Sounds In Motion

Fran SantoriThis week’s blog is written by my good friend Fran Santore. She is a speech-language pathologist who worked for many years as the Director of Communication Therapies at the New York League for the Hard of Hearing (now the Center for Hearing and Communication). She then moved into working with children in an elementary school where she continued her work on the  importance of listening for all children. Her Sounds in Motion program is of great assistance to clinicians and teachers.

In their classic text, Hearing in Children, Northern and Downs{{1}}[[1]]Northern, J. & Downs, M. (1979). Hearing In Children. Baltimore, MD. The Williams & Wilkins Co.[[1]] quote  Aristotle as having said “the ear is the organ of education.”  What he meant of course is that through the ability to hear, children acquire language, and consequently, knowledge. It is interesting to note that even though hearing is the foundation of communication and learning, it is often given minimal attention in school curriculum as a skill to be developed

How much do kids really listen

While children spend the majority of their school day listening, (anywhere from 45-70% of the time), listening is the communication skill that is the least taught{{2}}[[2]]Wilt, Miriam E. (1950). A study of teacher awareness of listening as a factor in elementary education, Journal of Educational Research, 43 (8), pp. 626-636.[[2]]. Teachers are often not aware of the effects of background noise, acoustics in the classroom, allergies, middle ear infections, etc, on a child’s ability to hear well and listen carefully. Children are asked to attend to their teachers’ voices, comprehend new information presented orally, follow multi-step directions, etc. throughout the day, yet activities concentrating on the development of listening skills are rarely taught. Much more time during the school day is devoted toward teaching and improving other communication skills such as speech, reading, and writing.

The importance of hearing and listening

Early in my professional career I worked at the Center for Hearing and Communication (CHC) in New York City (formerly the NY League for the Hard of Hearing), and I quickly learned the effects of hearing loss on children and adults – academically, socially, professionally, and emotionally. I took those lessons with me throughout my professional career. When I began working as a speech-language pathologist in an elementary school, and seeking to provide services to many of the kindergarten and first grade children who were being referred to me for articulation therapy, I decided to try going into the classroom one time per week and working with the whole class on auditory discrimination and articulation stimulation of consonants that are often confused. At the same time, in recognizing the importance of active listening skills for academic success, I decided to introduce the concept of “whole body listening,”{{3}}[[3]] Truesdale, S. (1990). Whole Body Listening: Developing Active Auditory Skills. Language, Speech, and Hearing Services in Schools, 21,183-184.[[3]] and incorporate developmental listening skills such as auditory memory and auditory comprehension into my weekly lessons. With input from the classroom teachers, additional components were added focusing on phonemic awareness, and auditory perception of the short vowels.

Using body movements

For the articulation stimulation, I chose to use body movements to develop perception and production of phonemes.

The body movements are part of the VerboTonal System{{4}}[[4]]Guberina, P. & Asp, C. (1981). The Verbotonal Method for Rehabilitating People with Communication Problems. Monograph#13. World Rehabilitation Fund, U.S. Department of Education, Washington, D.C.[[4]], an aural habilitation program developed by  Petar Guberina, a Croatian linquist and speech scientist. I had learned the method while living in France, and had used it successfully with hearing impaired children and adults when I worked at the CHC{{5}}[[5]]Santore, F. (1978).  The Verbotonal Aural Rehabilitation Program  for Hearing-Impaired Adults: A Five Year Summary Report. Journal of the Academy of Rehabilitative Audiology, 11, 33-44.[[5]]. The body movements are based on the linguistic aspects of the phonemes – pitch, tension, duration, intensity, and the placement of the articulators in space – and as the children perform the movement they also articulate the specific phoneme. Adapting the body movements to classroom instruction for articulation stimulation seemed to me to be an excellent way to stimulate kinesthetic awareness and production of speech sounds in children who had normal hearing.

