October 19, 2016. Hearing issues for students with deafblindness, auditory training. ****************DISCLAIMER!!!**************** THE FOLLOWING IS AN UNEDITED ROUGH DRAFT TRANSLATION FROM THE CART PROVIDER'S OUTPUT FILE. THIS TRANSCRIPT IS NOT VERBATIM AND HAS NOT BEEN PROOFREAD. THIS IS NOT A LEGAL DOCUMENT. THIS FILE MAY CONTAIN ERRORS. THIS TRANSCRIPT MAY NOT BE COPIED OR DISSEMINATED TO ANYONE UNLESS PERMISSION IS OBTAINED FROM THE HIRING PARTY. SOME INFORMATION CONTAINED HEREIN MAY BE WORK PRODUCT OF THE SPEAKERS AND/OR PRIVATE CONVERSATIONS AMONG PARTICIPANTS. HIRING PARTY ASSUMES ALL RESPONSIBILITY FOR SECURING PERMISSION FOR DISSEMINATION OF THIS TRANSCRIPT AND HOLDS HARMLESS TEXAS CLOSED CAPTIONING FOR ANY ERRORS IN THE TRANSCRIPT AND ANY RELEASE OF INFORMATION CONTAINED HEREIN. ***********DISCLAIMER!!!************ October 19, 2016. Hearing issues for students with deafblindness, auditory training. ****************DISCLAIMER!!!**************** THE FOLLOWING IS AN UNEDITED ROUGH DRAFT TRANSLATION FROM THE CART PROVIDER'S OUTPUT FILE. THIS TRANSCRIPT IS NOT VERBATIM AND HAS NOT BEEN PROOFREAD. THIS IS NOT A LEGAL DOCUMENT. THIS FILE MAY CONTAIN ERRORS. THIS TRANSCRIPT MAY NOT BE COPIED OR DISSEMINATED TO ANYONE UNLESS PERMISSION IS OBTAINED FROM THE HIRING PARTY. SOME INFORMATION CONTAINED HEREIN MAY BE WORK PRODUCT OF THE SPEAKERS AND/OR PRIVATE CONVERSATIONS AMONG PARTICIPANTS. HIRING PARTY ASSUMES ALL RESPONSIBILITY FOR SECURING PERMISSION FOR DISSEMINATION OF THIS TRANSCRIPT AND HOLDS HARMLESS TEXAS CLOSED CAPTIONING FOR ANY ERRORS IN THE TRANSCRIPT AND ANY RELEASE OF INFORMATION CONTAINED HEREIN. ***********DISCLAIMER!!!************ ^CH00:00:00 Chapter 1. Continuum of Auditory Skills Development >> Adam Graves: Good afternoon, everybody. Welcome to hearing issues for students with deafblindness. Today we're going to be discussing auditory training. This is a follow‑up to one of the webinars that we did ‑‑ actually, it was two years ago that we did this first webinar. >> Robbie Blaha: Was that with Susie Tiggs? >> Adam: With Susie Tiggs, yes, and Kate Hurst. I am Adam Graves and ‑‑ >> Robbie: I'm Robbie Blaha. >> Adam: Thank you. And if you all need to reference the initial webinar on auditory training, the website is up there for you. [Slide start:] It's www.TSBVI.edu/selected‑topics/deafblindness #w. So you can go back and look at that and watch these together and it might help give you a little bit more background if maybe you've forgotten some of the stuff that we talked about last time. [Slide end:] So today what we want to do is we want to just briefly go over some of the things that we talked about in that initial webinar, and then give you some examples of some of the techniques that we were describing in that webinar. And we're going to start out by talking about the continuum of auditory skills development. [Slide start:] This was a topic that was raised in that initial webinar, and we talked about, you know, the beginning level of building auditory skills and moving on through that to the level of comprehension. And we started the awareness level, and the continuum begins with just being aware of sounds. If you all have the handouts out there that are watching, this is in your handouts and it goes into a little more detail, but basically we're looking at just the ‑‑ starting at the very basic level of knowing that there is a sound or reacting to the presence or absence of a sound. And that is the awareness level. And as we work through that continuum, we go through recognizing sounds, that is, knowing the difference between familiar sounds such as recognizing the difference between the mother's voice and the father's voice. That is sort of the recognition. And then locating sound is the ability to turn towards a sound and make movement in the direction that a sound is coming from. And then we move into discrimination and comprehension. [Slide end:] And there are many different terms that people use to describe this continuum. Some people refer to it as gross and fine discrimination, but basically what they all are describing is this continuum of first being aware of a sound and then being able to respond appropriately to that sound and understanding the meaning of multiple sounds in an array. So just to give you some examples of the difference between awareness and comprehension, we have two videos. The first one is going to be a video of a student who is demonstrating an awareness level of sound comprehension. So let's take a look at that. [Video start:] >> There we go. There we go. [Video end:] >> So if you'll notice, the student in that video, basically his reaction was to the sound of the blender. He didn't really‑‑ he didn't respond to the teacher's out burst of saying "For crying out loud". His basic level of understanding of sound was that there was the presence of a sound that wasn't there before. And in this case it was the blender. So that is a very good example of awareness. So let's look now at comprehension. Here's a video of a young man who is listening for