Standards and Protocols

For

Tactile Aids

Australian Hearing / Audiological Engineering Corporation

Australian Hearing/AEC, 2001. 2

STANDARDS The client/parents is/are aware of the availability of hearing aids and other devices appropriate to

his/her/their child’s needs, and of their benefits and limitations. Devices selected will be appropriate to the client’s needs and necessary to achieve a satisfactory

rehabilitation/habilitation outcome. Where a device is provided, an accurate assessment is made of aided performance and benefit. The client/family manages the device competently, and communication strategies are used

appropriately. Rehabilitation/habilitation strategies necessary to achieve a satisfactory rehabilitation/habilitation

outcome and appropriate to the client’s needs will be used. Accurate, relevant and up-to-date documentation of all services provided to clients is maintained.

PROTOCOLSVibrotactile aids are appropriate for clients who receive minimal or no benefit from a hearing aid, and are unsuitable for, or choose not to have, a cochlear implant. A vibrotactile aid may help the hearing impaired person to identify environmental sounds, assist lipreading, and to improve speech production and voice monitoring. It can also be used to highlight time-intensity cues already provided by a hearing aid and thus supplement the communication training program. These benefits will more likely be achieved if an appropriate training program using specifically designed materials is implemented.

1. Selection of clientsA client may be suitable for a vibrotactile aid fitting given the following factors: Case History

All appropriate hearing aid options have been explored. Only in exceptional circumstances would a vibrotactile aid be fitted without a recent hearing aid

trial e.g. Medical contraindications to a hearing aid fitting, previous history of unsuccessful (but appropriate) hearing aid fitting and rehabilitation program.

Client is not suitable for a cochlear implant or an implant has failed, does not wish to consider an implant or is on a waiting list for an implant.

Infant who is profoundly deaf and concurrently undergoing a hearing aid trial.Audiometric Results

Aided thresholds are only recorded for the low frequencies at high intensities at client’s preferred listening level.

Aided thresholds fall below the maximums of the speech spectrum. Corner Audiogram individuals who do have low frequency hearing but poor or no higher frequency

hearing. A vibrotactile aid can be used with these children to get them aware of and/or improve pronunciation of sibilants. Some Adults in this category have also used a vibrotactile aid for a short period to improve consonant production.

Speech Perception Results(where assessment is possible ie: Adults)

No significant difference between auditory-visual and visual performance on a sentence test (e.g.: Helen, CIDs).

Inability to perform auditory alone on a simple sentence test (e.g.:Helen). Score at or below chance level on syllable pattern tests (e.g.: SILL, categorisation score on

PLOTT subtest 3). Ability to use time and intensity cues only, but requiring effort because of the limited aided signal

available. ie.: A vibrotactile aid may enhance this signal providing easier access and reinforcement of these cues.

Non-Audiological Factors commitment to training program willingness to wear the device supportive home environment and school/early intervention program if a child.

Option of Cochlear ImplantationMany clients suitable for a vibrotactile aid will be candidates for cochlear implantation and must be provided with information on the potential benefits and limitations of the device. This should include written material. The client should be provided with information that compares the performance capabilities and potential benefits of vibrotactile aids and cochlear implants. Where a client is interested in the possibility of receiving a cochlear implant, they should be referred to an appropriate Ear Nose and Throat Specialist or

Australian Hearing/AEC, 2001. 3

Cochlear Implant Clinic for assessment. The client should also be made aware of any local support groups for clients who have received a cochlear implant.

2. Pre-fit counselingPre-fit counseling should include:

Demonstration of a vibrotactile device. Discussion of realistic goals. Discussion of the training program and need for commitment to the program. If necessary, a few demonstration and training sessions, which may be helpful in establishing

interest in the vibrotactile aid and commitment to a training program. Creating an "open door" for the client/family if he/she is not interested in the vibrotactile aid or not

willing to participate in a training program at that point in time. Discussion of involvement of a communication partner wherever possible.

3. Selection of the most appropriate vibrotactile deviceThe selection of a Vibrotactile device entails looking at what devices are available, what their strong features are, and the most important goals of the user. Features and goals to consider are:

Speech reading assistance Speech training-reception/production (Children) Speech Habilitation/improvement (Adults) Environmental sound awareness Size of unit.

