Central Institute for the Deaf https://cid.edu Teaching children who are deaf and hard of hearing to listen, talk, read and succeed. Wed, 11 Jul 2018 23:32:11 +0000 en-US hourly 1 https://wordpress.org/?v=4.9.7 Not just child’s play: The relationship between play and language https://cid.edu/2018/07/09/not-just-childs-play-the-relationship-between-play-and-language/ https://cid.edu/2018/07/09/not-just-childs-play-the-relationship-between-play-and-language/#respond Mon, 09 Jul 2018 15:17:42 +0000 https://cid.edu/?p=21717 The post Not just child’s play: The relationship between play and language appeared first on Central Institute for the Deaf.


Not just child’s play: The relationship between play and language

by Emily Humphrey, MSDE, CED

Mr. Fred Rogers said, “Play is often talked about as if it were a relief from serious learning. But for children play is serious learning. Play is really the work of childhood”. Because play promotes cognitive, social-emotional and language growth, it’s important for children to have ample opportunities to participate in play with peers and adults. For children with hearing loss, this is even more important.

Play and language are interconnected, but how exactly? To develop language for meaningful communication, children must have mental imagery, representational and thinking skills (Westby, 1980). Children must be able to represent reality with symbols. Play skills must develop to a certain level before the corresponding language skills are possible (Westby & White, 2014).

Think about it: Children use objects to represent other things; a block as a car for example. Similarly, spoken words represent objects. Children with hearing loss have difficulty hearing and understanding spoken words. This directly impacts the connection between objects and their spoken words. Without a solid foundation of representational skills, a child will not be able to talk about their play, showing delays in both language and play. It is through play that a child can explore and practice representational skills foundational to developing language. Language and play go hand in hand.

According to Carol Westby (2017), “Pretend play and semantic language share the common feature of relational meanings between things. In pretend play, children learn to to classify, compare, and reason, all semantic organizational skills” (p. 10). As children play, they use objects flexibly, interchanging the purpose. That block that represented a car can be picked up and used as a phone. That same block can also be used as a building block. Children’s abilities to substitute objects in play allow flexible thinking. Thinking “out of context” can guide their ability to retell narratives. When retelling a narrative, children are free to use language that extends beyond the here and now.

CID’s Preschool Symbolic Play Rating Form is designed to show a student’s facility between spoken language and play. As an informal tool, it can be used to record baseline skills, to set symbolic play goals, to track progress and to share progress with others. The Preschool Symbolic Play Rating Form is organized by age, from 8 months to 5 years and can be used for children beyond that if play skills are delayed.

Here’s a look from the form at the language skills that typically develop with play skills at the age of 3.

 Play Skills                                                                  Language Skills

re-enacting experienced events and modifying original outcomes using past tense (ex: “I ate the cake.” I walked.”)
engaging in evolving episode sequences that are unplanned using future aspect (ex: “I’m gonna wash dishes.”)
transforming self into a role ability to use language to report and predict
engaging in associative play ability to use language to attempt to narrate or tell a story

The good news is that everyone can play! Parents, siblings, neighbors, teachers and clinicians alike can play. Make time for authentic play opportunities with varied play partners and with varied materials. Make room for exploring and offer subtle ideas to modify the play. One example: when racing cars with children, suggest a car has a flat tire. This encourages children to problem solve and models flexible thinking. Play should be incorporated both at home and in the classroom. Not just in the playroom or at recess; you can and should incorporate play into your daily routines and lessons.

For more information on how to guide, assess and report play and language skills in tandem check out CID’s Preschool Symbolic Play Rating Form.


Westby, C. (2017, September/October). Relationships between Pretend Play in Preschool and Later Language Skills. Retrieved June 13, 2018, from http://journals.sagepub.com/doi/full/10.1177/1048395017726551c

Westby, C. (1980). Assessment of cognitive and language abilities through play. Language, Speech and Hearing Services in Schools, XI, 154-168.

Westby, C. White, E. (2014). Preschool Symbolic Play Rating Form. Central Institute for the Deaf, St. Louis, MO.

Emily Humphrey served as a classroom teacher in the Anabeth and John Weil Early Childhood Center at CID – Central Institute for the Deaf. She currently works as a parent educator in the CID Joanne Parrish Knight Family Center (coaching caregivers of children ages birth to three with hearing loss). Emily organizes and contributes to CID’s blog for professionals.

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Summers at CID: How enrichment programs benefit students https://cid.edu/2018/06/18/summers-at-cid-how-enrichment-programs-benefit-students/ https://cid.edu/2018/06/18/summers-at-cid-how-enrichment-programs-benefit-students/#respond Mon, 18 Jun 2018 15:32:03 +0000 https://cid.edu/?p=21502 The post Summers at CID: How enrichment programs benefit students appeared first on Central Institute for the Deaf.


Summers at CID: How enrichment programs benefit students

by Andrea Osman, MSDE, MPPA

CID is dedicated to continuing educational and enriching opportunities for children with hearing loss over the summer. We have an extended school year program for current students, but what happens after students graduate? That’s where the summer enrichment program comes into play!

CID Summer Enrichment Program

In 2012, CID offered its first summer enrichment program for graduates of CID and their hearing siblings. The program was created to provide opportunities for children who are deaf and hard of hearing in the general education setting receiving minimal support to reconnect with their peers who have hearing loss.