sounds in his environment and being asked to identify them and where they're coming from. So let's take a look. [Video start:] >> The traffic behind you, do you hear the traffic? Now listen carefully. Ah‑ha, you hear the bird. Where? Where? Quiet. A little bit bird ‑‑ little bird, a music. That's good, happy. Where is the bird? Over there? Here's the bird and the tree and the pupupu. [Video end:] >> So that's a good example of sound comprehension. That student has some ‑‑ he has a concept of what birds are so he ‑‑ and he knows what kind of a sound the bird is making or that birds make, so when she asks him what he hears, he's able to identify that sound as being a bird. And in addition to that, he also with the background knowledge that he has of birds, he knows that birds could be up in the tree or they could be on the ground, so he's looking around for the source of that sound based on his knowledge of where birds might exist. So that is the difference between awareness and comprehension. The first student didn't even really know where the sound was coming from, and the second student knew not only that there could be multiple places that the sound was coming from, but that it was coming from a very specific source that he could name. So ‑‑ before I move on, I would like to ‑‑ I encourage all of you if you have questions to go ahead and use the chat pod to post your questions and we'll try and answer them as best we can as they come up. We'll be checking in with that from time to time, so please don't hesitate to use the chat pod. ^CH00:07:53 Chapter 2. Tips for Effective Auditory Training So I want to go ahead and bring Robbie into the discussion a little bit and talk about some of the things that we discussed in that introductory webinar. And the first one is be effective. [Slide start:] That was one of the tips that we gave. And some of the ways that we discussed that you could be more effective would be to avoid auditory and visual clutter. Allow time for processing and try to use a consistent pitch, rhythm, vocabulary and physical gestures when describing or drawing attention to a sound. [Slide end:] Robbie, I wanted to ask you about this particular tip because I know you've had experience in designing instruction that incorporates these things, so I was hoping that you might be able to give us some examples. >> Robbie: Well, actually, I wanted to kind of speak to the first one about controlling auditory and visual clutter. I think that it's much easier in my experience to manage the visual clutter. To move things out of the way. To put contrasting materials so that the object you're talking about is clearly visual. And you know, a lot of the kids use their hands as their eyes or to supplement their vision, and so that the object that you pick is something that they would find acceptable tactilely. There are different kinds of blenders. Some seem very, very big to a very small child, but finding things that would kind of fit that kid if you're going to get a blender, and what would be the best one for that child. Some kids like stuff a little heavier, some like a little more vibration, so selecting the object, presenting it in a way that it's attractive and not cluttered is easier visually. What I had a hard time with is the auditory clutter that can be going on in classrooms. That's a very difficult thing to manage sometimes with announcements. >> Adam: That's true. And just the general din of the classrooms, with multiple students having discussions at the same time, that can be very difficult to control. >> Robbie: One thing I've found is to get the adults on your side and let them know that during a period of time if they could avoid talking. Avoid comments or just logging on to a computer and you hear the Mac start up as they check their email in the background. Just working as a team to kind of limit the auditory sound as best as you can. You may have to actually pick another area to work sometimes. >> Adam: And that's what I was going to say is that sometimes it's so impossible to be able to have enough control over that auditory environment that sometimes you have to create another environment in order to focus on using the auditory skills that the child already has. So yeah, I'm glad you mentioned that. >> Takes a little extra effort, doesn't it. >> Adam: Yeah, it does. But it's worth it in the end because if ‑‑ without it, the child ‑‑ especially a child who is just on an awareness level is going to be ‑‑ it's going to be really difficult for them to be able to focus in on one ‑‑ on the one sound that you want them to be isolating, including speech. So, you know, that's a very important thing to keep in mind. [Slide start:] So the next topic was making it motivating. And this is a huge part of everything that we do in deafblindness is making it motivating, but this is especially true I think for sounds because sounds ‑‑ it's so easy, I think, for ‑‑ well, let me just put it this way: Our brains are wired to block out sounds that aren't motivating to us. So if there's not a