Brainworks hear to learn 2013

Hear to LearnDr. Krista YuskowBrainworks ConferenceNovember 2, 2013

Friday, 1 November, 13

Today’s Talk

1. Hearing vs. Listening

1. Barriers to Auditory Access

2. Auditory Processing

3. Strategies for the Classroom


Listening

Cognition Attention Memory Hearing

Children are required to listen throughout their day.


Listening



Chemotherapy


Listening



Chemotherapy

Radiation


Listening



Chemotherapy

RadiationRadiation


Listening



Chemotherapy

RadiationRadiation

Radiation


Listening



Chemotherapy

RadiationRadiation

Radiation

Difficulties Processing


Hearing Listening

Ear level

Passive process

The ear’s ability to detect sound

Brain level

Hearing with attention and intention

Demands mental effort

Brain Level

Reception of information, meaning and intent

Comprehending

Involve hearing, cognition, attention and memory.

Require cognitive and auditory processing.


Hearing Listening

Ear level

Passive process

The ear’s ability to detect sound

Brain level

Hearing with attention and intention

Demands mental effort

Brain Level

Reception of information, meaning and intent65%

Comprehending

Involve hearing, cognition, attention and memory.

Require cognitive and auditory processing.


The Role of Cognition for All Listeners

Allows listening to focus on a target

Supports more complex processing of information

Compensates by drawing on context and non-auditory issues (top down)

Precision and uncertainty (Singh, 2012)


Hearing is Assumed… and often overlooked.

If that’s true for hearing, even more true for listening

Hearing/listening skills are a scaffold for other types of information processing (language, attention, pragmatics, etc.)

All of this is wrapped in cognition


Audition and Cognition

Pichora-Fuller, 2006



Audition

Cognition




Audition

Cognition

Cognition

Audition



Classroom Acoustics

Hearing Loss

Auditory processing

Speech level & clarity

Language proficiency

Barriers to Auditory Access


Classroom Acoustics noise reverberation distance

? Cough!

Cough!

Cough!


10

As the distance between teacher & student increases, the amount of info the student is able

to understand decreases.


http://classroomhearing.com/acoustics.html






RATSI 11


A typical teacher’s voice measures 60-65dB at a distance of 1.2 metres – only enough for the front row to hear clearly!


1 m



1 m

60 dBA



1 m

60 dBA



1 m

2.5 m

60 dBA



1 m

54 dBA

2.5 m

60 dBA



1 m

54 dBA

2.5 m

60 dBA



1 m

54 dBA

2.5 m 5 m

60 dBA



1 m

54 dBA48 dBA

2.5 m 5 m

60 dBA



1 m

54 dBA48 dBA

2.5 m 5 m

60 dBA



1 m

54 dBA48 dBA

2.5 m 5 m

10 m

60 dBA



1 m

54 dBA48 dBA42 dBA

2.5 m 5 m

10 m

60 dBA



1 m

54 dBA48 dBA42 dBA

2.5 m 5 m

10 m

60 dBA



The Combined Effect

The farther the student is from the desired speaker the more noise and reverberation will interfere with speech

understanding.


50dB BGN

0 3 6 9 12Distance from teacher in Metres

20

40

60

80

100

typical classroom noise


50dB BGN


20

40

60

80

100



50dB BGN


20

40

60

80

100



50dB BGN


20

40

60

80

100



50dB BGN


20

40

60

80

100



50dB BGN


20

40

60

80

100



“Oh, they can hear me… I have a loud voice”.


Miniature Adults?

Children are not mini-versions of adults.- Language development- Auditory development

Children require a more complete, detailed auditory signal.


Think of the following words:WalkWalksWalkedTalkTalksTalkedTopTopsTopped

Making your voice louder

does not necessarily make your

voice heard.


Think of the following words:



voice heard.


Think of the following words:



voice heard.

WalkWalksWalkedTalkTalksTalkedTopTopsTopped


Hearing vs. Comprehending

Gr.2 vs 400 level college course

Auditory-Cognitive closure

Young ears/brains cannot accurately ‘repair’ what is missed or misheard.

The importance of high frequency information


19

Auditory-Cognitive ClosureFriday, 1 November, 13

Hearing Loss

¼ of K/1 students in typical classrooms do not hear normally on any given day.

Flexor, Richards, Buie, Brandy; 1994


Why do children get ear infections?

Eustachian tube

Becomes inflamed or does not open properly


• Fluid builds up and cannot drain. • Bacteria or viruses can move into this fluid.

May result in conductive hearing loss


Some chemotherapies can result in high frequency hearing loss


The Audiogram


The Audiogram


The Audiogram


The Audiogram


The Audiogram


The Audiogram


The Audiogram


The Audiogram


The Audiogram


The Audiogram


I’m so misunderstood….


Auditory Processing

Hearing occurs at the ear level.

Processing occurs at the brain level.

“What we do with what we hear.” (Katz)




What is it? A breakdown in auditory abilities resulting in diminished learning (e.g. comprehension) through hearing.

