FYI - First Years Info Newsletter logo
   FIRST YEARS > fyi - First Years Info > Summer 2011, July
   Previous issues
vertical line divider
Contents

Greetings from FIRST YEARS!
by Kathryn Wilson, M.A., CCC-SLP, LSLS Cert. AVT (kathryn_wilson@med.unc.edu)
FIRST YEARS Program Director

Greetings from Vietnam! I am currently joining some FIRST YEARS graduates, faculty and mentors in a training program in Vietnam. I thought I'd wish all of you, our readers, a belated "Happy July 4th" by sharing my journal entry (7/5/11) of what our hosts did to honor our 4th ...

The cook at the school made french fries for us and we also had watermelon.  I helped with breakout sessions in the afternoon.  In the last group, one of the nuns asked if my teaching partner and I would sing the national anthem.  Well, I can't sing worth a hoot but we did it.  A few minutes later one of the grad students came along and she has a beautiful voice and she sang for them.  I took a picture of a few of them standing up with their hands over their heart while the song was sung.  A young Vietnamese teacher was wearing a sparkly shirt with the American flag and USA underneath it.  She wore it just for us. 
I took a picture of a few of them standing up with their hands over their heart while the song was sung.
As you can imagine, this is a special "memorable moment" for me. Of course, just about everything is memorable here .... (We'll be sharing more about these experiences in the next fyi issue, but we preview some trip-planning concerns about the Ling Sounds, "A rose by another name ..." )

In this issue, we congratulate our new graduates and "inaugurate" a new feature - "Paying it forward." In this we begin sharing what our graduates have been telling us about new programs they have inaugurated. It turns out that participating in the Vietnam training program is just one of many projects our graduates have undertaken, armed with FIRST YEARS training.

And as usual, we share a document from our Reference Library, in part 2 of our series on "Learning to Listen; Listening to Learn," which highlights documents used in our course on Listening & Spoken Language Development & Intervention.

Congratulations to our 2011 graduates!
Job well done!
  1. Barton, Christine, MM, MT-BC - IN
  2. Breitkopf, Dara, M.S. Deaf Ed., TOD - NY
  3. Cross, Pamela, B.A. Sp. Ed/Deaf/HH/ECE, MAT. - MI
  4. Eitemiller, Patricia, M.Ed Spec Ed. - VA
  5. Ferguson, Ellen, M.S., CCC-SLP, LSLS Cert AVEd - WV
  6. Gryciuk, Maggie, TSHH, MSEd - NY
  1. LeBlanc, Mélissa, Ba BEd - New-Brunswick, Canada
  2. Lucius, Shana Smith, MA, CCC-SLP - MI
  3. Ludwig, Debbie, M.Ed - OH
  4. Miller, Amy, M.N.S., CCC-SLP - MI
  5. Robinson, Leigh Ann, M.S., CCC-SLP - TX
  6. Straub, Kristi, B.A., M.S., M.E.D. Deaf Ed. - CT
  7. Talamantez, Sara, M.A., CCC-SLP - CA

FYGRADS Listserv
One of the benefits of completing the certificate is the "fygrads listserv," a mailing list that connects all the graduates to each other and faculty. On the administrative end, we can send out news items. On the professional end, our graduates can send in requests for information. For example, when our 2011 graduates were announced in May via the listserv, Sherauna Provensal (class of 2010) sent in (5/4/11):
Hey fellow FYgrads.  Question....do you all use FM receivers bilaterally?  Our district has always used one receiver per kid (ordered by audiologist) and put it on the best ear.  Am talking with the teachers about receivers bilaterally.  Not sure why we have never done that (money maybe).  Does anyone have any info either way?
Twelve graduates responded, including Mary Smith-Johnson (class of 2007), who posed some questions of her own (5/4/11):
Duluth uses both when both ears can handle without question. We have had kids who report that they prefer one or they have too much distortion in one ear... But that's determined audiologically not monetarily ... I bet there's some research reporting the advantage. Also, I'm thinking the one ear FM would make it difficult to localize.
In addition, faculty member Heather Porter (AuD) sent in a detailed response (5/4/11) to both Mary and Sherauna and attached two articles with data to back it up:
I was able to find two studies that looked at unilateral versus bilateral FM use as part of their research paradigm (Tharpe, Ricketts, & Sladen, 2004 and Schafter & Thibodeau, 2006 )1.  It looks like research supports that bilateral FM use is better than unilateral FM use for children with varying degrees of hearing loss.  In Schafter & Thibodeau (2006) Figure 6 shows this for children with bilateral (sequential) CIs - lower scores are better for this measure.  Also, Figure 1 in Tharpe, Rickettes, & Sladen (2004) show this for children with minimal and mild hearing loss (lower is also better in this figure).  Disclaimer - I don't know if these are statistically significant differences, but the figures do a nice job of illustrating at least a trend toward differences in performance between conditions.

