The Parents' Guide to Cochlear Implants

6. Learning about Listening through Home Activities

67 LEARNING ABOUT LISTENING THROUGH HOME ACTIVITIES Learning about Listening through Home Activities Chapter 6 The initial switch-on of a cochlear implant is an important event; however, the real work of learning to listen begins when the child returns home after the implant is activated. At this point,an auditory focus becomes possible and, moreover, is necessary to maximize the benefits of the implant. Parents must realize that the surgeon’s job has ended and the long-term work of helping their child listen with the implant has just begun. Parents who abdicate their responsibilities at home, in light of what they believe is a “medical miracle,”will be disappointed with the outcome. Many parents are thirsty for a blueprint to help their newly implanted child learn to listen; what will assist parents at this stage is a broad-based understanding of auditory skills. Determining the appropriate point at which to begin listening activities at home is dependent upon the age of the child at implantation and the level of auditory skill demonstrated prior to implant surgery. Under the dual direction of the cochlear implant center team and educational personnel, parents should be encouraged to actively participate in the habilitation of the child.In so doing, there are three important guiding principles for designing listening tasks: 1. choose the appropriate level of auditory ability, 2. select motivating activities suitable for the child’s age and language ability, and 3. keep success high. Parents or caregivers are capable of providing listening opportunities in the home and having fun with their child at the same time. In order to accomplish this goal,they must understand 68 CHAPTER 6 the stages of auditory skill development. This knowledge will enable them to become key players on the child’s listening team. It is advisable, then, that parents learn the language and vocabulary of listening skills. The terms defined in this chapter are used to describe the auditory development of children in general . An understanding of these terms will guide the parents in developing activities that are appropriate throughout the time of the child’s post-implant program. LEVELS OF AUDITORY SKILL DEVELOPMENT
Detection
Pattern perception
Segmental identification (closed and open sets)
Auditory comprehension Detection Detection is the most basic of all listening skills. To demonstrate this ability, a child need only indicate somehow that a sound has been heard. A child who“alerts”to a sound is demonstrating detection. Alerting to sound may take any one of a number of forms: A child engaged in an activity may cease attention to the activity and look up; an infant or toddler playing with a favorite toy will pause slightly in the activity and then continue on with play; a child may begin vocalizing when the sound occurs. For example,a child may produce a speech sound in response to the music made by a favorite toy. The observant parent will need to watch for these subtle forms of detection by a child at this level of auditory skill development and report these“sightings”to the implant center personnel. 69 LEARNING ABOUT LISTENING THROUGH HOME ACTIVITIES While the alerting response is a valid means of demonstrating early detection,the child must also be taught to detect a sound in a structured activity. Active participation in evaluation tasks at the implant center (e.g., during the implant tuning or testing of the child) depends on the child’s ability to demonstrate a conditioned -response behavior. In general, a conditioned response occurs when the child is given a stimulus (such as a sound) and learns to provide a particular response back to the examiner (such as an action). In practice, an examiner presents the child with a sound and the child demonstrates detection by raising a hand, throwing a block in a bucket, or putting a game piece on a game board. Acquisition of a conditioned response is an important task for the young child and contributes to the development and assessment of later auditory skills. Parents can help the child get ready for assessments at the implant center by taking advantage of everyday activities in the home that call for the child to wait, listen, and then respond. In this way, parents help develop the concept of a conditioned response. The goal of the implant facility audiologist is to provide implanted children with a device set at a level that will allow them to...