Top Lang Disorders Vol. 38, No. 3, pp. 202–224 Copyright c 2018 Wolters Kluwer Health, Inc. All rights reserved. Guiding Principles and Essential Practices of Listening and Spoken Language Intervention in the School-Age Years Uma Soman and Mary Ellen Nevins Listening and spoken language (LSL) intervention and education have emerged as the preferred terms representing an intervention perspective that promotes “auditory oral” outcomes for many of today’s children who are deaf or hard of hearing (D/HH), including those who are English learners. Practitioners (including speech–language pathologists, educational audiologists, and teachers) working with students who are D/HH require access to evidence-based principles of LSL. A deep understanding of general principles will inform practitioners’ development of intervention to promote outcomes for school-aged students who are D/HH or D/HH and English learners. The purpose of this article is to identify principles and practices foundational to developing LSL. Knowledge, skills, and dispositions for practitioners are discussed; descriptions and examples of strategies and resources associated with LSL are included. Key words: auditory oral, deaf, hard of hearing, hearing technologies, language intervention, listening and spoken language, school-aged children, speech–language pathologists VER the last two decades, more children spoken language (LSL). When given a choice, O who are deaf or hard of hearing (D/HH) a majority of families want their children to are using hearing technologies, such as hear- learn their home language(s) and use hearing ing aids and cochlear implants, and receiv- aids or cochlear implants to develop auditory ing early intervention to develop listening and skills (Alberg, Wilson, & Roush, 2006). The cultural and linguistic diversity of the students whoareD/HHissimilartothatobservedin the larger population, and for a growing num- Author Affiliations: Carle Auditory Oral School, ber of families, the home language might be Carle Foundation Hospital, Urbana, Illinois (Dr Soman); and Audiology & Speech Pathology one other than English or one in addition to Department, University of Arkansas for Medical English. Sciences, Little Rock (Dr Nevins). There has also been a shift in educational The authors have indicated that they have no financial placements such that students’ time is maxi- and no nonfinancial relationships to disclose. mized in general education settings instead of Supplemental digital content is available for this schools or programs specifically for children article. Direct URL citations appear in the printed who are D/HH. Many of these students receive text and are provided in the HTML and PDF ver- sions of this article on the journal’s Web site (www. intervention from interprofessional teams that topicsinlanguagedisorders.com). might include speech–language pathologists Corresponding Author: Uma Soman, PhD, Carle Au- (SLPs), teachers of students who are D/HH, ditory Oral School, Carle Foundation Hospital, 611 W. special education teachers, general educa- Park St, Urbana, IL 61801 ([email protected]). tion teachers, reading specialists, and English DOI: 10.1097/TLD.0000000000000158 language teachers. A certified Listening and 202 Copyright © 2018 Wolters Kluwer Health, Inc. Unauthorized reproduction of this article is prohibited. LSL Principles and Practices 203 Spoken Language Specialist1 (LSLS) has expe- children who are D/HH and ELs. To date, lit- rience and expertise in working with students tle has been written on the needs of these who are D/HH and ought to be included on students. This article is offered to contribute the interprofessional team; however, only a to the conversation regarding children who limited number of professionals are currently are D/HH and who are learning at least two prepared and certified for this specialization spoken languages. (Alexander Graham Bell Association for the Practitioners working with students who Deaf and Hard of Hearing, 2017). are D/HH and who are ELs will benefit from Outcomes of students who are D/HH, espe- an understanding of the impact of hearing loss cially those who are English learners (ELs), are on language and academic development con- influenced by a number of intrinsic factors, sidered in the context of dual language learn- some of which are essentially immutable, as ing. There exists a body of knowledge and well as extrinsic factors, over many of which evidence-based strategies that can inform in- there is a degree of control. Importance of tervention for each student who is D/HH to intervention in the first 3 years of life has achieve his or her personal best, including received much attention at the levels of re- those who are ELs. search, practice, and policy. As a result, chil- dren