For years, CID had requests from parents for graduates of the program to return to CID’s Extended School Year (ESY), which is five weeks each summer. CID always made room for these students, but it wasn’t the best fit. The purpose of CID’s ESY is to ensure that students do not regress in their speech, language, listening and academic skills over the summer. Meanwhile, graduates of CID are in general education settings and no longer need the same amount of specialized services or qualify for their district’s ESY program. Therefore, placing graduates in classes with current CID students was not the ideal placement option for either group. However, graduates are often times the only students in their current school placement who are deaf and hard of hearing, and are eager to reconnect with friends from CID. Therefore, in 2012, CID sought to provide a summer experience to for CID graduates focused on appropriate social experiences to enhance or improve students’ listening, speech, vocabulary, language and peer relationship skills.

The Enrichment Program

From 2012 to 2017, the program consisted of two 2-week sessions, Monday-Thursday from 9 am to 4 pm. The program was geared for graduates of CID ages 6-12 and their similar-aged siblings with typical hearing. Each session revolved around a theme with a culminating activity to be presented by students to friends and family. Past themes have included: theater, art, photography, mystery madness, summer sleuths and journalism. Students also have the opportunity to attend at least one, sometimes multiple, afternoon field trip around St Louis with the ESY students. In addition, CID has provided families with standardized assessment results and recommendations as appropriate in the areas of vocabulary, language and reading if testing had not been completed by a clinic or school within the past year.

Where are we now?

For 2018, CID has made some changes based on enrollment trends and feedback from families. First, we have reduced the two 2-week sessions to two 1-week sessions, to better accommodate families vacation schedules as well as to allow students to attend other camps in the region. Secondly, we have added a third one-week session for students ages 11-14 after determining that there is very little programming for students who are deaf and hard of hearing in this age range in the St Louis area. The session for 11-14 year olds is focused on community outreach in the morning hours from 9 am to 12 pm and fun, social-activities in and around the St Louis area from 12 to 4 pm. Finally, CID has extended the program to Fridays for all 3 sessions, so students will now attend from 9 am to 4 pm, Monday to Friday.

Targeted benefits of the program

  • Opportunity to work on speech, language and vocabulary skills with a teacher of deaf who is trained in listening and spoken language
  • Practice using speech and language skills in front of a group
  • Improve reading and writing skills
  • Socialize with other students who are deaf and hard of hearing (current CID students and graduates)
  • Increase self-esteem and sense of belonging
  • Foster creativity and self-expression
  • Build stronger relationships with CID

Whether the children are solving a mystery, writing articles for a magazine, competing in a baking competition or goofing around on the playground, they are cherishing time with each other. CID’s summer enrichment program provides a place for children with hearing loss to swap stories and challenges they face in the mainstream, connecting new friends and reconnecting old friends.

If you would like more information about CID’s summer enrichment program, please contact Andrea Osman at 314-977-0135 or aosman@cid.edu.

Andrea Osman is the Director of Admissions and Program Evaluation as well as the Summer Programs Coordinator at CID—Central Institute for the Deaf. She received her undergraduate degree in deaf education and dance from UNCG, during which she participated in a grant focused on providing in-services to teachers in rural areas working with children who are deaf and hard of hearing. Andrea worked for many years as an itinerant teacher for the deaf for Cumberland County Schools in North Carolina before deciding to pursue her master’s degree. She completed a master’s degree in Deaf Education from Washington University, and began working for CID in 2006. Andrea also has a master’s degree in Public Policy Administration with a certification in Nonprofit Management and Leadership from UMSL. She is looking forward to another summer of fun and learning at CID!

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Modern insights from a CID school counselor https://cid.edu/2018/05/23/modern-insights-from-a-cid-school-counselor/ https://cid.edu/2018/05/23/modern-insights-from-a-cid-school-counselor/#comments Wed, 23 May 2018 16:46:32 +0000 https://cid.edu/?p=21291 The post Modern insights from a CID school counselor appeared first on Central Institute for the Deaf.


Modern insights from a CID school counselor

interview by Emily Humphrey

One of the most vital roles at any school is that of a school counselor. At CID, Pat Wasserman fulfills this role every day by supporting students and their families and collaborating with staff. As school counselor, she conducts one-on-one and group sessions covering topics such as social manners, acceptable behavior, advocacy, safety, bullying, decision-making skills, coping with hearing loss and cochlear implant surgery preparation. Pat provides children with strategies and support as they prepare to transition into their local schools, coordinates programming through community resources and organizes CID’s young alumni club.

Pat is an ideal role model for many of the students here. Having bilateral cochlear implants herself, she can relate to challenges in the school setting both emotionally and academically. Growing up, Pat attended St. Joseph’s Institute for the Deaf through middle school. She attended high school at Kirkwood High School in St. Louis, MO where she was able to use her listening and spoken language skills with her classmates and teachers. Pat later learned American Sign Language (ASL), too. Fueled by her passion to work with children with hearing loss, she earned bachelor and master’s degrees in child development, family relations, counseling and social work.

Pat recently provided some great perspective on her background and role as school counselor.


What was school like for you growing up?

At St. Joe’s I was the only one from St. Louis. I used to invite the girls (who lived in the dorm) to come over and spend the night. We were like one big family. We still keep in contact through writing letters. I didn’t have any mainstream preparation, like we do here now. No IEPs. My mother was my advocate; she would go and talk to the teachers. I had to sit in front of the class and lip-read. My classmates took notes for me. One thing that helped me get through high school was having an itinerant teacher.

Did you have a school counselor or mentor?

I had a wonderful school counselor. I did not have a deaf adult in the school setting to talk to about being deaf. I had that ah-ha moment! I could be a counselor.

