Brainworks hear to learn 2013

Hear to Learn
Dr. Krista Yuskow
Brainworks Conference
November 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

Cognition Attention

Memory

Chemotherapy

Hearing

their day.

Listening

Radiation

Cognition Attention

Memory

Chemotherapy

Hearing

their day.

Listening

Radiation

Cognition Attention

Radiation

Memory

Chemotherapy

Hearing

their day.

Listening

Radiation

Radiation

Cognition Attention

Radiation

Memory

Chemotherapy

Hearing

their day.

Listening

Radiation

Radiation

Radiation

Cognition Attention

Memory

Chemotherapy

Hearing

Difficulties
Processing

their day.

Hearing
Ear level

Listening
Brain level

Passive process Hearing with attention
and intention
The ear’s ability
to detect sound

Comprehending
Brain Level
Reception of
information,
meaning and intent

Demands mental effort

Involve hearing, cognition, attention and
memory.
Require cognitive and auditory processing.

Hearing
Ear level

Listening
Brain level

%
5
6

Passive process Hearing with attention
and intention
The ear’s ability
to detect sound

Comprehending
Brain Level
Reception of
information,
meaning and intent

Demands mental effort

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

Cognitio
n


Cognitio
n

Audition

Cognitio
n

Audition


Barriers to Auditory Access


Classroom Acoustics



Hearing Loss



Auditory processing



Speech level & clarity



Language proficiency


Classroom Acoustics




noise
reverberation
distance

?

Co

h
ug

!

Co

ugh

Co


ug

!

h!

10

As the distance between teacher & student
increases, the amount of info the student is able
to understand decreases.


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!


1m


60 dBA

1m


60 dBA

2.5 m

1m


54 dBA

60 dBA

2.5 m

1m


54 dBA

5m

60 dBA

2.5 m

1m


48 dBA

5m

54 dBA

60 dBA

2.5 m

1m


48 dBA

54 dBA

60 dBA

10 m

5m

2.5 m

1m


42 dBA

48 dBA

54 dBA

60 dBA

10 m

5m

2.5 m

1m


The Combined Effect

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

100
80
60
50dB
BGN

40

typical classroom noise

20
0


12
3
6
9
Distance from teacher in Metres

“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:
Walk
Walks
Walked
Talk
Talks
Talked
Top
Tops
Topped


Making your
voice louder
does not
necessarily
make your
voice heard.

Think of the following words:
Making your
voice louder
does not
necessarily
make your
voice heard.


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 Closure

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


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 delays
CANS disorders
Neurologic disorders/disease
Genetic 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

 repetition of information
 more time.

* Children with auditory processing difficulties as a result of
radiation/chemotherapy treatments, hearing loss or other nonmaturational 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/

 Children require a
more complete,
detailed auditory
signal.
 Young ears/brains
cannot accurately
‘repair’ what is
missed or misheard.


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

Sound
Waves

Auditory
Identification

Aud/Lang
Processing

Concept
Undrstng

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’ Talk
Hiyamac.


Lobuddy.

Fishin’ Talk
Hiyamac.

Lobuddy.

Binearlong?

Coplours.


Fishin’ Talk
Hiyamac.

Lobuddy.

Binearlong?

Coplours.

Cetchanenny?

Goddafew.


Fishin’ Talk
Hiyamac.

Lobuddy.

Binearlong?

Coplours.

Cetchanenny?

Goddafew.

Kindarthey?

Bassenperch.


Fishin’ Talk
Hiyamac.

Lobuddy.

Binearlong?

Coplours.

Cetchanenny?

Goddafew.

Kindarthey?

Bassenperch.

Ennysizetoom?

Couplapowns.


Fishin’ Talk
Hiyamac.

Lobuddy.

Binearlong?

Coplours.

Cetchanenny?

Goddafew.

Kindarthey?

Bassenperch.

Ennysizetoom?

Couplapowns.

Hittinhard?

Sordalike.


Fishin’ Talk
Hiyamac.

Lobuddy.

Binearlong?

Coplours.

Cetchanenny?

Goddafew.

Kindarthey?

Bassenperch.

Ennysizetoom?

Couplapowns.

Hittinhard?

Sordalike.

Igoddago.

Seyaroun.


Fishin’ Talk
Hiyamac.

Lobuddy.

Binearlong?

Coplours.

Cetchanenny?

Goddafew.

Kindarthey?

Bassenperch.

Ennysizetoom?

Couplapowns.

Hittinhard?

Sordalike.

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

Stay on topic

Identify and
paraphrase

Comprehension
Monitoring

Visual cues/
supports*

Provide short breaks

“Chunk” information


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


cs,
r acousti loss
Poo
ring
alth, hea g
he
sin
d proces n all
an
ca
ifficulties ibility
d
ellig
affect int ehension.
pr
and com


Questions???
k


epsb.ca
@
.yuskow
rista

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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