Advocacy Notes: Why do the Ling Sound Test

Why Should the Ling Sound Test be done at school?

Question from the field: Can you please clarify the reason for the LING sound test. Why do families want us to do this at school, and how can we implement this without stressing out the general education teachers?

The Ling Sounds let us know how our students are both accessing and discriminating sounds across the speech spectrum. The purpose of conducting this listening check is not for us to check the student’s personal listening abilities, and it is not a time for us to work on their auditory skills or IEP goals.

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Determining Listening Challenges

Speech perception and listening accuracy cannot be assumed by looking at the audiogram – it must be assessed. Teacher’s voices, room acoustics, and classroom management vary so identifying listening challenges – and specific accommodations – needs to be done for students who are hard of hearing each school year. New information about the Listening Inventory For Education – Revised will help guide consideration of what typical listening challenges look like for students with normal hearing, so that we can better quantify these challenges for students who are hard of hearing.

 

Click here to read through the rest of the Late September 2019 Update

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Advocacy Notes: Why do the Ling Sound Test

Why Should the Ling Sound Test be done at school?

Question from the field: Can you please clarify the reason for the LING sound test. Why do families want us to do this at school, and how can we implement this without stressing out the general education teachers?

The reason we do a daily listening check is purely and for the sole purpose of ensuring that our students’ personal and classroom technology is working and that they have full and clear access to their instruction.

The Ling Sounds let us know how our students are both accessing and discriminating sounds across the speech spectrum. The purpose of conducting this listening check is not for us to check the student’s personal listening abilities, and it is not a time for us to work on their auditory skills or IEP goals.

As Carol Flexer teaches us, we do not hear with our ears. We hear with our brains. “Hearing loss is a doorway problem… there is some type and amount of obstruction in this ear doorway that prevents auditory data from the environment to reach the brain where learning the meaning of that auditory information occurs. Hearing aids and cochlear implants break through the doorway to allow access, stimulation, and development of auditory neural pathways.”1 We do the daily Ling sounds listening check in order to ensure that the child has clear access through their technology (personal and classroom) to their brain prior to starting each day.

 

The LING Sound Check:

WHAT?

The Ling Sounds were identified by Daniel Ling. They are “ah” “oo” “ee” “s” “sh” and “m” We know that when a child can detect all 6 of these sounds, they have access to sounds from 250 Hz to 8000 Hz. When they can discriminate all 6 of these sounds, we know that they are ready to learn.

WHY?

We as educators are responsible for our students’ access to their instruction in the educational setting. We must ensure that before instruction starts, we are aware of any auditory limitations that the student may have on any given day. By doing the daily listening check, we may identify confusion of low frequencies such as “oo” and “m” or difficulty with high frequency information such as “s” and “sh.” We may see a pattern of difficulty that is reflective of equipment issues that has nothing to do with the child’s effort or how much he or she is paying attention. For example, if a child is not clearly able to perceive the “s” sound they could be unable to differentiate between cat, cap, cast, calf, etc. If the access issue is not as simple as a battery or that the child has a cold that day, then the information is shared with the teacher as well as the family who may then decide to follow up with their clinical audiologist.

WHO?

For most teams the general education classroom teacher will not be the one to conduct the listening checks as they have many other students and responsibilities at the beginning of each school day. This is not necessarily a task or responsibility that we want to add to the general education teacher’s load. We do want them to understand what it is and why we do it. Teams will typically identify a primary person on the school site who will be trained how to conduct the listening checks as well as training some back up personnel on campus. Examples of staff who may conduct the listening checks are a SPED teacher, SLP, classroom aide, school nurse or health tech, or a 1:1 aide. This is a good discussion to have as a team so that the Teacher of the Deaf and Educational Audiologist can train the appropriate team members.

WHEN?

It is important that the listening checks be done prior to instruction at the start of school. It only takes a few minutes and should always be done before instruction begins.

WHERE?

The listening checks must be done in a quiet location. It may be in a classroom before the other students enter, the nurse’s office, outside of the classroom after the students have all left the playground, or wherever the team identifies as an appropriate location with minimal auditory distractions or interference.

HOW?

In my experience the listening checks are done as follows:

  • The student is facing away from the adult. Most teams will assess at ear level, 3 feet, and 6 feet.
  • The adult says the 6 Ling sounds and sometimes includes silence.
  • It is imperative that the sounds are never done in the same order from one day to the next as our students are masters at knowing what comes next
  • The person conducting the listening check will put a check mark ✅ if the child gets the sound correct on the first attempt, “2nd,” if they get it correct the second time, and document2 the sound the child says (ie: “m” for “oo”) if they said it wrong.