Preference and distortion would be considerations, you are right.  Money also plays a part in district and family decisions.  FMs are expensive and most insurance companies do not offer any coverage. 

Quick note regarding preference: most technology allows children to hear the classroom teacher and their friends while using personal FM systems.  Many adjustments can be made to personal FM systems including adjusting the level of the teacher's voice relative to the level of the background 'noise' that the child might want to hear (e.g., classmates).  All things equal, I would encourage bilateral FM use. 

Quick note regarding distortion: it would not be beneficial to introduce an amplified signal to an ear that had distortion.  However, typically distortion occurs as a result of introducing amplification to an ear with severe to profound hearing loss.  Distortion would be present with amplification even without an FM system.  Most of these children will be CI candidates.  I'm having a hard time coming up with a scenario where a child would experience distortion through the slight amplification that would be provided by FM system use only (like a Phonak iSense micro)... 

In follow-up email (5/4/11), Heather provided a personal perspective requested from a friend, with bilateral severe hearing loss and hearing aids, who is currently taking graduate audiology classes. When asked on her take on bilateral FM use for children, she responded: 
"...it depends... What is the child's hearing loss?  Are they on FM only or FM plus mic? If they are on FM plus Mic can they hear conversation around them that might not be amplified appropriately? What has the school provided?  Sometimes they only provide one receiver... if that plugs into a neckloop icom they can use both ears (but again do they have t-coil only or t-coil plus mic) or only one receiver. Who do they need to and want to attend to in the classroom?

Personally when I am in a lecture that doesn't have interactive discussion, I use it in both ears (I get a binaural benefit).  When I am in a discussion oriented classroom I usually turn the FM on in one ear and leave it off in the other so I can hear discussion better.  I use a FM plus mic programming setting but if someone is talking over the FM it overwhelms the hearing aid mic and I can't parse it out (so then I separate the ears to do this instead)."

As Heather concluded: "... it is important to approach each child and their unique situation individually.  This is what makes being an audiologist so interesting!"
1 Referenced articles:
  • Tharpe, A.M., Ricketts, T. & Sladen, D.P. (2004). FM Systems for Children with Minimal to Mild Hearing Loss. In: Fabry, D.  & Johnson, C.D. (Eds), ACCESS: Achieving Clear Communication Employing Sound Solutions-2003. Proceedings from the First International FM conference. (pp.191-197). Phonak AG.
  • Schafer, E.C.  & Thibodeau, L.M. (2006). Speech Recognition in Noise in Children With Cochlear Implants While Listening in Bilateral, Bimodal, and FM-System Arrangements. American Journal of Audiology,15: 114–126. 

BEGINNINGS Report: Change in Communication Choice Over 10 Years
FIRST YEARS stresses our professional responsibility to ensure parents are aware of all communication options and to respect those decisions when helping the parents implement their intervention goals. 

However, thanks to medical and technological advancements in the field of deafness, we are seeing a shift in communication choices. Children, who are deaf or hard of hearing, now have greater opportunity than ever before for early access to sound. Because they can hear spoken language, they have greater potential to understand and use spoken language. Thus, communication modes stressing listening and spoken language (auditory/oral and auditory verbal) have become increasingly important (and chosen) options for parents.

Dr. Joni Alberg, Executive Director for the North Carolina-based BEGINNINGS for Parents of Children Who Are Deaf or Hard of Hearing, recently compiled NC data at the request of Tom Avril, Health and Science Reporter for the The Philadelphia Inquirer. His article, "Deaf education evolving with implants," subsequently appeared in the May 30, 2011, edition.
 
