EARLY CHILDHOOD INTERVENTION 2014 OUTCOME RESULTS
About the Cora Barclay Centre
The Cora Barclay Centre is the oldest and most comprehensive dedicated centre in Australia providing intensive, evidence-based intervention through Auditory-Verbal Therapy (AVT).
Listening & Spoken Language (LSL) program
The aim of the Cora Barclay Centre is to help children who are deaf or hearing impaired achieve life-long social and emotional well-being and economic independence. The Centre provides evidence-based, multi-disciplinary services for children who are deaf or hearing impaired, the majority of whom are fitted with hearing aids, cochlear implants or other listening devices. Programs include:
- Early childhood intervention
- Student support services
- Social participation programs
- Ongoing monitoring and assessment to children from birth to 18 years and their families.
Objectives of our Early Childhood Intervention Program
To assist children with hearing loss to develop listening and spoken language as their primary mode of communication and to facilitate their inclusion in mainstream education from the earliest age possible. Parents and caregivers actively participate in therapy and are guided and coached to facilitate their child’s spoken language development through listening.
Hearing loss is one of the most common disabilities in newborns, affecting approximately 2 in 1,000 babies each year.
1 per 1,000 live births is the estimated rate of permanent childhood hearing loss that is identified at, or very close to, birth. By the time each ‘birth cohort’ has reached 5 years of age, this rate has risen to approximately 3 per 1,000 children.
CORA BARCLAY CENTRE
ASSESSMENT PROTOCOLS
In February 2010, the Cora Barclay 2. to enable objective comparisons The assessment tools are: Centre introduced a new standardised between children who are deaf or assessment protocol as part of the hearing impaired undertaking the 1. Pre-School Language Scale First Voice early childhood intervention Cora Barclay Centre AVT Program and outcome measures. This protocol children with normal hearing of the assesses the speech, language and same age in order to determine if their 2. Peabody Picture Vocabulary vocabulary development of children spoken language skills are equivalent to aged 9 months to 5 years enrolled in their hearing peers. The Early Childhood Intervention AVT 3. Goldman Fristoe Test ofProgram. 3. to monitor and evaluate Articulation (GFTA-2) the effectiveness of Cora Barclay The purpose of Centre therapy programs. Cora Barclay Centre programs are assessment is: constantly reviewed in the light of Children attending the Cora Barclay national and international research and
- to obtain objective measurements Centre AVT Program receive a range its own program evaluations. As part of of each child’s speech and language its evidence-based approach, the Cora The tests are designed to measure the development to form their individual Barclay Centre contributes its data to children’s understanding of language, thetherapy plan. the First Voice national clinical database, expressive use of language and their which consolidates data for over 700 clarity of speech. children across Australia and New Zealand in early childhood intervention programs provided by First Voice centres.
CORA BARCLAY CENTRE ASSESSMENT METHOD
92% of children with permanent hearing loss are born to hearing parents.
Mitchell & Karchmer, 2004
Fifty-five (55) children All children (n55) were assessed using The stages and ages of assessment were: the Pre-school Language Scale Edition aged between 9 months (PLS-4/PLS-5). 6 months post hearing aid (HA) and 5 years who were or Cochlear Implant (CI) fitting In addition, children aged between 3 enrolled in AVT early and 5 years (n27) were assessed with 12 months post HA or CI fitting intervention at Cora Barclay the Peabody Picture Vocabulary Test 24 months post HA or CI fitting Edition 4 (PPVT-4) and the Goldman Within 3 months post 3rd birthday* Centre were assessed from Fristoe Test of Articulation (GFTA-2). Within 3 months post 4th birthday January 2014 to the end Within 3 months post 5th birthday of December 2014.
The amount of time the children had been receiving AVT at the Cora Barclay Centre ranged between 5 and 61 months with the mean being 30 months. * Where the 3rd birthday occurs within 6 months of the 24 month post-fitting criterion the 3rd birthday is taken as the priority assessment time.
Figure 1: Clients assessed
by assessment age
6 7 6 months 3 years
12 months 4 years
Number of children assessed by assessment age in 2014 (N=55). 9 24 months 5 years 12 55
13
8 13+22+14+23+16+12+D
Figure 2: Severity of
hearing impairment
Degree of hearing loss of children on service at the Cora Barclay Centre. 10 The children in the AVT Program had varying degrees of hearing impairment which ranged from unilateral hearing impairment to profound deafness. 4 4 3
1 1 1 1
Unilateral Mild Mild/Moderate Mild/Profound Mild/Severe Moderate Moderate/Severe Severe Severe/Profound Profound
Figure 3: Hearing devices 28
Number of children using each type of Amplification Device.
