Functional Listening Evaluations:HOW TO COMPLETE THEM AND HOW TO USE THE DATA

Presented by: Samantha Rogers, Au.D., CCC-ADistrict Audiologist for Fayette County Schools

Present Level Areas

HEALTH, VISION, HEARING, AND MOTOR ABILITIES

Functional Hearing and Listening

Functional Hearing, Listening Assessment and Functional Communication Assessment are completed for a student who is deaf or hard of hearing. The Present Levels summarize the status of the student in these areas.

The purpose of the Functional Hearing/Listening and Communication Assessment section is to:

provide information about how a student is able to understand and process linguistic information through hearing as well as how a student uses his/her hearing in the educational environment.

This may include how well a student is able to access verbal instruction and to what degree visual input, distance and noise affect performance.

Some of the Guiding Questions

Does the child require visual supports and/or speech reading?

To what degree does the distance from the speaker and or background noise affect the student’s ability to understand auditory information?

What noise reducing supports or accommodations are needed to enhance access to auditory information?

Does the student need an enhanced signal to noise ratio??

How does the student's hearing loss impact auditory function in the school/classroom setting?

How are we going to answer some of these questions….?

THAT’S WHERE FUNCTIONAL LISTENING EVALUATIONS COME INTO PLAY.

Purpose of a FLE?

Determine how listening abilities are affected by noise, distance, and visual input in the student’s natural listening environment

Demonstrated abilities in the real world as opposed to measurements made in a sound booth

The results may …

Show the need for amplification

Demonstrate need for sign support

Justify amplification is not necessary

Provide evidence to teachers, students, and parents regarding the impact of the hearing loss

Help justify accommodations needed

Provide information to include in the Functional Hearing Section on the IEP

FLE Protocol

It is Free and online

Protocol with word lists

http://www.handsandvoices.org/articles/education/ed/func_listening_eval.html

Materials Needed

CD Play/Computer Sound Level Meter Multi Talker Noise CD/ audio file Test stimuli (I.e. words/phrases/sentence lists) Tape Measure Speech hoop

Testing environment

Student’s Natural listening environment (IE classroom) Use while empty

A room that closely approximates size, ambient noise level and acoustic surfaces of the child’s classroom.

Physical Set-up of Testing Environment

Close Condition: Noise source and examiner 3 feet in front of student

Student

Noise Source Examiner

Distant Condition

Far Condition: Noise source stays at 3 feet in front of the student and examiner moves 12-15 feet away from the student.

Student

Noise Source

Types of Evaluation Materials

Word Level

PB-K

NU-6

W-22

Phrases/Sentences

Common Children’s Phrases

Common Children’s Non-Sense Phrases

BLAIR Sentences

SPIN Sentences

HINT-C

Considerations for picking materials

Students age

Language Abilities/Vocabulary

Memory Skills

Speech intelligibility

The sentence material should remain the same through the evaluation. The only variables that should be manipulated are distance, noise level, and visual inputs.

Presentation Levels

Protocol is set up to approximate +5 decibel signal to noise ration with close condition and -5 dB with distant condition

Examiner’s voice: 71 dBA at 18” from mouth

Noise: 60 dBA at student’s ear

*Use sound level meter to determine the loudness of the stimuli. Then adjust as necessary.

Sound Level Meter

Measures decibels (dB) of noise typically in Sound Pressure Level (SPL)

You want to use the A weighting scale (dBA).

Presentation Protocol

Use the child’s typical hearing mode If the child usually wears amplification it should be worn during the

evaluation

When Used as a validation tool to demonstrate improvement in listening ability with FM or other hearing assistance technology, the examiner should repeat the far conditions to demonstrate the benefits of the technology.

Testing Conditions

1. Auditory Visual Close Quiet

2. Auditory Close Quiet

3. Auditory Visual Close noise

4. Auditory Close noise

5. Auditory Visual Far Noise

6. Auditory Far Noise

7. Auditory Far Quiet

8. Auditory Visual Far Quiet

*** Modifications can be made to test protocol as needed. In this order it balances the difficulty across conditions.

Scoring

-

Step 1: Record results on scoring sheet while administering the evaluation

Step 2

Transfer percentages to Scorebox and Interpretation Matrix

Step 3

Calculate Averages

Step 4

Summarize results

Interpret Data

Make Recommendations

I have all the data.. Now what?

Data can show need for accommodations

FM System

Sign Support

Preferential seating

Data can be used as a counseling tool

Show need for amplification

Show need for FM system

Information can be added to IEP to demonstrate Functional Hearing abilities

Case Studies

Who do you expect to perform better?

Student 1 11 y/o female

Born with profound hearing loss in 1 ear, normal hearing other ear

Not using amplification

English is used to communicate

Student 2 9 y/o female

Born with profound hearing loss in 1 ear, normal hearing in the other ear

Not using amplification

English/Spanish are used to communicate at home.

FLE Results

Student 1

Student 2

Student 3

14 year old female, Diagnosed with a unilateral hearing loss at birth

Has worn amplification consistently for about 8 months

Right Side: Borderline Normal hearing

Left: mild sloping to severe sensorineural hearing loss

Reason for referral: To assess the need for FM or other assistive technology

Student 3 Test Results- Auditory Only

Amplification

Stimulus % correct 3’ quiet

% correct 3’ noise

% correct 12’ quiet

% correct 12’ noise

Hearing aids

Common Children’s Phrases

100% 100% 100% 95%

Hearing Aids Plus FM

Common Children’s Phrases

DNT DNT DNT 100%

Student 4

Age: 15

Amplification: Cochlear Nucleus 5

Activated at age 3

Bilateral Profound Sensorinerual hearing loss

Reason for Evaluation: Student stopped wearing FM

Student 4 Results– Auditory Only

Amplification

Stimulus % Correct at 3’ quiet

%correct at 3’ noise

% correct at 12’ quiet

% correct at 12’ noise

Cochlear Implant no visual cues

Common children’s phrases

80% 50% 80% 0%

Cochlear Implant with Visual cues

Common children’s phrases

DNT DNT DNT 80%

Student 5

5 year old male

Fit with hearing aids 3 months ago

Mild to moderate sensorineural hearing loss bilaterally

Reason for referral: Eligibility for HI services, new special education referral

Student 5 Results

Amplification

Stimulus 3’ quiet No visual cues

3’ quiet With visual cues

12’ quietNO visual cues

Hearing Aids

PB-K Words

20% 80% 20%

Hearing Aids Plus FM

PB-K Words

20% 85% * Did not Test

Contact Information

Samantha Rogers

Audiologist

Fayette County Public Schools

Phone: 859-381-4080

Email: Samantha.Rogers@Fayette.kyschools.us