Introduction to Aural Rehabilitation

Lisa Bowers, Ph.D. CCC-SLP

Auditory Stimulation in
Communication
Chapter Four

Auditory perception

can discriminate changes in frequency,

intensity and duration

frequency as measured by: Hz

intensity as measured by: dB
duration as measured by: sec

Environmental Sounds Audiogram

Acoustics of speech a review

intensity (dB)

frequency (Hz)

fundamental frequencies differ by person, but also

gender and age

male average = 130 Hz

female average = 260 Hz
children average = 400 Hz

consonants have a broader frequency composition

than vowels

Time

Transitional cues

Speech Perception and Comprehension

Auditory Skill Hierarchy

Speech Perception and Hearing Loss

intensity and frequency are impaired

not sufficient to hear the speech signal

Think co-articulation

consonant perception more difficult than

vowels
overall degree of speech perception difficulty

Redundancy

predictability of what the speaker will say

Table 4.3 List of Factors that can Influence
the Amount of Redundancy in Speech
Table 4.4 Linguistic constraints that enhance
speech perception

Auditory Training

aim to achieve maximum communication

potential

History

also known as the acoustic method

introduced by Dr. Goldstein in the US in the
early 1900s
Raymond Carhart begin using auditory
training exercises with adults at VA centers
after WWII

Father of Audiology

Current Approaches to Auditory Training

Begins with baseline assessment and progress

monitoring of auditory skills

for young children, discrimination and

localization will be the only way to really vary
auditory stimuli

Assessment

Factors that must be considered:

difficulty of perceptual task (auditory skill

hierarchy)
response format (open/closed sets)
speech stimulus (syllable, word, phrase,
sentences)
level of vocabulary (predicable/ unpredictable)
Signal to noise ratio (SNR) (+20, +15, +10)

greater than 0dB = indicates more signal than noise

SNR example

Assessments - Children

Developmental Approach to Successful

Learning II (DASL II)

evaluates sound awareness, phonetic listening,

auditory comprehension
sequential and highly structured (page 149)

SKI-HI Language Development Scale (LDS)

20 units
Table 4.10 in your text

Others: Speech Perception Instructional Curriculum

Evaluation (SPICE)

Early Speech Perception Test for Profoundly Hearing

Impaired Children (ESP)

criterion referenced test

assess pattern and word perception using a closed set format

4 categories: no pattern perception, pattern perception, some
word identification, consistent word identification

Infant/Toddler Meaningful Auditory Integration Scale

(MAIS/IT-MAIS)

questionnaire parents complete

assessment carryover auditory skills in the home setting

SLP Diagnostic Clinic

Test of Auditory Perceptual Skills Revised

(TAPS-3)

Auditory number memory, auditory sentence

memory, auditory word memory, auditory
interpretation of directions, auditory word
discrimination, auditory processing

Cottage Acquisition Scales for Listening,

Language & Speech 3rd Edition

Development of language, related cognition goals,

social interaction and syntax, sound awareness,
phonetic / phonemic discrimination, articulation

Lindamood Auditory Conceptualization Test -3

(LAC-3)

measure of auditory perception and

conceptualization of speech sounds

Assessment Adults

word recognition testing

Figure 4.7 in text

California Consonant Test

closed-set, MC format

use of speech babble, multi-talker babble =

several people talking at once
Speech perception in Noise (SPIN)

uses sentences with high and low predictability in

noise

Central Institute for the Deaf Everyday Speech

Sentences

Table 4.7 in text

Auditory Training Methods

4 general categories

Analytic: break speech into smaller components

Synthetic: use contextual cues

syntax, meaningful stimuli (everyday words)

Pragmatic: communication variables

phoneme syllable-word-phrase

SNR, context, complexity

use of conversational repair strategies

Eclectic: combination of above strategies

Auditory Training
Hierarchical Approach

Combination
Approach
discourse

Identificati
on
discriminat
ion

ID phrases

Comprehensi
on

detection

Discriminati
on of
sounds

ID words

3 Auditory Training Approaches

Natural
Structured
Conversation
Approach
Specific tasks

Auditory Training Approaches

DASL II
SKI-HI

Table 4.11 in text

SPICE

Auditory Training Approaches Adult

Communication Training Activities

Consonant Recognition Training

Drill, same/different, rephrase, simplify

audition only , audition plus visual cues
drill

Repair Strategies

Table 4.12 in text

Computer Approaches

Listening and Communication Enhancement

LACE

Earobics

Online Activities

Linguistic Constraints

guessing what words might be

Cloze procedures

add in correct information