This graph shows that 28 children participating in AVT at the Cora Barclay Centre were wearing two hearing aids and 13 had bilateral cochlear implants. 13 The five (5) children not currently fitted with an amplification device all had a 5 unilateral hearing loss. 2
5
CI - Cochlear Implant Bilateral HA - Hearing Aid 1 1 BC - Bone Conduction Hearing Aid Unilateral 2CI 1CI/1HA 2HA 1BC 1HA None
THE THREE KEY ASSESSMENT
TOOLS USED BY THE CORA BARCLAY CENTRE ARE:
1 2 3 PRE-SCHOOL PEABODY PICTURE GOLDMAN FRISTOE LANGUAGE SCALE VOCABULARY TEST TEST OF ARTICULATION EDITION (PLS-4/PLS-5) EDITION 4 (PPVT-4) (GFTA)
The PLS-4/PLS-5 is divided into 2 The PPVT-4 tests a child’s understanding The GFTA is a norm-referenced parts: (1) Auditory Comprehension of words used to name objects and assessment of articulation which which assesses the understanding of describe actions and attributes. It is provides standard scores and percentiles spoken language; and (2) Expressive a norm-referenced assessment of from early childhood to adulthood. Communication which assesses the vocabulary which provides standard The test provides information about child’s verbal language. Both parts of scores, percentiles, and age-equivalent a child’s articulation ability by sampling the assessments are used to calculate scores from early childhood to both spontaneous and imitative sound the total language score. adulthood. Standard scores have a production of consonants. The standard mean or average of 100 and one score system for the GFTA is similar The PLS-4/PLS-5 is a norm-referenced standard deviation is a difference of 15. to the PPVT, in that it has a mean assessment which provides standard Therefore children who score between or average of 100 and one standard scores, percentiles, and age-equivalent 85 and 115 fall within one standard deviation is a difference of 15. scores for children from birth to six deviation of the mean of 100 and Therefore, children who score years. Standard scores have a mean are within the ‘normal range’. between 85 and 115 fall within one or average of 100 and one standard standard deviation of the mean of deviation is a difference of 15. Therefore 100 and are within the ‘normal range’. children who score between 85 and 115 fall within one standard deviation of the mean of 100, which is regarded as ‘the normal range’. Sixty-eight percent (68%) of the overall population falls within this range (i.e., one standard deviation of the mean).
ASSESSMENT TOOL RESULTS
Pre-School Language Scale Edition (PLS-4/PLS-5)
Figure 4A: Comparison 100 97.98 100 97 100 96.10of PLS standard scores – all assessed clients
Comparison of the PLS Mean Standard Scores gained by all children assessed in the Cora Barclay Centre AVT Program (n=55) with the Mean Score gained by the general population.
This graph demonstrates that
children enrolled at the Cora Barclay in AVT
Centre are obtaining scores that are
comparable to the general population.
Hearing
impaired
children
General population
Auditory Expressive Total Language
Comprehension Communication Score
Figure 4B: Comparison of PLS standard scores 100 100 100 92.40 91.40 89.60 – diagnosed post 12 months
A comparison of the Mean Standard Scores gained by children assessed in the Cora Barclay Centre AVT Program diagnosed post 12 months with the Mean Score gained by the Hearing general population. impaired children This graph demonstrates that children enrolled in AVT diagnosed after 12 months of age are achieving scores slightly below children General who are diagnosed before 12 months of population age. It also shows that these children are Auditory Expressive Total Language obtaining scores within one standard Comprehension Communication Score deviation of the norm (85-115) that are comparable to the general population.
For Children Affected
By Hearing Loss, The Future Prospects Are Positive.
Thanks To Early Diagnosis, Continuing Advances In Hearing Technologies And Access To Listening And Spoken Language Early Childhood Intervention At A Very Young Age, Children Who Are Deaf Or Hearing Impaired Have The Potential To Learn To Listen And Speak.
Figure 5A: PLS Range Of Total Language Scores 140 The Range Of Standard Scores Gained By Each Child Enrolled In The Cora Barclay Centre AVT Program On 115 The PLS-4/PLS-5 Sub-tests. PLS Total 13 Individual Children Are Below One Language 100 Standard Deviation (85); 22 Within Score The ‘Normal Range’ And 7 Above One 85 Standard Deviation With 1 Achieving The Remarkable Score Of 140!
