Abstract
This chapter will introduce the listening and spoken language approach (LSL). Originally developed for children who are deaf/hard of hearing (D/HH), LSL is an evidence-based, family-centered approach that focuses on coaching parents/caregivers to provide the environment and input necessary for children to optimize language learning through listening. The role of the interventionist/educator is to guide, coach, and support caregivers. The therapist/educator models specific evidence-based strategies for the caregiver to use in natural environments, such as the home. LSL is well-suited to distance intervention or telepractice/teleintervention—the delivery of services via videoconferencing technology. LSL has been used successfully with children who are D/HH, including those with multiple special needs. Primarily used in early intervention, it has also been used with school-aged children and adults. LSL can be adapted to children with a variety of learning needs who need to strengthen auditory attention, listening skills, and overall spoken language.
Key Terms in this Chapter
Auditory-Verbal or Listening and Spoken Language Strategies: Specific evidence-based strategies based on individualized goals and intervention plans that facilitate listening, speech, spoken language and cognitive development and are modeled for the parent/caregiver to implement.
Cochlear Implant: An advanced hearing technology that uses electrodes to directly stimulate the auditory/hearing nerve. It involves a surgically implanted internal component and an external speech processor. Sounds are picked up by a microphone, sent to the speech processor, which converts them into electrical impulses, and then transmitted to electrodes implanted in the cochlea/inner ear. Cochlear implants are used with individuals who have severe/profound hearing loss. They have been approved for use in children since 1990 and the age of implantation continues to be reduced as the benefits early implantation continue to be scientifically demonstrated.
FM/Frequency Modulated Technology: These devices provide the speaker with a microphone which transmits their voice directly by the listener’s hearing device. They are most often used in school settings or settings with potential for noise. They reduce the distance to the listener’s ear and thus help eliminate noisy distractions.
Attention Deficit/Hyperactivity Disorder (ADD/ADHD): A condition indicated by difficulties with sustained attention, hyperactivity, impulsivity, or combination of these disorders.
Loudness: Perception of sound intensity.
Decibel (Db): Unit for measurement of loudness/sound intensity.
Collaboration: The concept of developing professional relationships, sharing information, and cooperating with others to work as a team to optimize services and achieve the best outcomes for the child and family.
Telepractice/Teleintervention: The use of telecommunication technology to deliver services, allowing families to receive home-based intervention and supporting parent/caregiver engagement.
Pitch: Perception of sound frequency.
Hearing Loss: Any level of hearing greater than that anticipated for typical development. In children this can be any loss greater than 15 decibels (dB).
Literacy: The processing of written information (reading and writing).
Ling Six Sound Test: This is an auditory test used to determine the child’s ability to hear over the spectrum of speech from low frequency to high frequency sounds. It is used to determine the distance from which the child can detect, discriminate, and identify these sounds: “oo-ah-ee-m-sh-s”. It can also be used to test the function of hearing technology.
Home-Based Intervention: Intervention in which the specialist professional provides services in the home—whether in-person or through teleintervention.
Deaf: Small “d” deaf is generally used to describe individuals with a severe to profound hearing loss who cannot process sound, particularly speech, without hearing technology. They may or may not consider themselves part of the deaf community.
Language: A system of spoken, manual (signed) or written communication used to express thoughts, views, information, feelings, experiences, or ideas. Languages have rules for encoding concepts/vocabulary, connecting and ordering words, and a grammatical system for combining and sequencing them.
Bone-Anchored Hearing Aid (BAHA): A hearing technology that involves direct stimulation of the cochlea through bone conduction, thus bypassing the outer and middle ear. It may be non-surgical (headband) or surgical. Then surgical option involves implantation of an anchoring “screw” behind the ear and an external processor. These devices are primarily used with individuals who have outer or middle ear problems or those who have a significant hearing loss in one ear. The non-surgical option is used with infants and young children.
Counseling: The interventionist usually provides informal counseling to the family regarding the nature and potential impact of their child’s hearing loss, the options for communication and education and provide supports for the family’s experiences with their child. More formal counseling would be referred to a specialist, such as a behavioral specialist, psychologist, or pediatric specialist.
Hearing: The process of receiving sound to the ear and auditory nerve.
Auditory-Verbal Practice: The evidence-based, parent/caregiver-centered approach to developing listening and spoken language communication in infants and children who are deaf/hard of hearing using advanced hearing technologies, such as cochlear implants, digital hearing aids, bone-anchored hearing aids and FM systems.
Individualized Treatment Plans: These plans are based on each child’s (and family’s) individual needs, based on assessment and observation. An Individualized Family Service Plan (IFSP) is the legal document that outlines the special services for children ages 0-3 and an Individualized Education Plan (IEP) is the legal document that defines special education services for students ages 3-21.
Early Hearing Detection and Intervention (EHDI): A national program in which each state is responsible for implementation of newborn hearing screenings, timely audiological evaluations, and referrals to early intervention services and for children with all levels of hearing loss. Information, family support and professional training can be found though The National Center for Hearing Assessment and Management (NCHAM) https://www.infanthearing.org/
Listening and Spoken Language (LSL): A model of intervention that uses evidence-based family-centered practice, current hearing technologies, and auditory-verbal strategies to promote the use of listening to develop speech, language, literacy, and cognitive skills for children with all levels of hearing loss.
Autism Spectrum Disorder (ASD): Term to describe a communication disorder that usually impacts how an individual socializes with others and may include repetitive patterns of behavior. ASD may have a wide range of symptoms on a continuum from mild to severe.
Deaf: Individuals who describe themselves as Capital “D” Deaf, identify with Deaf culture and the Deaf community and use sign language as their primary means of communication.
Evidence-Based Practice: The use of best practices for intervention based on current research.
Hertz: Unit of measurement for frequency of sound.
Listening: The process of receiving sound information and cognitively interpreting it to derive meaning.
Spoken Language: The use of a system of speech sounds (phonemes) to code language in verbal form for the exchange or expression of thoughts, views, information, feelings, experiences, or ideas. In addition to phonemes, spoken language uses prosody to convey meaning, which can include: pauses between utterances, changes in speed and rhythm, and changes in stress - using duration (length), intensity (loudness) and speech frequency (intonation/pitch). Each spoken language has rules for how particular phonemes can be combined/used in that language.
Digital Hearing Aid: A wearable hearing device that digitizes sound input and transmits the resulting amplified signal to the external and then middle ear.
Family-Centered Intervention: Intervention based on the values, needs and circumstances of each family.
Hearing Aid: A hearing device worn externally to amplify sound and deliver it to the external and then middle ear.
Disability/Disorder: Any restriction or lack of ability that interferes with performance.