Now Hear This! Effective Teaching for Children with Hearing Loss
By Lara Monico
Birds chirping. The clicking of a keyboard. The microwave beeping. Most of us hear these sounds easily. But a child with hearing loss may not hear these sounds well or even at all. Poor response to environmental sounds is easily noticeable and is one of the ﬁrst signs that causes concern about a child’s hearing. What may not be as obvious, particularly in infants and young children, is how hearing loss affects communication development. Hearing begins in utero, and from birth, a baby begins the amazing process of learning the sounds, voices and language of their world. This process can be disrupted by even a mild hearing loss, but for parents who want their hearing-impaired child to learn to speak, the opportunities are great.
The Joint Committee on Infant Hearing (JCIH) established 1-3-6 guidelines to ensure that children with hearing loss have early access to resources that will maximize their potential to develop language, cognitive and social-emotional skills commensurate with their hearing peers. The process includes screening before 1 month, conﬁrmation of hearing loss before 3 months, and intervention before 6 months of age. All newborns have their hearing screened at birth, and once hearing loss is conﬁrmed, hearing aid ﬁtting should soon follow. The superior hearing aid technology available today, including hearing aids and cochlear implants, ensures most children will have good access to the sounds and language around them. If adhering to JCIH guidelines, ampliﬁcation will be provided well within a critical period when language develops most naturally. So why is intervention necessary? After all, individuals with visual impairment can put on glasses and recognize what they see without intervention. If hearing technology allows a child to hear words, why can’t he immediately understand what hears?
The ear is the messenger of sound and speech, but it is the brain that interprets the message. This complex process begins with sound awareness and continues with a series of skills that overlap, but must all be achieved in sequence, including auditory attention, discrimination, identiﬁcation, memory and comprehension. A baby must hear words thousands of times in familiar routines, pay attention to and distinguish words from one another, associate words with what they represent, and store that information in their memory, to be retrieved when needed. While hearing technology allows access to speech, simply hearing a word does not mean it is understood. For example, while you can hear the words “manzana” and “perro,” you would not recognize these words as “apple” and “dog” without some exposure to Spanish. Likewise, children with hearing loss need time, meaningful exposure and often direct instruction before understanding language.
Auditory-Verbal (AV) Therapy is a method of teaching children to make maximum use of residual and ampliﬁed hearing to develop listening, speech, language, cognitive, literacy and conversational skills, ideally with the same competency as their typical hearing peers. Instruction is provided with an emphasis on listening rather than visual cues such as lip reading or gestures. As their child’s primary teachers and advocates, parents and caregivers actively participate in AV therapy sessions. Therapy follows a typical developmental sequence of listening and language acquisition, beginning where the child is most competent and building from there. Through guidance and coaching by the AV therapist, parents learn what skills to work on, as well as techniques and strategies to facilitate skill development. They are encouraged to use the knowledge and skills gained in therapy throughout their child’s daily routines and activities, so that learning occurs through meaningful and hands-on experiences as well as conversations. Parents then provide feedback about skills they have practiced and progress made between sessions, completing a perfect circle of therapist-parent collaboration that will advance their child’s communication development.
Building the listening and spoken language skills of a child with hearing loss is like building a house, with parent and therapist as architects and builders, and listening skills as the foundation upon which the structure, formed by language and experiences, is placed. It is built with care to serve for a lifetime.
In Auditory-Verbal Therapy, let’s build your child’s listening and spoken language house. On second thought, forget the house. Let’s build a mansion!
Lara Monico is a Speech-Language Pathologist and Certiﬁed Auditory-Verbal Therapist at Laskin Therapy Group in Ridgeland. For more information about Auditory-Verbal Therapy, contact her at firstname.lastname@example.org.