/chapin55/selfregulation-strategies-forschoolage-children?related=1
• Chermak, Gail D. PhD. (2002). Deciphering auditory processing disorders
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in children. Otolaryngologic Clinics of North America. Volume 35, Issue 4,
August 2002, Pages 733–749 doi:10.1016/S0030-6665(02)00056-7
http://www.sciencedirect.com.ezproxy.library.ubc.ca/science/article/pii/
S0030666502000567
Coen-Cummings, Ph.D. CCC-SLP. Intervention Using Metalinguistics to
Improve Comprehension and Literacy. Retrieved from [email protected] ASHA 2009 Conference New Orleans
Florez, Ida Rose. (2011) Developing Young Children’s Self-Regulation
through Everyday Experiences. Young Children.
Skills You Need. (2015). Problem Solving. Retrieved from
http://www.skillsyouneed.com/ips/problem-solving.html
• Slideshare. (2015) Teaching children self regulation. [Weblog message]. Retrieved
from http://www.slideshare.net/HLagace/teaching-children-selfregulation