Case Studies: Student 4
9/13/04 19:03

Student 4 is a young adult female born in China. She grew up speaking Chinese to her parents. She has with a profound sensorineural hearing loss with etiology reported as a high fever at one year of age. She attended regular public schools in China without any services provided. She never learned any sign language in China. She came to RIT in the late 90's to study Computer Science. Here, you may view an introduction to Student 4
(JK 23). She is currently beginning her fourth year at RIT and has had support from the speech language department throughout this time.

Background Information

Student 4 has a symmetric, severe to profound sensorineural loss bilateral with hearing out to 4000 hz.. Her PTA is 95db in right hear and 102 db in the left. She began using hearing aids at 5 years of age and wears a BTE on her right hear all the time. She took ESL classes in China before coming to the US. She did not have any speech-language therapy or sign language instruction. She is reported as speaking Chinese intelligibly, although “imperfectly.” She had no experience with sign language in China and began taking: ASL classes at the same time as she began speech therapy.

Diagnostic Results (entering)

Entering Speech Intelligibility:
NTID Write-Down Test: 82% (3.8) on a 1=low to 5=high scale).

Voice (qualitative):
NTID Voice Evaluation demonstrates slight elevation of pitch with noticeable breaks of small magnitude when reading. Her rate was moderately slow with severe problems with stress and inflection as expected of a speaker of another language. She also exhibited a mild problem in blending and coarticulation especially characterized by an addition of a syllable after voiced and voiceless endings which is also typical of a hearing speaker of Chinese. She used appropriate intensity levels and had a slight deficiency in air expenditure. There was no evidence of nasal resonance or vocal tension.

Speech/Articulation:
Fisher-Logemann Test of Articulation Competence showed a total error of 47% with 54% total consonant error. The majority of the consonant errors were in the fricative category. Air was being emitted laterally on the fricatives. Also noteworthy is the addition of a syllable on the final position of the stops. A 19% vowel error represents a substitution of the high front vowel /i/ (key) for both vowels and a substitution of the high back vowel 1W (two) for both vowels. Also noted was a distortion of vowel /r/. The addition of a syllable on the final position of stops and the vowel errors noted are common challenges for speakers of English whose first language is Chinese.

Language:
Her initial NTID writing shows a grasp of basic English grammar with simplistic vocabulary and topic. She goes from past to present habitual tense correctly most of the time. Most of her sentences are simple structurally but there is evidence of complex structures using "because," "if,” and "before." This writing sample placed her into Level III English which indicates a good potential for succeeding in RIT Liberal Arts.

Therapy Goals and Objectives

Long term:
1. To develop interactive spoken and signed English
2. To support the development of academic reading and writing skills
3. To teach English pronunciation rules and eliminate sibilant distortions and omissions.
4. To improve functional communication skills for social integration into this environment.

Summary of short term goals and gains for first two quarters at RIT

We began by reviewing English phonemes and basic English pronunciation using expressive and simple phrases receptive English with sign. After three weeks into the quarter Student 4 was beginning to understand some signed and spoken English on a one-to-one basis with supplemental writing. Her courses were challenging. She had to rely nearly totally on overheads, handouts and textbook information. She did not understand two instructors who were not using voice and did not have written material backing up their lectures. When aware of her challenge, they agreed to add voice and writing to their instruction or to tutor her independently. By the end of the ten weeks she was signing and speaking simple everyday English phrases and had successfully completed NTID English Level III.

As her sign language improved we focused on conversational strategies both using interactive email and videotaped interaction using split screen technology and group speech therapy. Continued English grammar, vocabulary, pronunciation and articulation instruction.

One strategy was the use of group therapy and videotaped interactions: Another instructor had aninternational student experiencing the same social difficulties we did group therapy together one hour a week. We used modeling techniques, along with content that increased their knowledge of American culture. We also did one session at lunch in an American restaurant. At the end of the quarter, the students interacted on videotape. The transcription shows good understanding of each other as well as equally sharing of topics.