WHAT NOT TO DO:

Do not ever do the following while conducting a Ling sound listening check:

  1. 1. Continue to repeat the sound until the student gets it right.
  2. 2. Turn the child to face us if they are saying the wrong sound.
  3. 3. Let the student know that they missed a sound. We want to say, “Listen again” and “Great job” and send them off to class. Remember that are checking the equipment and access, not the student.

The reasons we do the daily Ling sound listening checks are so that the we can confirm the equipment is working, so the educators know the student is ready to learn, and to inform the family if the equipment is not working in case they need to follow up with their clinical audiologist. Our students should not feel like they have failed or done anything wrong as this is not a time when we are working on their skills or IEP goals.

 

Melinda GilLinger, M. A.
Special Education Consultant
www.melindagilLinger.com

 

  1. 1. How to Grow a Young Child’s Listening Brain, Carol Flexer, PhD, CCC-A, LSLS Cert. AVT 6/26/2018
  2. 2. Suggested resource to document the Ling Six Sound Check: https://www.teacherspayteachers.com/Product/The-Ling-6-Sound-Check-1729553
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Determining Listening Challenges

Speech perception and listening accuracy cannot be assumed by looking at the audiogram – it must be assessed. Teacher’s voices, room acoustics, and classroom management vary so identifying listening challenges – and specific accommodations – needs to be done for students who are hard of hearing each school year. New information about the Listening Inventory For Education – Revised will help guide consideration of what typical listening challenges look like for students with normal hearing, so that we can better quantify these challenges for students who are hard of hearing.

 

Why challenged listening?

The primary difference between students with hearing loss and their typically hearing peers is that they do not access speech as fully. This reality is often unrecognized by school staff who ‘know’ that the child can hear them just fine. While all children under the age of 15 years have an immature auditory cortex, and therefore greater challenges listening as accurately as adults, those with hearing loss are more impacted.

Classrooms are often noisy and the person the child needs to hear is often more than 3 feet from the hearing aid microphones. While individuals can detect sound occurring beyond 3 feet, to truly perceive sounds like s, f, t, p (as in cat, cap, cast, calf) speech must be within the student’s listening bubble, or the range of hearing within which speech can be fully heard. 

For most classroom communication students who are hard of hearing must work harder to listen, resulting in fewer cognitive resources available to process what was said so that it can be comprehended and remembered. Because they expend more effort to listen and pay attention, they experience greater listening fatigue as compared to typically hearing peers. Greater effort for less comprehension, at a higher level of fatigue, all play a role in reducing the pace of learning and an increasing gap in achievement across school years. Refer to the Cascading Impact of Hearing Loss handout for more information.

How well a student is able to perceive speech in a classroom will impact educational performance. These impacts are often overlooked or misunderstood by school staff as they review whether it is necessary to evaluate a student with hearing loss to determine eligibility for sufficiently intensive specialized services and accommodations.

Almost 5 years ago (November 2014) the US Department of Education and US Department of Justice clarified that, under Title II of the ADA, schools are required to ensure that communication for students who are deaf and hard of hearing “are as effective as communication for others” [ADA Title II 28 C.F.R. 35.160 (a)(1)] through the provision of appropriate aids and services “affording an equal opportunity to obtain the same result, to gain the same benefit, or to reach the same level of achievement as that provided to others” [ADA Title II 28 C.F.R. 35.130 (b)(1)(iii)]. (Read more about ADA.)

To determine if communication is “as effective as others” we need to apply what is known about typically hearing children.

Functional Assessment

Performance under typical school conditions is necessary to assess either directly with the Functional Listening Evaluation (FLE), or indirectly, with checklists like the Children’s Home Inventory of Listening Difficulties (CHILD) or the Listening Inventory For Education-Revised (LIFE-R).

The Functional Listening Evaluation has become a mainstay in the field of DHH education and is commonly performed by educational audiologists and teachers of the deaf/hard of hearing. The FLE is a means to estimate how well a student is able to access verbal instruction, and to what degree speechreading, distance and noise effect performance.

90-95% = Typical Hearing Average

The FLE can be performed with a variety of age-appropriate stimuli including single words, phrases, nonsense phrases and sentences depending upon if the desired information is about the precision of speech perception (words/nonsense material) or to estimate access to classroom communication (phrases for young children, sentences for grade 1 and above). A steady source of background noise and a means to control the loudness of the noise in comparison to the presenter’s voice is needed to perform the FLE in a valid manner. The Recorded FLE Using Sentences was created to simplify and add consistency to FLE administration. See the 2-minute video demonstration of using the Recorded FLE Using Sentences on YouTube. A free 10-minute classroom noise file can be downloaded from this Supporting Success webpage for instructional use or to aid in assessment. Collected data (1999)1 on children age 3 to 17 with typical hearing listening in quiet and noise found that the typical score listening in quiet averaged 95+% and in noise 90+%, regardless of age and without the use of visual cues.

