Advanced spoken language development in children with hearing … · 2019-01-02 · • Children...
Transcript of Advanced spoken language development in children with hearing … · 2019-01-02 · • Children...
Inge Kaltenbrunn
Speech Pathologist, LSLS Cert. AVT
ADVANCED SPOKEN
LANGUAGE DEVELOPMENT
IN CHILDREN WITH
HEARING LOSS
Learning outcomes
• To learn about spoken language development beyond
the preschool years in children with hearing loss
• To identify appropriate goals to support advanced
spoken language development
• To identify strategies to encourage narrative
development
• To understand the importance of comprehension and
use of non-literal language by children with hearing loss
Learning outcomes
• To identify strategies to encourage understanding and use of non-
literal language
• To learn about strategies to build and expand vocabulary in older
children with hearing loss
• To learn how modelling strategies can be used to develop meta-
cognitive skills in older children with hearing loss
• To learn about social communication skills that children with hearing
loss need to develop for social competence.
Spoken language development beyond
preschool
• Improvement in the ability to tell stories or relate personal experiences in an organized way
• Changes in ability to have a meaningful and effective conversation
• Ongoing growth in the understanding of words and the relationship between words, e.g. synonyms, antonyms
Spoken language development in older
children
• Development of non-literal language (idioms, humour and figurative language)
• Development of metalinguistic skills and awareness (learning to think about language)
• Reading with comprehension
• Using written text to learn
• Listening to learn in the classroom
Summary of goals: Advanced level
• Audition
• Speech perception
and production
• Vocabulary building
• Complex grammatical
structures
• Narrative skills
• Non-literal language
• Meta-cognitive skills
• Social communication
competence
Advanced spoken language learning
• Focus on “diagnostic teaching”
• Integrate targets into age appropriate activities
• Balance the challenge level of each goal, e.g. a
new language goal should be paired with an
established auditory goal and vice versa (Garber
& Nevins, 2009)
Example of integrated goals
• Cognitive target: Creative association
• Language targets: “would”; “if”
• Auditory target: Identifying an object by a
series of descriptors/critical elements
• “If I were this animal, I would be able to swim in
the water, but live on land”
From Garber & Nevins (2009)
Features of stories
• All narratives have a hierarchical structure and
relay causally related events
• The demands of story telling is different than the
demands of conversation
• Narrative story telling requires the child to tell a
story containing specific story structures or
elements, also called “story grammar” (Pukulski
et al. 2003)
Story grammar
• Introduction of characters---Setting---Initiating
Event---Action---Consequence (Story Episode)--
-Internal Response (as in Table 1. SNAP Dragons Manual)
Development of narratives
• Children are ready for story telling from a very young age
(Linder, 1993)
• Children as young as 16 months of age recognize the
difference between stories and ordinary conversation
(Davidson (in Kephart, 2000))
• From 3 years of age, children begin to remember things
about self over long periods of time and develop inner
speech
What about narrative development in
children with hearing loss?
• Children with hearing loss aged 6-11 years using spoken
English showed (Jones et al. 2016):
• Equivalent performance to a hearing control group on narrative
macrostructure in a task that did not depend on their receptive
language skills
• Poorer performance on narrative microstructure than the hearing
group of children
• Less complete and/or relevant answers to inference questions that
assessed their understanding of the intentions and actions of the
story characters
• Expressive vocabulary strongly correlated with micro-level
narrative skills, but the relationship with macro-level narrative skills
was weaker.
Red flags in narrative development
• Short duration
• Minimal content
• Difficulty setting the scene
• Events are not well linked
• Lack of organization/coherence
• Irrelevant ideas are added
(Sperandio, 2014)
Encouraging story telling at home
• Parents should be encouraged to:
• Substitute 30 minutes of screen-time with
reading time every day (Sarant et al. 2014)
• Read aloud to the child everyday for at least 20
minutes (Flexer, 2014)
• Read text that is one level above the child’s
current language level (Flexer, 2014)
Encouraging story telling at home
• Parents should check the child’s comprehension periodically while they read, e.g.
- What is the name of the main character?
- Where and when is the story taking place?
- Who are you reading about in the current paragraph?
- What is the character doing?
- Why is the character doing this?
- What might happen next?
- How is the character feeling about the events?
- How might the story end?
- How did the story end?