Student 4 shows good ability to initiate topic, maintain a topic about a mutual course they will be taking. Both used good clarification strategies to insure understanding. After some clarification, they discover they will be in different sections of the same course for the next quarter.

Although they did not know each other at the beginning of the experiment, towards the end of the transcription, it is obvious that this experiment resulted in the two of them becoming friends.
A second strategy used to develop both English and conversation was email interactions which included feedback on grammar and vocabulary. This writing sample shows an example of an interaction done with a speech pathology intern who was the same age as Student 4 and able to include some of the current vocabulary used by hearing college students. In addition to the social interaction, the intern gave Student 4 suggestions for grammar and vocabulary improvement. At the end two quarters of her program, Student 4 finished NTID III and Level IV English and was recommended to begin the RIT Liberal Arts Sequence. She received an "A" in all her English courses.

She was comfortable conversing with other students using signed English but wanted to develop her ability to converse using spoken English only. Spoken instruction was focused on expressing English and developing strategies. Her spoken intelligibility when reading 10 sentences improved from an entering score of 3. 8 or 82% intelligible to 4.7 or 95 % intelligible. (Click here to hear the recording). Her fricative errors were decreased although she still maintains difficulty with the three vowels. She describes some success at interactions during an email.

Second year of her program

Student 4 was confronted with new challenges related to RIT Liberal Arts courses. Her spontaneous writing has shown good improvement. As a pretestshe reacts to the September 11th attack. It shows some ability to discuss what she read about it. Her Liberal Arts courses required her to do research for her written essays and to write essays about pieces of literature. Her greatest challenges were in organization and elaboration of her ideas by providing examples of her thesis from research. Limitations in her English vocabulary presented challenges in reading literature and articles for her research. Therapy strategies involved discussing her reading and expanding on her ability to elaborate. In addition to meeting twice a week, interactive email was used to clarify ideas for written essays.. She completed two prerequisite writing courses. Experiential activities were included to help her gain communication confidence and give her content to write about. In this writing sample she writes about how she instructed American children in the use of ASL and Chinese She completed successfully completed (grade: A) the first course liberal arts "Writing and Literature" in the spring quarter of he second year.

Third year of her program
Student 4 progressed through her liberal arts courses and courses in Applied Computer Technology and began looking for a co-op job. She also began taking some courses as a cross registered student at RIT. This presented new challenges for her. All of her NTID instructors and liberal arts instructors communicated using simultaneous speech and sign. She, in fact, selected instructors based on that criteria and would always meet them before registering for a course to be sure she could understand them.. RIT courses provided interpreting support. She was unable to follow the interpreter exclusively or the instructor's English exclusively. A solution for her was the use of C-Print, a system which provides text for the instructor's lecture. For one course in Math, C-Print was not available. She was the only student so she dismissed the interpreter and asked the instructor if he would be willing to show his examples on the board "the way they did in China." This RIT instructor was very accommodating. She took Discrete Math I and II from this instructor and got A's in both courses. This probably speaks more to her mathematical ability than her communication strategies but it is an excellent example of her progress in speaking up for what she needs and shows a great contrast from the beginning of her program at RIT.

In addition to continuing to provide support for her liberal arts courses, our therapy focused on successful job interviewing. It is helpful for students to relate the concepts they have applied to conversation and to written discourse to the unique goal of a job interview. An example of one strategy is the use of interactive videotaping using split screen technology. Discussion of conversations or interviews can be instructive.

• Segment JK 25 and JK 27 discuss the value of clarification strategies and show an example of successful application of these strategies to the practice interview.
• Segment JK 30 shows a review of a grammar principles relating to the use of adjectives and adverbs.
• Segment 31 and JK 29 shows strategies for elaboration on a job interview.

At the end of her third year, Student 4 had completed most of her liberal arts requirements successfully finishing courses in music theory, Sociology, Psychology, and Japanese.

The video sample shows her oral presentation for her Japanese class. She placed first for students in the basic course. During the summer of 2004, she was accepted for a science internship at Tufts University in Boston. She will complete her B.S. during the next year and hopes to go on for a Master's Degree.

Top | Home