5 Aspects of Optimizing Auditory Access

Hearing aids, cochlear implants and FM systems can provide children who are deaf or hard of hearing access to sound across the range of speech frequencies. However, listening conditions of the home, classroom and community can compromise that access. Parents, teachers, family members and friends can use the following five features of listening to help ensure children are receiving the auditory information needed for optimal listening, language, and speech development. Use the fingers on your hand to remember the five aspects of optimizing auditory access: technology, noise, distance, volume, and rate.

Technology:

Regular assessment and follow-up by a pediatric audiologist are essential for children who are deaf or hard of hearing and are developing listening and spoken language skills. Pediatric audiologists strive for fitting amplification (e.g., hearing aids, cochlear implants, and/or FM systems) at an early age. Once a child is appropriately fit with amplification, it should be worn all waking hours. Daily equipment checks and functional listening checks should be performed to ensure the amplification is working each and every day.

At Home and School:

Encourage full-time use of amplification. If the child’s eyes are open the hearing aids/cochlear implants should be on.
Do daily listening checks. Inspect the equipment. Are any pieces missing or broken? Perform a Ling 6 Sound Test to track the child’s ability to hear the range of speech frequencies (pitches).

Noise:

Children who are learning language do best in settings where the speech they are listening to is 20 decibels (dB) louder than the other sounds around them (Srinivasan, 1996). Think about the last time you were in a noisy store or restaurant. You likely had a difficult time listening and understanding the people around you. Imagine trying to learn new ideas and language skills in that noisy environment. Reducing noise in the environment is a great way to optimize the listening environment for a child.

At Home:

Turn off the radio and/or TV when talking or reading with your child.
Run the dishwasher or washing machine after your child has gone to bed.
Close doors to noisy rooms (e.g., laundry room).
Strategically place “noise makers” such as fish tanks, air conditioners, computer fans away from areas for talking, listening, and learning.
Manage the flow of conversation: think of having a “talking stick”. Avoid having multiple people speaking at the same time.

At School:

Strategically place “noise makers” (air conditioner, fish tanks, etc.) or use them when students are not asked to listen to the teacher or peers.
Strategically place students away from noise sources (loud hallway, street noise near windows, noise from adjoining rooms, pencil sharpener, etc.).
Introduce materials that absorb sound in the classroom. Think about carpet instead of tile floors. Hang curtains on hard window surfaces that reflect sound. Put tennis balls on chair legs.
Manage the flow of conversation: think of having a “talking stick”. Avoid having multiple people speaking at the same time. Speech can be noise, too!

Distance

Reducing distance from the speaker (parent, teacher, soundfield FM speaker) to the microphone (child’s hearing aid, CI, etc.) is one of the simplest and most effective ways of optimizing auditory access. Simply moving closer to the child and/or moving the FM microphone closer to the speaker’s mouth will uniformly increase the volume of all of the frequencies of speech without adding distortion. 6 dB rule: Each time the distance from the source of a sound is doubled, the signal is reduced (gets quieter) by 6 decibels. Conversely, each time the distance is halved, the signal is increased (gets louder) by 6 dB.

At Home and School:

Get closer! Don’t try to communicate with the child from across the room or from another room or upstairs/downstairs.
Use an FM system when appropriate.

Volume:

Increasing the volume of speech results in an increase in the volume of the voiced sounds—vowels and some consonants. Increasing volume does not increase the volume of unvoiced sounds (s, sh, f, th, t, p, k) equally with voiced (vowels, m, n, d, b, g, z, etc.). As a result, the louder voiced sounds will actually mask the softer unvoiced sounds resulting in speech that, although louder, is less clear than speech presented at a moderate volume.

At Home and School:

Speak at a moderate volume.
If sounds or words are not clear, move closer to the child’s microphone. Do not speak louder.
Use a personal FM system with appropriate microphone placement whenever appropriate.

Rate of Speech

A speaker’s rate of speech has a significant impact on the intelligibility of the sounds of speech. Speech that is too rapid results in some sounds being too short to be recognized, sounds that lack distinct features, or some sounds being dropped completely. Although experienced listeners may understand rapid speech, emerging listening and language learners’ understanding may be severely compromised if the rate of speech is too fast.

At Home and School:

Speak with a moderate rate.
Modify your rate of speech to aid the child’s understanding. Slow down if needed to highlight important parts of speech.

Technology: Notice the teacher is using an FM transmitter and the student is wearing her hearing aids with FM receivers. The student participates in a Ling 6 Sound Test to ensure her equipment is functioning.

Noise: The student alerts her classmates that she is “trying to listen” so they will quiet down. The teacher and student are in an area of the classroom without other students or noises.

Distance: The teacher and student are nice and close. The teacher wears a boom microphone with her FM system that is just inches from her mouth.

Volume: The teacher is speaking at a moderate volume.

Rate: The teacher uses a moderate rate of speech to ensure the clearest message.

References:

Srinivasan, P. (1996) Practical Aural Habilitation for Speech-Language Pathologists and Educators of Hearing-Impaired Children. Springfield, IL: Charles C. Thomas Pub.

This information is from the Auditory Consultant Resource Network Handbook available for purchase from Boys Town National Research Hospital by contacting ACRN@boystown.org or calling (402) 452-5042.