Case Studies of Children With ANSD
Auditory Consultant Resource Network
Boys Town National Research Hospital
1
Case Studies
Children With ANSD
Boys Town National Research Hospital
Jeffrey Simmons, M.A., CCC-A
Audiologist
Cochlear Implant Clinical Coordinator
Boys Town National Research Hospital
Katie Brennan, M.S., CCC-SLP
Speech-Language Pathologist
Auditory Consultant
Case Studies of Children With ANSD
Auditory Consultant Resource Network
Boys Town National Research Hospital
2
Boys Town National Research Hospital
Catherine C. Carotta, Ed.D., CCC-SLP
Associate Director
Center for Childhood Deafness
AN22 Case Study
Boys Town National Research Hospital
AN 22
• Normal birth history
• Passed newborn hearing screen
• OAEs screened again at age 14 months
– Present on left side
– Low amplitude but present on right side
Case Studies of Children With ANSD
Auditory Consultant Resource Network
Boys Town National Research Hospital
3
Boys Town National Research Hospital
AN22 Tymps
Boys Town National Research Hospital
AN22: ABR At 14 Mos. Old
Boys Town National Research Hospital
AN22 OAE Testing
Case Studies of Children With ANSD
Auditory Consultant Resource Network
Boys Town National Research Hospital
4
Boys Town National Research Hospital
AN22 OAE Testing
Boys Town National Research Hospital
AN22: 16 Mos. Old
Boys Town National Research Hospital
ABR Age 17 Mos
• Tympanogram normal on left, flat on right
• Left ABR–
– NR at 250 Hz, and 4000 Hz
– only wave III at only 95 dB HL for 1000 Hz
– Wave III and V at only 100 dB HL for 2000 Hz,
NR at 4000 Hz.
– Cochlear microphonics present
• Right ABR– NR at any frequencies
Case Studies of Children With ANSD
Auditory Consultant Resource Network
Boys Town National Research Hospital
5
Boys Town National Research Hospital
AN22: CI Candidacy
• CI Candidacy evaluation at 18 mos. of age (1;6)
• Developmental Profile-3 (DP-3)
– Physical and adaptive skills WNL
– Social-emotional and cognitive skills in
borderline range
– Communication skills in delayed range
• Normal MRI
Boys Town National Research Hospital
Bilateral CI Surgeries
• Left CI at age 1;10
• Right CI at age 2;2
Boys Town National Research Hospital
AN22: 3 Months Post CI
Case Studies of Children With ANSD
Auditory Consultant Resource Network
Boys Town National Research Hospital
6
Boys Town National Research Hospital
AN22: 1 Month Post 2nd Side CI
Boys Town National Research Hospital
0.4
2.4
5.4
7.6
0
2
4
6
8
10
12
Auditory Skills Development
IT-M AIS A ge
Equivalency
IT-MAIS
Time Post CI Activation
No
rmal
He
arin
g A
ge (
Mo
s.)
Boys Town National Research Hospital
AN22: 10 Mos. Post 1st Side
Case Studies of Children With ANSD
Auditory Consultant Resource Network
Boys Town National Research Hospital
7
Boys Town National Research Hospital
0
10
20
30
40
50
60
70
80
90
100
Monosyllable Identification (4-item closed set)
ESP (Low Verbal Version)
Bilateral CI's
10/12: (83%)
10 Mos. Post 1st Side
AN22 Communication
Boys Town National Research Hospital
What Areas Are We Assessing?