who are D/HH currently start their ele- GUIDING PRINCIPLES OF LSL mentary years with varying levels of readiness INTERVENTION to enter kindergarten. Readiness skills often reflect the quality and quantity of early inter- On the basis of a synthesis of knowledge vention services children have received, but from within the field, coupled with insights education and intervention across the school- from our experience working with this pop- age years continue to be critical for build- ulation, we offer five principles for plan- ing language foundations for literacy develop- ning and implementing LSL intervention with ment and for employment and social success school-aged children and adolescents who are in later life. Thus, it is critical to explore the D/HH and who come from culturally and lin- LSL needs of students who are D/HH in the guistically diverse backgrounds. Before ex- context of academic and social development ploring these principles for adoption and im- that occurs during the elementary and middle plementation, impact of hearing loss and its school years. prescribed management are reviewed. In this article, we propose three Profiles The guiding principles and essential prac- of Potential—Keep Up, Catch Up, Move tices of LSL intervention for school-aged chil- Up. These three profiles create a conceptual dren are intended to extend knowledge and nomenclature that describes 5- to 14-year-old skills of practitioners who strive to meet the students based on their needs, growth trajec- varied needs of students who are D/HH and tories, and the family’s desired outcomes. It to encourage sensitivity to cultural–linguistic provides shared terminology for working in variation. In our exploration of these princi- interprofessional teams and with families. In ples, we share examples from our practice as addition, this nomenclature can be applied to well as composite vignettes of students that practitioners might encounter. The five prin- ciples are as follows: 1. Intervention maximizes learning to listen 1The Listening and Spoken Language Specialist certifica- and learning through listening. tion is awarded by the Alexander Graham Bell Academy 2. Language and literacy development is for Listening and Spoken Language to individuals with de- foundational to all interventions and tar- grees in audiology, speech–language pathology, or deaf education upon the completion of advanced coursework, geted directly. mentoring, and a passing score on the certification exam- 3. Intervention is individualized, system- ination. atic, and richly multidimensional. Copyright © 2018 Wolters Kluwer Health, Inc. Unauthorized reproduction of this article is prohibited. 204 TOPICS IN LANGUAGE DISORDERS/JULY–SEPTEMBER 2018 4. Effective intervention is driven by inter- EHDI guidelines” than for the outcomes of professional practice (IPP). children who did not meet the recommended 5. Families are included and empowered timetable (Yoshinaga-Itano, 2003; Yoshinaga- to be partners in listening, spoken lan- Itano et al., 2017). The EHDI bill was reautho- guage, and literacy development. rized in November 2017 and will continue to recommend and support 1-3-6 for infants who Impact and management of hearing loss are D/HH. Application of the five principles requires Per the latest data available, 98.2% of all a deep understanding of the impact of hear- infants born in a hospital are screened for ing loss and the need to manage it effec- hearing loss. Unfortunately, approximately tively. Hearing loss limits auditory access to 30%–40% of children who are referred for speech and language present in the child’s en- additional assessments do not meet these vironment. Prelingual hearing loss has a neg- recommended starting points and are lost ative impact on development of spoken lan- to follow-up due to a variety of factors and guage(s) and can also have a cascading effect mitigating circumstances (Centers for Disease on social–emotional and academic develop- Control and Prevention, 2015). This results in ment. Every state (and territory) in the United unmanaged hearing loss that can have a con- States has an established Early Hearing Detec- siderable negative impact on development tion and Intervention (EHDI) program. Hear- of LSL. Here, unmanaged can refer to later ing screening by 1 month (but preferably be- identification of hearing levels, delayed fitting fore a child leaves the birthing hospital), iden- of hearing technologies, and/or no access to tification of hearing loss by 3 months, and en- skilled professionals to guide family-centered rollment in intervention by 6 months (called intervention. Fortunately, early identification, the 1-3-6 protocol) is the gold standard rec- early amplification, and early intervention can ommended by the National Center