reason for us to listen to a sound, we're just bound to not pay attention eventually. [Slide end:] And so if there are sounds that you definitely want to make sure that the child is listening for, adding that motivation for them to listen is incredibly important. >> Robbie: I think I probably got ahead of myself talking about the blender because some items are more motivating. You want that item to be selected. Also, their favorite activity, what does it sound like? What are the sounds in it. Yeah, I think the motivation is a huge piece because otherwise they ‑‑ you do habituate the sounds like clock ticking and the air conditioner coming on, and we don't want them to habituate to important environmental sounds. >> Adam: Right, right. And also, I mean, getting back to that habituation, a lot of sounds sound very similar to each other, like an air conditioner, so it might be okay for them to block out an air conditioner, but it also might sound very much like a water fountain or a vending machine that you want them to cue into when they're traveling so that they can anticipate a turn or squaring off or something like that. So, you know, that's a really important thing to keep in mind when you're introducing sounds. >> Robbie: And it may be one of the most important. >> Adam: Yeah. >> Robbie: Because they're going to learn what they love and what it sounds like. [Slide start:] >> Adam: Yeah, it's true. So just‑‑ other ideas on how to make it motivating, make sure that the sounds are in the child's hearing range. I mean, that seems like it's pretty obvious, but, I mean, I know that I have very often, you know, tried to get students to respond to sounds that aren't in their hearing range, you know, and it's easy for us to do because the human voice, you know, is ‑‑ has a pretty wide range of frequencies. [Slide end:] And so, you know, like my voice is very different from, you know, your voice or, you know, someone else's voice who has a much higher voice than either of us. >> Robbie: And sweeter. >> Adam: And sweeter and maybe more sing‑songy. And that's another thing too, pitch is a huge part of that. So that's something to definitely keep in mind. Make sure you check that audiogram to see where that child's primary hearing range is so that you can make sure that when you're delivering especially speech to them that it is in that frequency range that is best for them. [Slide start:] And then also consistency. We always are talking about being consistent in the delivery. >> Robbie: And one thing, if you're not sure about the sounds, what's in the child's hearing range, it's worth a discussion with the audiologist. [Slide end:] >> Adam: Absolutely. >> Robbie: Don't assume that ‑‑ don't assume anything. It's worth having that relationship and talking to the audiologist about items that might be in their range. >> Adam: Yes. Or the teacher of the deaf and hard of hearing. That's a great point. [Slide start:] And then objects or experience to which the student has an emotional connection, that's another aspect of deafblindness that we talk about a lot that isn't just related to hearing, but emotion, connecting objects or discussion points to an emotional experience is so important because a lot of what our students understand is on a basic emotional level. And so if you can make a connection between this object and the sound that it makes and the feeling that they have towards that object, they'll pick it up a lot quicker and they'll respond a lot more positively to that. [Slide end:] And going along with that, sort of along those same lines, is it's really important that you build trust with the child, because that level of trust, that feeling of safety that a child is going to have with you is going to make them feel a lot more comfortable going outside of the immediate area where they feel the most self‑assured, because they know they can come back to you and you'll be able to provide them with some reassurance that the things that they are used to and are most comfortable with, will still be there. So that's a really important aspect too. >> Robbie: I really AM glad you emphasized that because I do think it's very ‑‑ I think especially with sound. Sound, when it's unfamiliar, is an easy thing to shut down to and withdraw from. And you do see kids covering up their ears a lot. And I think feeling safe makes you feel less a need to defend yourself. And I'm glad you put that in. >> Adam: Yeah. And that's a good point because you see kids shutting down like that and closing off their ears, but if you have a good relationship with the child, just sitting next to them you'll find that eventually they'll start to remove their hands from their ears just so that they can hear your voice. >> Robbie: Yes. >> Adam: Because it's reassuring to them. And once they hear your voice that provides them with some amount of self‑soothing that they can then like maybe move on and start to ‑‑ you can start to introduce those sounds that they're so afraid of to them so that they're more familiar with them the next time