A Session Summary to understand how speech is developed in children with hearing loss!
The first and foremost thing every parent of a child with hearing loss asks is, ‘when will my child start speaking?’
One needs to understand that speaking is directly related to our listening experience.
So when do we start hearing? And what is the difference between Hearing and Listening?
Typically in human beings, the hearing ability is functional by the 20th week of gestation. This means that at birth typical hearing infants have 20 weeks of auditory neural experience, in utero.
So the point to understand here is that in kids with congenital hearing loss, the brain didn’t get access to those sounds which had been presented before birth. Therefore if the hearing loss is diagnosed at the age of six months, the auditory deprivation for the brain has been for ten months already, leading to speech and language delay.
We all hear with the brain; the ears are just a doorway ( Carol Flexor) and the hearing loss restricts the sound from reaching the brain.
Let’s also understand the difference between Hearing and Listening.
Hearing is an act of perceiving sound and receiving sound waves through the ear.
Listening is the act of hearing a sound and understanding what one hears after the brain processes the meaning from words and sentences.
As mentioned above, hearing is first provided and then listening develops followed by development of spoken language.
A typical hearing child speaks four to five words at the age of one year. This speech stage comes when the child has already had a hearing age of sixteen months and good listening environment. For children with hearing loss the stages for speech and language development are the same. Their speech will depend upon the appropriate fitting of the technology whether it is hearing aids or cochlear implants, auditory verbal therapy, good listening environment and the most important thing, the active involvement of the family in the process.
A good voice pattern can only be learned through listening. It improves the child’s ability to self-monitor and self-correct and reduces exaggerated and evident mouth movement.
There is some research done which shows how much practice is needed to influence the neural structure for speech and language development. The Hart and Risley study says that by 4 years of age typical hearing children have hear around 46 million words.
According to Pittman, children with hearing loss require 3 times more exposure to learn new words and concepts and yet they do not have 24/7 hearing.
It is imperative for the parents to understand the significance of language rich environment and providing the same to the kids following the Learning and Spoken Language strategies in a day to day routine.
LSL STRATEGIES FOR SPEECH AND LANGUAGE DEVELOPMENT
Listed below are some of the Listening and Spoken Language Strategies which parents should use in their conversation with the kids having hearing loss:
MOTHERESE/ PARENTESE: It is the sing song voice pattern like lullabies, generally used with babies. It helps to gain the attention of young toddlers and babies towards auditory signal.
It is an indirect or informal language stimulation technique where a targeted sound, word, phrase or sentence is said more than one time. In the first year of hearing, this strategy is very helpful.
Kids are bombarded with specific target words or sounds time and again for maximum auditory exposure.
Multi syllabic words can be broken into smaller units thus making it easier for the kids, followed by full word exposure e.g., spaghetti, caterpillar.
Build upon new vocabulary and language on already known language so it becomes easier for the kids to comprehend.
It is the pause used between an adult’s interaction with a child that allows the child time to process the auditory information and formulate a response.
It is a very important strategy and should always be remembered by the parents especially in the initial months when auditory memory is building up.
It is useful in almost all the age groups and especially implemented with kids dependent on speech reading.
In this, information is presented through listening before the introduction of visual or other support information is given and then auditory input is repeated again.
Its purpose is to encourage comprehension and communication through the child’s auditory abilities.
ORAL MOTOR EXERCISES
Oral cavity and muscles play an important role in speech acquisition and development which is generally not very well developed in kids with hearing loss.
Here are some exercises to help for the same
- Breathing Exercises
- Blowing (cotton balls, candles, feathers, bubbles)
- Sucking (with short, long and twisted straws)
- Tongue Rotations (licking chocolates, honey and ice creams smudged around the mouth)
GAMES AND ACTIVITIES
Early intervention is undoubtedly important but without compromising on the chuckling childhood of our little munchkins. So here are some of the fun filled games through which parents can practise speech therapy:
- Build up blocks and knock them down
- Drop things in water
- Put Ice cream sticks in play dough
- Throw balls in a bin
- Jigsaw puzzles
- Build lego and house pieces
- Zooming vehicles down a slide
- Dropping objects through a pipe
- Putting candles into a playdough cake
- Banging things with a toy hammer
- Pegs in pegboard
Most Importantly: Follow the Child’s Lead.
Although after doing everything, dedicating time and energy, putting in efforts in the right direction sometimes the child doesn’t progress as expected, there is no need to panic but be vigilant and patient.
Check the child’s speech in relation with his aided audiogram
Optimal Hearing aid programming / Cochlear Implant mapping
Be patient and encouraging, learning to listen and speak with confidence is inculcated and is a learning process which needs its own sweet time.
If you have any concerns, never hesitate to question the related Professional.
BELIEVE AND MAKE BELIEVE, CHILD WILL LEARN TO LISTEN AND SPEAK.
Session Conducted by: Ritu Nakra (LSLS Cert.AVT)
Session Hosted by: Chetana Misra
Session Complied by: LE Nyla Ahamed