S Social-
Emotional
C Cognitive
A Auditory
L Language
E Extra
S Speech
A Balanced Approach
Home
Comprehensive Communication Assessment explores all aspects of a child’s development
Case Studies of Children With ANSD
Auditory Consultant Resource Network
Boys Town National Research Hospital
8
Boys Town National Research Hospital
McConkey Robbins, 2001; Nussbaum, Scott, Waddy-Smith, Koch, 2004
A AV AV VA V
Fully Auditory
Communicator
Mostly Auditory
Communicator
Mostly Visual
Communicator
Fully Visual
Communicator
Communication Continuum
Boys Town National Research Hospital
• Normal developmental milestones
• Support services: one visit per week (speech or deaf educator); outpatient speech-language therapy
• Communication at home: primarily spoken English and sign
AN22 Educational Background
Boys Town National Research Hospital
<50
60
68
89 90 90
45
55
65
75
85
95
Co mmun icatio n (DP -3/P LS-5) Re cep tive Language
(Mu llen/PLS-5 )
Expre ss ive Lan guage
(Mu llen/PLS-5 )
Candidacy; A ge 1y6m 6 mo post-CI 1 yr post- CI
AN22 SLE Results
Case Studies of Children With ANSD
Auditory Consultant Resource Network
Boys Town National Research Hospital
9
Boys Town National Research Hospital
• Receptive Language Identifies familiar objects, pictures, body parts
Follows commands
Understands use of simple objects
Difficulty understanding use of spatial concepts: in/on
Difficulty answering some question: How did Anna get hurt?
• Expressive Language
Names pictures, objects, body parts
Uses 2- 3 word phrases; produces a variety of sounds
Mean Length of Utterance: 1.26/should be 3.16
AN22 Preschool Language Scale-5: 2 -10
Boys Town National Research Hospital
AN22 Communication Continuums
Boys Town National Research Hospital
SCALES Weight 1 DAP
2 DAS
3 DAC
Soc-Emotional Behavior
Cognitive/Curriculum
Auditory
Language: Receptive (effect of visual supports )
Expressive: Mean Length of Utterance
Extra: Memory, Organization, Fine Motor
Speech
Home
X X
A Balanced Approach
X
X
DAP = Developmentally Appropriate Progress DAS = Delayed Acquisition of Skills DAC = Different and Additional Challenges
AN 22 SCALES
X
X
S Social-
Emotional
C Cognitive
A Auditory
L Language
E Extra
S Speech
Case Studies of Children With ANSD
Auditory Consultant Resource Network
Boys Town National Research Hospital
10
AN21 Case Study
Boys Town National Research Hospital
AN21 Background Information
• Normal full-term pregnancy
• Mild jaundice at birth
• Varying reports re: family history of hearing loss
• “Refer” result on newborn hearing screen
• “Pass” for OAE screening at 3 weeks
Boys Town National Research Hospital
AN21 Early OAE Test
Case Studies of Children With ANSD
Auditory Consultant Resource Network
Boys Town National Research Hospital
11
Boys Town National Research Hospital
AN21 Age 20 Months
• Seen in Audiology Clinic for concerns related to no speech development
• Normal tympanograms, present OAEs
• Could not condition child to respond reliably to tonal stimuli in the test booth
• Responses to speech stimuli down to 15 dB HL for at least one ear
• Recommended re-eval in 2 to 3 months
Boys Town National Research Hospital
AN21: Age 22 Months
• Normal tympanograms
• Present OAEs for right ear, did not test left
• Could not condition a reliable response in the test booth
• Recommendation for speech-lang eval
• Recommendation for audiology follow-up in 6 months
Boys Town National Research Hospital
AN21: Age 29 months
