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Student 4 is a young adult female born in China. She grew up speaking Chinese with her parents. She has a severe to profound bilateral sensorineural hearing loss with etiology reported as a high fever at one year of age. She attended regular public schools in China without any support services provided. She never learned any sign language in China. She came to RIT in the late 90’s to study Computer Science.

Here is an introduction to student #4.

She is currently beginning her fourth year at RIT and has had support from the speech language department throughout this time.

Degree of Deafness/PTA

Symmetric, severe to profound sensori-neural loss, bilateral, with hearing out to 4,000 Hz. Her PTA is 95db in right ear 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 has had no experience with sign language in China and began taking ASL classes at the same time as she began speech therapy.

Speech Intelligibility

NTID Write-Down Test5: 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.


Fisher-Logemann Test of Articulation Competence3: 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 /u/ (two) for both vowels. Also notes 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.

Fisher-Logemann Test of Articulation Competence3 (words): 78% total errors; 82% consonant errors; 61% vowel errors; of consonant errors 55% = deletions, 24% = manner of phonation errors, 9% = voicing errors; correct consonant sounds = /b, d, w, f, v, l/


Her initial NTID writing test 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 poential for succeeding in RIT Liberal Arts.

Therapy Goals and Objectives
  • To develop interactive spoken and signed English
  • To support the development of academic reading and writing skills
  • To teach English pronunciation rules
  • To eliminate sibilant distortions and omissions and improve production of vowels
  • To improve functional communication skills that facilitate social integration into the college environment.
Therapy Progress

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 receptive spoken English with sign support (simultaneous communication). After three weeks into the quarter, Student 4 was beginning to understand some signed and spoken English in a face-to-face interaction supported by some 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 to support their lectures. When the instructors became aware of her difficulties, 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 her NTID English course.

As her sign language improved we focused on conversational strategies using interactive e-mail, videotaped interactions, and group speech therapy. She continued working on her English grammar, vocabulary, pronunciation and articulation. Group therapy and videotaped interactions were done with another international student experiencing the same social difficulties. Modeling techniques were employed and often the content of the conversations focused on American culture. At the end of the quarter, the students interacted on videotape. A transcription of that conversation (pdf) shows both students successful with perspective taking and turn-taking. Student 4 also displayed skills needed to initiate and maintain a topic about a mutual course they will be taking. Both used good clarification strategies to ensure understanding.

A second strategy used to develop both English and conversational skills was exchanging email and then supplying feedback on grammar and vocabulary. This writing sample (pdf) shows an example of an interaction done with a speech pathology intern who was the same age as Student 4 and was 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 by using parenthesis around the selected words. At the end two quarters of her program, Student 4 finished NTID English and was recommended to begin the RIT Liberal Arts.

At the end of her first year at RIT, Student 4 was comfortable conversing with other students using signed English but wanted to develop her ability to converse using spoken English only. Instruction focused on using correct grammar and vocabulary in a spoken English context 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.

Her fricative errors decreased although she still had difficulty with the three vowels.

Second year of program

Student 4 was confronted with new challenges related to her RIT Liberal Arts courses.

She was required to do research for essays and to write 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 e-mail was used to clarify ideas for written essays. View the instructor's feedback (pdf) for the student’s first essay draft. This sample shows her final essay (pdf). Student 4 completed two prerequisite writing courses. Experiential activities were included to help her gain communication confidence and to give her content to write about.

Third year of 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 other 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 communication. 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 so special accommodations were provided by RIT to support her understanding of the class lectures.

In addition to continuing to provide support for her liberal arts courses, speech and language therapy focused on successful job interviewing. It is helpful for students to relate the concepts and strategies 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. In addition to continuing to provide support for her liberal arts courses, speech and language therapy focused on successful job interviewing. It is helpful for students to relate the concepts and strategies 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.

This video shows the value of clarification strategies and shows an example of successful application of these strategies to the practice interview.

This video shows a review of a grammar principles relating to the use of adjectives and adverbs.

This video shows strategies for elaboration in 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.