that that sound comes into their environment. >> Robbie: Yes, I think that's true. [Slide start:] >> Adam: That's a really good point. And then finally, seize the opportunity. We talk about that. Basically what we're talking about there is when there are sounds in the environment that we don't often think about. You know, we were talking about the sounds of, you know, compliances, like the vending machine. If you hear it go on ‑‑ if you're going ‑‑ [Slide end:] I think this is a good example is if you're out traveling with a student and you walk past the vending machine or a water fountain is probably more likely, then the water fountain suddenly turns on, you want to make sure that the child is aware of that and you get ‑‑ the two of you explore that water fountain together and really, like, get up next to it so that you're listening for it together and take advantage of those opportunities when they arise because that's something that you want the child to cue into if it's a landmark especially. But even just sounds in the classroom, you know. >> Robbie: You know, and one thing I just tending to more toward vision. I don't know why. Eyes are bossy, I guess, so when I go on a walk, I'm more likely to point out something visual to a child and I really need to remind myself that maybe sometimes we're on a listening walk, almost have to tell myself we're listening on this walk because, otherwise I wind up just throwing the sounds in as an afterthought. Do you know what I mean? >> Adam: Yeah, I do. I do that all the time too. Well, because, we are so used to, like, looking for visual landmarks. We're not used to listening for them. But echos, you know, are a huge part of orientation and mobility, listening for those sound shadows and those echos. And I know I've worked with several students that will stop at a hallway, you know, that's a long cross hallway, and just listen because they hear the echo coming down from either side of the hall and it's confusing to them because they're not sure, like, where the sound is coming from and whether it's coming from behind them or to the sides or in front. And if it's coming from in front, is it something that I need to, like, avoid? So those are things that we don't even think about. >> Robbie: And if I can just put one more thing in there. And I don't know who told me this, but it really stuck with me, is for children with vision loss, hearing is their distance sense. >> Adam: Right, absolutely. >> Robbie: So it kind of makes you bump it up a little bit. >> Adam: Yeah, that's true. [Slide start:] And then finally, responding to and making note of the difference between sounds that people make intentionally and sounds that are made involuntarily. And an example of this that I like to use is there's a big difference between a child banging a pot on a table and dropping a pot on the floor as they're walking to the dishwasher or the microwave. [Slide end:] And making them aware of the ‑‑ that the pot makes the same sound whether you're banging on it or dropping it on the floor, but when you drop it on the floor, there's an added element to it where you have to go and look for it. So those are things that, again, we don't often think about drawing attention to, but it's important. >> Robbie: And what about vocalizations that children make unintentionally. >> Adam: Like sneezes are a good example. >> Robbie: Yeah, they are. >> Adam: When a child sneezes and repeating that sneeze back to them and mimicking it back to let them know oh, you made a sneeze and that's different than when you on purpose make a ba‑ba‑ba sound. It's important to repeat. We talk a lot about mimicking the child's sounds, but it's important to do that with the sounds that they make a purpose in addition to the sounds that they make without, you know, doing it on purpose. >> Robbie: Right. >> Adam: Thanks. I'm glad you brought that up. So our next section is talking a little bit more about what this looks like. And actually Robbie and I were in here a little bit earlier and going over some of these videos and we had the opportunity to chat about what was ‑‑ what we saw on the videos. And we actually recorded that conversation. So we're just going to show the conversation ‑‑ we'll show the videos that we had prepared and then the conversation that Robbie and I had. And while we're doing that I would encourage those of you who are watching to use the chat pod to ask questions and discuss what you see in the videos and as part of the discussion that Robbie and I have ‑‑ are engaging in there. So let's go ahead and show that video. [Video start:] >> Yeah. Hurt. Hurt. Yeah. You have a hurt on your mouth. Hurt. Hurt. Your mouth. You have a hurt. You have a hurt on your eye, hurt in your mouth. Hurt in your eye and hurt in your mouth. Yeah. Uh‑huh. Eye. Hurt. Hurt. Hurt. Mouth. Hurt. Hurt. Hurt. Hurt. Head. Head. Mouth. Mouth. Mouth. [Laughter] Head, head, head, head. Chin. Chin. Chin, chin. Eye. Eye. Hurt, hurt. Eye. Hurt eye. Hurt mouth. Hurt mouth. Hurt mouth. Hurt eye. Eye. Hurt eye. Hurt