What were your jobs before becoming school counselor?

CID is my first and only job. My dream job. My mother was a counselor and my neighbor turned sister in law was a teacher of the deaf. I always knew I wanted to work with the deaf. I started out working at the clinic part time. Because I knew how to sign, I would evaluate prospective students that used sign language. They were interested in hiring me; they knew what I was studying. I was in graduate school at the time that I was hired in fall of 1984.

Not including hearing technologies, what are some changes you’ve seen at CID over your career?

We now have e-mail! It makes communication so much more accessible. When I started, we didn’t have air conditioning or structural considerations to sound proof classrooms. Now we have air conditioning and our school is sound proofed. As for the children, they are mainstreamed much earlier these days.

What are some of the most common issues you have to work through with students who are deaf and hard of hearing?

It is important to note that having a disability makes you vulnerable. The students with hearing loss want to fit in. I work to empower these students to form positive thoughts, to make positive decisions, to become good advocates and make healthy choices. We practice what to do in different scenarios.  Internet safety and bullying are two big topics. I will be partnering with our media literacy teacher to teach how to be careful on the internet. So many people are so vulnerable online. You can be taken advantage of. I feel for the younger generation, they are growing up too fast with technology.

What is or was the most surprising thing about your job?

The kids inspired me! They inspired me to get a cochlear implant. When I started, there was one boy with a cochlear implant. As more children got cochlear implants, I saw their results and was amazed at their results.

How does being deaf/having cochlear implants inform what you do?

My cochlear implants have helped me with my listening skills. They allow me to keep up with my students and I can relate to them so well. I do use an ASL interpreter at meetings and I talk to the children about ASL. Growing up, there was a stigma around ASL and it doesn’t have to be that way today. I want the children to know we can talk about it. It’s important for them to be open-minded. ASL is a wonderful language; it’s learning a foreign language that aligns to their identity as a person with hearing loss.

Why is it important to have a school counselor on staff?

Children with hearing loss are likely to face unique issues compared to children with typical hearing. It is important to have someone on staff dedicated solely to their emotional wellbeing. The students can come to me with issues they don’t want to bring up in the classroom or at home. I’m here to validate their feelings. I empower them all the time. No excuses! I tell the older kids I better watch you finish high school, go to college and get a job.

Pat Wasserman currently serves as school counselor at CID-Central Institute for the Deaf, located in St. Louis, Missouri.

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Toys and targets: Top picks for students from CID SLPs https://cid.edu/2018/05/03/toys-and-targets-cid-slp-top-picks-for-students/ https://cid.edu/2018/05/03/toys-and-targets-cid-slp-top-picks-for-students/#respond Thu, 03 May 2018 15:34:38 +0000 https://cid.edu/?p=20981 The post Toys and targets: Top picks for students from CID SLPs appeared first on Central Institute for the Deaf.


Toys and targets: Top picks for students from CID SLPs

interview by Emily Humphrey

May is Better Hearing and Speech Month. In honor of the great work speech-language professionals around the world do, we are bringing you some simple and motivating classroom and therapy ideas. We’ve teamed up with two CID speech language pathologists to highlight items they love to use with their students. Read their answers below to learn about the particular toys they enjoy using!


Greta Bohnenkamp is a SLP at CID who currently conducts individual therapy with two-year olds in the CID Joanne Parrish Knight Family Center.

What is your most used or most coveted item on your shelf?
Right now I am using the Melissa and Doug Caterpillar Gear Toy a lot!

Why do you like it?
It is a great toy for the beginning listener and toddlers.  There are six pieces, which can be used for the Ling six sound check.  Little hands can easily grasp the pieces, and then match them to the board.  Plus it is durable and easy to clean!

What are your goals when using this toy?
This simple toy can be used in a variety of ways…

Ling 6 sound check: The child can hold the toy and put it on the board for detection or I will hold the toy and hand it to them for identification.

Listening for Suprasegmentals: Before we start the listening check, I lift the puzzle “up up up” and then say, “Dooooown” as I tilt the game and let the pieces fall.  Then “uh-oh” as we try to find the pieces.  After the child puts a piece on the board they can twist the piece and say, “Around and around and around”

Language: Once the routine is in place for the toddlers, this game can add a lot of language opportunities as well.  Teaching colors and matching is obviously the intended use, and there is so much more.  We hide the pieces for where questions, purposefully forget one for what’s missing, and let the child select two colors for working on and.


Jessica Klein is a CID SLP who currently provides speech and language assessments and intervention to students in the Anabeth and John Weil Early Childhood Center and Virginia J. Browning Primary department at CID.

What is your most used or most coveted item on your shelf?
I love to use simple and motivating games like “Pop-Up Pirate” and “Pop the Pig” during speech, language and auditory training sessions.

Why do you like it?
These games are versatile and are great for using as reinforcers for any goal that I am targeting.  Incorporating them into my sessions makes structured tasks that may seem mundane or tedious for students, fun.  They can also be used with a variety of ages, are readily available at most stores and are affordable.

What are your goals when using this toy?
I use these games often when doing articulation therapy.  I require the student to say their target sound, word or sentence a designated number of times (the more repetitions the better!).  After they have completed this, they get to take a turn with the game.  I also use these games to reinforce language structures being targeted in class, from simple carrier phrases (e.g., “I want ____” or “my turn”) to more complex structures (e.g., “I will put blue sword in the barrel” or “I want to feed the pig the purple burger”).

These games are also a great way to support pragmatic language skills by working on turn-taking and making requests.

