The Penny

Example is not the main thing in influencing others. It is the only thing.

[Sunday, February 20, 2011]

"Sister Hasting Taught Us.."

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I've was out of Primary last week and the week before.. but back in today. Playing the piano! Fun times. The music leader was introducing a new song today, The Books of the Old Testament. I may have mentioned this song before.

Right, so the music leader had me play the first line, and apparently no one recognized it. Well, my kids have never actually heard the music--just my lousy voice. As I looked around, only four of the eight kids in my class last year were here: three girls and a boy. And one of the girls only comes to church about once a month. But I would think that one of the other three would recognize it! Oh, well.

Then the music leader asked if anyone knew the first book of the Old Testament. One hand--one of my girls. Then the light went off in the other three kids' heads, and they about leapt from their chairs to answer the rest of her questions: "And what comes after Genesis? Does anyone know how to say this long word? And what comes after that?" Four hands up after every question.

Then one of my girls said (with typical 10-year-old patience), "We already know this song."

Poor music leader. She stuttered for a minute. I know exactly what was going through her head: This is all I have planned for today! She asked how they knew the song, and the same girl responded, "Sister Hasting taught us in class."

The music leader was visibly relieved. She still needed to teach the song to everyone else.

She had them sing the first line (four books) and stop... and naturally my smart alecky class didn't stop but softly sang as she told them, "We're not ready for that yet!"

So then she decided to challenge them. This was mainly directed at two girls. My boy (my favorite student) was also singing, just not so obviously showing off that he knew this wordy song. He's a respectful kid. The music leader said that they would sing that first line again as a group, then she would have me play until she didn't hear anyone singing. They would be on their own, singing for as long as they could last.

We haven't sung this song since probably November. I thought they might get lost at Lamentations--they've certainly never sung it on their own. And it's a difficult song, because you're basically just memorizing words in isolation, without the benefit of context.

But wrong me! (Yes, I speak ASL sometimes. So?) Those little angels got all but the last two books.

About a minute later, I heard one say to another, exasperatedly, "It was Zechariah, Malachi!" Hey, at least she knew where to find them, even if she didn't remember every book.

This was a big reminder to me that kids really do listen and remember what you teach them, so make sure it's something worthwhile! Of course I was very, very proud of them.

And a wee bit amused at a certain non-Hasting-fan-club adult's slack-jawed expression as my kids rocked what is arguably the most difficult Primary song.

[Saturday, February 5, 2011]

Evaluation

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Laynie was interested in seeing how she was doing with her cochlear implants in relation to other CI users, and she wanted to see if she could improve her listening skills, so she went for a rehabilitation consult at The Listening Center at Johns Hopkins.

Let me give extraneous background information... My experiences as a professional working with members of The Listening Center team has been negative so far. Audiologists who don't email us back, AVTs who are anti-signing for every deaf child (including my favorite little guy, who had no language until he began learning ASL at age 6 (yes, years, not months) and was implanted at age 7), who diagnose apraxia for any deaf child who hasn't caught up in spoken language by two years post implant... the list goes on. And it's not just The Listening Center. Kennedy Krieger, which is the Johns Hopkins clinic for hearing kids with developmental/speech/language/whatever issues, is even worse. They have SLPs diagnosing autism (should be a psych or doctor), and they also love to call everybody apraxic. I actually had them diagnose one child with a language disorder after she scored within the normal range on all of their language testing. Basically, parents pay for the diagnosis. Whatever they went in thinking is what the child ends up having. So based on all of this, I did not have high hopes for Laynie to get much out of the appointment, especially with her being so ASL and Hopkins being famously anti-ASL. Well, I was wrong, and I was happy to be wrong.

The appointment was great!