Beginnings
Communication Choice FY01 FY06 FY10 FY11*
ASL 4% 3% 4% 2%
Cued speech 1% < 1% < 1% -
Listening and Spoken Language 69% 83% 89% 90%
Total (or Simultaneous) Communication 21% 14% 6% 8%
Other 5% - - -
*FY11 reflects 10 months of data.


Ling Sounds: "A rose by another name ..."
Not all sounds mean the same thing in all cultures!

Several of our FIRST YEARS students and mentors, along with our director Kathryn Wilson, are currently participating in a teacher training program in South Vietnam. (We will be reading more about their experiences in the next issue.) In preparation for the training, we helped pull in some instructional materials and ended up tackling an interesting question involving the Ling Sounds. 

Ann Baumann (class of 2007) wrote in an email: "I don't think the Ling sounds are the same ... or at least, the /s/ for instance, isn't one they'd use in 'polite company' because it is the sound they make to indicate someone is going to the bathroom!" (3/25/11)

We contacted Elizabeth Cole, author of our Basic Speech Acoustics course, about using the Lings in different cultures. She responded: "How funny not be able to use the /s/ sound!  The sounds used should probably be vowels and consonants from Vietnamese ... If they have any high frequency voiceless fricatives (such as /f, th/) in Vietnamese, those sounds would work.  For the demonstration, they could just use the English vowel sounds and also "m" and "sh" and either "f" or "th" (both voiceless) -- and explain the principle behind the Ling sounds ..." (3/27/11)

In another communication, Kim Hamren, a FIRST YEARS mentor, and Ann were brainstorming objects to use for the Learning to Listen Sounds.  They discovered that snakes could not be used for the /s/ sound because snakes are such an issue of safety there. " ... the parents were a little concerned about using that to represent the /s/ sound. This /s/ sound is such a problem!" (6/25/11)

Interestingly, the topic of the Lings in other countries came up in another context,  a forum posting in the speech acoustics course, currently being taught by Beth Walker. This time, the question concerned what could and could not be used in Mandarin. In response to Tracy Vale (class of 2012, 6/4/11) we discovered that the /s/ sound could be used in Mandarin but not in Cantonese. Chris Barton (class of 2011), the course guest forum mentor on using music in therapy, brought up another issue when dealing with other cultures: 

The other consideration when thinking about Chinese music is that it is built on scales different from ours in the Western world. So, not do-re-mi-fa-so-la-ti-do. It would be difficult for us to sing some of the music because the pitch differences are even smaller than we have. This is one reason why the tonal languages (like Mandarin) sometimes pose problems for implant users. The spectral resolution necessary to discriminate those small pitch increments is very fine. Even our perfectly normal ear would have difficulty hearing the difference at first. However, I would still welcome the parents to share their songs with me and certainly with their child! Why? Because it is their native language and when sharing something as intimate as a lullaby or children's song, the natural inclination is to do it in the way one knows best. (6/4/11)
But that's not the final chapter in the "Ling mystery."  In a follow-up email (6/4/11), Kathryn Wilson commented: "All very timely ... I just finished watching a video of one of the Vietnamese teachers sent in for the training.  She started the session with the Ling Sounds and she did do the /s/!!!"

We await the next issue to resolve the mystery.


Paying it forward …
FIRST YEARS offers a unique learning environment, where all involved are professionals, sharing their diverse expertise in the back-and-forth interactions that characterize the program. In other words, the students are not the only learners! As one of our practicum mentors Kim Hamren related, "…  I didn't expect to participate in such an amazing professional skill-building opportunity for myself." (fyi, January, 2010).

As students, both current and former, have reported what is happening in their own districts, we see the impact of the learning experience: Our students have become agents of change – "paying it forward" – not only transitioning their own, local therapy settings to include more auditory-focused strategies, but garnering acceptance and increasing participation from colleagues beyond their districts, even to state and national levels.

In this new feature, we begin sharing some of what our students are saying. We begin with Patty Eitemiller (class of 2011).