Encouraging story telling at home
• Parents should be encouraged to use visual
prompts or reminders to assist the child, if
needed
Encouraging story telling
• Build own story scripts by using the child’s favourite toys
or games. Create a story by adding on to the child’s play
(Sperandio, 2014)
• Expose the child to a range of different types of stories,
e.g. fairy tales and cultural stories
(www.worldoftales.com); popular stories adapted for
Australian culture (“Going On A Croc Hunt”) (Sperandio,
2014)
Encouraging story telling
• Tell a familiar story from another perspective, e.g. the
wolf in the story of the Three Little Pigs
• Use comic strips to learn sequencing a story (Garber &
Nevins, 2009)
• Make news newsworthy, e.g. My Best Day At Telecamp
• Utilize computer based products (Apps) to allow the child
to create and record their own stories, e.g.
www.storyplace.org; StoryMakerFree
Encouraging story telling
• Create “car” stories
• Participate in blank book story telling
• Create a bedtime story of the child’s actual day
• Play thinking games that involve classification, sorting
and sequencing to show the child how things relate to
each other
• Talk beyond what you can see when looking at pictures
Encouraging story telling
• Pretend often
• Prompt the child to relate events to others
• Wait for the child to finish telling the story
• Model and expand the child’s story, e.g. restate or reorganize the events shared by the child
Encouraging story telling
• Have the child retell a story in other formats, e.g.
using puppets
• Tell a story and have the child manipulate the
objects
• Compare a story to other stories
• Tell silly stories
• Retell longer stories seen in movies
Encouraging story telling
• Learn about popular movies, videogames and
toys in order to use the characters and themes
for the child to create their own stories, e.g.
FLOATZELF BIO
This lil' cloud's always got a
silver lining! Storm's sis is
full of bliss and always finds
the good in the bad. After
every storm (even her big
bro's), there's a rainbow!
ZELF POWER
Silver Linings
Non-literal language “People say the
strangest things”
• “Time is just flying”
• “I got the thumbs up to continue with the project”
• “Pull your socks up and get the homework done”
• “She decided to run for president”
• “Warning: Repair crew ahead, please give them a brake!”
• “Last week at the beach, I saw a man eating fish”
• “Break a leg!”
Non-literal language: Jokes and riddles
• “Which vegetable has conversations with Jack?
Jack and the beans talk”
• “What time do ducks get up? At the quack of
dawn”
• “Knock-knock…Who’s
there?...Lena…Lena…who?...Lena little closer
and I’ll tell you”
• “I have legs but I can’t walk”
Non-literal language in written text
“Tonight was the night she had been waiting for. Princess
Penelope was head over heels for Prince Patrick and
she had finally persuaded her father to allow her to
attend the annual royal ball. Penelope had sprinted like a
cheetah all the way down to the royal dress shop to pick
out the perfect dress. After hours of searching her eyes
landed on the most beautiful dress ever made. The
dress was a sparkling ruby. Penelope thought that it
must be the colour of Dorothy’s slippers…”
Why is understanding and using non-
literal language important?
• The category of non-literal language includes
idiomatic expressions, humour and figurative
language (Garber & Nevins, 2009).
• There is a greater chance to misunderstand a
message if the words do not quite mean what
they say (Garber & Nevins, 2009)
• This is true when reading and when having a
conversation with family, friends or others
Use of non-literal language by children
with hearing loss
• Children with hearing loss do not have the same opportunity to overhear language, because of difficulty hearing in noise and over a distance
• Children with hearing loss may not be able to overhear small differences between speech sounds or stress or intonation cues that can be crucial to understanding a specific ambiguous word or phrase or sarcastic expression
• Children with hearing loss are therefore more at risk for having difficulty understanding and using non-literal language
Problems caused by poor understanding
of non-literal language
• Academic difficulties, e.g. understanding written text for learning; following directions in the classroom. Impacting on academic performance and literacy
• Personal and social difficulties, e.g. not understanding puns, slang, jokes, sarcasm, irony and idioms can lead to embarrassment and difficulty building relationships with peers (making friends)
• Job-related difficulties
• Loss of pleasure found in humour and word play based on language ambiguity, e.g. understanding a funny advertisement on television
What clues do we use to understand non-
literal language?
• Situational context
• Knowledge of the speaker’s knowledge
• Speaker’s body language, facial expressions and eye gaze
• Speaker’s tone of voice
What clues do we use to understand non-
literal language?
• Placement of stress cues in the expression
• Spelling of the word
• World knowledge and previous experiences
• Form of an utterance as it relates to the content
Use non-literal language naturally in authentic
conversations (Garber & Nevins, 2009)
• Don’t get stuck in a language rut
• Keep an ear out for slang and expressions used
by the child’s peers
Use non-literal language naturally in real
conversations
• Be aware that ambiguity is out there…then
problem solve:
- Search for contextual clues that may support the
intended meaning of a word, phrase or sentence
“Whiteboards are remarkable”
Use non-literal language naturally in real
conversations
• Fully discuss all possible explanations for each
ambiguous word/phrase/sentence
• Encourage the child to think aloud when attempting to
figure out problematic ambiguous material
• Ask the child to paraphrase what was actually said, e.g.
