Showing posts with label auditory oral. Show all posts

Resource List: Keeping Hearing Aids on Young Children...

It's surely no surprise that keeping hearing aids (HA) and/or cochlear implant (CI) on little ones is a near impossible feat...
According to research reported by Anderson & Madell (2014), only about 10% of children achieve full time hearing aid wear (defined as 12 hours/day) & 40% of children wear their hearing aids 4 hours or less per day!! These numbers make me want to rip my hair out... if the kids aren't wearing their equipment, then they aren't hearing ... and if they aren't hearing then how will they ever to listen & speak? Figuring out how to keep the hearing equipment on little ones is an ongoing struggle and continues to be the #1 discussion that I have with caregivers.

The Anderson & Madell article linked above has some really awesome printable brochures for families that are full of fantastic ideas for how to keep hearing aids on children birth-kindergarten. Their list of retention ideas is also great -- they include parent ratings of different products & lots of detailed information about the development of listening skills from infancy through kindergarten age.

Below, I've compiled my own list of resources for products to help keep hearing aids on young children including commercially produced, handmade & DIY solutions ... in terms of ages, the effectiveness & appropriateness of the solutions listed will vary greatly from child to child - again see Anderson & Madell (2014) for a parent review of effectiveness & suggestions by age group. Now onto my list...
Most simply, there are four primary categories of 'hearing equipment retainers' for children:
  1. Caps/Hats
  2. Cords/Clips 
  3. Headbands 
  4. Adhesive/Tape
Caps & Hats
For very young children, one of the first suggestions frequently is a tight fitting 'pilot' cap style hat that covers the ears & hearing equipment and ties securely. This makes it more difficult for babies to pull their hearing aids out... but not impossible! Look for a tight fitting cap made of light weight material & strings long enough to tie securely.

Commercially Available Pilot Caps: 

Handmade Pilot Caps: 

 DIY Options:

Cords & Clips
This options is pretty simple -- a cord (i.e. string) of some sort attaches to the child's hearing equipment and then is secured to the child's clothing. If the equipment comes off, it doesn't go far!

Commercially Available Options: 

Handmade Options:

DIY Options:
Dental Floss & Safety Pin
Sunglasses Holder & Safety Pin

Headbands
Headbands for behind-the-ear (BTE) hearing aid & CI's are specially designed with loops and/or pockets to hold the behind-the-ear portion - that is often too heavy for the tiny ears of an infant or toddler. Look for light weight materials and avoid covering the microphone area of the HA/CI.

Handmade Options 

DIY Options 

Toupee/Wig & Medical  Tape 
Toupee/wig and medical tape are adhesives that are specially designed for use on the skin - but can potentially be irritating to sensitive skin. Toupee/wig tape (i.e. double sided tape) can be trimmed to size then placed on a BTE hearing aid or CI processor - on the side that rests against the head. Medical tape (i.e. single sided tape) can be placed over the earmold portion of the hearing aid - over the entire outer ear. Used alone, adhesive options are not especially reliable, but are a nice addition to other methods. (affiliate links below for your convenience)

Toupee/Wig Tape

Medical Tape

References: 
Anderson K, J Madell. Improving hearing and hearing aid retention for infants and young children. Hearing Review. 2014;21(2): 16-20.


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In the News: Hearing Aids Improve Outcomes...

Well.... yeah! A recent study indicates that when children with hearing loss wear hearing aids, their speech & language abilities improve - seems kind of like a no-brainer, but it's a little piece of tangible evidence to support what many speech, language and hearing professionals have known for years. The more that kids wear their hearing aids, the better they do!


The study looked at a relatively small group of 180 three to five year old children with mild-moderate and moderate-severe hearing loss - the study did not include children in in the severe-profound range.  The researchers collected information on speech, language & articulation performance, hearing loss degree and hearing aid wear time. Two important facts were noted in their results:
  1. Children who received the most benefit from their hearing aids showed higher speech & language scores. 
  2. And, duration of hearing aid wear improved outcomes -- especially in children who received the most benefit from their hearing aids. 
These results provide a strong rationale for children with a mild hearing loss to receive & wear hearing aids - as they stand to benefit the most! For children with a moderate-severe hearing loss, it provides support to double & triple check hearing aid programing in order to ensure maximum gain - the more access to sound that these children receive from their hearing aids, the greater the potential long term outcomes!