eye. Hurt eye. Eye. Hurt eye. [Video end:] >> Adam: So one of the things I really like about that video is the fact that I don't know if you were able to notice that initially she wasn't even wearing her CI. We just started with the tactile. And that was ‑‑ that was the mode of communication that she was most comfortable with. And that was a good way for me to be able to develop a little bit of trust with her because she's the type of student who is kind of reluctant to put on her CI at first because she's ‑‑ there were a lot of sounds that bothered her. So when we were comfortable that the auditory clutter had been reduced sufficiently that she could focus on the sound of our voice and that she felt comfortable with me being in such close proximity to her, then we added the cochlear implant, later. And so I think that that's a ‑‑ I really like using that as an example of that auditory training doesn't necessarily‑‑ it's part of a holistic approach. >> Robbie: Well, there were a lot of things I liked about that. >> Adam: Yeah. >> Robbie: About that clip. You know, the ‑ it's interesting because when a child is hurt you think, well, maybe this wouldn't be a good time to work, but she really wanted to talk about it. >> Adam: Yeah, she did. >> Robbie: She wanted it to be acknowledged. So it was a topic that was important to her. >> Adam: Right. >> Robbie: And your pacing was so nice because she was hurt. And the clutter ‑‑ you kept the language to two words. And I just ‑‑ I think the kindness and everything, it was a very comforting package for her. And it's interesting that the way you're always thinking about how to overlay the auditory on a situation. It's not about, okay, auditory training, we're here, let's do it, let's focus on auditory. You put that layer on in a way that it meant something. >> Adam: Yes. Yes. And I think that's really something that's kind of what makes for me this clip a very good example of all of the points that we were stressing earlier is the fact that it is sort of part of that layer of trust and of processing and all of those things that we're talking about. They all go together. And the auditory is just a piece of that. >> Robbie: But that's where it gets the meaning. >> Adam: Yes, exactly. [Slide start:] [Slide end:] [Slide start:] So one of the things we saw in the video with Zoe was the fact that the physical interaction was the basis from which the language was placed on top. That's kind of going back to one of the tenets that we had talked about in our previous auditory training session, which is start close to the body and work your way out. And the reasons for this are the fact that it provides a physical and emotional stability for the students. We know that it's so important that tactile interaction with the students is really kind of the base from which they are able to gain so much sensory information. So that's where we're going to start. And then we attach the other sensory elements, in this case sounds, on top of that. Let's take a look at a couple of videos that illustrate that. [Slide end:] [Video start:] >> [Singing]. Beep! Boo! [Singing]. Beep! Boo! Beep! Boo! Beep! Boo! [Singing]. Beep! Boo! Beep! Boo! Beep! Boo! [Singing]. >> Adam: That video, I watch that video a lot in preparing for this webinar, and we showed that in the previous auditory training webinar. And every time I see it that song just gets stuck in my head. [Laughter]. >> Robbie: I know. >> Adam: And not only that, but every time I hear her do the beep!, I want to raise my hand because it's so visceral. But I love that video because, you know, it's just a wonderful illustration of incorporating all of those physical elements first and then adding the sounds on top of it and then making it motivating. That's obviously a really fun activity for both of them. >> Robbie: And it has such a clear juncture point when that motivating ‑‑ I can't do the sound the way you do it. >> Beep! Boo! >> Robbie: You're just kind of waiting for it. And something about the intonation and rhythm keep you going along and keep it rhythm and light. It's very simple, but that really features the auditory. >> Adam: Oh, yeah. Absolutely. So that's a perfect example of a way to start out with a really simple exercise in introducing auditory cues to a student in an activity in which you're in close proximity to them and starting at the body and, you know, giving them meaningful sounds to respond to. I think that's a great example of how to do that. >> Robbie: And it just shows how much fun it can be, simple and fun. >> Adam: Yeah, yeah, absolutely. So let's take a look at this video of trey and this is ‑‑ there's a little bit more going on here, so let's watch this and then talk about it. [Video start:] >> The little ball. One, two, three, four, five, six, seven, eight, nine, 10. Nice job. Are you going to throw that ball. One, two, three ‑‑ you know how to shotput, trey. Good job. One, two, three, throw the ball! Good job. Here's another one. That's a big one. One, two, three, throw the ball! Good. Last