Case Studies of Children With ANSD
Auditory Consultant Resource Network
Boys Town National Research Hospital
12
Boys Town National Research Hospital
AN21 Audiogram Age 29 Months
Boys Town National Research Hospital
Diagnosis Of Hearing Loss
• Normal tympanograms
• Present OAEs at robust levels
• No responses to tonal stimuli at very loud levels
• No acoustic reflex responses at 500 or 1000 Hz
• Audiologist records concern for ANSD and refers for ABR ASAP
Boys Town National Research Hospital
AN21 Age 30 months
Case Studies of Children With ANSD
Auditory Consultant Resource Network
Boys Town National Research Hospital
13
Boys Town National Research Hospital
AN21: ABR Age 30 Months
Boys Town National Research Hospital
ABR: No Response + CM
Boys Town National Research Hospital
Following Diagnosis
• Hearing aids fit at 2 yrs, 7 mos. using behavioral audiogram as a guide – Small changes in listening and speaking
behavior after one month of amplification use
– Some inconsistent responses to test sounds with aids on, but only for louder levels
• Recommendation for cochlear implant evaluation
Case Studies of Children With ANSD
Auditory Consultant Resource Network
Boys Town National Research Hospital
14
Boys Town National Research Hospital
CI Candidacy
• Evaluations completed at 34 mos. of age
• Developmental Profile 3 (DP-3) – Physical and adaptive behavior WNL
– Cognitive, communication, and emotional skills significantly delayed
• CT and MRI both within normal limits
• Cochlear implant surgery at 38 mos. – Right ear, Advanced Bionics device
Boys Town National Research Hospital
Audiogram: 2 Months Post-CI
Boys Town National Research Hospital
Audiogram: 7 Months Post-CI
Case Studies of Children With ANSD
Auditory Consultant Resource Network
Boys Town National Research Hospital
15
Boys Town National Research Hospital
Audiogram: 1 Year Post-CI
Boys Town National Research Hospital
1.5 2.4
0
2
4
6
8
10
12
4 mos. 7 mos 12 mos.
Auditory Skills Development
IT-M AIS A ge
Equivalency
IT-MAIS
Time Post CI Activation
No
rmal
He
arin
g A
ge (
Mo
s.)
Boys Town National Research Hospital
100 100 100
50
0102030405060708090
100
ahh vs. hop-
hop
1 syll. vs 3
syll. (ball, icecream cone)
1 syll. vs 2
syll. (ball,baby)
Closed- set
(ball, baby,ice cream
cone)
Pattern Perception-Discrimination
1 year post- CI
Early Speech Perception (ESP)
Per
cen
t C
orr
ect
Case Studies of Children With ANSD
Auditory Consultant Resource Network
Boys Town National Research Hospital
16
AN21 Communication
Boys Town National Research Hospital
Background:
• School district has now diagnosed Autism Spectrum Disorder
• Communication at home: spoken Spanish paired with signed English
• Communication at school: simultaneous communication/Spanish-speaking aide
AN21
Boys Town National Research Hospital
<50 50
45
55
65
75
85
95
Co mmun icatio n (DP -3/P LS-5)
Candidacy; A ge 1y6m 6 mo post-CI
AN21 SLE results
Case Studies of Children With ANSD
Auditory Consultant Resource Network
Boys Town National Research Hospital
17
Boys Town National Research Hospital
• Physical: 114; 2 yrs., 6 mos
• Adaptive Behavior: 107; 2 yrs; 10 mos
• Social-Emotional: 59; 1 yr., 4 mos
• Cognitive: < 50; 9 mos
• Communication: <50; 5 mos
AN21 Developmental Profile-3: 2 yrs, 10 mos
Boys Town National Research Hospital
• Interaction: 18 mos
• Pragmatics: 6-9 mos
• Gesture: 15 mos
• Play: 21 months
• Lang Comprehension: Scatter to15 mos.