What does a typical lesson with this game look like?
I keep several of these games in my therapy room, and at the beginning of the session I let the student choose which one they want to play.  Since the games are all open-ended, whichever game they choose works.

I have picture cards with the target sound or word on the table.  I let the student know ahead of time what the expectation is (e.g., “You need to pick a card and say that word 5 times with a good /s/.  After you choose 3 cards, you can take a turn with the game.”).  Even though the game is a reinforcer, I still require the student to use good speech and language when playing, such as, producing intelligible speech and including all words and word endings in their requests.

Another fun way to use these games is to use the game pieces as tokens.  For each good production the student makes, they earn a game piece (e.g., a sword for “Pop Up Pirate” or a burger for “Pop the Pig”).  This gives the student a tangible “reward” and also gives them immediate reinforcement for a job well-done.

Greta Bohnenkamp joined CID in 2007.  She received her master’s degree in speech-language pathology from Vanderbilt University, during which she participated in a grant focusing on pediatric cochlear implants.  Bohnenkamp worked with Preschool and Primary departments at CID for many years, providing speech and language assessments and intervention.  Currently she serves two-year olds and families in the toddler class as an individual therapist, and lectures for Washington University’s Program in Audiology and Communication Sciences. 

Jessica Klein began working as a speech-language pathologist at CID in 2004, assessing and treating children from birth-age 12.  Klein co-wrote the “Targeting Speech Skills for Children Who Are Deaf and Hard of Hearing” workshop, presenting annually at CID as well as at Southeast Missouri State University and at the Missouri Speech and Hearing Association conference.  In 2011 she accepted a job as a speech language pathologist in one of St. Louis’ charter schools.  While in the public school setting, Klein assessed and provided speech and language services to students in kindergarten-fourth grade with varying speech and language needs.  She was a member of the school’s CARE team, collaborating with teachers and specialists to develop interventions for students struggling in the classroom.  In 2015 Klein returned to CID ready to share her public school experiences with colleagues to help better prepare CID students for the mainstream setting.   Since her return, she has written a webinar about developing literacy skills in children who are Deaf and Hard of Hearing as well as spoken about literacy skills and case managing Deaf and Hard of Hearing students at Fontbonne University.  She currently provides speech and language assessments and intervention to students in the Pre-K and Primary departments.

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Dr. Judith Lieu and applying quality of life measurements to children with hearing loss https://cid.edu/2018/04/05/dr-judith-lieu-and-applying-quality-of-life-measurements-to-children-with-hearing-loss/ https://cid.edu/2018/04/05/dr-judith-lieu-and-applying-quality-of-life-measurements-to-children-with-hearing-loss/#respond Thu, 05 Apr 2018 20:05:38 +0000 https://cid.edu/?p=20792 The post Dr. Judith Lieu and applying quality of life measurements to children with hearing loss appeared first on Central Institute for the Deaf.


Dr. Judith Lieu and applying quality of life measurements to children with hearing loss

interview by Emily Humphrey

Quality of life (QOL) is defined as the standard of health, comfort and happiness an individual or group experiences. QOL is often subjective, that is, it’s altered by an individual’s perception and can be influenced greatly by a difference or disability.  Individuals with hearing levels that vary along the audiogram can experience a decrease in QOL at any point due to communication differences, communication breakdowns and difficulty listening in noise.

After St. Louis based pediatric otolaryngologist Dr. Judith Lieu and her colleagues observed a lack of validated hearing-related QOL measurements for children, they developed the Hearing Environments and Reflection on Quality of Life (HEAR-QL). They used this measure to discover how a child perceives the effects of their hearing loss as well as to help the clinician determine where intervention is warranted to improve the child’s overall well-being.

A subsequent study, “Quality of Life in Children with Hearing Impairment: Systematic Review and Meta-Analysis” (Roland et al., 2016), looked at relevant publications that evaluate QOL in school-aged children with hearing loss. The researchers found decreased QOL detected in these children in the domains of school function and social interactions. Dr. Lieu gave more insight on QOL and her study in an interview with CID:

It may be beneficial to hear about your interest in this particular topic. Will you share a little background?

While I was conducting my research in children with unilateral hearing loss, I spoke with many parents who described that their children faced many difficulties that were not measured by the audiogram. Some of these difficulties included misunderstanding words and conversation, coping with noisy backgrounds and keeping up with social situations with many different speakers at one time.  These sounded like problems with quality of life as a result of decreased hearing.  However, very few studies evaluated these children with validated measures of QOL. Most used generic QOL instruments that did not include the areas of difficulty that children with hearing loss faced.

Am I correct that you developed the HEAR-QL as a part of your interest?

Yes, because there were no validated hearing-related QOL measures for children at that time.

How is the test administered?

The HEAR-QL is a self-reported measure with 2 forms, one for children aged 7-12 years old and another for adolescents 13-18 years old.  Ideally, the child will read the items and answer by checking one of the 5 options (never, almost never, sometimes, almost always, always).  If the child does not have the reading skills, an adult will read the items and the response options, but should not coach or answer for the child.  Both forms were field tested with children in the target age to make sure they could understand the items.

Was reading level and language level considered when assessing the children?

Because this was designed for children with normal cognitive levels, there may be children with low cognition or language skills who still have difficulty answering.  We are developing a Preschool version of the HEAR-QL intended for a parent (or caregiver) proxy to respond for the child.  Eventually, we hope to have a parent-proxy version for older children as well.

Does the outcome of this study (or your previous research on the topic) leave you with lingering questions?

