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ESPCI'2017 - Luis Jesus


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Date 2017/05/27
Title The use of the Table-to-Tablet (T2T) intervention materials in paediatric cochlear implantation rehabilitation
Speaker Luis M. T. Jesus
Event ESPCI'2017
Location Lisboa
Country Portugal

Purpose of the study: To present new intervention materials that promote early speech perception and literacy skills, in the context of an Auditory Verbal Therapy (AVT) approach for children who have hearing problems and their families.

Materials and Methods used: The stimulation of auditory brain development, with audition as the primary sensory modality in developing listening and spoken language, is core to an Auditory Verbal Therapy (AVT) program [1, 2]. The Table-to-Tablet (T2T) therapy materials [3] can presented in a physical and digital version, which include eight activity areas: (1) Auditory Bombardment; (2) Hearing Perception and Discrimination; (3) Grapheme-phoneme correspondence; (4) Phoneme identification; (5) Phoneme Segmentation; (6) Blending; (7) Rhyme identification; (8) Phoneme manipulation. The T2T materials are currently being piloted in AVT sessions by two speech and language therapists, with the families of children implanted or with hearing aids, as a base tool in the work developed in the areas of hearing, speech and language.

Results: The T2T materials include eighteen different activities (with at least one activity for each area). As a companion to the “in practice” activities, a set of games and worksheets have been specifically developed to be used as “homework” for the children. This regular homework is recommended for maximising progress [4]. Furthermore, generalisation tasks were also created. The activities are based on a phonological therapy approach (combination of expressive and phonological tasks, phonological awareness, listening and discrimination activities). Most of the activities have two levels of difficulty that differ in terms of the inclusion or absence of the written word and in some cases the level of segmentation made (onset-rime or phonemic). The most common phonological processes for European Portuguese [5] were used to group the intervention words. For each process a list of fifteen words was selected (ten for intervention and five excluded from intervention and used in the generalisation tasks) [6].

Conclusion: Few validated intervention materials for children exist, so a new framework for speech and language therapists (SLTs) was developed for European Portuguese. It is crucial that SLTs develop children’s expressive phonological skills and phonological awareness in order to support the underlying skills for literacy. Speech and language therapy interventions with T2T materials embedded with AVT strategies can be used to rehabilitate cochlear-implanted children, thereby minimising the long-term consequences, aid self-monitoring of audition level, and support autonomous discrimination and comprehension for reading and writing [7, 8].


[1] AG Bell Academy (2016). Listening and Spoken Language Specialist ( LSLS ) Certified Auditory-Verbal Therapist ( LSLS Cert . AVT ). Washington: The AG Bell Academy for Listening and Spoken Language.

[2] W. Estabrooks (2008). Auditory-Verbal Practice Today: A Shifting Paradigm. Toronto: WE Listen International.

[3] L. Jesus, J. Santos, J. Martinez, M. Lousada, and D. Pape (2015). The Table to Tablet (T2T) Therapy Software Development Approach. In Proceedings of the 10th Iberian Conference on Information Systems and Technologies (CISTI 2015), Volume 2, Águeda, Portugal, pp. 57-60. doi: 10.1109/CISTI.2015.7170549

[4] T. Günther and S. Hautvast (2010). Addition of contingency management to increase home practice in young children with a speech sound disorder. Int. J. Lang. Commun. Disord., vol. 45, pp. 345-353.

[5] Jesus, L., M. Lousada, D. Domingues, A. Hall, and D. Tomé (2015). Phonological Processes in Portuguese Children with Speech Sound Disorders. Pozn. Stud. Contemp. Linguist., vol. 51, no. 1, pp. 75-88.

[6] G. Gillon and B. McNeill (2007). Integrated phonological awareness: An intervention program for preschool children with speechlanguage impairment. Christchurch: University of Canterbury.

[7] S. Nittrouer (2016). Beyond Early Intervention: Supporting Children With CIs Through Elementary School. Otol. Neurotol., vol. 37, no. 2, pp. e43-9.

[8] A. Wieringen and J. Wouters (2014). What can we expect of normally-developing children implanted at a young age with respect to their auditory, linguistic and cognitive skills? Hearing Research, vol. 322. pp. 171-179.