Find study materials for any course. Check these out:
Browse by school
Make your own
To login with Google, please enable popups
To login with Google, please enable popups
Don’t have an account?
To signup with Google, please enable popups
To signup with Google, please enable popups
Sign up withor
o Everyonecan naturally speech read to a certain extent
Speaker-listener familiarity improves speech reading ability
1. Appropriatefacial expressions and gestures
a. Ideallyboth horizontal and vertical, but aim for horizontal
1. Speakerwith slightly slower than normal rate with good (not exaggerated) articmovement are easiest to speech read
1. Avoidother oral activities like chewing, yawning, smoking while speaking
1. Studies show that from waist up is best.
a. Large scale studies- put theatrical masks onpeople except for opening around lips; then used masks with more and morevisibility of face; then from neck up; then waist up
1. Onlyabout 1/3 of phonemes are visible to speech read (ideal conditions); 10-25% ineveryday conditions
a. Visemes are to speech reading as phonemes are tolanguage
b. /f/ and /v/, two phonemes but one viseme
can speechreader detect if sounds is voiced or voiceless
Can auditoryand visual distraction affect speech reading?
Auditoryand visual distraction can affect under certain conditions
dobetter with related picture and auditory cues
is there variability in individuals ability to speech read?
1. Greatvariability in individuals ability to speech read; some excellent, some poor
ability develops throughout childhood and early adulthood.Related to emergence of language skills. Even infant may use speech reading tosome extent
1. Olderpatients with _________ (trouble understanding with hearing) alsofrequently do poorer with speech reading, even when vision isn’t a factor
1. norelationship if intelligence is above the “low normal” range; mentallychallenged patients did have poorer scores
can’t stereotype based on personality patterns; however, highlymotivated patients tend to speech read more effectively than non-motivated
1. Visualactivity: even slight visual activity problems (20/40) have negative effect onspeech reading
1. Visualacuity must be at least 20/80 before speech can be decoded visually
professional have concluded successful speech readers have theability to visually piece together fragmented pictorial and spoken stimuli intomeaningful messages.
1. There is some relationship between speechreading ability and degree of loss; more hearing the greater ability to speechread because of more available acoustic cues (combines auditory and visualcues) àmore hearing the greater potential the patient has
1. Lingpoint out the that the speech reader NOT able to get visual info on:
i. All three are auditory
Examples include: sunglasses, beards,mustaches, long hair around face, dangling earring, facial piercings, pipes andcigarettes, chewing, hand movements around face, facial tattoos, etc.
1. Thickness of lips; research study with White andAfro-American speakers, both with thick and thin lips à race not related to results
a. As lips become thicker, harder to speech read
b. Also whites speech read whites best, same withAfro-Americans
1. Anyauditory cues patient can get are helpful, but so are ________ cues.
a. speakersays “baseball”, listener has verbotactile device that vibrates on everysyllable and stress (longer vs. shorter vibrations). Vibrates more with voicedphonemes vs. unvoiced
· What makes a good speech reader? (Ling)
o Must have good knowledge of spoken language
o Use both verbal and non-verbal contexts to getcues on messages
o Patient must be able to synthesize (put it alltogether)
o Presented vision-only or in combinedvisual-auditory manner
§ Used to assess communication problems
analytic and synthetic
break speech into smallercomponents; phoneme, syllable; Incorporate into auditory therapy exercises –same-different vowels or consonant discrimination – ex: pie vs. thai
use cues fromsyntax and context to derive meaning –ex: patient knows topic and clinicianpresents related words or sentences patient must repeat
§ Analytic: must identify _______ before words. Words before sentences and phrases (phoneme andsyllable key for visual perception).
o 1) /ba/ /ba/ or /ba/ /la/ > initial consonantdifferent or same?
o 2) Talk, Tool, Mop > which has/m/ in initial
o 3) Give list words (close set). Have speechreadeach word in set
o 4) QRE’s (Quick Recognition Exercises)
§ Synthetic: emphasizes the _______, or theperception of the whole as paramount. Speechreader is encouraged to get _____ meaning rather than concentrate on getting each component of message. Mustpredict and synthesize info they can see, hear and use ________ to getmeaning. ________ are backbone of approach
Key words, sentences and phrases
1. Key words
2. Fill in missing info
a. She __ across __ __ and __ him.