Laynie's name was called, and I tapped her. The woman came over to introduce herself, and my interpreting hands went up.. and back down as the woman fingerspelled her own name. Then she signed, "I sign but lousy." It was English signing (L handshape for lousy.. hehe) but it was signing! She explained that she had requested an interpreter and was going to look for that person. Laynie was kind of anxious about that, because interpreters usually make it harder for her to communicate. Not harder than relying on lipreading and gestures, but harder than.. um.. me. Or writing. She usually gets, and I quote, "Stink terp." They miss half of what she says and don't ask her to repeat herself, just make stuff up to fill in the blanks. And they don't do much better with the English message. But, another happy surprise, the interpreter was good! He missed only about 5% of what she said, and I spoke up when it was important and let it go when it wasn't. He was so nice. I wonder if you can request specific interpreters or if it's just whoever the agency sends.

I thought that the woman Laynie would see was an SLP, but no, she was a teacher of the deaf. I'll call her the TOD. She was kind and patient, and she seemed genuinely interested in what Laynie had to say. The purpose of the consult was to determine Laynie's current level of performance with listening and spoken language, but mainly with listening. The TOD explained the four levels of listening:
1. Detection--you know that you hear something
2. Discrimination--you can tell whether it's this sound or that sound when given choices
3. Identification--you can tell which sound you hear (without choices--could be anything)
4. Comprehension--you understand what you hear

For example:
1. Someone says "see," and you raise your hand.
2. Someone gives you a paper with the words see and go on it and says "see," and you point to or say "see."
3. With no visuals, someone says "see," and you use your voice to repeat "see." When they ask you what word it was, you shrug.
4. Someone says "see," and you sign or voice "see," and you know that it means to look at something.

Jumping from level 1 to 2 isn't bad. From 2 to 3 is a bigger jump, and from 3 to 4 is a huge jump.

Before the testing, the TOD had Laynie fill out a short checklist using a Likert scale: 1 for almost never, 2 for rarely, 5 for practically always.. you get the picture. It focused on understanding language through listening without the person signing, and it had items like, "I have difficulty communicating in small groups," and "I become upset with my hearing skills." The TOD had me fill one out, too. I gave Laynie all 5s (as in, practically always difficult) except for the ones about becoming upset and it preventing her from making friends. We didn't look at each other's forms, but later we compared notes, and I think we answered pretty much the same.

The TOD asked questions about sounds Laynie doesn't like to hear, music she likes and why, etc. It seemed like she was mostly interested in Laynie's enjoyment of sound and making sure that if Laynie didn't like something or got frustrated, she was thinking about why that happened. She was surprised that Laynie reported being able to understand a few words and phrases over the telephone. Actually, she was surprised that Laynie understood anything without lipreading. She doesn't understand much, but occasionally she gets something. The TOD explained that she would do some closed set (given choices of answers) tasks and some open set (no answer choices--could be anything) tasks, and that Laynie should just roll with it and not worry if she couldn't do something. There were six tasks: one closed set detection task, three closed set discrimination tasks, and two open set identification/comprehension tasks.

All of the tests were done with the TOD's mouth obscured by an acoustic screen. It's just speaker fabric stretched over an embroidery hoop, but it does double duty: blocking all visuals but letting all sounds through without distortion (if you cover your mouth with your hand, you distort the sounds).

1. First was the Ling test. Laynie was already familiar with the Lings, because we've done them. There are six Ling sounds: ss, sh, mm, oo, ee, and ah. They are used as hearing checks, because they cover all of the speech frequencies from low (mm) to high (ss). Laynie correctly identified ss and sh. She got mm and mixed up the vowels. But the task was really just detection, so she got 100%--she just needed to hear them. I think identification was hard, because the TOD used a very quiet voice for all of the sounds. Much quieter than conversation level.

2. Laynie was given a page with three columns of words: single syllable, two-syllable, and four/five-syllable. For example, hot, table, qualification. The TOD would say a word from each row, and Laynie would have to tell which word she heard. She had to have one item repeated several times, but she got the rest correctly pretty quickly. There were about 20 items.

3. Laynie was given a page with sets of four sentences, such as:
A. She is ten years old.
B. Close the back door when you leave.
C. The man was eating a salad.
D. He went to work at nine o'clock.
So all of the sentences were pretty different. Laynie had the woman repeat the sentences several times and used process of elimination, which the TOD thought was a good strategy. Laynie missed one of the ten sentences.

