Visual Cues

Lip reading or speech reading is the act of using visual cues of the speaker's lip movements, body language, and facial expressions to understand the meaning of what they are saying (Tye-Murray 2008).

Learning to lip read involves developing and practicing certain skills that can make the process much easier and more effective (Tye-Murray 2008).

EBP: This research and clinical communities suggest that lipreading training is important to improving speech recognition in adults with acquired hearing loss. (Bernstein, 2022)

References:

Bernstein, L. E., Jordan, N., Auer, E. T., & Eberhardt, S. P. (2022). Lipreading: A review of its continuing importance for speech recognition with an acquired hearing loss and possibilities for effective training. American Journal of Audiology, 31(2), 453–469. https://doi.org/10.1044/2021_aja-21-00112

Tye-Murray, N. (2008). Foundations of Aural Rehabilitation: Children, adults, and their family members. Delmar Cengage Learning.

Impairment: Adults with hearing loss and hearing aid users

Data Collection Tool

AuditoryVerbalTherapyEditableLessonPlanTemplate-1.pdf

Activity Breakdown

Step 1: The clinician will teach the place, manner, and voice of the group of sounds working on that specific day.

Step 2: The clinician will slowly voice the minimal pair/sentence and the patient has to identify the difference.

Step 3: The clinician will repeat the minimal pair words without voicing and the patient will have to use clues of lip reading to identify the word/sentence.

Hierarchy Cuing

Independently: The patient will identify the word/sentence without any help

Repetition: The patient will identify the word/sentence with 1-2 verbal repetitions from the clinician.

Visually over-articulate: the clinician will exagerate the movement of the mouth when producing word/sentence

Forced choice: the clinician will provide the minimal pair/sentences (2)

Provide answer (Model): the clinician will voice and point to the word/sentence.

Analytic Vowel Training

Focus on vowel and consonant recognition
Gradually increase reliance on auditory signals for discriminating phonemic contrasts while speech reading
(Bruhn and Jena method)

Goal: In 6 months the participant will discriminate words with /i/ and /u/ in 4/5 daily trials with 90% accuracy as measured by self, communication partner, and/or SLP.

Analytic Consonant Training

Focus on place, manner, voice
Place: visible AND audible
Manner & Voice: NOT visible, but audible
(Bruhn and Jena method)

Goal: In 6 months the participant will discriminate consonant pairs that differ in the place of production and share either voice or manner in 4/5 daily trials with 90% accuracy as measured by self, communication partner and/or SLP.

Synthetic Training

Takes the meaning of the message into consideration as a whole
(Nitchie and Kinzie methods)

Goal: In 6 months the participant will listen plus lipread to two related sentences and paraphrase them in 4/5 daily trials with 90% accuracy as measured by self, communication partner, and/or SLP.

Postlingual (Henry, B., 2015)

The table above represents the hierarchy for patients with postlingual hearing loss. The clinician will adjust according to the patient's baseline. This will help prepare the clinician in figuring out what minimal pairs to use.

Prelingual (Henry, B., 2015)

The table above represents the hierarchy for patients with prelingual hearing loss. The clinician will adjust according to the patient's baseline. This will help prepare the clinician in figuring out what minimal pairs to use.

References:

Henry, B. (2015). Adult cochlear implant home-based auditory training guide for clinicians. Cochlear.

Stacy Crouse (n.d.) Auditory verbal therapy editable lesson plan. TeachersPayTeachers.

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