The Listening Inventory For Education was revised in 2012 (LIFE-R) resulting in a suite of checklists for students, classroom teachers and parents. Most frequently used is the LIFE-R Student Appraisal which is a self-report measure for students grade 3, or age 8, and above. Students must consider each of the 15 school listening situations and decide the how difficult it is for them to hear and understand. Via this rating, a potential score of 100% is possible on the LIFE-R Student Appraisal.

72% = Typical Hearing Average

Two recent research studies provide helpful insight into interpretation of LIFE-R results. In 20181, researcher in Belgium translated the LIFE-R verbatim into Dutch and it was completed by 187 secondary students with normal hearing. Even though a score of 100% is possible, the typical listening situations in a classroom can be challenging for students with normal hearing as well as those with hearing loss. The average score for students with normal hearing was 72% with the most difficult listening situations being when classmates were noisy or when listening to responses during class discussion. The first ten questions on the LIFE-R relate directly to instructional classroom situations, in which students score significantly higher than the five questions related to social or group listening situations.

57% = DHH Average

A second study2 analyzed the data collected from use of the online LIFE-R over a period of 4 years (no identifying information), resulting in 3500-5000 responses, depending on the question analyzed. In every listening situation, students with severe to profound hearing loss showed greater hearing difficulty than all other groups, including cochlear implant users. The total average score for all 15 listening situations across students of different grades, hearing technology and hearing levels was 57%. Of the data analyzed, 509 had grade level indicated. Students in grades 3-6 reported poorer listening (53%) than those in grade 7-9 (61%) for all 15 situation responses. The most challenging situation was trying to listen to the teacher when other students were making noise, while difficult for all respondents, was even more so for the younger students. The second most difficult scenario was listening in a large room or school assembly.

If a student with hearing loss scores less than 90% on the FLE, or less than 72% on the LIFE-R it is evidence that communication is not as effective as peers and that auxiliary aids and services MUST BE PROVIDED to close this gap.

 

Formal Assessment

When students are present in classrooms it is assumed that they will hear and understand instruction. Hearing loss impacts this basic assumption and the question “to what degree is this student impacted” must be addressed. Although it is expensive to purchase norm-referenced tests, it is necessary to have the ability to collect data that is relevant to children with hearing loss in both a norm-referenced and functional performance (informal) format. The following are felt to be the best tools available to gather this information to identify areas of weakness, which make results advantageous to eligibility discussions and planning.

  • Developmental Test of Auditory Perception (DTAP): age 6-18. Takes 30 minutes to administer via CD. Results in language and non-language auditory perception index scores and background noise and no background noise index scores. The DTAP and FLE are a powerful combination to provide evidence of the impact of hearing loss on access to communication.
  • Assessment of Story Comprehension (ASC): Pre-K and K, age 3-5 years. Takes 3 minutes to administer and 1 to score. Teacher reads a story and student answers literal and inferential questions.
  • Oral Passage Understanding Scale (OPUS): age 5-21 years. Takes 10-20 minutes. Teacher reads a passage and student answers questions. It identifies knowledge and use of words, word combinations, syntax, and use of language in which meaning is not directly available from the words used. Yields more information than simply whether the individual can comprehend; deeper processing abilities.
  • Listening Comprehension Test – 2 / Listening Comprehension Test – Adolescent: ages 6-11 and 12-18 years. Takes 35 minutes to administer. Results are a good predictor of how well a student will be able to function in the mainstream classroom. Subtests are listening for the main ideas, details, reasoning, vocabulary and understanding messages. Results can readily be used to develop intervention goals.

 

References

  1. 1. Bodkin, K., Madell, J., & Rosenfield, R. (1999). Word recognition in quiet and noise for normally developing children. American Academy of Audiology Convention, Miami, FL – Poster session.
  2. 2. Krijger, L. DeRaeve, K. L. Anderson & I. Dhooge (2018). Translation and validation of the Listen Inventory for Education Revised into Dutch. International Journal of Pediatric Otorhinolaryngology, 107, 62-68. Online article.
  3. 3. Nelson, K. Anderson, J. Whicker, T. Barrett, K. Munoz, & K. White (2019). Classroom Listening Experiences of Students who are DHH using LIFE-R. Submitted manuscript.
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Advocacy Notes: Key Things for Classroom Teachers to Know

What are the key things that classroom teachers need to know in order to support my students?