Patty recently participated in developing presentations for a one-hour webinar as part of the monthly "Talks on Tuesday" series for early intervention providers across her state (Virginia). As she shared (6/23/11): 

For the past several years, I've been participating in a Hearing Workgroup with several key members around the Commonwealth of Virginia.  One of our goals is to ensure that children who fail their newborn hearing screen are referred to Early Intervention and receive the services and support they may need.  The group includes staff from our state EHDI office, Part C and Part B staff and interventionists, coordinators of our Guide By Your Side program and Hearing Aid Loan Bank, training personnel, an audiologist, and private speech therapist who works primarily with children with hearing loss.

In Virginia, in order to work in Early Intervention, we have to be certified by the state (basically complete and pass training modules) and also complete a number of trainings over the course of a three-year period to "re-certify."  The "Talks on Tuesday" are just one thing that our state's training collaborative is doing to help all EI providers gain more information, but also gain hours we need for certification.

The "Talks on Tuesday" focusing on hearing loss aired live on June 7th, with over 60 registered participants. The webinar was very introductory in nature, based on a recent survey of EI providers in Virginia, which showed most knew very little about hearing loss or working with young children with hearing loss. As the advertisement went out:
Have you ever heard of the Centers for Disease Control's 1-3-6 plan?  Have you ever wondered about the difference between conductive and sensorineural hearing loss or what's involved in testing an infant's hearing?  Have you every wondered about what families should do when follow-up is required after an infant's hearing screening?  Have you every wondered about the impact of hearing loss on other areas of child development?  Have you ever wondered about effective intervention strategies when hearing loss is detected? 

If you answered "yes" to any of these questions, please make plans to participate in next week's "Talks on Tuesday" on June 7th at noon.  This session, "Everything You Always Wanted to Know About Hearing But Were Afraid To Ask," will provide an overview of Virginia's Early Hearing Detection and Intervention (EHDI) Program, Hearing 101 (general overview of hearing, hearing evaluation, and intervention approaches), and key information all early intervention providers need to know about hearing and hearing loss.  A Q&A session will also be provided.

The hour-long webinar was presented in three parts, following the CDC’s 1-3-6 plan.  The first included statistics and information specific to how many children in the state have been identified with hearing loss and how many have been '"lost" versus the numbers enrolled in EI services.  The second included details of the various types of hearing loss and testing that is involved when identifying a child's hearing loss. Patty, the presenter for the third part, "concluded the webinar by sharing information focusing on working with a family of a child who has been newly diagnosed, the various communication options available, and things to consider about each option."

The webinar, both the slides and audio version, is available at: http://www.eipd.vcu.edu/talks_tuesdays.html

Patty relates that she has also been busy in other training aspects: "I have two interns this summer, with the next one starting in a week. :)"

Thank you, Patty, for paying it forward.

Patty Eitemiller
Patricia Eitemiller, M.Ed.  (Patricia.Eitemiller@alexandriava.gov)
Infant and Toddler Connection of Alexandria (http://infantva.org/)
4480 King Street, 5th Floor
Alexandria, VA 22302


FIRST YEARS in Spain
Kathryn Wilson and FIRST YEARS faculty member Patricia Roush joined other international speakers in Madrid, Spain, May 26-27, 2011, for the II International Symposium: Early identification, diagnosis and treatment of deafness in infants.  Sponsored by the Ramón Areces Foundation, a non-profit that supports scientific and technical research and educational initiatives, the two-day symposium featured speakers from Spain, Canada, the United Kingdom, the United States, and Venezuela.  Topics included state-of-the-art early identification and diagnostic procedures, the current status of infant screening programs in Madrid, genetic counseling, prevention, essential components of the hearing aid fitting process, surgical considerations in infants and children receiving cochlear implants, and family-centered intervention.

In an email prior to the symposium, our host and hostess, Dr. Antonio Denia and Dr. Belen Lombardero, informed the invited speakers that "it is not all about work."  The social activities began with a Spanish wine reception on the evening prior to the conference.  To say that we enjoyed some of the finest Spanish cuisine to be found in Madrid during our stay is surely an understatement.  Following the close of the meeting, the group was entertained with world-class flamenco dancing at Corral de la Moreria.  Before departing for the U.S. there was time for exploration of Old Madrid and a day-trip to the mountain-top city of Toledo.

