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Literacy and Auditory-verbal practice

Posted by Stacey Lim on March 21, 2014 12:03 AM

Stacey Lim

Literacy is the ability to use printed and written information to function in society to achieve one’s goals, and to develop one’s knowledge and potential.
-National Assessment of Adult Literacy

When I was in high school, I read a statistic that the national reading average for adults who were deaf was a fourth grade reading level. To me, that was a shocking and sobering statistic.  This statistic has remained constant through the years.  When I read that statistic, I could not imagine graduating from high school with a fourth grade reading level.  Throughout my undergraduate and graduate programs, I focused my research on cochlear implants and their function. However, I have always been interested in literacy and how children learn to read.  Over the past few years, I have also begun to explore literacy and the reading skills possessed by children who are deaf and hard of hearing.

The ability to succeed in a variety of academic courses, such as science, mathematics, history, English, among many other subjects, is dependent on the reader’s ability to extract information from texts.

Reading is the foundation of these topic areas, and children who struggle to read generally have difficulties understanding text-based information in their other courses.  For some children, this struggle becomes so insurmountable that they drop out of school. In our information-driven society, we are constantly accessing print in many forms, including paper-based and online formats.  Thus, reading impacts many different arenas of a person’s life, and extends beyond the classroom, affecting other opportunities such as workplace advancement.  Given our increasing dependence on printed matter and our increased focus on higher education, giving our auditory-verbal children access to a language-rich environment is critical for their future successes.

Reading comprehension is at the very core of literacy.  This complex task consists of a variety of component skills, including word recognition and vocabulary knowledge. Word recognition consists of several different components, including orthographic knowledge. Orthographic knowledge is our understanding of letters and how they are combined in a language. For example, we know that in the English language, vge can never be at the beginning of a word.  However, recognizing words extends beyond simply understanding the orthographic construction of a word, and also requires knowledge of the alphabetic principle and phonological awareness skills.

The alphabetic principle refers to the understanding that different letters of the alphabet represent spoken words, while phonological awareness is understanding of the relationship between letters and sounds (sound-to-letter mapping).  These skills have been shown to impact reading comprehension skill.

Research has suggested that reading comprehension appears to be influenced by phonological skill.  Even before a child begins to learn to read, he or she becomes a pre-reader, and in this stage of reading development, becomes aware of print and sound. Further, the child begins to make associations between print and sound.  In auditory-verbal practice, the child with hearing loss has access to spoken language, thus is able to build the sound-to-letter mapping relationships used in decoding printed words.  This developing skill, in auditory-verbal practice, is highly dependent upon appropriate auditory access. The audiologist plays a role by (1) assessing the child’s hearing ability on a regular basis, (2) providing appropriate hearing technology, including hearing aids, cochlear implants, and FM systems, and (3) working with the parents to ensure that the child’s auditory environment is optimal for language learning.

Written language and spoken language share a common linguistic base.  Word knowledge is one of the largest contributors to later reading comprehension. For an auditory-verbal child, the ability to access spoken language allows them to access a wide range of vocabulary, which is necessary for understanding text-based information.  Hart and Risley (1995) investigated the amount of language and vocabulary exposure occurring in children’s homes, and what they found is that 86% to 98% of the children’s vocabulary was dependent on their parents’ vocabularies. In other words, the more words that children heard their parents say, the more exposure children had to a varied, large set of words, which then became part of the child’s permanent vocabulary set.  Children with hearing loss may have more difficulty with this task because of the acoustic filter caused by hearing loss, but audiologists can play a key role in alleviating this challenge.

One key point to consider is the idea of incidental listening.  In general, we tend to learn words incidentally—these words are generally not purposefully taught (just think of all the bad words or slang we learned—they were not learned in a formal instructional setting. Rather, we overheard them being used conversationally).

Incidental learning is more difficult for children with hearing loss, because the range of hearing is lessened. Thus, the audiologist’s role would be to ensure that the child has access to sound in a variety of settings and across various distances. 

To bring the primary speaker’s voice closer to the child’s ears with minimal loss of sound quality, the audiologist will need to fulfill the second Principle of Auditory-Verbal therapy by using appropriate hearing technology.  In addition to programming the child’s hearing aids and/or cochlear implant(s) to provide maximal auditory access, the audiologist should encourage the use of an FM system. This FM system can be worn at home, with the parents using the transmitter and the child wearing the receiver. In this way, the child will be able to hear his or her parents’ voices, as if they were next to him or her.  Thus, the child will have access to a fuller range of vocabulary and the nuances of spoken language.

The fourth Principle of Auditory-Verbal therapy states that parents are the primary facilitators of their child’s language learning, and the fifth Principle states that environments conducive to listening for language learning is critical.  To create a literacy-rich environment that will lead to greater phonological awareness, better letter knowledge, and better vocabulary, the audiologist can work with the family to help them create an acoustically accessible environment to promote literacy and language learning. In addition to facilitating the use of appropriate hearing technology, the audiologist can work with the family to make some adaptations to the existing home environment to ensure that background noise is at a minimum. For example, parents may want to turn off the television and any other appliances that may make loud noises that interfere with their speech productions.

Not only is it important to provide access to conversations that are rich in everyday language, but as Emilie Buchwald wisely said, “Children are made readers on the laps of their parents.” Indeed, reading aloud to children is one of the best ways to build language and literacy skills. Again, providing auditory access to the parents’ voices allows children to create a social activity where conversational techniques are used.  Parents can use the FM system or read next to their children, so that their voices are heard clearly.

By promoting appropriate acoustic access to spoken language, the audiologist gives the parents the skills to help their children develop age-appropriate reading skills that carry them through life. William James wrote: “So it is with children who learn to read fluently and well: They begin to take flight into whole new worlds as effortlessly as young birds take to the sky.”

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Hart, B., & Risley, T. R. (1995). Meaningful differences in the everyday experience of young American children. Baltimore, MD: Paul H. Brookes Publishing.

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