Of course!  Our HEAR-QL validation studies suggest that in adolescents, using a hearing device is associated with lower, not higher QOL.  This may provide one answer to why teens, in particular, may choose not to wear hearing aids even though they did so successfully when they were younger.  The obvious questions is why? And what can we do to improve both hearing function and QOL?  What are other or adjunctive interventions that might work?

What would you like to see happen?

Counseling begins with parents, I believe, then moves to the schools.  The parents need to encourage their children, and advocate for them in the schools.  Teachers also need counseling.  There is a general trend to underestimate the disability from hearing loss. Unless they have personal experience or prior students with hearing loss, [teachers] are often well-meaning but oblivious to what the child with hearing loss faces in a noisy classroom.  Using QOL assessments also helps, so that we can gain the child’s own impression of how they are doing, not just the word of the parents or teachers.  Depending on what the child appears to experience, self-esteem or self-advocacy counseling and training may be appropriate.

It’s common practice for teachers to collaborate with other professionals and their students’ families to assess the whole child. QOL assessments enable the child to share their perspective providing insights that can help professionals create targeted interventions to improve success inside and outside of schools.  Dr. Lieu is currently working on developing and validating a HEAR-QL for preschool aged children. This effort will directly influence intervention based on perspective at a younger age.


Hear QL. (2008). Retrieved March 15, 2018, from http://oto.wustl.edu/lieulab/Lab/HEAR-QL

Roland, L., Fischer, C., Tran, K., Rachakonda, T., Kallogjeri, D., & Lieu, J. (2016). Quality of Life in Children with Hearing  Impairment: Systematic Review and Meta-Analysis. Otolaryngology–Head and Neck Surgery: Official Journal of American Academy of Otolaryngology-Head and Neck Surgery, 155(2), 208–219. http://doi.org/10.1177/0194599816640485

Umansky, A. M., Jeffe, D. B., & Lieu, J. E. (2011). The HEAR-QL: Quality of Life Questionnaire for Children with Hearing Loss. Journal of the American Academy of Audiology,22(10), 644-653. doi:10.3766/jaaa.22.10.3

Dr. Judith Lieu is a Pediatric Otolaryngologist at St. Louis Children’s Hospital and an Associate Professor in the Department of Otolaryngology at Washington University School of Medicine and has many research interests. Current research focuses on the effects and consequences of hearing loss in children, especially unilateral hearing loss (hearing loss in one ear). She uses clinical epidemiology research methods, and collaborates with colleagues in neuroscience, psychology, and auditory science to investigate speech-language, cognition, educational effects, executive functioning, and quality-of-life in children with hearing loss. She hopes to identify factors that can lead to targeted earlier intervention and possibly better educational performance or language skills acquisition in the future. Current Areas of Research in Children include:

  • Development and Validation of Preschool HEAR-QL Questionnaire
  • Hearing Loss and Cognition
  • Unilateral hearing loss and MRI study

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Eliciting language using sabotage https://cid.edu/2018/03/09/eliciting-language-using-sabotage/ https://cid.edu/2018/03/09/eliciting-language-using-sabotage/#comments Fri, 09 Mar 2018 21:11:28 +0000 https://cid.edu/?p=20593 The post Eliciting language using sabotage appeared first on Central Institute for the Deaf.

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Picking the right fight https://cid.edu/2018/02/28/picking-the-right-fight/ https://cid.edu/2018/02/28/picking-the-right-fight/#comments Wed, 28 Feb 2018 22:21:27 +0000 https://cid.edu/?p=20430 The post Picking the right fight appeared first on Central Institute for the Deaf.


Picking the right fight

by guest author Jenna Voss, PhD, CED, LSLS Cert AVEd and The Radical Middle Leadership Team

Aye, fight! But not your neighbor. Fight rather all the things that cause you and your neighbor to fight. –Mikhail Naim

The goal of The Radical Middle: Unity, not Uniformity in Deaf Education, is to create a community of practice among researchers, teachers, parents, and the deaf community around a common goal of philosophical partnership as it applies to communication choices and educational options for children who are deaf or hard of hearing. Those with radically middle mindsets are actively opting out of the fight of one another, and opting to fight to promote outcomes for learners who are deaf/hard of hearing. We can fight language deprivation, child maltreatment, illiteracy, and ableism—but fighting one another does not serve to end these oppressors. We’re learning to fight these oppressors without fighting one another.

The purpose of this group is to provide a forum for individuals invested in improving the educational outcomes for students who are deaf/hard of hearing (DHH) to discuss, challenge, and think through our differences so that we can broaden our understanding of multiple perspectives and, ultimately, find ways to work together towards a common goal. The Radical Middle (TRM) welcomes individuals with expertise representative of a wide range of philosophies who are willing to work together (through research and collaborative efforts) towards a common goal of doing what is best educationally and linguistically for individuals who are deaf or hard of hearing, with the hope of creating a more balanced perspective on how we address these issues in our research, practice, and otherwise.

As we create a community of practice among researchers, teachers, parents, and deaf individuals, we continue to refine our activities in an effort to bridge the “research to practice” gap and serve our membership and the field of deaf education. Thus, The Radical Middle Team has developed two strands focusing on research and practice. Our Research Strand team will focus on research dissemination and discussion and our Professional Strand (practice) team will focus on strategy instruction, professional development, and outreach.