• Lang Exp: 3-15 mos
AN21 Rosetti Language Scale: 2 yrs, 11 mos
Boys Town National Research Hospital
• Words/Signs Understood: 14 signs
<5th Percentile, < 9 months
• Word/Signs Produced: 6+ signs
<5th Percentile, <9 months
AN21 MacArthur Communicative Development: 2 -11
Case Studies of Children With ANSD
Auditory Consultant Resource Network
Boys Town National Research Hospital
18
Boys Town National Research Hospital
• Receptive Language: 8 mos, < 1 %ile
Responds to “No” ½ time
Lifts arms when you say “Up”
Does not respond to simple commands
Does not look at objects when named
• Expressive Language: 4 mos, <1 %ile
Sometimes plays patty cake
Cries to get attention
Does not babble or chatter
Sometimes says “aaa”
AN21 REEL-3: 2 yrs, 11 mos
Boys Town National Research Hospital
• Auditory Comprehension SS: 53, 1st %ile, 1 yr., 4 mos
Functional Play with objects
Follow directions with gestures
Does not identify familiar objects, pictures, body parts
• Expressive Communication SS: <50, < 1st %ile, 5 mos
Protests by gesturing or vocalizing
Imitates facial expressions
Does not vocalize two different vowels/consonants
Does not combine sounds
AN21 Preschool Language Scale-3: 3yrs, 5 mos
Boys Town National Research Hospital
AN21 Communication Continuums
N/A Picture/Signs- - -P/SG- - - GPS- - -GP/S- - - Gestures
(ACRN, 2011)
Use of Pictures/Signs and/or Gestures
Case Studies of Children With ANSD
Auditory Consultant Resource Network
Boys Town National Research Hospital
19
Boys Town National Research Hospital
SCALES Weight 1 DAP
2 DAS
3 DAC
Soc-Emotional Behavior
Cognitive/Curriculum
Auditory
Language: Receptive (effect of visual supports )
Expressive
Extra: Memory, Organization, Fine Motor
Speech
Home
X
X
A Balanced Approach
X
X
DAP = Developmentally Appropriate Progress DAS = Delayed Acquisition of Skills DAC = Different and Additional Challenges
AN21 SCALES
X
X
S Social-
Emotional
C Cognitive
A Auditory
L Language
E Extra
S Speech
AN4 Case Study
Boys Town National Research Hospital
AN4: Background
• Fraternal twin
• C-section @ 32 weeks gestation
• 4 weeks in NICU
– 4 days on ventilator
– Intravenous Gentamicin prophylaxis
– Passed OAE screening at discharge
• No family history of congenital hearing loss
Case Studies of Children With ANSD
Auditory Consultant Resource Network
Boys Town National Research Hospital
20
Boys Town National Research Hospital
Initial Audiological Testing
• HL identified at age 1;11 – Parent suspicions of hearing loss
– < 5 recognizable words
• Absent acoustic reflexes
• Absent otoacoustic emissions (TEOAEs)
• ABR – No response for clicks
– Possible response for low frequencies (90 dB nHL)
– No response for bone conduction up to 65 dB nHL
Boys Town National Research Hospital
Initial ABR Samples: 2003
90 dB Click
75 dB Click
55 dB Click
Boys Town National Research Hospital
Initial Unaided And Aided Findings
Case Studies of Children With ANSD
Auditory Consultant Resource Network
Boys Town National Research Hospital
21
Boys Town National Research Hospital
Assessment At BTNRH
• Age 2;2 -- Binaural hearing aids x 3 months
• “Denied” CI by two implant centers
• ABR:
– Different morphology than previously obtained
– Cochlear microphonic present
– Thresholds suggested mild to severe loss, bilaterally
• Behavioral audiometry
• Speech-language & articulation assessed
Boys Town National Research Hospital
ABR Findings: Clicks
Boys Town National Research Hospital
ABR Findings: 1000 Hz
Case Studies of Children With ANSD
Auditory Consultant Resource Network
Boys Town National Research Hospital
22
Boys Town National Research Hospital
Auditory Thresholds
Boys Town National Research Hospital
AN4 Pre-Implant Language (PLS-4)
89 84 85
50
60
70
80
90
100
110
120
Expr essive Rec eptive Total Language
Sta
nd
ard
S
core
Mean
-1 s.d.