ball. One, two, three! Throw the ball! Nice job. High five. Let me try again. There. Ready? One, two, three, throw the ball! Good one, trey. All right, high five. What do you think? Do you want more balls? All right. Are you ready? One two three, throw the ball! Nice! Good job. What do you want? You want more balls? Okay. This will be your last time, okay? We're going to do three more balls and then we're going to walk back to the classroom. Okay? One two three, throw the ball! Woo! Good job, trey! Good job. Okay. Ball exercise is finished. We're going to talk back to the classroom. I'm going to get those balls, let's put them in the cart. Okay. This one. All right. Let's go back and mark the calendar, ball exercise. [Video end:] >> Adam: So that video I think is ‑‑ it's ‑‑ I think that that really is a good illustration of kind of expanding on what we saw in the video with Ray. It's a video obviously they're not in quite as close proximity to each other, but she still is maintaining physical ‑‑ a physical connection with him at the beginning of the activity so that he knows that he can ‑‑ that his communicative attempts are going to be responded to in a way that is meaningful to him. >> Robbie: And the connection, maintaining that connection is really important with him because, as I recall, he did not have vision. And so maintaining a connection with someone who can't see you, she did a great job of that using the auditory. >> Adam: Yeah, she did. >> Robbie: To keep that connection going. And I think another thing that was really cool about that is when she was celebrating with the auditory. Yay! >> Adam: Yeah. >> Robbie: That he ‑‑ he showed comprehension because he went like this. >> Adam: Yes. And that's a good way for her to check to make sure that he is ‑‑ that his auditory processing skills are being developed and that he's using those skills for her to be able to go through that routine, and when she gets to the celebratory part, the yay and the clapping, you know, this is obviously something that they've practiced, that they clap and there's a certain sound that goes along with that and then there's a high five. So, you know, he's responding to that auditory input that she's giving him by making those celebratory sounds. So that's a good comprehension check that she just did, you know. It's a natural thing to do, but you know, if you sit down and actually analyze it, you can see, oh, yeah, I can really check to make sure that he can hear what I'm saying because he knows to do this. >> Robbie: You know, another thing about it that I thought was kind of interesting, originally you had said, you know, watch out for clutter. Keep it clean. >> Adam: Yes. >> Robbie: So with Zoe, hurt, eye, very clean. Then it got a little more complex, but still very clean with Julie with the repetitive song, but there was more to it. They had to attend longer, but it was still clean in that there was no clutter or chatting or anything. Then in this one, it got a little more natural, but Kim still did not throw in comments. >> Adam: Right. >> Robbie: You know, she made a couple, like the shotput, kind of acknowledging him. So you could see that she trusted his ability to stay attending with a little bit of more natural banter coming in, but primarily it was clean, you know, the way she spoke to him. >> Adam: Yeah. And along with that, when she did need to add more information, such as letting him know that they were going to throw three more balls and then walk back to the classroom, she supported that with tactile sign so that it wasn't ‑‑ she wasn't asking him to rely solely on his hearing. She gave him the sign language to go along with it and she reduced that ‑‑ she increased the proximity to him so that he could, you know, get that information in a clear form that he understood, you know, in combination with the auditory information that she was providing him. >> Robbie: So it sounds like you're saying she trusted him to get the fun and the banter without tactile support, but once it came into speech and language, she tied the tactile speech and language to ensure that the speech was understood because that's more complex. >> Adam: It is. >> Robbie: So it's really neat that she knew ‑‑ that she made that shift. That's why she is who she is, but it's neat that ‑‑ that's a neat example of knowing when to come in precisely and support that understanding of speech. >> Adam: Oh, yeah, absolutely. And it's a great ‑‑ yeah, like you said, I really like the way that it demonstrates the fact that, you know, as you said, as you increase the distance the simplicity in the auditory information also increases, but as you decrease the distance, you can add a little bit more complexity to the ‑‑ to the language that you're providing to the student. >> Robbie: But you know that one thing, the further out you go and the simpler you get, the more motivating and sparkling you can be in terms of auditory because it's so easy to disconnect when you can't see and your hearing is a little faulty. >> Adam: And that's why she added