Single or dual channel vibrotactile aids are usually fitted initially to allow a client: Child or Adult to adapt to simple tactile information.

Clients suitable for fitting with multichannel vibrotactile aids are: Adults who have no residual hearing. Adult clients with neurofibromatosis (NF2) who are potential auditory brainstem implant

candidates. Effective users of single, dual or multichannel vibrotactile units.

Children should start with a single channel unit and move to a multichannel unit when they show recognition and use of the vibrotactile information.

Post lingually deafened Adults whose main goal would be for the vibrotactile information to support lipreading would find a vibrotactile aid with a processing strategy oriented to this task preferable e.g.: a LTD.

4. Fitting of vibrotactile deviceDepending on the client, the initial fitting would include the following:

device management revision of goals demonstration of possible benefits (e.g.: conversation with vibrotactile aid, some simple

environmental detection tasks, a simple syllable pattern task) outline of a structured program of use including provision of home activities aided testing ie.: aided thresholds or phoneme detection (if client wears a hearing aid compare

phoneme detection with aid and with vibrotactile aid)

Baseline Speech Perception Testing for Adult ProgramsBefore commencing training, some baseline assessment tasks should be performed. This further assists with the development of the communication training program and provides baseline results for outcome measures.This testing may include the following:

sentence test (Helen, CIDs) - *Auditory-visual , Auditory-visual-tactile speech tracking - Auditory-visual, Auditory-visual-tactile syllable test (Plott, SILL) – Auditory-tactile

* Auditory: denotes use of hearing aid if worn.(See also List of Rehabilitation Materials - Appendix 1).

Australian Hearing/AEC, 2001. 4

5. Developing a goal-based rehabilitation planIt is strongly recommended that a comprehensive rehabilitation/habilitation program be employed, as the tactile signal will be new and unfamiliar to the client. Clients fitted with vibrotactile aids should receive an initial eight hours of training, provided on an individual basis. Training for children may be provided by their Specialist Teacher. This may be in consultation with a Paediatric Audiologist.

ADULT PROGRAMS The areas to be covered in the rehabilitation program are:

communication counseling information counseling discussion of psycho-social issues goal-based communication training which may include any number of the following - aid to

lipreading, environmental awareness, voice monitoring, telephone training. Communication counselling, hearing loss information counselling and discussion of psychosocial issues should be covered as part of a communication training program.

In providing goal-based communication training specifically for a client with a vibrotactile aid, the audiologist needs to be aware of the type of information provided by the device and its potential benefits and limitations. However, general principles and considerations in devising and administering the program will be similar to those for clients fitted with conventional hearing aids. Establishing the client’s needs and goals, in combination with specific knowledge of the device, guides the audiologist in decisions regarding the appropriate training modality, blend of analytic and synthetic training and level of complexity. Motivation of the client can be maintained through sensitive consideration of the timing and pace of the program, keeping the program relevant and realistic, establishing client responsibility and involvement of a communication partner. Use of a structured home listening program and activities plays an important role in the program.

Goal-Based Communication Training for Vibrotactile Aids(1) Aid to LipreadingAnalytic Training

Information provided by the particular device needs to be considered. Auditory-tactile alone training should be provided for tasks involving time-intensity cues (ie.

syllable pattern, sentence pattern/length, vowel length, final voicing, emphatic stress in sentences).

Tactile alone training for tasks which involve spectral information should only be provided for aids which supply this type of information (e.g.: Tactaid 7 or Little Tactile Device).

Auditory-tactile-visual training can be provided for homophonous contrasts which may be assisted with tactile-visual information.

Analytic training would normally be limited to short periods of time (e.g.: 5 to 10 minutes per hour).Resources: Tactaid 2 Program, Tactrain, Analytika, Commtram, Tactilator Training Manual, Targo.

Synthetic Training Will always be provided in Auditory-tactile-visual mode. Level of complexity will depend on client’s abilities. Aim is to provide structured and appropriately graded practice in tasks similar to everyday face-to-

face communication. Tasks should include - conversation tasks

- synthetic exercises - tracking sessions

(See also List of Habilitation/Rehabilitation Materials - Appendix 1).

