"The Miracle Worker" Clip: The Story of Helen Keller

(*skip to two minutes and forty seconds*)

Sign Language Inspired Me

For this entry, I will sign my thoughts instead of typing them. It has been a personal choice of mine to learn sign language so that I will be able to work with a more diverse group of children when I become a speech pathologist, specifically deaf children or children with a hearing loss. The video below will explain how I became interested in the field of speech pathology and sign language. I will translate it here:

Thank you for reading my blog. My inspiration for joining this community was a movie I watched about Helen Keller as a young child. The movie was a motivation for me to learn sign language as I am now taking a sign language course. I have been studying this language for several years. I hope you learned something about the field of speech therapy that you found interesting. I am more excited than ever to be part of this community. In conclusion, I will show you a short clip from the movie "The Miracle Worker" that to this day still inspires me. (*above is the video from "The Miracle Worker" in a new entry*)

 

 

Auditory Processing Disorder: Its Effect On Learning, Hearing, and Communication

Speech language pathologists often work with audiologists on evaluating, diagnosing, and treating those with communication disorders. Dr. Teri James Bellis is recognized in the audiology community as a leader for her outstanding accomplishments by the American Speech-Language-Hearing Association. She is recognized as an expert on the subject of Auditory Processing Disorder, also known as APD or CAPD. Auditory Processing Disorder is “a deficit in the neural processing of auditory information that cannot be attributed to higher order disorders, including those related to learning, attention, memory, cognitive-communicative and/or language-related skills. Therefore, although CAPD may coexist with higher order deficits (ADHD), learning disability, language impairment, it is not the result of these disorders” (Geffner and Swain). Dr. Deborah Swain is the founder, owner, and director of the Swain Center for listening, communicating, and learning. Dr. Donna Geffner is a professor and program director in the department of Communication Sciences and Disorders. 

Children with APD have difficulty understanding speech in noisy environments, understanding and following directions, and distinguishing between speech sounds that sound similar. Sometimes, they act as if they are hearing impaired or have a hearing loss and will ask for something to be repeated or clarified. They may appear inattentive and have difficulty following oral directions. In actuality, what those affected by CAPD are hearing is unrecognizable, disordered, and incoherent sounds. Children affected with this disorder may become anxious and are prone to poor academic performance. Those affected by CAPD have difficulties in speech, language, and learning. 

Assessment of auditory processing disorder is done first by an audiologist to check for hearing acuity. Then the audiologist will do an assessment to determine if the patient can listen to signals or sounds going into one ear while other signals and sounds are going into the other ear. In other words, can the patient's hearing separate and integrate the sounds. Following the audiological assessment, a speech pathologist will evaluate the patient to see how they are processing speech sounds, discriminating between sounds, and their understanding of receptive language. 

Treatment of APD focuses on three areas. The first is changing the learning or communication environment so that the auditory information can be more easily presented.  Next, using skills like problem solving, memory, attention, and other skills to overcome the auditory disorder. Finally, using treatment activities to treat the auditory deficit. These activities might be computer assisted or one-on-one treatment with a therapist. With intervention, there is hope that the learning, language, and communication impairments due to APD may be remediated.  

 

Newborn Screening Tests For Hearing Loss

Children should be tested for hearing loss as soon as possible, preferably before they leave the hospital. Current hearing screening tools include the otoacoustic emissions and auditory brainstem response testing. Both tests are objective, safe, noninvasive, and have a fairly high degree of accuracy. The otoacoustic emissions tests evaluate outer hair cell efficiency and how the inner ear produces energy during the hearing process. Readings are separated into two categories, spontaneous and evoked. “Thus, the EOAE (Evoked Otoacoustic Emissions) screening program is identifying almost 5 children per 1,000 with a sensorineural hearing loss. This prevalence of sensorineural hearing loss is two to three times what is typically expected in the general population. This is strong evidence that EOAE can be successfully used to identify children who have a hearing loss” (Bess and Hall). Dr. Fred H. Bess is a professor of hearing and speech science at the Vanderbilt Kennedy Center. Dr. James W. Hall III is a clinical professor in the department of speech, language, and hearing sciences at the University of Florida in Gainesville. 

 The Auditory Brain response testing (ABR) monitors brain activity that occurs in response to sound and does not require any cooperation by the child. Children undergoing the ABR test must be kept very still, as any movement will invalidate the test results. Therefore, young patients are usually sedated for the administration of this procedure. The American Speech-Language-Hearing Association (ASHA) recommends this newborn screening test prior to hospital discharge. “Based on our experience, we believe that accurate identification can be enhanced when the ABR is applied as a diagnostic procedure to those infants who fail its administration as a screening test. For the infants, immediate diagnostic application permits prediction of both degree of sensitivity loss and probable site of dysfunction” (Bess and Hall).

As a result of the newborn hearing screening, there are greater educational opportunities for children who are born deaf or hard of hearing. Technological advances for the future will improve upon the assessment methods already being used to accurately screen and confirm hearing loss in newborns. "Both ABR and OAEs will continue to be refined as methods for UNHS (Universal Newborn Hearing Screening). Promising new technologies are emerging which combine OAE and AABR methodologies into a simple, handheld device permitting rapid measurement of both responses. These devices hold promise for rapid testing with a two-stage protocol for all infants, thereby reducing refer (false positive) rates associated with transient external or middle ear dysfunction, and improving identification of infants with more unusual forms of hearing impairment such as auditory neuropathy." This information was taken from an academic journal discussing the current screening tests and their effectiveness for the future. 

Early Identification of Hearing Loss Affects Communication

According to the National Institute on Deafness and Other Communication Disorders, “Hearing loss is the most common birth defect, and it estimates that as many as 12,000 new babies with hearing loss are identified every year” (Cole and Flexer). Dr. Carol Flexer is a distinguished audiologist whose expertise is in the field of pediatric and educational audiology. Dr. Elizabeth B. Cole is a professor and has written many publications on the subject of hearing loss. In the past twenty years, there has been a vast amount of information and improved technology for testing and treating hearing loss in infants and children. The result has been the adoption of universal newborn hearing screening. Early identification has provided us opportunities to fit amplification equipment and cochlear implants on babies. These screening tests have allowed us to access important auditory brain centers during peak periods of maximum neuroplasticity.  

“Neuroplasticity refers to the brain’s availability and malleability to grow, develop, and alter its structure as a function of external stimulation” (Cole and Flexer). It is important that auditory language be provided during the first few years of life, a critical period of maximum brain neuroplasticity. “In order for auditory pathways to mature, acoustic stimulation must occur early and often because normal maturation of central auditory pathways is a precondition for the normal development of speech and language skills in children” (Cole and Flexer). Today, babies and young children who are born deaf or with a hearing loss have greater opportunity to achieve language, reading, and academic skills than ever before.  

 Today, newborn hearing screening has changed everything we know about hearing loss, and early identification and intervention have given us access to the auditory brains of babies with even the most extreme deafness. It is extremely important to intervene during the first three and a half years of a child’s life when the neuroplasticity is greatest. “Rapid infant brain growth requires prompt intervention typically including amplification and a program to promote auditory skill development. Early amplification or implantation stimulates a brain that is in the initial process of organizing itself and is therefore more receptive to auditory input, resulting in greater auditory capacity. Therefore, identification of a newborn hearing loss should be considered a neurodevelopmental emergency” (Cole and Flexer). Studies have shown that early intervention allows for a significant improvement in the development of language for children who suffer from hearing loss.

 

 

Speech & Language Therapist