Whether you're a parent or a teacher, the next time you hear (or think): 'He does fine without his hearing aids - why fight this battle?' remember this study! As a teacher who deals with this issue frequently, I often counter with my own question: How much better could he do if he could hear like you do?  

Check out the Reuters article for more information or the original article from the JAMA Otolaryngology - Head & Neck Surgery.


References: 
Doyle, K. (13 Apr. 2014). Hearing aids for kids could improve speech and language. Reuters Online. Retrieved from: http://www.reuters.com/article/2014/04/07/us-hearing-aids-idUSBREA361HJ20140407

Tomblin J, Oleson JJ, Ambrose SE, Walker E, Moeller M. (2014). The influence of hearing aids on the speech and language development of children with hearing loss. JAMA Otolaryngol Head Neck Surg. doi:10.1001/jamaoto.2014.267.
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Listening & Language Games: What's in the Bag?

What's in the Bag? is a simple & entertaining guessing game that I frequently utilize in my preschool classroom... It's great because the possibilities for play are endless! The game can be easily modified to meet the individual needs of all of my students with very little effort on my part & it targets a wide variety of developmental & early learning skills including: vocabulary development, listening skills, speaking skills, social-communication, turn-taking, self-control and tactile perception.


What you'll need: 
A bag that you cannot see through
Collection of 5-10 small objects that fit inside the bag


There are many different ways to play, but he most basic instructions are as follows:
  1. Put the items in the bag - all, a few or only one at a time - you decide! 
  2. Take turns reaching into the bag - don't peek! Try to identify an object by feeling it before removing it from the bag. 
  3. The player to guess the most items correctly before removing it from the bag wins! 
Now here's where it gets fun... the possibilities are endless...

 Practice Listening - Use objects that have sounds associated with them - we frequently use items from a collection of listening toys including objects like: cow/moo, butterfly/uffuff, baby in cradle/shhhh, ice cream cone/mmmm, airplane/ahhhh, ghost/oooooo, bee/eeeee, snake/ssssss, boat/buhbuh etc. Once the kids have a few minutes to explore the toys & practice the sounds, we put all of the items in the bag. The bag keeper will name an object OR make the sound associated with the object. The students must listen, then try to pull the correct item from the bag without looking. Once all the items have been removed, the items are cleaned up in the order the bag keeper dictates - so the students must continue listening in order to figure out which items have been requested by the bag keeper.

Practice Asking Questions & Giving Clues - Have a player choose an object to put inside of the bag. When we play this version at school, I have my students choose from a limited selection of items, so that the possibilities are a closed-set (i.e. only a limited number of possible answers). The bag keeper either gives clues OR answers questions posed by the other players. I usually have the bag keeper give 3 clues OR each player may ask 3 questions before guessing. If no one guesses correctly, we reveal the item & give another child a turn to be the bag keeper.

As the teacher, I'm often the 'bag keeper' when we play any version of this game, which allows me to modify game play based on each child's individual strengths & needs from turn to turn. I really love this game, as there are few small-group games that allow for listening skill practice along the entire hierarchy (detection, discrimination, identification & comprehension) in addition to expressive language skills practice.  
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Listen! I hear audiobooks...

Over the last couple of months, I've purchased quite a few audiobooks through our school's Scholastic book orders and have been trying to figure out how to best set up a listening center for my preschool students who have varying degrees of hearing loss AND different amplification devices. Some of the audiobooks have been pretty good, with music and/or sound effects that compliment the story while others, have been awful renditions! Here's what I came up with so far:


I dug out my old iPhone, cleared off the content & set it up with some of the audiobook mp3 files. Since it was an old iPhone 3, I was unable to upgrade to the newest operating system, so I moved all of the icons except for the 'music' icon off to the 2nd and 3rd screen (on newer devices, you can 'drag them on top' of each other to put them into other 'folders.') I also went into settings & restricted internet, email & camera access to make the phone less functional - so my kids could only use it for the purpose intended. This is much easier on newer devices and can easily be set under the accessibility menu to only grant access to a single function at a time. I used the internet to add cover art to each of the audio tracks so that my non-reading Prek students could easily figure out which audio file matched the book they wanted to read.