(2) Environmental Awareness Detection and some discrimination tasks may be performed in clinical setting. Use of ‘Vibrotactile Home Assignments.

(3) Voice Monitoring Use of Commtram (speech production section) and Vibrotactile Home Assignments.

(4) Telephone Training

Australian Hearing/AEC, 2001. 5

Discussion of telephone options e.g.: fax, TTY: telephone typewriter, relay service, E-mail, Medi-Alert.

Emergency training for normal phone use e.g.: Yes-Yes/No code as outlined in Commtram.

CHILDREN’S PROGRAMThe goals for vibrotactile aid training for Children are: (1) The development of sound awareness and tactile pattern perception of non-speech and speech

stimuli.(2) Use of the aid as a supplement in the development of speech reading and overall communication.(3) Use of the aid in the development and monitoring of speech production.

The development of tactile pattern perception is an important prerequisite for the first two goals and should not be viewed as an end within itself. The integration of tactile pattern and speech perception skills with speech production and whole language objectives best describes the overall goal of a vibrotactile training program. Ultimately though the appropriate choice of goals must be suitable to the needs of the child and family.

Parents and teachers should be counselled on the following realistic expectations: Identification and discrimination of environmental sounds in an unstructured, noisy setting is a difficult

task with a vibrotactile aid. Although identification of environmental sounds is difficult, a review of tactile aids, by Australian Hearing in 1995, indicated that parents reported sound awareness as the greatest benefit obtained from tactile devices for their children.

Open set speech recognition is not a realistic goal with a vibrotactile aid alone. However, research has indicated that information from vibrotactile aids can enhance speech reading performance.

The Australian Hearing Review of Tactile Aids in 1995 indicated that support and training in the educational setting is a critical factor for the success of a tactile aid fitting for a child. A vibrotactile fitting should not proceed if such support and training will not be provided.

Goal-Based Communication Training for Vibrotactile AidsIn order to achieve the goals outlined above, training should progress from simple sound awareness exercises to the perception of voice, speech, speech patterns and features. For older children training should incorporate information from their educational programs so that it is meaningful and encourages integration of learning e.g.: themes used in the classroom can be used for training purposes so that language does not become the limiting factor in training, books used for improving reading skills can be used for tracking exercises. It is thus ideal that the training program be undertaken by the child’s specialist teacher in their educational setting.

Before commencing training it is important to understand what information is available through the child’s particular vibrotactile aid.

Analytic Training – Sound awareness and tactile pattern perception1. Sound detection2. Tactile pattern perception3. Word syllable number and type4. Other time-intensity contrasts 5. High frequency detection and other feature cues (if this information is available from the tactile aid

e.g.: a dual or multichannel aid)

Presentation Modality: Tactile/Auditory aloneMay require use of a heirachy of cues before task is introduced as tactile/auditory e.g.: tactile/auditory/visual/sign tactile/auditory/visual tactile/auditory

(See List of Habilitation/Rehabilitation Materials - Appendix 1).

Synthetic Training - Whole Language Tasks (supplement and development of lipreading)1. Discourse level: discrimination between larger units of language e.g.: paragraphs, rhymes.2. Sentence level: identification of sentences of varying length.

Australian Hearing/AEC, 2001. 6

Presentation modality: Tactile/Auditory/ Visual May require use of a heirachy of cues before task is introduced as tactile/auditory e.g.: tactile/auditory/visual/sign tactile/auditory/visual

(See List of Habilitation/Rehabilitation Materials - Appendix 1).

Speech Production1. Integrate with whole language tasks and analytic program (e.g.:Tactaid 2 program, TARGO, Tactilator Training Manual. See List of Habilitation Materials – Appendix 1). 2. Use VT aid during speech work.

6. Outcomes assessment Following the initial eight hours of training, progress and commitment to training should be

reviewed. Outcomes assessments should be performed, including goal assessment and speech perception

testing.(See Australian Hearing Tactile Aid Training Program and Paediatric Tactile Aid Evaluation Form – Appendix 2). The device should be withdrawn if the client feels it is of little benefit or they are not wearing it.

On completion of the initial training program, a maintenance program should be arranged. This may involve one appointment per month for three months, followed by aftercare assessments as required for Adults or may be undertaken by a Child’s teacher and/or Specialist Audiologist.