Teachers reactions

The teachers found that the children loved doing the movements, and noticed an unexpected outcome – almost immediate improvement in their students’ ability to acquire sound/symbol associations. Not only did the children develop active listening skills and improve  their auditory perception and articulation, but as a result of the therapy techniques, and input from the classroom teachers, a program evolved  (SOUNDS IN MOTION)  which also helped in developing phonemic awareness, receptive and expressive language,  and early literacy skills.  In addition, while the program was designed for children in regular kindergarten and first grade classes, it has been adapted to older children who are having difficulty learning to read, and to children with a wide variety of disabilities in special education settings.

How does the program work?

SIM is presented in thirty to forty minute sessions one time per week for 15 weeks to the entire class taught by the speech-language pathologist and/or the classroom teacher. This can be modified to several shorter sessions during the week depending on the needs of the children.

Each session will include:

1. A call for “whole body listening”

2. A review of phonemes previously taught

3. Introduction of 1 – 2 new phonemes with the corresponding body movement

4. Practice in combining the new sounds/movements with phonemes previously learned to create new syllables and words.

5. Practice in a specific listening activity which might include syllabification, auditory perception of phonemes, discrimination of consonants and vowels which are often confused (e.g. p/t/k; or f/s/th(voiceless, short i/e), auditory sequencing and following directions.

Prior to and following the 15 week period testing is completed to evaluate the effectiveness of the program, and further needs of the students.

Learning about the ear

Since great emphasis is spent on listening skills in SIM, and the incidence of high frequency hearing loss is increasing in children due to noise abuse,{{6}}[[6]]Shargorodsky, J., Curban, S., Curban, G., Eavey, R. (2010). Change in Prevalence of Hearing Loss in US Adolescents. JAMA.304(7):772-778.[[6]], two weekly sessions are devoted to teaching the children about the anatomy of the ear, noise abuse and how to protect their hearing.  During Better Hearing and Speech Month letters are sent home to parents to inform them about noise abuse, and how to protect the hearing of all family members by limiting output levels on personal listening devices, evaluating noise levels of toys for toddlers, use of ear plugs in noisy environments, etc.   

The results

Positive test results from clinicians and teachers who have been trained to use the program indicate that in addition to improvement in articulation skills, kindergarten and first grade children, many of whom are in Title 1 schools, are also achieving reading and writing benchmarks after exposure to SIM. The program seems to be effective for three reasons: it emphasizes the development of listening skills; it uses body movements that correspond to the linguistic aspects of the articulation of each phoneme rather than corresponding to the orthographic symbol; and, it is fun. It engages the children through movement, which reinforces perception, production, and sound/symbol association. In addition this program also provides an avenue for speech-language pathologists to work collaboratively with teachers to demonstrate the importance of the development of listening skills, and gives children, at an early age, information about protecting their hearing.

Further information can be obtained at the sounds in motion program website.

Additional References:

Eisenberg, D. & Santore, F. (1976).The Verbotonal Method of Aural Rehabilitation. The Volta Review, 78,16-22.

Foster, W. & Miller, M. (2007). Development of the Literacy Achievement Gap: A longitudinal Study of Kindergarten Through Third Grade. Language, Speech, and Hearing Services in Schools, 38, 173-181.

Strother, D.B. (1987). Practical Applications of Research: On Listening. Phi Delta Kappan, 68 (8),  625-628.

Van Kleek, A. & Schuele, C.M. (2010). Historical Perspectives on Literacy and Early Childhood, American Journal of Speech-Language Pathology, 19, 341-355.






About Jane Madell

Jane Madell has a consulting practice in pediatric audiology. She is an audiologist, speech-language pathologist, and LSLS auditory verbal therapist, with a BA from Emerson College and an MA and PhD from the University of Wisconsin. Her 45+ years experience ranges from Deaf Nursery programs to positions at the League for the Hard of Hearing (Director), Long Island College Hospital, Downstate Medical Center, Beth Israel Medical Center/New York Eye and Ear Infirmary as director of the Hearing and Learning Center and Cochlear Implant Center. Jane has taught at the University of Tennessee, Columbia University, Downstate Medical School, and Albert Einstein Medical School, published 5 books, and written numerous books chapters and journal articles, and is a well known international lecturer.