Boys Town National Research Hospital
Cochlear Implant At Age 2;4
Case Studies of Children With ANSD
Auditory Consultant Resource Network
Boys Town National Research Hospital
23
Boys Town National Research Hospital
Synchronous Responses VIIIth Nerve
Evoked Compound Action Potentials
Boys Town National Research Hospital
Early Progress With CI
• Some difficulty getting full-time use
• Some signs of loudness intolerance at times
• Needed “start up” program or volume
• 100% compliance while at school
Boys Town National Research Hospital
AN4 Post Implant Function
Case Studies of Children With ANSD
Auditory Consultant Resource Network
Boys Town National Research Hospital
24
Boys Town National Research Hospital
Bimodal Hearing Candidate?
Boys Town National Research Hospital
1;6 Post CI
Unaided = 5/10
HA Alone = 10/10
HA+Implant = 8/10
CI Alone = 14/15
WIPI (Closed Set) @ 55 dB HL
Boys Town National Research Hospital
2;2 Post CI Speech And Language
97
84
102
50
60
70
80
90
100
110
120
EOWVT PLS-4 Articulation
Sta
nd
ard
Score Mean
-1 s.d.
Case Studies of Children With ANSD
Auditory Consultant Resource Network
Boys Town National Research Hospital
25
Boys Town National Research Hospital
52
69
86
6
41
77
0
10
20
30
40
50
60
70
80
90
100
PBK- 50 Words PBK- 50 Phonemes HINT- C Sent
CI Alone
HA Alone
2;7 Post CI (Age 4;11)
Per
cen
t C
orr
ect
Boys Town National Research Hospital
AN4 Recent Audiogram
Boys Town National Research Hospital
64
84 89
80
91 86 88
96 95
0
10
20
30
40
50
60
70
80
90
100
CNC Words CNC Phonemes AZ Bio Sent.
HA Alone
CI Alone
CI + HA
8;11 Post CI Speech Perception (Age 11;4)
Per
cen
t C
orr
ect
Case Studies of Children With ANSD
Auditory Consultant Resource Network
Boys Town National Research Hospital
26
AN4 Communication
Boys Town National Research Hospital
• Born at 32 weeks
• Mainstream Education
• Special services: Speech, Deaf Educator
• Oral Communicator
AN4 Educational Background
Boys Town National Research Hospital
84
89 88
67
90
70
90
85
100
76 80
Re ce p Lang
(P LS- 4)
Exp Lan g
(P LS- 4)
Co re
Langu age
(C ASL)
CELF
Co ncept s &
Follo wD irect s
CELF R ecall
Sent ences
CELF Fo rm
Sent ences
CELF
Expr ess
Vo cab
CELF
Unde rstan d
SpPar agr aph
CELF C &FD CELF Fo rm
Sent
TOPS To tal
AN4 SLE Results
Candidacy 6 yrs post 7 yrs post
8 yrs post
Case Studies of Children With ANSD
Auditory Consultant Resource Network
Boys Town National Research Hospital
27
Boys Town National Research Hospital
CELF Formulating Sentences:
The boy hurried quickly to the door.
The woman can buy strawberries or she can buy apples.
Unless he finished he homework he can go to the game.
Until the bike shop is open we can get a bike.
AN4 Language Performance
Boys Town National Research Hospital
AN4 CELF Concepts & Following Directions
Point to the shoe and the ball after you point to the big fish and the little black fish.
Before you point to the house on the left side of the ball, point to the fish and the shoe.
Boys Town National Research Hospital
Problem Solving: • The boy has a fever and he’s hot. What could make him cool off? Ice
Predicting: • When will the boy go back to school? When he feels better.
Determining Causes:
• What made the boy sick? Weather, allergies. The sun gives me headache.
Making Inferences: • How do you know this boy is sick?
Feel his head
Sequencing: • The dad checked the boy’s temperature.