Australian Hearing/AEC, 2001. 7

List of Habilitation/Rehabilitation Materials Appendix 1.

ADULTS

Rehabilitation Packages NAL Auditory Training Program, Geoff Plant /Australian Hearing, 1982. Commtram: A Communication Training Program for Profoundly Deafened Adults, Geoff

Plant/Austalian Hearing, 1984. Communication Therapy, Norm Erber 1988. Communication Strategies in Speechreading: a way to improve understanding. Kaplan, Bally and

Garretson. Chapter 4. Clerc Books, Gallaudet University Press. 1995. Cochlear Ltd Rehabilitation Manual, July 1989. Analytika, Geoff Plant/Audiological Engineering Corporation. TACTRAIN (Adult Tactile Auditory Training Program). Geoff Plant/Audiological Engineering

Corporation. Vibrotactile Home Assignments: Australian Hearing.

a. An introduction to your vibrotactile aid and home assignments.b. Using the vibratory signal to understand speech.c. Listening to sounds around the house.d. Differentiating sounds.

"Synthetic" Communication Training Exercises Syntrex, Geoff Plant/Australian Heaing.

Exercises such as: Questions and answers. Spondee Exercises. Questions and Instructions. "Describe, Perceive and Draw" tasks. Referential tasks such as barrier games and map reading. "Fill the gap" sentences.

Connected Discourse Tracking, as described in Commtram, Geoff Plant/Australian Hearing. QUEST?AR, Norm Erber, 1984. "Overlearned " Speech, Australian Hearing. COMMTRAC, modified Connected Discourse Tracking excercises for Hearing Impaired Adults. Geoff

Plant/Australian Hearing, 1989. TARGO, Audiological Engineering Corporation. Tactilator Training Manual, Audiological Engineering Corporation.

ASSESSMENT MATERIALS FOR PRELINGUALLY DEAFENED CLIENTS OR CLIENTS WITH LOWER LEVEL ENGLISH LANGUAGE COMPETENCY.

Detection tasks: Plott Test, subtest 1. Geoff Plant and Sharan Westcott, Australian Hearing. Auditory Skills 7 Sound Test. Auditory Skills Program: NSW Department of School Education ,

Australia or found in the Manual of Speech Perception, Australian Hearing.

Syllable detection (listed in levels of difficulty): Plott Test, subtest 2. The Auditory Numbers test. Geoff Plant and Sharan Westcott, Australian

Hearing. Plott Test, subtest 3. Monosyllable, Trochee, Spondee and Polysyllable test. Training lists from Commtram Pages 21-29. Geoff Plant/Austalian Hearing. Training lists from the NAL Auditory Training program. Geoff Plant /Australian Hearing, 1982. SILL test. Comtramm page 16. Geoff Plant/Austalian Hearing.

Sentence perception CID everyday sentence lists (NAL standardised) found in the Manual of Speech Perception, Australian

Hearing. BKB Sentence lists found in the Manual of Speech Perception, Australian Hearing. NAL Lipreading test found in the Manual of Speech Perception, Australian Hearing. Plott Sentence Test, Geoff Plant and Alessandra Moore, Australain Hearing. Australian Hearing/AEC, 2001. 8

Training lists from Commtam Pages 33-39. Geoff Plant/Austalian Hearing.

Vowel length perception Plott Test, subtest 5. Geoff Plant and Sharan Westcott, Australian Hearing. Training lists from Commtram pages 72-75. Geoff Plant/Austalian Hearing. Test lists from NAL Auditory Training program. Geoff Plant /Australian Hearing, 1982. Analytika, Geoff Plant/Audiological Engineering Corporation.

Closed set materials Plott Test. Geoff Plant and Sharan Westcott, Australian Hearing. Plott Sentence Test. Geoff Plant and Alessandra Moore, Australain Hearing. WIPI test. Mark Ross and Jay Lerman. Measures of vowel and consonant recognition (examples of these tasks to be found in Commtram).