During a concurrent session at the 2018 Association of College Educators of the Deaf and Hard of Hearing (ACE-DHH) Conference in Tucson, Arizona, TRM leaders addressed the development of a shared google document to connect researchers (and those who want to participate in research) across expertise. A room full of ACE-DHH conference attendees discussed the potential value of cross-expertise collaboration. Following this session, professionals entered their contact information and research profiles in a shared document with the hopes of expanding the effects/implications/impact of their research capacity by connecting with researchers across our diverse field. Think of this as a match-making of sort – researcher-seeking-researcher for a common interest, be it specific methodology, population, or aspect of literature in order to expand the collective research capacity. If professionals take advantage of  this type of match-making, we believe the impact will include:

  • Expanding research across demographics and settings
  • Collaborating across research interests to enhance opportunities for future large-scale funding (e.g., Spencer, Institute for Education Sciences, etc.)

Research has clearly demonstrated that each child has his/her own individual and unique needs, strengths, and preferences when it comes to communication and education, and that a “one-size-fits-all” approach for education and communication with children who are DHH cannot possibly meet the needs of every child (Easterbrooks & Maiorana-Basas, 2015; Gardiner-Walsh & Lenihan, 2017). Yet, many parents, professionals, and individuals who are DHH make decisions based on their personal and/or philosophical stance, rather than the characteristics or needs of a particular child (Lederberg, Schick, & Spencer, 2013). Researchers with a radical mindset aren’t aiming to radically shift their own expertise, but intentionally partner with those whose work will complement, challenge and ultimately enhance their ability to seek answers to critical questions in our discipline.

Are you a researcher? Join us! Are you a practitioner with critical practice questions or access to subject populations? Join us! This Google doc is our first attempt at matchmaking. Please add your profile and join this community.

If this radical concept appeals to you, but contributing to research isn’t quite your jam, hang tight. We will continue to build the Professional Strand geared towards professional preparation and development. (Obviously we’re all consumers of research, so we too have an interest in this radical matchmaking of researchers.)

A few more opportunities to engage…TRM has launched an online professional development series this year. We are looking for collaborators to develop and present content to our members on a variety of topics. Do you have a topic that might appeal to our radical community? Drop us a line by using the “contact us” feature on our homepage, http://radicalmiddledhh.org.

Additionally, we have developed a series on The Art of Expertise: 10 Tips to Finding the Middle.  We are also looking for collaborators and participants for this series. You can get more information about these moderated conversations here: http://radicalmiddledhh.org/live-moderated-discussions/

Not sure if you are Radical Middle? Check out this link! http://radicalmiddledhh.org/what-makes-a-radical-middle-er-radical-middle/

Much of this content was originally presented during a concurrent session, “The Radical Middle: Collaborative Research that Reaches All Students” on Friday, February 16, 2018.


Cannon, J.E., Maiorana-Basas, M., Guardino, C., Beal, J.S., Voss, J., & Ballard, M.B. (February 15, 2018). The Radical Middle: Collaborative Research that Reaches All Students. 2018 Conference of Association of College Educators of the Deaf/Hard of Hearing. Tucson, AZ.

Easterbrooks, S. R., & Maiorana-Basas, M. (2015). Literacy and deaf and hard-of-hearing students In Harry Knoors & Mark Marschark (Eds.), Educating deaf learners: Creating a global evidence base (pp. 149-172). Oxford University Press.

Gardiner-Walsh, S. & Lenihan, S. (2017). Communication Options. In S. Lenihan (Ed.), Preparing to teach, committing to learn: An introduction to educating children who are deaf/hard of hearing (8). EHDI Learning Center. Retrieved from http://www.infanthearing.org/ebook-educating-children-dhh/index.html

Lederberg, A. R., Schick, B., & Spencer, P. E. (2013). Language and literacy development of deaf and hard-of-hearing children: successes and challenges. Developmental Psychology, 49(1), 15.

Jenna Voss, PhD, CED, LSLS Cert AVEd, is an Assistant Professor in the Communication Sciences and Disorders & Deaf Education program at Fontbonne University. She received her undergraduate degree in Deaf Education, and her master’s degree in Early Intervention in Deaf Education from Fontbonne University. As a National Leadership Consortium in Sensory Disabilities (NLCSD) fellow, she completed her PhD in Speech and Hearing Sciences in the Program in Audiology and Communication Sciences at Washington University in St. Louis. She holds teaching certification in the state of Missouri in the areas of Deaf Education and Early Childhood Special Education. Her background, as a teacher of the deaf and early intervention provider, has sparked diverse interests in topics including the health disparity among children and families living in poverty, primary prevention of abuse and neglect for children with disabilities, provider use of strategies and techniques implemented in family-centered practice, and the application of research in cognitive psychology to the field of deaf education to improve the efficiency of learning and instruction of pre-service teachers. Voss is also the co-author of “Small Talk: Bringing Listening and Spoken Language to Your Young Child With Hearing Loss.”

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Using the Ling sound test with children who have asymmetrical hearing https://cid.edu/2018/02/05/using-the-ling-sound-test-with-children-who-have-asymmetrical-hearing/ https://cid.edu/2018/02/05/using-the-ling-sound-test-with-children-who-have-asymmetrical-hearing/#respond Mon, 05 Feb 2018 16:54:48 +0000 https://cid.edu/?p=20315 The post Using the Ling sound test with children who have asymmetrical hearing appeared first on Central Institute for the Deaf.


Using the Ling sound test with children who have asymmetrical hearing

by Kathy Holtman, AuD CCC/A

The Ling sound test is an effective way to check a child’s access to a range of speech sounds. But how should the test be conducted when one of the child’s ears is hearing in the typical range, and the other is fit with a hearing device with unaided hearing in the moderate to profound/no response range?