With the help of our audiologist, I collected audio accessory cables & other connectors for the array of hearing aids that my students have including Phonak, Oticon & Cochlear Ltd. products. I also had to get a headphone jack adapter because of the recessed headphone jack in the old iPhone made it impossible to plug in the audio cords - my techie husband helped me out with this! Here's a picture of all of the listening center supplies in their box (I found these great Lego storage boxes on clearance at my local Walmart - they're just the right size for a bunch of books!)


We've experimented with the audio cables for direct input - which has been interesting. Some of the kids like the direct input, while others seem to prefer to hold them up to their 'ear' like a telephone. Some students have even quite accurately named this activity the 'book phone.'

I was a bit surprised by how much my students engaged with this activity! Most of my students are doing very well with it & find it fun - however, I think that it's worth noting that all of the students who have found it enjoyable also have pretty good auditory comprehension & receptive language skills - but not necessarily 'mild' hearing loss; some of the students that like this the most actually have a severe-profound loss & have to work VERY hard to understand what they're hearing! For students who have lower receptive language skills, I think that I will be working on recording alternates with simplified language, no sound effects & integration of learning to listen sounds/simple songs.

I also MUST mention that listening activities like this are absolutely NOT a substitute for having high quality conversations & interactions with young children who have hearing loss. The use of these audiobooks isn't necessarily intended to improve their language skills, but rather provide an interesting opportunity to engage with technology in a way similar to my students' hearing peers. I'd venture to guess that most preschoolers have probably played a game on a caregiver's phone or tablet from time to time - but my students, while they've all likely engaged with technology, have probably missed out on a significant portion of the music and sound effects that go with it. Listening centers are a way for my students who have hearing loss to engage in experience with technology more like their hearing peers do - and if we end up working on language skills - great!

Since setting up the first listening center, I've located two additional older iPhones from family & friends and I'm working on also setting them up for use in my classroom!  This is definitely something that we'll continue to explore in the classroom... check back for more of our experiences with these listening centers.

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Fun FREE App for PreK!

I'm always on the look out for high quality, affordable apps that have a valid learning purpose for the classroom... recently I discovered two FREE apps - 123 Ninja and ABC Ninja from Alligator Apps that I just LOVE!


ABC Ninja is just like that other addictive fruit slicing app that so many adults have mindlessly played... I think that this, however, is a great learning tool to reinforce letter names AND sounds! I don't feel guilty letting my three year old play this on the commute to and from work and my students just about beg to play the 'ninja game!' The sound effects and music are subtle and not annoying in the least -- and are even minimalist compared to some apps, which is great for my students who have hearing loss; too much background noise & sound effects can be overwhelming and confusing! The game play is customizable with three different levels of difficulty (easy, medium, hard), can be adjusted to focus on capital, lowercase letter names and sounds and can be set for a time limit from 1-10 minutes! At the end of each session, data is displayed but cannot be emailed - I've used the screenshot function on my iPad to capture data when I need it.





123 Ninja is the exact same concept, except it focuses on numbers 0-99. Again, a hit with my students and my own child. It's customizable with different levels of play, the ability to select target numerals and time limits.


With both apps being free to download & also free of in-app purchase opportunities, it's really a win all around!

The only thing that might make this set of apps better would be to have the letter/number repeated somehow, as my students sometimes miss the target when it's announced. And the ability to email data after the game is played by a student and/or the ability to set up individual student profiles so that you don't have to go back and forth changing the settings every time a new child comes to play would be great. I'd also like to see this game expanded to include a version for shapes and colors - my youngest preschoolers would really love reinforcing options for practicing listening & basic concepts!

p.s. just for the record, I was not asked to write this review and did not receive any sort of compensation for my opinion.
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Thanks for Thanksgiving...

Here are a few of the Thanksgiving activities and crafts we've been working on... I just haven't had time to get them all posted! The following activities are heavy on receptive and expressive language practice!

Last week, we learned about letter T. Here's our Letter T turkeys...