Madrid … una experiencia maravillosa ...
L-R: Pat Roush, Belen Lombardero, Antonio Denia, and Kathryn Wilson at the


From FIRST YEARS Reference Library
Focus on Learning to Listen; Listening to Learn, Part 2 - Tracking and Assessing Development
In our upcoming fall course in Listening & Spoken Language Development & Intervention, our co-instructors Beth Walker and Sherri Vernelson guide students in exploring listening and spoken language approaches to auditory, language and speech development. Key resources examined include three intervention "roadmaps," each tied to the developmental sequence: the Bloom and Lahey Model for Normal Language Development, the Cottage Acquisition Scales for Listening, Language, & Speech (CASLLS), and The Auditory Learning Guide, or ALG.

In the Winter/January 2011 edition of fyi we highlighted the Auditory Learning Guide/ALG, developed by FIRST YEARS instructor Beth Walker

Here, we include our 2-part compilation of Tests & Measurements: Auditory, Speech, Language and General Developmental, which the class examines in the language units. The compilation's first part includes links to all assessment products; the second is a chart categorizing the assessments in terms of domains assessed, delivery format, and age range. The listing is comprehensive, but not all-inclusive, and represents some favorites of the FIRST YEARS faculty

The original list was compiled by Krista Heavner (MS CCC-SLP/LSLS Cert AVT), Consultant, Deaf & Hard of Hearing Program, Exceptional Children Division, NC Department of Public Instruction, Raleigh NC. FIRST YEARS then added the click-able links and a bit of formatting. You can see the result below.

Check it outFIRST YEARS: Tests & Measurements: Auditory, Speech, Language and General Developmental

Are there others you would like to see included on the compilation? Send us your suggestions.

FIRST YEARS is fortunate to have a broad network of experts who willingly share their creations with our students and, via our website, with other professional colleagues. We thank them!


Names in the News
Recent publications by FIRST YEARS faculty, students, and mentors
  1. Rossi, K. Talking Tips, April, 2011. (Theme: "Bath time")
  2. Rossi, K. Talking Tips, May, 2011. (Theme: "In the garden")
  3. Rossi, K. Talking Tips, June, 2011. (Theme: "Outdoor play")
To subscribe to Talking Tips, send an email to: learntotalk@cox.net

Upcoming workshops by our faculty and students

  1. Barton, C. (class of 2011). The Art of Harmony. State-Wide Family Learning Vacation, Center for Communication, Hearing & Deafness in Milwaukee, WI. August 19-20, 2011. Will feature SongBooks, created with Tar Heel Player.
  2. Heavner, K. & Vernelson, S. Bloom & Lahey I / CASLLS I: Roadmap to Language Development. September 19-20, 2011. LSLS credit.
  3. Heavner, K. & Vernelson, S. Bloom & Lahey II / CASLLS II: Roadmap to Language Development. November 14-15, 2011.. LSLS credit.
  4. Henderson, L., Knott, M. & Teagle, H.F.B. Cochlear Implants & Challenging Cases. December 12, 2011. LSLS credit.
  5. Teagle, H.F.B. A different approach to programming Advanced Bionics 90k recipients:  Return to traditional methods and concepts. CI2012 International Pediatric Symposium. July 14-16, 2011.
  6. Thomas, E. Developing Language for Children with Hearing Loss who are in Bilingual Environments. NC Department of Public Instruction, Exceptional Children Division,  Summer Institute, UNCG Campus. July 29, 2011.
  7. Vernelson, S. "Roadmaps" Review & Make it, Take it. September 17, 2011.
At the upcoming LSL Symposium in Washington DC, July 21-23, 2011:
  1. Alberg, J. & Wilson, K. Longitudinal Research on Outcomes for Children in North Carolina, July 22, 9:30 – 11:30 a.m.
  2. Goldberg, D. M. Listening, Language and Learning for Infants and Children Who are Deaf or Hard of Hearing, July 21, 8 a.m. – noon.
  3. Teagle, H.F.B & Roush, P. Auditory Neuropathy Spectrum Disorder, July 21, 8 a.m. – noon.
new topic
Now it's your turn!
Job changes? Interesting training opportunities? Additional certifications? New tips & tricks? Please send us your news at FIRST YEARS Webmaster.

new topic
© 2011, The University of North Carolina at Chapel Hill FIRST YEARS Certificate in Auditory Learning for Young Children with Hearing Loss. All rights reserved. May be reproduced in any medium for non-commercial purposes.
Publication date: July, 2011