3. Read or talk about something. They speechread questions
4. Discuss use of minimal voicing
6. clue word
7. paragraph or stories related to picture or slide
§ use of auditory cues alone – can’t follow
§ cover mouth, and say something and have patientrepeat what was said
§ NO whispered speech – always voiced speech, justdecrease intensity to where it is not understandable with mouth being covered –then uncover mouth and see if you can be understood
§ Varies from patient to patient
§________ , or combined approach is ideal
1. Pseudo-conversation technique
1. From easy to more difficult; over time changeangles, distance, movement, noise, longer passages, etc.
1. Continuous Discourse Tracking (CDT)
1. Continuous Discourse Tracking (CDT):
· Used in assessment and therapy
· HOH speechreads verbatim in either vision-onlyor auditory-only manner
· Count number of words per minute (wpm) correctlyidentifies
· Schow (author of text) with normal collegestudents (2005, with combined audio-visual) CDT range from 76-102 wpm. Mean 88wpm.
o Assess my own. See book or website chapter 5.
a. Clinician writes a script for the client toread, and then client has to speech read the clinician’s response. Here areexamples of things the client would read
1. What are you doing Sat?
2. What after that?
3. Could you call me?
a. “Our family likes to bowl.”
b. “That was a great boxing match.”
c. Know the difference between key word and clueword- look in book
a. Examples: “pain in the neck”, “you said amouthful”, “face the music”, “leaps and bounds”
b. Can be difficult for those who speech read
*Optimal distance for speech reading is 5 ft
- Use both vision-only and combined in therapy
- Can be individual sessions or group- Majorityof improvement in speech reading occurs within first 5-6 hours of training
o Limitedattempt to teach speech reading to kids. Have emphasized _______approach
o Itseems to develop along with their auditory and language skills
o Inmost cases, kids (HOH) are encouraged to always be _______ whilecommunicating to develop and use speech reading cues
· Types of manual communication
o Different Signed English Systems
§ SEE I, SEE II, and LOVE
o Finger spelling
o Cued speech
· The greater the hearing loss, the ________ theirspeech reading
Exaggerated verbal cues can be a distraction forspeech readers
· As HOH patients increase their skills, clinicians work to increase their ______
· To slow one's rate of speech....
· Gestures and body language
o Randomor inappropriate gestures become distractions
o Very limited value
· When doing speech reading therapy, a lot ofactivities involve ____
communication exchange between two people (pseudoconversations)
· Difference between sign language and signsystems
o Sign language (ASL) is independent of spokenlanguage
o Sign systems (SEE) are systems derived anddeveloped from spoken language
· How to help the child succeed in school
o Give the HOH child preferencial seating
o Don’t shout at child
o Always have the child’s attention before givinginstructions
o Repeat directions in complete sentences
o Look at handout! Tons of points on it
o Do’s and Don’ts for parents
process where individual separatesfrom significant lost dream- projected into the future
o Grievingis for life- not all ___
Grieving is a process-not ______. Process you experience
o Herresearch was focused on those dealing with death and dying
o Followedfamilies who lost loved ones in fire (around 1960s)
grieving (does/doesn’t)seem acceptable to culture
o _____of grieving helps with growth
o Notour job to take pain away
o Stages (always/don't always) occur in order
does the length of stages vary
Can one revert back to a stage?
· Studies of grieving typical length________for major loss
· Acute symptoms include anger, guilt, and somaticdistress usually lessen or gone ______
· Acute phases about_______
what happens in acute stages over 6months?
§ Manifestedmany ways; sometimes ____, sometimes ____
in the first stage, what does the person deny?
§ Candeny loss (deny that child has speech delays)
§ Candeny loss affects, no impact
§ Cansay not going to do anything about it
§ Deny event has impact on life or changes theirlives
§ Denial of feelings
§ think child will grow out of it or asks for manysecond opinions
· Encourage the client to get a second opinion!They will probably only confirm your diagnosis
How can we prepare for losses?
§ Welive in _____ or we wouldn’t function daily
· We constantly that bad things will happen to us
§ Whenloss occurs, people go into _______
· “How can this happen to me?”