Same/different tasksConsonant testsVowel Rhyme test Consonant Rhyme testVowels in /hVd/Consonants in /aCa/Nonsense syllable test

Open set materials BKB sentences found in the Manual of Speech Perception, Australian Hearing. Helen test found in the Manual of Speech Perception, Australian Hearing. CID sentences found in the Manual of Speech Perception, Australian Hearing. Modified SPIN sentences found in the Manual of Speech Perception, Australian Hearing. SPIN test found in the Manual of Speech Perception, Australian Hearing. AB Word lists found in the Manual of Speech Perception, Australian Hearing. Connected Discourse Tracking, as described in Commtram Geoff Plant/Australian Hearing,

Informal assessments eg: Examples can be found in Synthrex and Commtrac (Geoff Plant/Australian Hearing). Interviews Referential tasks such as picture discussion, barrier games etc. Token tests. Games e.g.: questions and answers, 20 questions, "who am I?". Topic -centred sentences. Connected Discourse Tracking. Topic related discussion to practise communication repair strategies, turn taking and pragmatic skills.

Telephone Training NAL Auditory Training Program, Geoff Plant /Australian Hearing, 1982.

Australian Hearing/AEC, 2001. 9

CHILDREN

Analytic Training – Sound awareness and tactile pattern perception Sound detection Tactile pattern perception Word syllable number and type Other time-intensity contrasts High frequency detection and other feature cues (if this information is available from the tactile aid e.g.

a dual or multichannel aid)

Resources: Tactaid 2 Program: Geoff Plant Australian Hearing. TARGO Tactilator Training Manual: AEC CHATS:The Miami Cochlear Implant, Auditory and Tactile Skills Curriculum. Vibrotactile Training, Activities for Young Children: Janette Thorburn, Australian Hearing. A Home Program for Preschool Vibrotactile aid users: Sally Pat Orange/Heather Reid, Australian

Hearing Paediatric Tactile Aid Evaluation Form: uses heirachy of tasks. Australain Hearing Synthetic Training - Whole Language Tasks (supplement and development of lipreading) Discourse level Sentence level

Resources: Auditory Skills Program: NSW Department of School Education , Australia. CHATS: The Miami Cochlear Implant, Auditory and Tactile Skills Curriculum. Vibrotactile Training, Activities for Young Children: Janette Thorburn, Australian Hearing. Paediatric Tactile Aid Evaluation Form: use heirachy of tasks, Australian Hearing. TARGO, AEC. Tactilator Training Manual, AEC

Speech Production1. Integrate with whole language tasks and analytic program (Tactaid 2 program, TARGO Tactilator Training Manual). 2. Use VT aid during speech work.

SOURCES OF TRAINING MATERIALS

These sites can lead you to where materials may be purchased or will provide information on ordering.

www.tactaid.com Audiological Engineering Corporations's site which has information on Tactile aids and references to organisations using their products.

www.hearing.com.au Australian Hearing site where you can follow the path to NAL Research and click on Order Publications.

HeaRF@aol.com for materials produced by Geoff Plant.

www.auditec.com

Appendix 2

Australian Hearing/AEC, 2001. 10

ADULT TACTILE AID TRAINING PROGRAM

All tactile aid fittings must be supported by a tactile aid training program. This form is designed to monitor the program and for data collection.Prior to traininga. The audiologist and client should discuss individual and common goals that may be achieved through

a tactile aid training program. These should be ticked or included on the front of this form.b. Perform baseline speech assessment using sentence and syllable tests and speech tracking.

The test should be carried out using the sensory cue combinations indicated on the form:A = auditory V= visual T = tactileE.g. AVT = auditory + visual + tactile - if using hearing aid in conjunction with tactile aid.

Training:Record all training appointments and approximately 5-10 minutes of speech tracking should be done at each appointment, allowing for the client's abilities. Use the same text for each training appointment, this need not be the same as the assessment text.

Outcome:The client should be interviewed and a result recorded against each goal - e.g. slightly better.Pre-training speech tests should be repeated, results recorded and asterisked where there is a significant difference in scores pre and post training

BASELINE ASSESSMENT ((A) with hearing aids if worn) Date:........................ Sentence Test(Helen/SPIN/....................)

AV .......................%V. .......................%(A).......................%

Speech TrackingText:.......................................Scores:

AV ................... wpmA. ................... wpm

A – Syllable Test(PLOTT/SILL/..................) Scores:

Categorisation...............Identification ...............