“When John was away at school, he grew another foot.”
“When John was away at school, he grew a foot taller”
Use non-literal language naturally in real
conversations
• Discuss definitions of new or unfamiliar words as they
occur
• Search for visual clues, e.g. story situation, facial
expressions, gestures, eye gaze, etc.
• Emphasize the words that may be causing the ambiguity
in order to highlight them for the child
• Contrast literal and figurative meanings
• Make use of idiom or proverb dictionaries
Use non-literal language naturally in real
conversations
• Increase the child’s world knowledge, e.g.
classic literature; popular fiction; classic and
popular films; classic and popular games and
board games; music genres; a variety of direct
experiences (museums or other places of
interest; special interest clubs; sports;
opportunities for social interaction)
• Use role play, if needed
Strategies for vocabulary building
• NEW-Familiar-NEW strategy (Garber, 2011)
• Use a word that is new to the child
• In the next sentence, follow up with a known
word that means the same thing
• In another phrase, go back to the new word
Strategies for vocabulary expansion
• NEW-Explain-CONNECT strategy (Garber,
2011)
• Use a new word
• In the next sentence, explain it
• Then connect it to something that the child has
experienced directly
Developing meta-cognitive skills
Strategies to model for developing meta-cognitive
skills (Garber, 2010 from Duncan, 2007):
• How to think and remember
• Rehearsal: repetition, highlighting important facts,
physical cues
• Elaboration: creating mental images, paraphrasing
• Organization: grouping, classifying, identifying main
ideas
Towards social communication
competence
• Self-advocacy (Lucker & Molloy, 2014)
• Topic maintenance
• Topic shift
• Role shift
• Communication repair strategies, e.g. asking for specific
clarification; summarizing
• Child’s own strategies for successful communication
(Lucker & Molloy, 2014)
Resources for spoken language in older
children with hearing loss
• LEAPing on with language. Rehabilitation section on
www.cochlear.com.au
• Garber, A.S. & Nevins, M.E. Cochlear HOPE Tips: Ideas
for the elementary aged child. AudiologyOnline webinar.
www.audiologyonline.com
• Garber, A.S. Listen and Think II: Take it to another level.
Cochlear HOPE AudiologyOnline webinar.
www.audiologyonline.com.
Resources for spoken language in older
children with hearing loss
• Garber, A.S. Project ‘Versatile Vocabulary’.
Cochlear HOPE AudiologyOnline webinar.
www.audiologyonline.com.
• Black Sheep Press resources: Black Sheep
Press-language support for learning and life.
www.blacksheeppress.co.uk.
References
• Berndsen, M.A. (2001). Developing conversation
narrative skills in children with hearing impairment. The
Auricle, Early Winter edition, 12-15.
• Flexer, C. (2014). The auditory basis of literacy. RIDBC
Renwick Centre workshop event. Sydney, Australia.
• Garber, A.S. & Nevins, M.E. (2009). Cochlear HOPE
Tips: Ideas for the elementary aged child.
AudiologyOnline webinar. www.audiologyonline.com
References
• Garber, A.S. (2010). Listen and Think II: Take it to
another level. Cochlear HOPE AudiologyOnline webinar.
www.audiologyonline.com.
• Garber, A.S. Project ‘Versatile Vocabulary’. Cochlear
HOPE AudiologyOnline webinar.
www.audiologyonline.com.
References
• Jones, A.C., Toscano, E., Marshall, C.R., Atkinson, J.R.,
Denmark, T., Herman, R., & Morgan, G. (2016).
Narrative skills in deaf children who use spoken English:
dissociations between macro and microstructural
devices. Research in Developmental Disabilities, 59,
268-282.
• Lloyd-Richmond, H. & Starczewski, H. (2002). SNAP
DRAGONS-Stories/Narratives Assessment Procedure
Manual. Nottingham Cochlear Implant Programme,
Nottingham, England.
References
• Lucker, J.R. & Molloy, A.T. (2014). Overcoming
challenges with group conversations. Volta Voices
Nov/Dec 2014, 22-24. AG Bell Association for the Deaf
and Hard of Hearing.
www.listeningandspokenlanguage.org.
• Pakulski, L.A., Kaderavek, J.N., & Repphun, S. (2003).
Narrative story structure in response to a role play task:
A case study. Volta Voices, Jan/Feb 2003, 29-31.
References
• Sarant, J., Harris, D., Bennet, L. & Bant, S. (2014).
Bilateral versus unilateral cochlear implants in children: a
study of spoken language outcomes. Ear & Hearing,
35(4): 396-409.
• Sperandio, D. (2014). Rehabilitation for children with
hearing implants. MED-EL workshop. Sydney, Australia.