Therapy for the Hearing-Impaired Child: Maintenance and Transfer

Publisher: Thieme Medical Publishers, Inc., 381 Park Avt A great deal of effort has been expended over many years in order to assist the congenitally and prelingually severely and profoundly hearing-impaired population achieve intelligible and usable speech.14 This effort has come primarily from educators of the hearing impaired and speech clinicians. Some recent texts, for example, testify to the great dedication that many professionals have in seeking to achieve this aim.68 Over the years, a number of studies have been reported that document the speech-production skills of the hearing impaired and all attest to the wide variety of errors contained in their speech.+I2 These speech errors are essentially segmental and suprasegmental; segmental errors involving consonants, consonant blends, vowels, and diphthongs and suprasegmental errors involving intonation, stress, intensity, voicing, voice quality, nasality, pitch and timing.4.13J4 A recent article by Osberger and McCarrl%as comprehensively reviewed the literature, docu~nerlting the speech errors of the hearing impaired via perceptual, acoustic, and physiological studies covering both segmental and suprasegmental areas. In addition lo the marly studies that have investigated and docurrlented the speech-production skills of the hearing impaired, a number of programs have been published containing descriptions of methods for improving the speech skills of this p ~ p u l a t i o n . ' ~ J ~ There have also been reEoEts of studies investigating the effects of therapeutic intervention of selected aspects of speech production skill^.'^-^^ Despite the seeming plethora of reports on this topic, a review of the (then) status of speech-training procedures for the hearing impaired by Moores22 highlighted a scarcity of data-based reports on their efficacy. Moores' comprehensive criticisms were directed at every facet of the intervention procedure: from inadequate assessment and training procedures through to lack of data on the effectiveness of using other agents (such as parents) to carry out generalization and maintenance on behaviors trained in the clinic or classroom. It is the aim of this article to examine therapeutic intervention with the hearing impaired by taking account of the points 257