A = auditory V=visualProgram format: Intensive (3-5 days) Appointment series Residential TRAINING APPOINTMENTS

DATE DURATION TRACKING A/AV w.p.m. TEXT

OUTCOMES ASSESSMENT Date : …………………

Australian Hearing/AEC, 2001. 11

NAME: D.O.B. ______/______/_____

Audiologist: Centre/Site: ____________________

Tactile Device: Fitting Date: _____________________

GOALS RESULT*

To improve my recognition & awareness of environmental sounds

To improve my ability to monitor the loudness of my voice

To improve my lipreading with the help of tactile sensations

To make following a conversation easier/less of an effort

*Result : worse / no difference / slightly better / better / much better

Sentence Test(Helen/SPIN/..................)

AV.......................%V .......................%A .......................%

Speech TrackingText:.................................

Scores:AV ................... wpmA .................... wpm

(A) – Syllable Test(PLOTT/SILL/.................)

Scores:Categorisation...............

Identification.............….

ACTION : Tactile program extended Cochlear Implant Tactile device returned

Audiologist's comments :

Client's comments :

Australian Hearing/AEC, 2001. 12

Child’s Name: _________________________ Date of Birth: ___/___/___

Audiologist: _________________________

SECTION A. ALL CHILDREN. Date __/__/__ Date__/__/__ Date__/__/__

Parental perception of benefit.1. No benefit at all. 2. Benefit during auditory and/or speech training sessions only. 3. Benefit in structured environments e.g.: Preschool. 4. Benefit in some everyday listening situations. 5. Benefit in most everyday listening situations.

Device Use.1. Refuses to wear device or does not wear it. 2. Wears device only during Auditory and/or speech training sessions. 3. Wears device during training sessions and in structured environments. 4. Wears device for most of the day. 5. Wears device most of the day and indicates when it is not working.

Sound detection.1. Does not seem to respond to any sound. 2. Responds to loud, short sounds (e.g.: drums, loud phoneme). 3. Responds to a variety of sounds (e.g.: speech and environmental). 4. Detects presence/absence of voice 5. Responds to both loud and soft voice.

.6 Has concept of on/off (indicates when sound has stopped).

Pattern perception.1. No ability to perceive patterns. 2. Able to discriminate a long continuous sound from a series of short sounds. 3. Able to discriminate a long sound from a short sound. 4. Able to discriminate fast from slow. 5. Able to discriminate 2 element sound patterns (e.g.: long short vs short short).

.6 Able to discriminate 3 element sound patterns. 7. Able to discriminate 4 element sound patterns. 8. Able to discriminate a whisper from a loud sound. 9. Able to discriminate soft and loud.

.10 Able to discriminate whisper/soft/loud.

Australian Hearing/AEC, 2001. 13

Paediatric Tactile Aid Evaluation Scale

Speech perception tests.Auditory AlonePLOTT Test

.1 Unable to perform any subtests.

.2 Detects vowels. 3. Detects vowels and voiced consonants. 4.Detects most speech sounds on Subtest 1.

.5 Some success on Subtest 2.

.6 Able to tell monosyllables from polysyllables. 7. Able to tell monosyllables from spondees. 8. Able to tell monosyllables from trochees. 9. Able to tell spondees from polysyllables.

.10 Able to tell trochees from polysyllables.

.11 Able to tell spondees from trochees.

Auditory-VisualCOT Test

.1 Not able to complete any f Subtest 1 accurately.

.2 Able to complete Subtest 1. 3. Able to complete Subtest 2 and 3 (red/green confusions acceptable). 4. Able to complete modified version of Subtest 4 where

carrier phrase remains constant. 5. Able to complete a modified version of Subtest 5 where carrier phrase remains constant.

PLOTT Sentence test.1 Not able to perform. .2 Correctly completes at least half of test.

3. Is able to complete test accurately.

Vocalisation while wearing the tactile aid..1 No vocalisation. .2 Vocalises only when encouraged to do so.

3. Vocalises spontaneously. 4. Imitates vocalisations. 5. Imitates patterns of vocalisation (including loud & soft, long & short, fast & slow).

Speech sound production while wearing tactile device..1 No improvement in speech production. .2 Imitates some vowels (e.g.: a, I, u).