· First impact: they “lose their magic”
§ Denialbuys time to discover ____ to deal with it and the external supports needed to deal with it
§ Externalsupport is information, circumstances and people
§ Denialwill drop off when we have enough______ to handle loss
§ Don’tassault their denial
§ Getinformation to them; maybe use humor
Our _______ can get us into trouble, therefore _____
§ Remember,____ and ________- are a unit
§ Our ______ is frequently picked up on
§ Won’twin a ____ argument, therefore don’t insult denial
§ ______how you think they feel- “That makes sense to me; how can I help you?”
§ Don’tget hooked into ________. How?
· If they are forced to come see you- “that’s finebut you are here, what do you want to do while you are here?”
§ Badfeelings of grieving are eventually ....
§ Resultsfrom inability to maintain denial
§ Isa result of accepting fact that loss has occurred or will occur
§ Anger,resentment, even rage
§ Patientsin this stage are _______
§ Professionalshould _________ because the anger isoften directed at them
§ Patientmay even feign _______at tasks
§ Maybe _____. How?
Bargaining stage is attempting to...
§ Maybargain with who?
· Long periods of bargaining _______
§ Bargainingis helpful to patient because ______
The patients frequentlysay never ask again if ___
§ “If I work really hard, am I going to get all myspeech back?” (aphasic) What should we say?
· Be very honest with them, but there is no way Ican answer that
§ Patientin this stage are ____
§ SLPsand Audiologists see what stage a lot?
§ Depressionis _______ turned _____
How does society act around depressed people?
§ Oftenput on drugs
§ Depressedmay feel________
§ Somefeel ____if feel no hope of restructuring situation
§ Depression,anger, and guilt make people ask _____
“what is the meaning of my existence?”
§ Peopledo strange thing to ________
§ Non-christiansturn ____
§ Religiouspeople may ______
§ Depression is over when
loss can no longer be denied and anger and rage have run itscourse
§ Bargainingcompleted and acceptance is closer
§ Patient with depression knows that ______
§ Don’ttry to tell patient to ___
full pain of loss
Depression is a _____ and _______reaction to loss
§ Manytimes family trying to cheer up patient are actually ______
§ Counselingof both _____ and _____ advised
__________ may also be experiencing depression
§ Spouseand family
§ Weview depression as a _______
§ Weworry about ____ with severely depressed
§ Suicideis the most powerful statement of _____
§ Whyoften hear someone say about patient who committed suicide say ________
§ Haddecided suicide was _____; felt ______
What isthe goal of grieving?
_____ is evident during acceptance stage
Acceptance stageis almost devoid of ______
§ Patientduring acceptance is neither ________ about fate
§ Acceptsfate as _______; just the way things are
§ Patientduring acceptance stage show _____; family needs ______
§ Goodtherapy candidates at ______ stage. Why?
§ Candirect more energy to therapy process
§ Patientsoften ______ during grieving process
§ Notacceptable feeling in society to be ______
· This says “your anxiety is bugging me”
Should we offer suggestions?
§ We_______anxious people, or they _________
§ Highpercentage of _______ are depressed and anxious; self-medicate
· If we stop grieving, we stop __________. Why?
· Anxiety helps to mobilize energy needed to dealwith loss
· Allows to make ______ changesneeded
internal and external
what happens if we stop anxiety with medication, booze, etc.
§ Youshould say what to grieving?
§ Givethem activities that use energy
Modeland ask to do things tailored to situation
§ Womenhold onto _____ longer; men hang on to _____ longer
· Anxiety has external force known as what?
· Fear related to confronting our _______
What are different ways it can manifest itself
o I caused handicap and I can tell you how
o Is a punishment for something terrible I did,thought, or felt
o Good things happen to good people and vise versa
· Unconditional positive regard
· Feeling focus
o Perceivepatients experience and accurately report back to them
· Non-judgmental is neither _______ nor _________
· Unconditional positive regard deals with what type of therapy? What does that mean?
o Client-centeredtherapy; means “I respect and value you simple because you exist”
§ Avoid positive reinforcement of denial
§ Be honest, open, and tactile
§ Avoid punishing anger
§ Avoid bargaining with patient
§ Avoid use of mood altering drugs
§ Avoid early distractions
§ Don’t suggest getting immersed in work or hobby
§ Distractions can include drugs, work, hobbies,and alcohol
§ Avoid displaying anxiety about depression
Sign up for free and study better.
Get started today!