Common phrases used for this hearing configuration include “asymmetrical hearing” (if there is a significant difference in hearing between ears) or “single-sided deafness” (if there is no measurable hearing in the ear opposite the typical hearing one). If you want to check for optimal access to sound in the aided condition, there are a few options for how to do a Ling sound check successfully. The ear that is hearing in the typical range must be plugged so that the hearing device is stimulating the brain to listen. Otherwise, the better hearing ear will interfere! To accomplish effective plugging, the audiologist or hearing health care provider might obtain an occluded full shell custom earmold for the better hearing ear. Advantages of this strategy are good reduction of sound, comfortable fit, and being re-usable. Possible disadvantages of a custom earmold would be its cost and the accessibility of obtaining one. Custom earmolds may be covered by insurance, especially if a letter of necessity from the provider accompanies the request. In this scenario, an aided Ling sound test could then be conducted in the normal fashion (remember the silence prompt!).

If a custom Earmold is not a feasible option, another strategy would be to use non-custom noise reduction earplug in the ear that is hearing in the typical range. These can be obtained from your audiologist, hearing health care provider or over-the-counter at the pharmacy for reasonable prices. Since these are non-custom, it may be necessary to utilize a second ear covering, due to slit-leaks where sound is still getting into the ear system past the earplug. Over-the-ear (circum-aural) headphones can be placed over both the outer ear and over the noise reduction earplug that is plugging the ear canal. The headphones will need to placed in a way that allows the Ling test to still occur with the aided ear open and listening. This is often called a “plug AND muff” method. The aided Ling sound test could then be conducted using the standard approach. While the advantage of this approach allows effective sound reduction, the disadvantage is that it can be difficult to put both earplug and headphone over one ear without covering up the other!

There is a third method used by audiologists while in appointments. When there is access to an audiometer, the ear with hearing in the typical range can be masked with low level noise directly from the audiometer to an insert earphone placed in the ear canal. The Ling sound test can then be performed in the aided condition at the opposite ear. The advantage for this method would be effective masking of the sound, yet a disadvantage is that audiometers and booths are not easily accessible.

In cases where one ear is in the typical range of hearing and the opposite side is aided, pre-planning is necessary to conduct a proper Ling sound check of the hearing device. To ensure that you have effectively plugged or muffed that better hearing ear, try the Ling sound check in the unaided condition before turning “on” the listening device and completing the aided version. Precision of the Lings in the unaided condition should be lower than in the aided condition if effectively plugged or muffed. Contact an audiologist near you for to obtain other strategies if the ones above cannot be executed easily.

Kathy Holtman works as a pediatric audiologist at the CID Martha E. Jones Pediatric Audiology Center in St. Louis, MO.

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Talkin’ in a winter wonderland: Planning a thematic syntax lesson https://cid.edu/2018/01/30/talkin-winter-wonderland-planning-thematic-syntax-lesson/ https://cid.edu/2018/01/30/talkin-winter-wonderland-planning-thematic-syntax-lesson/#comments Tue, 30 Jan 2018 21:24:28 +0000 https://cid.edu/?p=20288 The post Talkin’ in a winter wonderland: Planning a thematic syntax lesson appeared first on Central Institute for the Deaf.


Talkin’ in a winter wonderland: Planning a thematic syntax lesson

by Emily Humphrey, MSDE, CED

Winter brings mixed emotions and varying levels of motivation for students and professionals alike. On one hand, it seems a fine time for hibernation-for getting back into the swing of school after break and maintaining skills. On the other hand, winter is a perfect time for exciting thematic learning. Syntax lessons can center on weather, winter clothes and the thrill of snow!

Below is a play-based snowball fight lesson I find exciting and motivating for my students, year after year. I use the TAGSTeacher Assessment of Grammatical Structures rating forms to guide my planning and assessment. It starts with the five fundamentals of planning a syntax lesson.

  1. Determine present levels: Take a language sample to mark baseline data on the TAGS. A language sample will give you a snapshot of common errors specific to your student.
  2. Determine what’s typical: Consider what a child with typically developing language around the same age would say during this activity. How would he play? Use this information to guide expectations.
  3. Determine syntactic lesson objectives: Target emerging syntax structures, areas for growth and/or IEP goals.
  4. Determine activities: Consider age, interest and appropriate expectations.
  5. Determine expected outcomes: Think about your goal. Will you assess comprehension? Will the child require model and imitation? Will you prompt for language or expect spontaneous use of the target language?

Every winter, I adapt the same snowball fight lesson, altering the target language to fit my students’ needs. A fun activity to repeat, particularly when it snows and it’s easy to evaluate the carry-over of target language into more natural situations, such as centers and recess.

Snowball fight syntax lesson:

Materials: rolled up socks or crumpled paper

Language targets:

  • verb-noun
  • verb tenses (past, present and future)
  • pronouns: (my, your)
  • prepositions (to, under, over, through)

Activity: Snowball fight! Have your students take turns picking up a snowball and using language to talk about what they will do. Pause the play after the action so they can talk with each other about what just happened.  Use the language targets below to practice and assess comprehension by following directions.

Sample language:

  • throw/roll/kick the snowball; snowball under/on table;  snowball over head; snowball through legs
  • roll the snowball to me; throw the snowball to me; snowball over your head; snowball through my legs: roll the snowball under the table; throw the snowball over my head; roll the snowball through my legs
  • I will kick the snowball under the table. I will throw the snowball over your head. I kicked the snowball under the table. I threw the snowball over your head. You threw the snowball through my legs.