Even if peripheral hearing sensitivity is normal.

Deficits in auditory processing are often associated with listening, comprehension, language, and learning difficulties.


What Causes APD?

Developmental delaysCANS disordersNeurologic disorders/diseaseGenetic predisposition

Reduced or inconsistent auditory stimulation Brain injury Demeylinating Diseases


Auditory Processing is Typically Maturational

Children require:

a louder speech signal a slower rate of speech

* Children with auditory processing difficulties as a result of radiation/chemotherapy treatments, hearing loss or other non-maturational causes may not develop listening skills to that of their peers.

http://www.learningthroughlistening.org/Listening-A-Powerful-Skill/The-Science-of-Listening/History-and-Overview-of-Listening/91/

repetition of information more time.


https://portal-owa.epsb.ca/exchweb/bin/redir.asp?URL=http://www.learningthroughlistening.org/Listening-A-Powerful-Skill/The-Science-of-Listening/History-and-Overview-of-Listening/91/

https://portal-owa.epsb.ca/exchweb/bin/redir.asp?URL=http://www.learningthroughlistening.org/Listening-A-Powerful-Skill/The-Science-of-Listening/History-and-Overview-of-Listening/91/

Children require a more complete, detailed auditory signal.

Young ears/brains cannot accurately ‘repair’ what is missed or misheard.


Bottom-Up ProcessingHow the information gets from the ear to the brain.Bottom-up processing can result in incomplete information.

Sound Waves

Auditory Identification

Aud/LangProcessing

ConceptUndrstng

To compensate for incomplete information we use top-down processing.


Top-Down Processing

Once information is in the brain… how it is categorized, organized, retrieved, etc.

Applying meaning to language (Beck, 2012)


Fishin’ Talk


Fishin’ TalkHiyamac. Lobuddy.



Binearlong? Coplours.




Cetchanenny? Goddafew.





Kindarthey? Bassenperch.





Kindarthey? Bassenperch.Ennysizetoom? Couplapowns.






Hittinhard? Sordalike.







Igoddago. Seyaroun.







Igoddago. Seyaroun.Yatakideezy. Guluk.


Students with APD often have difficulties with the following

educational activities:


Hearing or understanding speech in a noisy room or in groups of people

Following long conversations

Learning a second language

Learning challenging vocabulary words

Remembering spoken information/instructions

Maintaining focus in the presence of noise


Taking notes

Organizational skills

Following multi-step instructions

Spelling, reading and/or phonemic awareness skills

Keeping up with classroom work

Paying attention and may be easily distracted


Students with APD may additionally experience difficulties with:


Exhibiting inappropriate behaviors because of frustration

Peer relations and social confidence

Sensitivity to loud sounds

Locating traffic and other environmental sounds

Fatigue and may tire more easily than classmates

Passive learning: students with miss important information when the conversation is not directed towards them


Management: What Can I do to Help?


Management Myth The problem needs to be cured for the treatment to have value.

Conclusion: since there is no ‘cure’, nothing can be done.

The “diagnosis as treatment” model: Recognize that the disorder exists.

Current research in neuralplasticity suggests that changes occur over a long time frame (The Brain that Changes Itself by Norman Doidge, 2007)

Whitelaw, 2012


Make the classroom a good listening environment.

Improved bottom-up (CADS or pFM)

Seating placement/arrangement

Reduce classroom noise

Slow rate of speech


CADS

Universal Design for Learning

CADS improves signal-to-noise ratio

CADS help to maximize speech/intelligibility

CADS provide redundancy to the bottom-up system.

Be aware that the use of technology is NOT a panacea for children with APD.


44

SPEECH TRANSMISSION (RASTI)


Help the Student Focus on What is Being Said

Eye contact

Identify and paraphrase

Visual cues/supports*

“Chunk” information

Stay on topic

Comprehension Monitoring

Provide short breaks

Self advocacy / Mindfulness


Watch for Signs of Frustration

Provide extra time to process auditory information

Paraphrase rather than repeat.

Summarize discussions.


Other Strategies New concept/vocabulary support

Provision of notes / technology to support

Demonstrations and experiments

Exam accommodations

Multiple means of representation

Elbow partner


Poor acoustics,

health, hearing loss

and processing

difficulties can all

affect intelligibility

and comprehension.


Questions???krista.yus

[email protected]


APD Management: Auditory Training FastForWord Earobics Lindamood-Bell material (e.g. LiPS) Treating Auditory Processing Difficulties in Children (Sloane) Rosner’s approach (good home material) Helping Children Overcome Learning Difficulties; pages 189-210.

Rosner's books and tests can be found in Academic Therapy Publication catalog.

Noise desensitization training Training in areas of deficit, including speech perception training Moncrieff: Dichotic listening skills - dichotic interaural intensity

difference training Sweetow, LACE Jirsa, P-300 research; Kraus, BioMAP research


APD Management: Direct Treatment

Communication repair strategy development Build in top-down skills.

Multiple modality input may be beneficial However in some cases, global/multiple modality processing issues arise.


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