I had my classroom assistant pre-cut all the pieces for this craft. The children practiced following directions with specific shape, color and location vocabulary concepts. Before we got started, I introduced all the pieces and named them by shape, color and which part of the turkey each piece would be. I verbally reviewed the steps involved and layed the pieces together on my page for my students to see. Then, my students helped to tell me the directions. When they got stuck, I gave the direction and had them listen carefully to choose the pieces - the brown half circle vs. the brown circle etc.

We read the book "Today is Monday" by Eric Carle and sang the book. I found this great little write-on version with a dry erase marker at a local discount store. I asked each child to name a food as we read and I drew a picture of the food and wrote the words while we read.


We also played the "Today is Monday" game - another item I picked up somewhere for cheap! Although the game is for ages 3+ it did seem to work better with my 4 year old students.


It lent itself to both expressive and receptive language practice. My assistant and I modeled using whole sentences when the children drew a card from the pool "I got spaghetti." "I picked a chicken." I also asked the children questions about the food items, "Do you like meatballs with your spaghetti?" And when it was my turn to choose a card, I gave the students clues about my card before showing them, "I picked something that is a vegetable, it is long and green, and the porcupine ate it on Monday. What did I choose." We also talked about whose turn it was - "My turn." and "Your turn." When we got down the end of the game, where players only needed one or two items, we talked about the concepts of 'sharing' and 'giving' game pieces that players didn't need.

Next week at school, we'll be wrapping up Thanksgiving as we head into a 5 day break... then onto Winter and Holiday themes!


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Short and sweet tonight...

I've been working on some materials about cochlear implants and hearing aids for my students. I recently created a short mini-book for a student who won't wear his implant and needs to get comfortable with the idea of just putting it on. I designed a printable mini-book called "I Put on my CI" that can be used as a coloring book or as a reusable book with cut-out cochlear implants for the student to put on the boy in the book. Check it out in my TpT store and see the preview for the cover, first page and printable CI pieces.






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Green Eggs...

This week, we read "Green Eggs and Ham" by Dr. Seuss. The students really enjoyed this book - especially shouting 'NO!' every time Sam asked about eating the green eggs and ham!

Green Eggs and Ham Sensory Bin
I LOVE our Green Eggs and Ham sensory bin! There are tons of fun things int his bin - the kids' favorite things are the felt eggs and ham inside of the mini plastic eggs. They've been 'cooking' up interesting plate fulls of green grass, green eggs, green ham and multicolored pom poms for my assistant and I to 'eat' - mmm yummy!

I made lots of adaptations to the reading of this story so that all of my students could get into the story and understand it on their level. Interestingly enough, this book works great for multiple speech, language and listening goals.

I was able to incorporate many 'listening' sounds and phrases into our reading to keep students who are just learning to attend to sounds and words interested in the book:

eggs/ham - mmm yummy
mouse - squeak
car - beep beep
train - ooo-ooo
rain - "it's raining its pouring.." 
boat - buh-buh + "row row row your boat..."
goat -  maaah
tree - up, up, up
crazy train tracks - up, up, up wee!
falling into the water - uh-oh!

 The simplified version of the story when something like this:

Sam: Do you like green eggs and ham?

Man: No, no, no! I don't like them! 

 Read & REPEAT...

I paired the simplified story with reading the actual rhyming text and threw in the 'sound effects' as we went...

We made Green Glitter letter G's and Painted with lots of Green... what a mess! I think we'll hand up all of these green pages in the hall like a giant green quilt mural. Green's a great color for spring :)


Green Finger painting
We made a plate of green eggs and ham. The kids watched me put the pieces together to make the completed plate of green eggs and ham, then had to figure out how to do it themselves - kind of like a puzzle. They did pretty good remembering how I made mine and copying the steps themselves. There's also our Cat in the Hat letter C's too!
Green Eggs and Ham Craft

We also played "Who at the Green Eggs and Ham" Card Game from Elaine over at the Schoolhouse blog. Once the students realized it was a funny game and that getting the Green Eggs and Ham card wasn't a 'bad' thing, they enjoyed it.



Who at the Green Eggs and Ham? Wasn't me...

To finish out our week of Green Eggs, we had planned to eat green eggs and watch the old green eggs cartoon on Youtube, but I forgot the eggs... The kids enjoyed the movie anyway though. Perhaps next week we'll get to the eggs... 





