Le
arning to Listen is a Process
While it would be amazing if a child could begin to comprehend what is being said right away after being aided or implanted, it doesn’t work that way. According to Erber* (1984) there is a process to auditory (re)habilitation which includes 4 steps: detection, discrimination, identification, and comprehension. The key to making progress is working on listening throughout the day and helping your child to move through the stages. Remember these stages are not stages of language development, but rather of listening development and require the child to complete these tasks using audition alone.
While a hierarchy seems like it would be something you move up and complete, it should be expected that at certain points along the way, your child will revisit these levels when working on higher level discrete listening skills.
1. Detection
Detection is exactly what it sounds like. The ability to hear the presence or absence of sound. The child is expected to express if he/she hears or doesn’t hear a sound or speech. At the very early stages, this may be alerting to a noisemaker, environmental sound, or voice.
Detection can be a closed set task or open set task. Closed set is easier as it allows for a guess during a specified time period. For example, if using an acoustic screen when the parent or therapist removes the screen, the child can express if she heard or didn’t hear the sound. There is a 50/50 chance of being correct. An open set task would be to hold up the screen for a period of time and have the child let you know whenever she hears it. Another open set detection task would be the child notifying you that she hears something (usually an environmental sound) during the day. At the early stages of listening, a child is encouraged to point to her ears when she hears something (i.e. a telephone ringing). This would be open set detection.
What to do at this stage
This is the stage when your child is having new listening experiences daily and it is your job to have him understand that so many things make sound in this world.
- Point out sounds in the environment all day
- Go on listening walks drawing attention to all of the things around you that you hear (i.e. clock ticking, refrigerator humming, birds chirping, etc…)
2. Discrimination
When a child has demonstrated that she hears a sound, that doesn’t necessarily mean that she hears it differently than other sounds. Before understanding or attaching meaning to a sound, a child must be able to hear that two sounds are different.
At this level of listening, a child is able to hear and tell when sounds are the same or different. For example, when two sounds are presented (drum/bell or “ah” vs “oh”) the child expresses that they are the same or different.
Of course, the concept of same/different is not an easy concept to learn. It is likely that, for the youngest child, these are vocabulary concepts that he doesn’t even yet possess. So, at the very early stages of listening, how can we tell if he is discriminating? In the beginning, the child begins to recognize a sound that is very familiar in the environment (i.e. dog barking, telephone ringing). Then the next time the child hears a sound, he may think it’s the same object, thus not discriminating between the two sounds. Once discrimination skills have set in and he is hearing sounds as different, he might look quizzically at you when he hears the unknown sound, meaning “I know that’s not the phone, but what is it?”
What to do at this stage
- Play games with two different sounds. These can be non-speech (i.e. instruments, animal sound toys) and speech (sounds with your voice) where the child has to show that she hears them differently. You might start with one toy, get detection of the sound, then hold two toys and child has to decide if the sound is the first toy that you have introduced or the other one.
- Make speech changes in volume (loud vs soft) or length (long vs short). If the child is beginning to imitate, she can show that she hears them differently by imitating what she hears.
3. Identification
At this stage, the child not only detects your voice, discriminates between things that are the same or different, but begins to understand exactly what he is hearing. The child attaches meaning to a sound by identifying what object is making the sound or attaches a word to a picture/object. Given a verbal label, the child will be able to select the correct picture from an array of pictures.
What to do at this stage
- Play games where your child has to listen to and understand single words. You might send them on a treasure hunt looking for the items you label.
- For the child who has had language (verbal or sign) prior to working on this stage of audition, you can use words that differ in syllable number, which will make identification easier. For example “pear” vs. “watermelon”
4. Comprehension
This final level, is the point where the child begins to understand connected speech (sentences and conversation) using audition alone. She will be able to follow single and multi-step directions, answer simple questions and questions about stories he has heard, as well as participate in conversational exchanges. Once a child reaches this level of auditory development, you will likely be revisiting the previous levels with discrete listening work.
What to do at this stage
At this point, you need to keep talking, introducing new vocabulary and phrases, multiple meaning worlds, as well as idioms and figurative language.
Revisiting Levels
Once your child is functioning at a level of listening comprehension, you will likely circle back to some of the other stages at some point.
Detection
Even after language comprehension, you may need to check in on detection of specific sounds. Maybe there has been a change in hearing, maybe your child is due for a MAPping, or maybe you are just beginning to find some sounds that your child is not detecting. This may be stating whether or not he hears the high frequency sound /s/, the low frequency sound /m/, or a final consonant on the end of a word.
Discrimination
Discrimination tasks may come into play again when the child is saying a word incorrectly or mishears a word. It might be that he is having difficulty hearing the difference between minimal pair words, such as white/wipe or mine/nine. Discrimination tasks can be done to have the child listen to two words consecutively and determine if what she hears is the same or different (white white vs. white wipe). Sometimes, just by hearing the two words consecutively, he can hear the difference and then after practicing, can discriminate among them. It is at this level that a therapist can tease out if an error is a perception error or a production error.
Identification
At a higher level, identification tasks require the child to accurately identify words, whether through open set word recognition tasks (repeat the word I say) or determining exactly which minimal pair word you have said (white or wipe). These errors of identification should be shared with the audiologist as they may be helpful in hearing aid programming or MAPping.
*Erber N (1982). Auditory Training. Washington DC: Alexander Graham Bell Association for the Deaf & Hard-of-Hearing