WHAT WE THINK WE BECOME (BUDDHA) AND WHAT WE HEAR IS WHAT WE SPEAK (Hear Me Speak)

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.

REPETITION

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.

 

AUDITORY BOMBARDMENT

Kids are bombarded with specific target words or sounds time and again for maximum auditory exposure.

 

BREAKING UP

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.

 

SCAFFOLDING

Build upon new vocabulary and language on already known language so it becomes easier for the kids to comprehend.

 

WAIT TIME

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.

 

AUDITORY SANDWICH

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)
  • Chewing
  • 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

 

 

 

 

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Advocating Self Advocacy

 

 

Parents having children with hearing impairment are extra cautious around them. The need to be around their children and ensure that no harm comes to them is but natural. However an important fact to keep in mind is that children with any kind of impairment need to be taught to lead normal lives. The fundamental reason behind going for hearing aids or cochlear implants is to enable such children to live fairly independent, normal and regular lives.

This fundamental reasoning is lost if the parents are forever hovering around the child and helping them do basic things. The child needs space to grow and to handle situations by himself. This is possible only if we teach them self advocacy right from the beginning.

What is self advocacy? Self advocacy literally means ‘the action of representing oneself or one’s views or interests.’ Being able to do things independently will give your child a sense of purpose and worthiness.

Self advocacy helps them gain awareness of personal preferences, likes, dislikes, strengths, interests, potential and limitations. It helps them differentiate between wants and needs. It helps them make choices and consider multiple options after calculating the consequences of their actions.

The following points will help you understand the importance of self advocacy and how it will help your child gain confidence to face any situation head on.

Teach them the basics:

Children can be taught the basic workings of their hearing aids or Cochlear Implants and should also be able to recognise when the battery runs out or gets disconnected. Children going to play school (age 2.5yrs-3yrs) can be taught to inform if their device is not working. This differentiation will help them reach out and report to adults as soon as they sense something wrong.

Start Early:

There is no such thing as ‘too early’. Start developing self-advocacy skills in your child as early as possible.

As they grow older children (age 4yrs to 5yrs) should be taught to be more expressive if they fail to hear or understand something. They should be able to judge the distance required to hear better. They should be able to clearly communicate that they require the speaker to talk softer, louder or slowly. Teach them to ask for repetitions if they have not understood something.

Being vocal will help them develop their vocabulary as well. The more words they use, the more they learn pronunciation, sounds, vocabulary and language.

Communicate:

In a new environment, the child must have the confidence to walk up to an adult and inform them about his or her needs.

They should be able to explain to the teacher and find the right spot to sit in class. A shy child might find it difficult to do so, but make them understand that they need to speak up for themselves if they have to learn in class.

Most importantly the child should be made to understand that the hearing aid or Cochlear Implant is meant to help them function like regular children and should not be taken as a mark or symbol of any disability. It is their friend and should be treated as one.

Seeking Help:

If communication is important, then asking for help is equally important. The child should be made to understand that asking for help is not wrong. Asking for help will not lead to them being mocked or laughed at. They can confide in friends and ask them for notes or updates if they miss out on hearing the instructions or lectures in class. This confiding will strengthen their bonds with these friends and will make for a wonderful foundation to a long lasting friendship too.

Mental Preparation:

In a comfortable, known environment with help from family and friends the child will be able to function normally. However, how will the child cope in a new environment without a known person to help or support? Prepare your child for such unaccounted or unplanned situations. What if the child gets separated from the parents in a mall? What if the child has to go to another school for a project or a submission? How will the child deal with such situations if he is not made aware of them in the first place? Mentally prepare your child to face such challenges. Teach him to approach people and ask for help without feeling insecure. Teach him to be confident and importantly encourage him to go out and experience the world first hand by himself.

Maintenance:

Teach your child to keep the hearing aid or Cochlear Implant in a safe place or in the Dehumidifier when they are not wearing it. They should be taught to automatically include ‘wearing of device’ into their morning rituals once they wake up. It should be as natural as brushing teeth.

Final word:

Do understand that children with hearing impairment are like normal children but hear differently. They need to lead normal lives and enjoy all the things that regular children do. They only need a little help in hearing and that is possible with the collective cooperation and support of everyone the child comes across.

Hearing should not be a privilege, it should be a right.

Ritu Nakra

LSLS Cert.AVT

Listening beyond hearing

 

 

 “Deaf people can do anything hearing people can, except hear!” – Dr. King Jordan

Any journey to unknown territory is scary. The excitement, anxiousness, fear, emotional upheaval and anticipation add to the drama. However once you set sail, you face the waves as they come and that is exactly what we at HearMeSpeak have done.

It has been an educative, sometimes tiring, sometimes exciting, and never-a-dull-minute kind of journey for us this past year. With wonderful and heartfelt support from parents, doctors, specialists, therapists and lovely children themselves; we have completed a year on a high.