 

Question from the field: I have students whose IEPs call for staff inservice training prior to school starting or within the first couple of weeks. Some use hearing aids and others use cochlear implants, but they are all placed in general education classrooms. Knowing that the general education teachers have limited time, what are the key things that they need to know in order to support my students?

 

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Surface Learning is Not Enough – the Need for Deeper Understanding

 

In most classrooms, new information is presented in a lecture format supplemented by reading material, until students build surface knowledge of the topic. Interaction activities such as classroom discussion, small group work, and partner problem-solving are used to solidify surface knowledge and to move students to a deeper level of understanding1.

Therefore, how well students are able to converse in the classroom setting truly impacts their move toward deeper understanding and learning at the expected pace.

 

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Advocacy Notes: Key Things for Classroom Teachers to Know

What are the key things that classroom teachers need to know in order to support my students?

 

Question from the field: I have students whose IEPs call for staff inservice training prior to school starting or within the first couple of weeks. Some use hearing aids and others use cochlear implants, but they are all placed in general education classrooms. Knowing that the general education teachers have limited time, what are the key things that they need to know in order to support my students?

Starting each school year with a staff inservice training sets the stage for success. This is a great question with which many Teachers of the Deaf (TOD) and Educational Audiologists struggle.

The 2 most important things to remember when providing trainings to staff who will be working with our students with hearing loss in the general education setting are:

1. Always share the WHY behind what you are asking them to do for the student. Once teachers understand WHY they need to use the teacher transmitter or pass-mic, WHY students need strategic preferential seating, and WHY we ask for pre- and post-teaching, most begin proactively thinking about what else they can do to support the student.

2. Everyone who will influence the success of the student needs to be at the training. It is critical that all staff who will interact with our students attend the training to hear the information from the TOD, AUD, or expert conducting the training. Asking teachers who attend the training, but are not experts in this field, to pass on the information is not fair to the student, the teacher who has just learned everything about the new student, or the teacher who missed the training.

 

General education teachers have shared with me that the following were things that they did not know and helped them to better serve the student with hearing loss:

  • Difference between hearing aids and cochlear implants: It is important for people outside of this field to understand that cochlear implants are not the same as hearing aids. Additionally, there are still teachers and administrators who believe that cochlear implants restore normal hearing or believe that the students are no longer deaf.
  • Understanding the audiogram: I explain the audiogram not from the technical perspective that clinical and educational audiologists understand it, but rather in order for teachers, coaches, and service providers to understand the speech spectrum and where the critical features of linguistic information occur. It is also very important for everyone to understand the unique loss and history of the student they will be serving. Many general education teachers and providers who have previously served students with hearing loss are under the impression that this means they understand what all students with hearing loss will need. Knowing the individual child’s loss, the technology they use, and their history helps everyone have a better school year.
  • Incidental hearing/Incidental learning: It is critical for everyone to have an understanding of how our students may have gaps in their knowledge of language and concepts that their typically hearing peers know and how that can lead to misunderstandings in both their academics and social interactions.
  • Hearing Assistive Technology (HATS): Hearing assistive technology is a term that encompasses the low incidence equipment in the IEP such as the personal FM/DM system, classroom sound field system, and pass-mic for access to peer input. After explaining what a student has in his/her IEP, it is very helpful to share the Hearing Loss in the Classroom video1.

 

Melinda Gillinger, M. A.
Special Education Consultant
www.melindagillinger.com

 

1. Hearing Loss in the Classroom video, J. Madel, Sept. 2010

 

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Surface Learning is Not Enough – the Need for Deeper Understanding

 

In most classrooms, new information is presented in a lecture format supplemented by reading material, until students build surface knowledge of the topic. Interaction activities such as classroom discussion, small group work, and partner problem-solving are used to solidify surface knowledge and to move students to a deeper level of understanding1. Therefore, how well students are able to converse in the classroom setting truly impacts their move toward deeper understanding and learning at the expected pace.

 

It is faulty to assume that:

(1) a student will ‘catch up’ once they enter school,
(2) just because a student has ‘okay’ language at school entry that he/she will be able to keep up with class expectations across the academic years, and
(3) non-DHH-specific specialized services provided with less intensity than needed for a student to close gaps and to keep up will be sufficient to counteract the access issues caused by hearing loss.

