Use the auditory sandwich to facilitate auditory skills for children with hearing loss in speech therapy!
Welcome and thanks to my guest blogger, Stacy from TeleTalk!
Many Speech-Language Pathologists have limited experience working with children who have hearing loss, despite many years in the field. When they do serve a child who wears cochlear implants or hearing aids they may wonder how language therapy should be different than for a child with typical hearing. While many aspects of language intervention are not different, there are some valuable strategies that can be implemented to facilitate language growth for a child who is learning speech and language through hearing technology.
One of the most effective and versatile strategies to use with this population is the auditory sandwich. Use this strategy to teach any receptive or expressive language target, such as vocabulary, verb tense, or word order. When using the auditory sandwich, you first provide the child with auditory input of the target word, phrase, or sentence. Next, you provide auditory input again while using a visual or gestural cue, such as pointing, showing a picture, or using a gesture. This step ensures that the child is learning and attaching meaning to the auditory input. Last, you provide the information auditorily again. Now the child has heard the target three times, in addition to having access to a visual cue to supplement their learning of the word or concept.
How to Use the Auditory Sandwich
The auditory sandwich is an effective tool for children of all ages. For example, you might be playing “baby dolls” with a newly implanted child and say, “The baby is hungry and needs to eat”. You give the auditory input and your goal is that the child demonstrates an understanding of the word eat by grabbing a play spoon and pretending to feed the baby. However, the child only looks at you because she didn’t understand the language. So, you provide the visual, or the middle part of the auditory sandwich, by picking up the spoon and beginning to feed the baby as you say, “I’m helping her eat”. Next, you set down the spoon and say once more, “the baby is still hungry. She wants to eat some more,” while looking at the child and waiting for her to feed the baby. Now, the child has heard the word eat three times and has been given a visual cue for eating, making her much more likely to be successful in the task.
For an adolescent, the structure of the auditory sandwich remains the same although the goal and type of visual cue may be very different. If you’re having a conversation with a child who is working on past tense verbs and he says, “We watch a movie yesterday,” this might be a great time to use this strategy. To do so you would say, “Oops! We watched a movie yesterday”. If the child repeats it again incorrectly, supplement your next auditory cue with a visual, such as writing the word “watched” on a piece of paper. To finish the sequence, remove the visual and allow the child one last opportunity to hear the target and be successful with it. Below are examples of types of visual cues that you can use with the auditory sandwich.
The auditory sandwich provides multiple chances for children to learn through audition, but also a familiar visual cue as needed. It is a useful technique that you can use across a variety of clients/students, goal areas, and settings. In conjunction with other strategies, implementing the auditory sandwich facilitates confidence in SLPs modifying language therapy for their deaf and hard of hearing population.
My name is Stacy Crouse, and I have a been a pediatric Speech-Language Pathologist since 2008 and a Certified Auditory-Verbal Therapist since 2017. I currently live in Des Moines, Iowa with my husband and 2 children, and provide school-based teletherapy.
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