Next week, we'll dive into "Mr. Brown Can Moo"!
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We LOVE Dr. Seuss!

We're currently in the middle of a month long Dr. Seuss extravaganza in my classroom! Our Dr. Seuss unit quickly became one my very favorite units to do with my students. Last year was actually the first year that I even attempted more than just a few days of Dr. Seuss books and activities due to a awful experiences in my past...

Years ago, when I tried to introduce Dr. Seuss books to my deaf/hard of hearing students, they HATED them! Looking back, I think know that the failure was my fault... I didn't really think it through very well. Seriously, Seuss books are complete nonsense; to a child who can't hear and is struggling to learn to listen and talk, just to simply make sense of their world, listening to a Dr. Seuss story could be torture!

Last year, I rethought my approach, my goals, my story choices, my teaching style -- well EVERYTHING! The very first thing that I changed was my overall goal for the unit - since I'm working with deaf/hh students in an auditory/oral program (i.e we're working on listening and talking and do not use sign language) we always we have extensive speech and language goals integrated into every aspect of every activity - including vocabulary (expressive & receptive), comprehension, listening, oral language and the list goes on, with different and very specific goals for every child. My primary goal for every child became simply to have FUN; enjoy the stories, books, silly pictures, the 'sound' of the books (rhyme and rhythm) etc. I had to approach a nontraditional type of literature with a nontraditional approach to goal making...

The next thing that I did was choose books with a story line as my primary focus - books like 'There's a Wocket in my Pocket' just wouldn't cut it; they were too nonsensical and the kids, might listen to them, but I wasn't confident that we could do much more with them. My favorite books for my preschool students usually include: "dGreen Eggs and Ham," "The Cat in the Hat," "Mr. Brown Can Moo," and "The Cat in the Hat Comes Back." Some of these books get a little lengthy, but surprisingly, even my most fidgety students will usually sit for the entire book! These books include a reasonably familiar and fairly useful set of simple words (for vocabulary goals), not too much nonsense, silly pictures that go with the story and sequential related events (i.e. first, then, next, last). Picking the right books was half the battle...

I also altered how I read these books. The first time I read, I usually read right through without asking questions or stopping to point out pictures; I just want them to listen to my voice, the rhythm and the rhyme. The second time that I read, I often will read the words on the page and then follow with a short and simple explanation of what all those rhyming words meant - "All we could do was sit, sit, sit, sit. We did not like it, not one bit." - followed by " There was nothing to do- just sit. They didn't like it." Sometimes I simplify further for students who struggle with understanding more than a couple of words at a time -- "they are sitting" I'll read it several times with my simplified explanation before asking students any questions about the book; they need extra time to let it sink in and need to hear it many times before I can begin working on comprehension at any level. We might pick up the book and name pictures together, then I might ask them to name a picture or identify a picture - eventually, we get to more difficult comprehension questions (i.e. who, what, where, how...) I have to be on my toes and alter my questions for each students current level of understanding.

To make this long story - short, my deaf/hh preschoolers LOVE Dr. Seuss! Here are some of the fun activities that we're working on:



Circle Time Tree - Dr. Seuss Theme

Our Dr. Seuss Tree which hangs over our circle time corner. The kids love this tree; we decorate it for whatever theme or time of year it is. Soon we'll add flowers and green leaves for spring; we just took down snowflakes that were hanging in it.


The Cat in the Hat Bulletin Board

Up close of our bulletin board... all the things the cat in the hat does silly tricks with in the book. These are just hand drawn with sharpie marker, painted with liquid watercolors and laminated. They've been moved around several times and used for multiple activities. We've worked on receptive language (i.e. following directions "go get the cake and the cup"), prepositions (i.e. having students tell me where to put them up on the bulletin board on, under, next to, beside etc.) and silly pictures with the kids laying on the floor and the items positioned like they're balancing them just like the Cat in the Hat did in the book.

Some of our work trays/centers right now include:

Cat in the Hat Sensory Bin

One Fish Two Fish Counting Mats from Lakeshore

Gruff Tails - Fine Motor, Counting, Sorting & Patterns

Sand tray and sandpaper letters

Dr. Seuss Mini Felt Board Playset


ABC Magnet Match
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