4. For the fourth task, Laynie was given a page with 15 or 20 sentences. Each sentence had a "missing" word with two choices, such as:
His wife said he was all take/talk.
Laynie would have to tell which word was said. It was really hard, because the word choices had the same sounds at the beginning and end, with only the vowel being different (the spelling doesn't matter, just the sounds in the word). She got all of them right except one! I was shocked. We had worked on vowels last year, but we ended up skipping it and focusing on other things, because she just wasn't getting it. We haven't worked on it since then, but she has obviously made progress just from listening experience.

5. The fifth task was the first open-set task, and it certainly was harder. The TOD read simple sentences and questions, and Laynie was to say what she thought she heard. They were really common sentences, such as Turn on the TV and What time is it? I think Laynie was pretty nervous about that one. She got a couple of word right; she got "are you" in one of the sentences. I can't remember the rest of that sentence. But even when she missed all of the words, she was able to identify some sounds, and she always knew how many words and syllables were in the sentences. I was impressed that she recognized that Turn on the TV had five syllables but only four words. And she thought on was are. Pretty close.

6. The last task was one that the TOD thought would be harder than the fifth one, but as soon as she explained it, I knew Laynie would do better on it. It was imitation of what you hear. You would think that would be harder, but Laynie has become pretty good at imitating simple sounds/syllables. She doesn't know what they are, but she can parrot them. The TOD wanted Laynie not only to make the right sounds (or try to) but to try to get the suprasegmentals right: pitch, duration, number of repetitions, etc. So it might be a long, "Mmmmmmmm." Or a high and low alternating, "OOooOOooOOoo." Or just "bee." Laynie was able to get almost all of them with repetition. The Mmmmm was the first one, and Laynie shook an M handshape in front of her. Up until now, Laynie had not used her voice. She had signed back all of the responses. The TOD said, "Can you use your voice and try to say what I said?" So Laynie said a perfect, "Mmmmmmm." And the TOD's face lit up. She was shocked and amazed that Laynie could use her voice, and she commented on what a nice voice quality Laynie had. That was when she started to get excited. And she got more excited when Laynie imitated the high and low pitches on the OOooOOooOOoo. And when Laynie could make consonant sounds, like the S in see and the SH in shoe. The TOD exclaimed, "You have really good speech!"

She had been cheerful and giving off positive vibes the whole time, but after seeing how well Laynie did on the testing and the fact that she was able to make most speech sounds (Laynie can say everything except R, but she's not good at sequencing the sounds when there are more than two syllables--she'll start to omit sounds and substitute sounds), her demeanor changed. The only way I can describe it was excited. I know exactly how she feels: when you can tell a student has great potential, you become excited that you will be able to witness the progress. And Laynie looked so proud of herself. I knew that she was embarrassed to use her voice with the interpreter there, but she did a great job. The TOD thinks Laynie has great foundational skills and just needs some more practice. And confidence! And time. Laynie is able to identify many sounds (with repetition--but she'll get quicker at it with practice and time). The comprehension piece isn't really there yet, but it's starting to emerge. One weakness the TOD identified was auditory memory. Laynie might remember one sound from the word but forget what else she heard and need repetition. So of course there were weaknesses but so many strengths and positive indicators. The TOD thinks Laynie has the potential not just to enjoy what she hears but to understand what she hears.

Of course, I left the consult with a very happy girl. And I was happy for her. The TOD said that Laynie could continue to practice at home or come in weekly for therapy at The Listening Center. I am hoping Laynie will go weekly to The Listening Center (and I'm hoping she can see this particular person, because she seemed pretty realistic), because using her voice with someone who is not me or her mother will build her confidence. And I think it will keep her motivated to practice, knowing that someone will ask, "So how was practice this week?"

I am so glad Laynie went for this evaluation, and I am so proud of her for being willing to do everything the woman asked her to do. And I'm proud of her for the progress she has made!