What did the dad do next? See if right
AN4 Test of Problem Solving - Elementary
Case Studies of Children With ANSD
Auditory Consultant Resource Network
Boys Town National Research Hospital
28
Boys Town National Research Hospital
AN4 Communication Continuums
Boys Town National Research Hospital
SCALES Weight 1 DAP
2 DAS
3 DAC
Soc-Emotional Behavior
Cognitive/Curriculum
Auditory
Language: Expressive Receptive
Extra: Memory?, Organization, Fine Motor ?
Speech
Home
X X
A Balanced Approach
X X
X
DAP = Developmentally Appropriate Progress DAS = Delayed Acquisition of Skills DAC = Different and Additional Challenges
AN4 SCALES
X
S Social-
Emotional
C Cognitive
A Auditory
L Language
E Extra
S Speech
AN5 Case Study
Case Studies of Children With ANSD
Auditory Consultant Resource Network
Boys Town National Research Hospital
29
Boys Town National Research Hospital
AN5 Background
• Male, normal birth history
• REFER on screening ABR in newborn nursery
• Passed follow-up ABR at local children’s
Hospital
• Passed OAE screen at AFB Hospital
• Parental concerns for auditory sensitivity
• ABR retested at BTNRH at 11 mos. of age
– No neural response to stimuli
– Present cochlear microphonic
Boys Town National Research Hospital
AN5 ABR Results
Boys Town National Research Hospital
AN5 Intervention
• HA trial within one month of Dx
– No distinct benefit from amplification
– Consistent use of HA not well-established
• No consistent responses to sound with amplification
Case Studies of Children With ANSD
Auditory Consultant Resource Network
Boys Town National Research Hospital
30
Boys Town National Research Hospital
Responses With Hearing Aids (1;0)
Boys Town National Research Hospital
Pre-Implant Evaluation
• Age 1;4
• Play and interaction/attachment skills WNL • Expressive language (9-12 mos. range)
– Use of a few signs – Primarily vowel sounds for speech
• Receptive language (6-9 mos. range) – Response to simple gestures in routine context – Understands “no” and “bye-bye” – Attentive to family signing
• Overall delays of up to 10 months
Boys Town National Research Hospital
Right Side Cochlear Implant (Age 1;10)
Case Studies of Children With ANSD
Auditory Consultant Resource Network
Boys Town National Research Hospital
31
Boys Town National Research Hospital
1 Month Post Initial Stim
Boys Town National Research Hospital
4.5
11.2
13.7
0
2
4
6
8
10
12
14
Pre-implant 3 mos. 9 mos. 12 mos.
Auditory Skills Development
IT-M AIS A ge
Equivalency
IT-MAIS Scores For 1st Year Post-CI
Time Post CI Activation
No
rmal
He
arin
g A
ge (
Mo
s.)
Boys Town National Research Hospital
AN5 Audiogram: 1 Year Post CI
Case Studies of Children With ANSD
Auditory Consultant Resource Network
Boys Town National Research Hospital
32
Boys Town National Research Hospital
70
87
72
59
55
65
75
85
95
105
115
Expre ss ive Vocab
(EOWPVT/EVT)
Re cep tive Language
(PLS-4/C ELF-4 )
Expre ss ive Lan guage
(PLS-4/C ELF-4 )
Artic (GFT A)
2 yrs post-CI; A ge 3y9m
AN5 SLE Results – 2 Years Post CI
Boys Town National Research Hospital
84% 85%
0
10
20
30
40
50
60
70
80
90
100
WIPI TA C Sutest V
3;1 Post CI
AN5 Speech Perception: Closed-Set
Per
cen
t C
orr
ect
Boys Town National Research Hospital
AN5 Audiogram (8;0 Post CI)
Case Studies of Children With ANSD
Auditory Consultant Resource Network
Boys Town National Research Hospital
33
Boys Town National Research Hospital
AN5 Open-Set Speech Perception Ability
52
80 78
64
81 83
44
70
80
0
10
20
30
40
50
60
70
80
90
100
PBK- 50 Words PBK- 50 Phonemes HINT Sent.
