Speech Language Pathology: Final Case Study

Final Case Study

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Final Case Study

Whether Further Audiology Testing Should be Recommended

            Audiology testing also known as audiometry refers to a painless, noninvasive hearing assessment to determine an individual’s ability to hear a variety of frequencies, pitches, and sounds. Routine audiology testing for babies is usually important to identify any hearing problems early enough during the child’s growth. As per the case study, Baby M underwent several audiology major tests including the Auditory brainstem response, otoacoustic emissions, tympanometry test, and behavioral audiometry test all of which led to a conclusion that Baby M had severe sensorineural hearing loss (SNHL) in both ears. In light of the conclusion drawn from the tests conducted on baby M, no further test is recommended since the test results are sufficient and hence provide a clear guide regarding baby M’s treatment and management of the hearing loss.

The Best Communication Approach to Optimize the Child's Language Development

            Listening and Spoken Language (LSL) approach emphasizes the development of lipreading (also referred to as speechreading) while discouraging sign language use (Schow & Nerbonne, 2018). Because of the severe sensorineural hearing loss, listening will not be the main source of communication so Baby M will depend on lipreading as well as gesture and sign language. Lip reading is accompanied by facial expressions and lip movement. As such, baby M will be trained in lip shapes and become familiar with communication involving eye contact as well as various facial expressions. She will learn to gain important knowledge on how to acknowledge common phrases and words and how to link lip shapes to sounds. Some of the proper ways to teach Baby M lip reading and develop her auditory comprehension is through the use of story retelling and barrier games. Barrier games usually involve facing the client (hearing-impaired listener) while setting up a barrier between the clinician (Speech-language pathologist) so that the hearing-impaired listener cannot see what is in front of the SPL, or not see what the SLP is drawing or writing (American Speech-Language-Hearing Association, n.d). On the other hand, auditory comprehension involves the SLP covering their lips so that the patient (In this case baby M) cannot have clues through lip reading.

            Cued speech approach is another communication approach that Baby M could learn. According to the American Speech-Language-Hearing Association (n.d), offering an early and natural language model for hearing-impaired children who are born to hearing families is crucial to language acquisition. Through natural communication and cued speech with the individuals around them, hearing-impaired children develop phonologic and phonemic familiarity with language that is fundamental to language acquisition (Schow & Nerbonne, 2018). As such, cued speech is recommended to Baby M as it would provide her access to the foundation that forms the basis of language and guidelines for assembling them. The acquisition of phonology via cued speech would therefore allow for the natural development of the English language by Baby M. Moreover, it would offer an unmatched building block on which speech and literacy production would be learned by Baby M. Consequently, if Baby M is exposed to English visually through cueing in her daily interactions, she will develop the phonemic and phonological familiarity to internalize the language in a similar approach to other hearing peers.

Whether Amplification is Needed

            Hearing amplifiers refer to wearable gadgets that use a microphone to receive nearby sounds which are then processed and transmitted to a person’s ear at a louder volume (). However, hearing amplifiers are not usually recommended for persons with hearing loss and are only suitable for persons with mild hearing impairment (). Given this fact, amplification would not be recommended for Baby M.

Consideration of a Cochlear Implant

            A cochlear implant refers to a gadget that electrically stimulates a patient’s (with severe to profound hearing loss) auditory nerve to offer them speech and sound information (Schow & Nerbonne, 2018). According to Schow & Nerbonne (2018), not every patient with hearing loss is a suitable candidate for cochlea implants. The U.S. Food and Drug Administration states that cochlea implants are eligible for individuals with moderate to severe SNHL as a result of damage in the inner ear and who have a challenge in interpreting speech Schow & Nerbonne, 2018). This includes single-sided hearing loss persons, persons with hearing loss in both ears as well as persons who have ordinary hearing for low pitches which drops off to moderate to severe hearing loss (Schow & Nerbonne, 2018). In addition, persons eligible for the implants must possess certain traits and healthcare providers recommend implants if:

• the candidate is highly motivated and has the desire to participate in the hearing world.
• do not have any underlying health problems which may risk undergoing surgery
• have severe to profound hearing loss.

            As revealed in the case study, Baby M possesses all the above-mentioned traits. It is reported that Baby M is a happy and healthy child. Being happy signifies that baby’s motivation to take part in a hearing universe despite the challenges that she faces due to SNHL and she is also healthy, meaning there is no record of underlying health issues that could trigger surgery. Therefore, Baby M is an appropriate candidate who can be considered for a cochlea implant.

Consideration of Educational Placement Options

            The severity and category of hearing loss are crucial aspects that must be considered when deciding the type of educational placement for children with hearing impairment (Schow & Nerbonne, 2018). Other vital considerations include the support services available, the mode of communication, and the educational setting. That said, Baby M’s need will better be met if she is put in a part-time regular education setting with part-time special education held in another resource room. A special education teacher can assist the regular tutor in ensuring that Baby M together with other children with SNHL receives and follows as much instructions as their peers with no hearing loss. The special education teacher can provide special instruction in the resource room on oral/verbal communication via cued speech, sign language systems, or auditory-verbal forms. Special learning features such as language and speech must therefore be taught efficiently by use of picture exchange communication systems, video modeling, and visual schedules (American Speech-Language-Hearing Association, n.d). This will assist students such as Baby M to establish a basic sense of communication and provide clear and congruent visual examples that students can relate to.

Considering Services from Any Other Discipline

            Concerning the question of whether Baby M’s family should consider services from other disciplines, the answer is a resounding yes. The family indeed should consider the intervention from other disciplines to further support the baby’s development and wellbeing. Some of the disciplines that can be beneficial include special education teachers. Children with SNHL such as Baby M can perform better in school, however, they often require extra assistance to learn at their full capacity. It is hence, vital for the school and family to collaborate and work together in deciding what is best for the baby. According to Smiley (2021), special education teachers are usually equipped with a special set of skills that are critical to assisting SNHL children develop listening skills. For instance, special education teachers have been trained to use visual cues and models in class during lessons which help in the retention of memory by the students, enhancement of comprehension as well and enabling of accessible communication (Smiley, 2021). In addition, they understand and know when to pause and use the wait-time approach while questioning students to give the students enough time to process the correct responses when asked questions. As such, the above skill sets are fundamental in helping baby M develop listening and communication skills to be able to thrive in the hearing world.

References

American Speech-Language-Hearing Association. (n.d). Preferred Practice Patterns for the Profession of Speech-Language Pathology. Available at: https://www.asha.org/siteassets/publications/pp2004-00191.pdf (Accessed 20th July 2024)

Schow, R. L., & Nerbonne, M. A. (2018). Introduction to Audiologic Rehabilitation. Pearson. (7th Edition). Available at: https://plus.pearson.com/products/cbc73b52-d1e9-4987-b31c-6dc212d1ee3f/pages/f51b8d80-00ce-11ed-8ddc-0ffea1e88caa?userPreferredType=read. (Accessed 20th July 2024)

Smiley, D. F. (2021). From Clinic to Classroom: Helping Families of Children With Hearing Loss Navigate the Educational Environment. Leader Live. Available at: https://leader.pubs.asha.org/do/10.1044/2021-0419-family-concerns-hearing/full/ (Accessed 20th July 2024)