the clap when she moved further away. >> Robbie: She really ramped up the personality to keep that auditory motivating so he would stay connected to her even when he couldn't touch her. >> Adam: Exactly. Yeah. All right. That was great. I like that video a lot. [Slide start:] So let's talk a little bit about joint tactile attention. That's ‑‑ we saw a little bit of that in ‑‑ well, we saw quite a bit of it actually in the video with Julie and ray. And then we saw a little bit of it with Kim and trey as well. But it's really important, joint tactile attention is really important especially if you are thinking of auditory training in terms of language and being able to listen for language because without joint tactile attention, the ability for the students to be able to conceptualize what it is that you are referring to is impossible. [Slide end:] If they don't know what it is that you're talking about. >> Robbie: It could be anything you're talking about. So to ensure that you are on the same page, that tactile is critical. >> Adam: Right. And we talk about this a lot, but, you know, it really is just like the basic building block of language is to be able to maintain joint attention. And for a student like the kids that we work with who are deafblind, that joint attention primarily is going to come from tactile, which means that you both need to be attending to that object tactilely. So let's take a look at a video that illustrates this point I think really well. [Video start:] >> Ball. Ball. Yes. We got you a ball. I'm here. Ball. >> Adam: So that's just a very simple example, but I think it's a really strong one because you can see that the teacher's hands are available to the student during that entire interaction, and by doing that she's not necessarily guiding the interaction, she's allowing the student to guide the interaction, but she also is able to comment and sign the word "Ball", so she's able to ‑‑ there's an exchange of turns there between the two of them where the student asks her to both attend to the object that she's interested in and then the teacher is able to then take that attention and add a little bit more information to it. And that's ‑‑ to me that's a perfect example of step one in joint tactile attention and using tactile sign language as well as pairing it with auditory information. [Slide start:] So let's talk about cause and effect activities. A lot of the things that we do with the students when we're trying to introduce auditory information or some sort of auditory element into their routines [Slide end:] is that we'll use cause and effect activities or cause and effect technology like, you know, the buttons that you push that have a voice output. >> Robbie: Right. >> Adam: And those are ‑‑ they are effective in teaching the kids that they might be associated with a certain object. We saw that with Abbey and ball. The ball had a certain noise she could tell. She was able to learn that when she shook the ball it made a certain sound. And it can also teach them that they can control sounds by either pushing this thing or shaking this object or not. But that's just the very basic level. That doesn't help them ‑‑ that doesn't really go that extra step that we want to be able to make sure that they're getting all of the sensory information that they need about that object. So it's a really important thing to remember that each new sound that you introduce needs to be taken through that auditory continuum. As it gets more complex ‑‑ >> Robbie: All the way to comprehension. If you introduce a new sound, take it back through there is what you're saying? >> Adam: Yes. So that ‑‑ yes. And, you know, do those comprehension checks for awareness and for discrimination and all the way up through comprehension. >> Robbie: You know, that's a good reminder because sometimes when I see a kid comprehending, comprehending, comprehending, I forget that all these sounds and words that they comprehend are based ‑‑ are solid because they went through that continuum. And I can't assume that on a new sound or a new word they're going to leap to comprehension automatically. >> Adam: Right. >> Robbie: There's no rule that says well, they've got 15 now. The 16th one, just pop it in there. It doesn't need roots or supports because that's not true based on what you're saying. >> Adam: Right. And I think that that's something that we're really trying to emphasize is the fact that every time that a new sound comes in to the student's understanding or awareness, they need to still have that solid tactile reinforcement in order for them to really reach that comprehension stage. They really need to understand that object fully and what it means, what it represents, where it's coming from, the localization, all of that ‑‑ all of those elements need to be incorporated for each new sound. And for students who are able to go through that continuum quicker, they'll go through it faster. You know, for example, the student that we used earlier who was listening for the sounds of the birds, you know, that