5;9 post CI
6;9 post CI
8;0 Post CI
Per
cen
t C
orr
ect
AN5 Communication
Boys Town National Research Hospital
Background:
• Special Services: Speech, Deaf Educator
• Self-Contained D/HH Classroom
• Simultaneous Communication
• Primarily Spoken English in the Home
AN5 Educational Background
Case Studies of Children With ANSD
Auditory Consultant Resource Network
Boys Town National Research Hospital
34
Boys Town National Research Hospital
AN5 Current Speech-Language
• Age 3;9 (2 yrs. post CI)
• EOWPVT: Standard score=70 (low avg.)
• Preschool Language Scale
– Comprehension: Standard score=87 (WNL)
– Expression: Standard score =72 (low avg.)
• Goldman Fristoe Articulation Test
– Standard score=59 (below avg.)
– 1st percentile
– Plosives, nasals, and glides
– Absence of most fricatives and affricates
Boys Town National Research Hospital
70
87
72
59
77
104
84
61
79
93
73
55
65
75
85
95
105
115
Expre ss ive Vocab
(EOWPVT/EVT)
Re cep tive Language
(PLS-4/C ELF-4 )
Expre ss ive Lan guage
(PLS-4/C ELF-4 )
Artic (GFT A)
2 yrs post-CI; A ge 3y9m3 yrs post-CI; A ge 4y10m8 yrs post-CI; A ge 9y9m
AN5 SLE Results
Boys Town National Research Hospital
Correct
• Hyena
• Plumber
• River
• Catching
• Vase
• Heart
• Pigeon
• Ankle
• Safe
Did Not Identify
• Harp
• Horrified
• Swamp
• Flamingo
• Flaming
• Wrench
• Aquarium
• Refueling
• canoe
AN5 Receptive Vocabulary
Speech perception confusions: Fine/vine Slamp/swamp
Balley/alley
Case Studies of Children With ANSD
Auditory Consultant Resource Network
Boys Town National Research Hospital
35
Boys Town National Research Hospital
• The coach could not find the uniforms that the team wore last year.
• The people can’t find their uniform their team yesterday
AN 5Recalling Sentences
Boys Town National Research Hospital
• The people are having a running race.
• I got the best trophy in the world.
• I am the third person to get a drink.
• Why you riding a skateboard although you have a cast.
• Can I have or neither can I have a cup?
• If you do that however you break it.
AN5 Sentence Formulation
Boys Town National Research Hospital
AN5 Communication Continuums
Case Studies of Children With ANSD
Auditory Consultant Resource Network
Boys Town National Research Hospital
36
Boys Town National Research Hospital
SCALES Weight 1 DAP
2 DAS
3 DAC
Soc-Emotional Behavior
Cognitive/Curriculum
Auditory
Language: Receptive (effect of visual supports )
Expressive
Extra: Memory, Organization, Fine Motor x
Speech
Home
X X
A Balanced Approach
X X
X
DAP = Developmentally Appropriate Progress DAS = Delayed Acquisition of Skills DAC = Different and Additional Challenges
AN5 SCALES
X X X
S Social-
Emotional
C Cognitive
A Auditory
L Language
E Extra
S Speech
Boys Town National Research Hospital
Jeffrey Simmons Boys Town National Research Hospital
555 North 30th Street
Omaha, Nebraska 68131 [email protected]
Boys Town National Research Hospital
Katie Brennan, MS, CCC-SLP Boys Town National Research Hospital
555 North 30th Street
Omaha, Nebraska 68131 [email protected]
Case Studies of Children With ANSD
Auditory Consultant Resource Network
Boys Town National Research Hospital
37
Boys Town National Research Hospital
Catherine C. Carotta Ed.D Boys Town National Research Hospital
425 North 30th Street
Omaha, Nebraska 68131 [email protected]
Boys Town National Research Hospital
A production of the Lied Learning & Technology Center at Boys Town National Research Hospital
©2012