How does Hearing Loss Affect Speech-Language Development?

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Cleveland Hearing & Speech Center.

Children learn to talk by listening to speech. The first few years of life are a critical time for speech and language development. Children must be able to hear speech clearly in order to learn language. A fluctuating hearing loss due to repeated ear infections might mean the child doesn’t hear consistently and may be missing out on critical speech information. Permanent hearing loss will also affect speech and language development, especially if it is not detected early. The earlier a hearing loss is identified and treated, the more likely the child will develop speech and language skills on par with normally hearing children.

What are the methods of communication that can be used?

The choice of a communication method is a very important step in learning to develop successful communication between the family and the child who is deaf or hard of hearing. Important factors to consider include the mode of communication that enables all family members to communicate with the child and whether it enhances your relationships and enjoyment of each other. Factors that may influence making these choices include the following:

• Degree of hearing loss
• Age of diagnosis (identification of hearing loss)
• Family perceptions and values
• Health of the child
• Level of family participation
• Child’s learning style
• Child’s intelligence
• Effectiveness of the child’s amplification devices (hearing aid, cochlear implant)
• Hearing potential
• Amount of residual hearing

Success with any communication mode depends upon the above factors and the desire and willingness of all family members to support, nurture, and actively participate in promoting functional communication. The following is a brief summary of the different communication methods and approaches available for children with a hearing loss.

• Auditory-Verbal Approach: Children can use their hearing potential to learn to talk and communicate through listening. Many children who are deaf or hard of hearing have usable hearing, and when amplified via hearing aids and/or cochlear implants; this enables them to hear spoken language and learn to listen and talk. A child’s listening skills are developed; visual cues are not used.
• Bilingual-Bicultural Approach: Is a means for communicating with and educating deaf children that incorporates the use of American Sign Language (ASL) as the primary language of instruction. ASL is a distinct language that uses visual-gestural-spatial hand and body movements as components of the language to express its own grammar and sentence structure. This approach supports and teaches children about deaf culture and the deaf community. English is a taught as a second language through reading and writing.
• Auditory-Oral Approach: Children use their residual hearing and use speech as their primary means of communication. Children use speech reading to aid listening skills and touch cues to aid in speech sound production. Appropriate amplification with hearing aids and/or cochlear implants is warranted to maximize the oral approach’s effectiveness.
• Cued Speech Method: This oral method adds hand positions for each sound in each word spoken to assist in reading lips. Children using cued speech develop speech-reading skills, recognize pronunciation, develop good reading skills, develop and understand how to pronounce sounds and form spoken words and learn English naturally. Cuing is always used in conjunction with speaking. Cuing alone does not carry meaning; therefore it is not a separate language.
• Total Communication Approach: Use any and all ways of communicating that will enable the child with a hearing loss to learn language. Children use a combination of signs, gestures, speech, hearing aids, FM systems, speech reading and print. Children learn English as the native language through sign language, commonly referred to as manually coded English. Total communication involves simultaneously combining talking and signing in English.

Can a child who is deaf learn to speak?

The answer to this question is that children listen, listen, listen and practice, practice, practice. During childhood there is a lot of exposure to talking and the notion that we behave and respond to this talk as interesting, important, and meaningful. Babies who are deaf or have hearing loss develop language in much the same way as hearing children, but with some important differences.

Children with hearing loss who have amplification need to use the hearing aids or cochlear implant all day, every day. Exposure to talking and to sound cannot be emphasized enough. Talking with others needs to be focused, face to face and ear to ear. The child will benefit from being encouraged to listen and be attentive. Caregivers can reinforce and shape the child’s vocalizations by first imitating the baby’s sounds in order to teach the baby to imitate and repeat sounds.

Pause and allow time for the baby to respond. This “wait time” is important time for your baby to process what he/she is hearing. Your baby might need encouragement to look and listen and to know that sound is important. Using simple words, phrases and sentences over and over again, so your baby can learn from repetition, is effective.

Comprehension, or understanding, of words comes before the use of words. Helping your baby learn and understand the names and uses of common objects, people, toys, actions and routines is important in helping the child develop language. First words will occur only after the child has a thorough understanding and association that objects have a name and that name carries meaning. Research indicates that spoken language is most likely to develop in children taught by an oral method, and that daily use of appropriate amplification (hearing aids or cochlear implants) is essential.

If you suspect your child may have a hearing loss, or other communication issues, contact Cleveland Hearing & Speech Center for more information or an evaluation at 216-231-8787, www.chsc.org