On the way to deeper understanding: For students with hearing loss, keeping pace in moving to a deeper level of understanding can be very challenging. Background, or world knowledge is necessary to build surface level understanding of a specific topic. Prior knowledge is an excellent predictor of performance. Our students tend to have ‘Swiss cheese language’ with unpredictable knowledge gaps in vocabulary and concepts. They also are often limited in the number of language attributes they use to describe objects or concepts, further contributing to their gaps and limited world knowledge. Imagine learning about the conquistadors if you lacked knowledge of geography, discoveries of early explorers, and that there are different countries and they may desire different things.

 

Filling the gaps. Due to prior knowledge deficits we can expect that surface learning will take longer for students with hearing loss than their typically hearing peers. Students who have a less complete understanding of surface level information are not going to benefit to the same degree, or at the same rate, during interactive peer activities that are meant to move them to deeper understanding. “Closing the language gaps” is not something that is a nice extra touch to provide to our students if there is a teacher of the deaf/hard of hearing available – it is a necessary accommodation for equal access to learning.

Filling in the gaps in prior knowledge is necessary if a child is to be able to develop the surface learning needed prior to developing deeper understanding. Without this surface learning, a deeper understanding similar to that of class peers is not possible.

Added to typical knowledge deficits is the reality that reduced precision listening ability caused by hearing loss very often delays literacy skill development and slows reading fluency. Teaching vocabulary, when the student does not have sufficient phonological awareness skills, will not develop the reading fluency needed for comprehension, especially in the secondary grades.

 

Conversational inequalities. Research2 has indicated that during one-on-one conversations in a quiet setting, students with hearing loss have conversational skills equivalent to their hearing peers. This includes skills for initiating a conversation, maintaining a dialogue over several turns, shifting the topic, and terminating the conversation. In a typical mainstream classroom, there are many choices for communication partners along with background noise, reverberation, and listening at distances beyond 3 feet. These conditions all interfere with speech perception of students who are hard of hearing.

 

Students with hearing loss make 25% fewer overall communication attempts than their hearing peers. They also often seem unaware that their peers had tried to initiate conversation and do not attempt to maintain a conversation. When they attempt to maintain a conversation, they generally use one-to-two-word phrases to maintain communication and do not add new information.

 

A teacher repeating key information from class discussions cannot ‘level the playing field’ for our students.

Students with hearing loss frequently try to maintain the conversation by bringing up a topic that is unrelated to the conversation. In other words, they are not aware enough of the content of the conversation to contribute information, so they bring up a new topic. Thus, when classroom activities move to peer interaction as a way to facilitate deeper understanding it is often very challenging for students with hearing loss to participate successfully. As can be inferred by the research, in quiet settings performance in conversation equal peers. Therefore, it is the unequal acoustic access in the classroom that results in conversational challenges for students who are hard of hearing. This provides a powerful argument for the use of hearing assistance technology that will improve perception of peer voices in 1:1 or group settings.

 

Moving to a quieter area for discussion will not ensure full participation by the student with hearing loss. Including him or her in a group that sticks to the topic will heighten the value of the activity for the learner with hearing loss and improve the deepening of understanding.

Challenges repairing communication breakdowns. Another aspect of conversation relates to what a person does when they do not fully understand what another person has said. One study3 found that persons with hearing loss have difficulty when a shift in topic is made during conversation. The more predictable the conversation, the fewer the likelihood of communication breakdowns. If a student is sitting with a group of peers who maintain their focus on the problem-solving task, the level of understanding is likely much higher than if the student was in a group who wandered off topic repeatedly. The teacher needs to be aware of this issue when pairing our students with different partners or groups.

 

Keeping up in the classroom is a challenge for children with hearing loss due to access issues that interfere with understanding conversational communication and the gaps in knowledge resulting from decreased  auditory access since infancy (or sign communication with limited language models since infancy). Filling the gaps of vocabulary and phonological awareness is necessary for students to keep up with class expectations for developing surface learning. Access to classroom discussion and for all group activities is necessary for

deep learning to occur. Providing the appropriate access technology is a necessity if we are to allow deeper learning to occur within the classroom. Selecting appropriate group partners and honing communication repair skills is also critical to achieving at the same rate and to the same level as peers.

 

References:

  1. 1. Fisher, Frey, Hattie (2016) Visible Learning for Literacy Grades K12: Implementing the Practices that Work Best to Accelerate Student Learning. Corwin/SAGE, Thousand Oaks, California
  2. 2. Duncan (2001). Conversational skills of children with hearing loss and children with normal hearing in an integrated setting. The Volta Review, 101(4), 193211.
  3. 3. Caissie (2002). Conversational topic shifting and its effect on communication breakdowns for individuals with hearing loss. TheVolta Review, 102(2), 4556

 

Some products to check out related to this topic:

 

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