is a good example of a student who probably moves through the continuum really quickly, but that doesn't mean that when a new sound comes in he still doesn't have to figure out what's the source of that sound? Where is that sound coming from? What is the ‑‑ what is the purpose of that sound? What do I do when I hear this sound? What should my reaction be? So it doesn't change just because he can ‑‑ he has the language to be able to talk through that more quickly. Right. And I like your emphasis on that because you're not underestimating the student or shortchanging him on his ability when you go back. >> Adam: Right. >> Robbie: You are honoring the deafblind learning style because they're so at risk, permanently at risk for incidental learning or inability to gather information simply and synthesize it the way typical learners do. So the fact that they need this process is not an indication that they're very slow learners or anything like that of. That's just getting the information in on their radar in a way they got it. >> Adam: Right. >> Robbie: And can move ahead with it. That's the deafblind learning style. And you're going to see that with students with formal language, with emerging language, and, you know, that's just a very good rule to carry around in your head. You've always got to do with the work with every new sound and every new word. You've got to do the work. >> Adam: Yeah. I think that's important to remember. Let's take a look at a video of a cause and effect activity. [Video start:] >> Did you hear anything? [Popcorn blower]. >> With the machine on do you hear it? [Video end:] >> Adam: So that's ‑‑ you know, I think there's some elements in there that are a little bit beyond the ‑‑ strictly the awareness level, but really that activity in itself is ‑‑ it's basically just an "I can do this and then this happens". Which is important. That's a very important first step, but if that were all that the routine were about and that were the ‑‑ that was the only auditory information that he got from that routine, then it would be difficult for him to then build on those skills to be able to, like, move on through that continuum. So I think that that's ‑‑ it's a good ‑‑ >> Robbie: It's essential. >> Adam: Yeah, it's a good place to start. >> Robbie: But you're not done. You've got more to do. He knew that they thought sound was important too. >> Adam: Yeah. That's actually a really good point because their reactions indicated to him that that was something worth listening for, and that's another thing to keep in mind when you're working with kids who are, you know, being ‑‑ who are working on trying to listen for specific sounds or you're trying to help the students listen for specific sounds. It's really important to make sure to reinforce that with the kids. So we have just a few more minutes left, and we have one more video that we really want to take a look at. And this is on play imitation and turn taking games. [Slide start:] And the reason we've included this one is because imitation games are a great way to practice listening for verbal or other auditory cues. And so we have an example of that with Emma, so we're going to show you that video right now. [Slide end:] [Video start:] >> Your turn. Oh, my turn. My turn. Clap, clap, clap, clap. [Laughter] >> Clap. >> Clap. Your turn. Your turn. Here. There. Clap, clap, clap, clap. Clap, clap, clap, clap. Clap, clap, clap, clap. Is it my turn? My turn. My turn. Clap, clap, clap, clap. [Laughter] Excited. My turn. Oh. Tap your knee. Knee, knee, knee, knee. Knee, knee, knee, knee. [Laughter] Your turn. Knee, knee, knee, knee. [Laughter]. My turn. Knee, knee, knee, knee, knee. >> Knee. >> Knee. My turn. Knee, knee, knee, knee. [Video end:] >> Adam: So I don't know if you noticed in that video that she was repeating the word clap and knee when it was my turn. And that's just a good example there of incorporating, you know, those ‑‑ all those elements that we talked about before, but the physical as well as the auditory in order to reinforce the language that you want to ‑‑ them to be able to incorporate. So ‑‑ well, we're almost out of time. So I want to ‑‑ we have a couple more videos that we will ‑‑ that we can add to this webinar once we have it up on our website that we can include after we're done here. And we'll get those up once we have it ready for people to watch, you know, or rewatch later on ‑‑ in the year, in a couple of weeks. [Slide start:] But for now, I just want to leave you all with the reminder from Susie Tiggs that auditory training is something that happens all day everyday, not just Tuesday at 4:30. [Slide end:] So I hope that you all were able to get quite a bit out of this, and that you were able to find some ideas for activities that you can do with your students that will help you build in auditory training into your routines. And Robbie, do you have anything to add? >> Robbie: I think you've said it all, Adam, I really do. >> Adam: All right. Well, thank you so much for joining us and we'll see you next time.