HearMeSpeak was started as a forum to help and educate parents with hearing impaired children. The idea was to explain to them that children with hearing impairment are no different from regular children.  At the same time, the mission was to help them get access to specialists who would help them help their children overcome the disability. The goal was to separate the ‘dis’ and focus on the ‘ability’.  Together with a team of individuals who believed in the vision and shared the same set of beliefs we have come so far.

The icing on the cake for HearMeSpeak was the Audio Visual movie directed by Vernita Verma and narrated by the face of HearMeSpeak – Alpa Bhawani. The movie focussed on how parents can use every day routines to develop spoken language in their child. A big thank you and round of applause to the parents who agreed to come on camera without inhibition and share their stories with the world.

In this exhaustive but highly productive year, we have grown- not just in numbers, but also in knowledge, information and support. We started off by connecting with families of children with hearing loss. Interacting with them, helping them understand the shortcomings, explaining treatment options and therapy benefits and seeing them succeed has been gratifying. Watching hearing impaired children communicate effortlessly and normally gives us a sense of satisfaction and euphoria.

Over the past year we have connected families with professionals (both within the country and those based overseas) from this field, through our face book page. Using technology to our advantage, we have conducted online sessions through blab podcast with these professionals and empowered families. We have discussed at length on various topics including, working upon higher language goals by cert. AVT, cochlear implant and what happens after switch on, guidance from audiologist and much more. In addition, we have released blog posts on special occasions like mother’s day, father’s day, Diwali and Christmas.

What makes the journey interesting is that all the activities we have initiated and carried through have been done with unconditional love and with a will to educate our society, all free of cost. We haven’t charged any of the families involved a single fee and have given our services wholeheartedly.

As a result, our good work and good will has spread not only in India but many parts of the world too. As we celebrate our first anniversary, we are reminded that we have much more work to do and many more people to connect with.  Because like Dr Jordan mentioned, “Deaf people can do anything,” and that’s precisely what we aim to be able to do – ANYTHING!

A special mention and heartfelt thanks to Ritu Nakra, Chetana Misra, Vernita Verma, Alpa Bhawani, Dr.Mohnish, Dr.Shomeshwar, Rajiv Thakkar (Parent), Dr.Ruchika Mittal, Vandana Joshil and all those families who came forward to be a part of it. We are blessed and honoured to have your continued support.

Best Wishes

Team

of

Hear Me Speak

 

 

 

Tips for fathers and professionals to help facilitate spoken language skills in young children with hearing loss

Father_s_day [1490963]

Dear Dads,

You play a very vital role in the development of your little ones. When you are around your child, the child feels much more secure and protected. As a therapist, I would like to acknowledge all your efforts in helping your child to be a strong individual in his/her life, especially on this Father’s Day.

Tips on how you can contribute in a better manner towards the speech and language development of your child:

  • The male voice is naturally at a lower frequency as compared to a female voice. Hence, your natural low pitch gives an opportunity for children with hearing loss to acquire a good base of suprasegmentals through your voice. Therefore, the golden rule for you is to sing, sing and sing to your child.
  • Since the mother gets tired of all the household chores during the day, you can take the initiative for a bed time story telling session with your child. This gives you a good opportunity to share some special moments with your little one and foster a stronger bond between you both.
  • One of the principles of Auditory Verbal Therapy (AVT) states that to guide and coach parents so that they can help children to integrate listening and spoken language skills into all aspects of their lives. To make the learning experience more natural, joyful, meaningful and fun at home, you can easily supplement the lessons learnt by your child in the therapy sessions by taking your family out during weekends for picnics, jungle safaris, farmhouse visits or even to beach fronts.
  • If you are unable to visit your child’s therapy centre frequently, do try to go at least once a month to meet the professionals involved with your child and to attend guidance and counselling sessions / workshops organised by the centre.
  • Research done by AVT’s in India has concluded that families where there is a healthy relationship between the husband and wife overcome the grief of knowing the fact that their child has a hearing loss in a better way. So, be very supportive of your spouse.

Tips for Professionals to encourage the father’s involvement :

As per the national survey of over 262 fathers of children with hearing loss conducted by Dr. K. Todd Houston, PhD, CCC-SLP, LSLS Cert. AVT, following are the conclusions:

  • Treat fathers as equal partners in the parenting process.
  • Give flexibility of appointments as per their
  • Don’t ignore fathers during meetings. Make eye contact with them, ask them how they are coping and look for ways to support them in the process.
  • Be unbiased in your recommendations.
  • Be sensitive & empathetic to the father’s situation.
  • Don’t make assumptions about the father’s role or level of interest.
  • Provide father-specific information / materials like websites, books or support materials which can help them.
  • Help them to connect with other families with hearing impaired children, especially their fathers and also advocates.
  • Discuss and explain latest technology.
  • Be sensitive to religious and cultural differences.

Wishing all fathers a Happy Father’s Day and hope you have a wonderful journey full of beautiful surprises with your children.

With Warm Regards,

Ritu Nakra

LSLS Cert. AVT