NB Two Of The Children Below The Standard Deviation Had Additional Disabilities Which Impacted On Their 40 development and a further two had 1 Clients Assessed 43 only recently established consistent hearing aid wear.
Assessment Tool Results
Peabody Picture Vocabulary Test Edition 4
(PPVT-4) 2
Figure 6: PPVT
Standard Score
Comparison of the Mean Standard Scores gained in the PPVT-4 by children enrolled in the CBC AVT Program with the Mean Score 103.48 100 gained by the general population.
This graph shows that children accessing the Early Intervention AVT Program have vocabulary knowledge that is higher than the Mean Score of the general population. These results Children who are deaf General suggest that individualised AVT from a or hearing impaired Population young age improves listening skills and ultimately vocabulary development.
Figure 7A: Range of PPVT 140
Scores by Assessment Age 115 The range of Standard Scores gained 100 by the children enrolled in the Cora Barclay Centre AVT Program within each 85 assessment group on the PPVT-4 (n=27). 60 This graph shows the range of vocabulary 3 years 4 years 5 years knowledge scores for children aged 3, 4 and 5 years (n=27). It demonstrates that 20 children approaching school age have vocabulary knowledge equal to or better than their hearing peers. 0
Figure 7B: PPVT Scores
By Assessment Age 130
The range of Standard Scores gained 115 by each child enrolled in the Cora 110 Barclay Centre AVT Program within PPVT each assessment group on the PPVT-4. Standard Score 90 This graph demonstrates that all of the 85 children receiving AVT in 2014, except 3 years 4 years 5 years for 2, had vocabulary knowledge equal 70 to or better than their hearing peers.
50
1 6 9 12
Individual client assessment results
Assessment Tool Results
Goldman Fristoe Test Of Articulation
(GFTA) 3
Figure 8: GFTA Standard Score
Comparison of the Mean Standard Scores of the GFTA gained by children aged 3-5 91.56 100years (N27) enrolled in the AVT Program with the Mean Score gained by the general population.
This graph demonstrates that children enrolled in the Cora Barclay Centre AVT Children who are deaf General program are obtaining speech results or hearing impaired Population enrolled in AVT within one standard deviation of the mean.
Figure 9: Range of standard 160 scores gained from GFTA
The range of Standard Scores gained by children enrolled in the AVT Program within 120 each assessment group in the GFTA-2. 115
This graph demonstrates variability in the 85 80 speech skills of children with a hearing loss,ranging from below average to above. A number of factors can contribute to this 3 years 4 years 5 years variability e.g. age of diagnosis,consistent 40 use of hearing equipment etc.
0
WHAT DO THESE ASSESSMENT RESULTS TELL US?
These assessments show that children who are deaf or hearing impaired in the The Cora Barclay Centre Auditory-Verbal Therapy Program in 2014 have:
-
An understanding of language comparable with children with normal hearing of the same age (Assessment: PLS – Auditory Comprehension)
-
Verbal language comparable with children with normal hearing of the same age (Assessment: PLS – Expressive Communication)
-
Vocabulary knowledge equal to or better than children with normal hearing of the same age (Assessment: PPVT)
-
Speech skills comparable with children with normal hearing of the same age (Assessment: GFTA)
NATIONAL COMPARISON
At the national level, all five Australian First Voice centres follow the same sandardised assessment protocols yielding a consolidated national outcomes database of over 1,000 children in our listening and spoken language programs.
Analysis of the First Voice clinical database shows outcomes very similar to those reported above, providing further validation oft he effectiveness of listening and spoken language early childhood intervention as practised in Australia.
OUTCOMES FOR EACH CHILD ATTENDING THE CORA BARCLAY CENTRE
The Cora Barclay Centre uses these objective assessments: (1) to review and modify each child’s individual service plan in order to achieve the best possible outcomes for each child and (2) to evaluate our programs and compare them with those of comparable organisations.
These outcomes demonstrate that children who are deaf or hearing impaired who participate in listening and spoken language early childhood intervention programmes have excellent prospects of learning to listen and speak fluently; attending mainstream schools; completing secondary education or other vocational pathways; and ultimately attaining high levels of social and emotional well-being and economic independence.
185 Melbourne Street
North Adelaide 5006
08 8267 9200
reception@corabarclay.com.au
corabarclay.com.au