For more information about how the TAGS can work in your classroom, check out the free online course, Getting Your Feet Wet With TAGS.

White, E. (2014). TAGS – Teacher Assessment of Grammatical Structures (2nd Ed.): Revision of 1983 curricula by J. Moog and Victoria Kozak-Robinson. Central Institute for the Deaf, St. Louis, MO.

Emily Humphrey served as a classroom teacher in the Anabeth and John Weil Early Childhood Center at CID – Central Institute for the Deaf. She currently works as a parent educator in the CID Joanne Parrish Knight Family Center (coaching caregivers of children ages birth to three with hearing loss). Emily organizes and contributes to CID’s blog for professionals.

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Theory of mind and hearing loss: Teaching children for social and academic success https://cid.edu/2018/01/12/theory-mind-hearing-loss-teaching-children-social-academic-success/ https://cid.edu/2018/01/12/theory-mind-hearing-loss-teaching-children-social-academic-success/#comments Fri, 12 Jan 2018 15:26:14 +0000 https://cid.edu/?p=20138 The post Theory of mind and hearing loss: Teaching children for social and academic success appeared first on Central Institute for the Deaf.


Theory of mind and hearing loss: Teaching children for social and academic success

by Emily Humphrey, MSDE, CED

Five-year-old Sam is building a tower out of blocks when Jack walks by and knocks it over. Jack pauses, laughing, while Sam cries. Jack hands Sam some blocks to build, but becomes frustrated when Sam walks away. Ultimately, Jack ends up most upset in this scenario. Jack cannot understand that Sam did not think knocking his tower over was funny.  At this point, a teacher must intervene and understand that Jack is exhibiting difficulty understanding theory of mind. Theory of mind is the ability to understand that what you think and believe may be different from what another person thinks and believes. Behavior is motivated by our own and others’ knowledge and beliefs. By age 4, children can correctly predict that a person’s behavior is dependent on what he thinks and knows, even when the belief is false (Schick, Villiers, Villiers and Hoffmeister, 2007).

Research shows that children with hearing loss have delays in developing theory of mind. Researchers speculate that the lack of access to conversations in the environment causes children with hearing loss to miss important information about the world. Even with the best hearing technology, children with hearing loss often miss out on overhearing and incidental learning opportunities. Children with hearing loss often have varying levels of receptive and expressive language abilities. One study shows an ability to comprehend complex syntactic elements predicts theory of mind skills. For example, a child who understands and uses sentences like “He thought the cheese was in the refrigerator” perceives theory of mind (Schick et al. 2007).

An underdeveloped theory of mind affects reading comprehension, critical thinking, social relationships and collaboration. All of these are imperative to success in school. Children with hearing loss are often explicitly taught vocabulary, syntax and concepts. Why should teaching theory of mind be any different? Below is a list of ideas compiled to encourage theory of mind development in the classroom.

Language: Target language that includes metacognition; “thinking about thinking”. As educators, we can model how we think about thinking by using phrases such as “I think…” “I wonder…” “What would happen if…” “I remember…” “I would…” “I bet…” throughout the day. Make complex language structures such as because and but a priority. This syntax offers insight and practice explaining actions and behaviors.

Literacy: Fairy tales are generally rich in exposing characters’ perspectives. Use the above language to encourage inferences directly based on a character’s behavior. Act out the story. Your student can internalize a character’s perspective when he takes on that role.

Play: Offer ample opportunities for symbolic play and encourage role play. Create a play script and model how to play. Practice changing the ending or sequence of play to further flexibility in thinking. Board games can foster collaboration and perspective taking.

Math: Practice having students explain how they got an answer, even if that answer is wrong. Math errors are most commonly miscalculations but could be misinterpretation of the directions or task. A misinterpretation would give you and the other students insight into another way to think. A calendar routine provides ample mathematical concepts that can strike conversation. You can incorporate predictions about weather to practice mental state verbs.

Science: Take advantage of the scientific method! The scientific method is a structured and repetitive tool to practice making predictions. Encourage disagreements for students to hear views and rationale that differ from their own. Reflect on the outcomes and circle back to what you thought versus what happened.


Schick, B. (2014). Social Cognition and Theory of Mind. Communication Considerations A-Z,1-4. Retrieved October 13, 2017, from https://www.handsandvoices.org/comcon/articles/pdfs/socCogTheoryMind.pdf

Buijsen, M. V., Hendriks, A., Ketelaars, M., & Verhoeven, L. (2011). Assessment of theory of mind in children with communication disorders: Role of presentation mode. Research in Developmental Disabilities,32(3), 1038-1045. doi:10.1016/j.ridd.2011.01.036

Peterson, C. C. (2015). Empathy and Theory of Mind in Deaf and Hearing Children. Journal of Deaf Studies and Deaf Education,21(2), 141-147. doi:10.1093/deafed/env058

Schick, B., Villiers, P. D., Villiers, J. D., & Hoffmeister, R. (2007). Language and Theory of Mind: A Study of Deaf Children. Child Development,78(2), 376-396. doi:10.1111/j.1467-8624.2007.01004.x

Emily Humphrey served as a classroom teacher in the Anabeth and John Weil Early Childhood Center at CID – Central Institute for the Deaf. She currently works as a parent educator in the CID Joanne Parrish Knight Family Center (coaching caregivers of children ages birth to three with hearing loss). Emily organizes and contributes to CID’s blog for professionals.

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