3. Imitates some consonants (e.g.: b, m, w, and h). 4. Imitates single syllables.

.5 Imitates repeated syllables.

.6 Able to produce loud and soft sounds. 7. Able to produce long and short sounds. 8. Imitates syllable patterns. 9. Imitates stress patterns.

.10 Imitates fricative sounds.

If the child can succeed at all 10 levels, he/she should continue to acquire speech sounds slowly with continued training.

Speech reading without signs..1 No ability to follow communication without signs.

2. Responds to short, stereotypic phrases in context

Australian Hearing/AEC, 2001. 14

(e.g.: time for school, Where is your doll?) 3. Selects one item from 4. 4. Selects two items from 5 or follows a 2-element command in context (e.g.: Wash your hands).

SECTION B CHILDREN > 6 YEARS.In addition to the areas listed above, older children may achieve the following outcomes:

Speech/Sound perception.Vowel length

.1 Unable to perform. 2. Able to discriminate vowels with marked difference in length (e.g.: a, u). 3. Able to discriminate all long vs short pairs.

Voicing.1 Unable to perform. .2 Able to discriminate an extended s from z.

3. Able to discriminate voiced and voiceless fricative in the initial position. 4.Able to discriminate bilabial stops in the initial position.

.5 Able to discriminate remaining initial stops (k/g, d/t). 6. Any ability to discriminate voiced/voiceless for final consonant pairs.

Number and type of word/syllable (WSNT).1. Unable to discriminate sentences containing target words of different patterns.

.2 Able to discriminate WSNT in sentences.

If the child has a multichannel device..1 Unable to detect presence of a high-frequency fricative. .2 Detects a high frequency fricative in initial position.

3. Detects a high frequency fricative in final position. 4. Detects plural marker.

Speech reading (Closed set – with signs)Item selection.

.1 Able to select 3 items from 6.

.2 Able to select 4 items from 6 to 8.

Commands1. Able to follow a 3 element command (e.g.: put the doll in the bath). 2. Able to follow a 4 to 6 element command (e.g.: put the doll in the bath and the boy on the chair).

Tracking.1 Able to track from a familiar book. .2 Able to track using unfamiliar material.

Whole language Tasks.1. Able to identify 3 simple sentences that make a story. (e.g.: The postman came. The dog bit him. The postman ran away.) 2. Able to identify 3 more complex sentences that

Australian Hearing/AEC, 2001. 15

make a story. 3. Able to identify 4 sentences that make a story. 4. Able to identify 5 sentences that make a story.

.5 Able to identify 6 sentences that make a story.

Speech ProductionSame as detailed for children < 6 years.

Telephone use.1. Unable to recognise telephone signals (dial tone, engaged sound, telephone ring).

.2 Able to detect telephone ringing. 3. Able to discriminate dial tone from other telephone signals. 4. Able to identify telephone signals.

.5 Able to use simple yes/no code. 6. Able to use a grid system for closed set telephone communication.

SECTION C. TACTAID VII FITTINGS.

Vowel Discrimination1. Able to discriminate vowel pairs having different F1 and F2 values (a vs i). 2. Able to discriminate vowel pairs where F1s are similar but F2s are dissimilar (i vs u). 3. Able to identify vowels from a small closed set (5 item maximum).

Word Discrimination (Closed Set).1 Able to identify spondees (choice of 3). .2 Able to identify spondees (choice of 6).

3. Able to discriminate between words having a stop or fricative initial consonant. 4. Able to discriminate between words having a stop or nasal consonant initially. 5. Able to discriminate between words that have a stop or an affricate consonant initially. 6. Able to discriminate word pairs on the basis of place cues alone.

Stereotypic Sentence Discrimination (Closed Set).1 Identifies sentences of different lengths (set of 3). .2 Identifies sentences of different lengths (set of 6).

3. Identifies sentences of similar lengths with varied vowel composition (set of 3) e.g.: The boy got a new cup. vs The boy bit the hard bone. 4. Identifies sentences of similar lengths with varied vowel composition (set of 6).

.5 Identifies sentences any vowel composition (set of 3).

.6 Identifies sentences any vowel composition (set of 6).

Australian Hearing/AEC, 2001. 16