Communication Options for Children with Hearing Loss

  Listening and Speaking Total Communication Sign Language
Definition Children learn to listen with digital devices (e.g. hearing aid) and one-on-one teaching to use their residual hearing. Using multiple ways to communicate with a child e.g. signing, gestures, speech-reading, body language, oral speech and hearing-device use. Manual language distinct from spoken language (sign language does not use spoken-language grammar or syntax).

e.g. Irish Sign Language (ISL)

Primary Goals To develop speech with hearing devices, and to teach communication skills for the hearing world. To teach vocabulary and language at a multi-sensory level. To be the child’s primary language.
Offered at ARC? Yes – using auditory verbal techniques.

For maximum results, these techniques should be introduced before the child starts Primary School.

Yes – ARC therapists are happy to help you use a total communication approach to your child’s language development. No – ARC therapists are not currently trained in Irish Sign Language
Language Development Child learns to use spoken and written language fluently, and understands others through listening rather than visual cues. Child’s simultaneous use of speech and sign is encouraged, with exposure to oral speech, sign, speech-reading and hearing device use. Understanding and expressive language is developed with the use of sign language. Written language is taught as a second language.
Hearing Early, consistent use of hearing aids, implants and/or a FM system is vital and central to the child’s learning. Use of hearing aids, cochlear implants, FM system is advised for the child to maximise their remaining hearing. Hearing devices are not essential for success with sign language.
Family Responsibility Family are the child’s first teachers. Parents need to build listening and speaking into a child’s routine and playtime, for a spoken language-rich home life. Family learns chosen sign-system for the child to develop their language. Child needs access to adults fluent in sign language to develop sign language as a primary language.
Parent Training Parents learn strategies for speaking and listening (auditory verbal strategies) to use at home, out-and-about, and in crèche/school. Parents sign as they speak to the child (simultaneous communication). To become fluent, sign must be routine in your communication. If parents are not Deaf, intensive sign language education is needed for the family to become fluent.

What to expect from your Assessment

What to expect from your assessment at ARC if you are choosing “speaking and listening” (Auditory Verbal techniques) as your child’s primary mode of communication…

This assessment is divided into two parts – The Initial Consultation and the Initial Assessment

Initial Consultation

  • The Initial Consultation is attended by parents alone (without your child present), so that you may speak freely about your child, and think clearly, without distraction.
  • Case history interview – a detailed discussion with your therapist regarding your child’s developmental and medical history, their strengths, and the concerns you have for them at present. You will need to bring a copy of your child’s most recent audiology (hearing test) report to this meeting.

Initial Assessment

  • This follows the initial consultation and is attended by one or both parents and your child. It is used for the purposes of direct assessment of your child’s communication and listening skills within the clinic environment.
  • Equipment function check – if your child wears a removable hearing aid/s, the therapist will ask you (or your child) to remove these one at a time, and will demonstrate how to check them regularly to make sure they are performing as they should (i.e. that they are making the right sounds loud enough for speech, based on the audiogram in your child’s audiology report).
  • Functional listening skills assessment – the therapist will observe your child’s reaction to a number of speech sounds and environmental sounds (while your child is wearing their hearing aid/cochlear implant/etc.) to make sure they can properly hear the sounds they need for speech. Depending on your child’s age and ability, this may involve anything from making sounds quietly behind your child to see if they react, to asking your child to copy some sounds themselves.
  • Language/communication skills assessment – this assessment looks at how your child understands language, and how they express themselves. It is adapted to the age and maturity of your child. Toys are used with younger children, while pictures may be used with older children. For very young children and babies, much of the information about your child’s communication may be gleaned from a parent-questionnaire, which the therapist will discuss with you.
  • Speech-sound assessment – this assessment examines the types of sounds your child is using (e.g. cries, babbling, and/or pronunciation of words and sentences, as appropriate), as well as how your child is moving their oral muscles. Again, it is adapted to the age and maturity of your child. If your child is not yet saying words, you will be asked to bring a short video clip (1-2 minutes) of your child making the sounds they usually make at home (e.g. cries, grunts, babbling, etc.), either on your phone or emailed to the clinic before your appointment. This is to allow the therapist to evaluate your child’s early “speaking and listening” skills even if they are quiet on the day.
  • Depending on your child’s age, their play, attention and social skills may also be evaluated informally.
  • At the end of the assessment, the therapist will discuss the results with you and discuss whether therapy is required. If therapy is indicated, the therapist will explain what the options are and give an idea of the proposed therapy schedule.

What to expect from Therapy

What to expect from therapy sessions at ARC if you are choosing “speaking and listening” (Auditory Verbal techniques) as your child’s primary mode of communication…

  • Therapy sessions are attended by one or both parents, with your child, and may last 30-45 minutes depending on your child’s age and attention level
  • Therapy schedules are tailored to the individual needs of your child, in consultation with parents – children may attend fortnightly, monthly, or less regularly on a review/monitoring basis.
  • All sessions start with a quick “equipment function check” (if your child is wearing hearing aid/s) and/or a “functional listening check” (using the 6 Ling sounds, as demonstrated during your initial assessment)
  • Therapy sessions using auditory verbal techniques are done through play, which is tailored to your child’s developmental level and interests. For example, music and cause/effect toys may be used with younger children and infants; while older preschool children may enjoy pretend play or arts and crafts.
  • During therapy sessions, parents are coached by the therapist to use auditory verbal techniques and strategies during the play. Your therapist will demonstrate how to use these techniques to help build your child’s listening and speaking skills; and you will have a chance to practice these.
  • At the end of each therapy session, parents leave with key “take-home messages” – in consultation with your therapist, you decide the most important strategies/techniques you are taking from each therapy session. The therapist will help you to brainstorm ways to incorporate these into other everyday activities, so that your child continues to develop their listening and speaking skills outside the therapy room.

FAQ

“My child is only a few months old – isn’t he too young for speech and language therapy?”

Early intervention is key to helping children with their speech, language, and communication skills. Babies born with hearing loss have already missed out on up to 20 weeks of development of auditory brain (“listening brain”) pathways. Even in these early stages, parents can learn invaluable techniques (such as enhancing the child’s listening experiences) to facilitate communication and brain development in the child’s natural environment.

“My child has a profound hearing loss, and his audiologist has told me his hearing aids are only providing a little help. We’re waiting for him to get a cochlear implant – will speech and language therapy be of any benefit before this happens?”

Using auditory verbal techniques, parents can learn how to maximise on the types of sounds their child can hear, to provide vital stimulation to their child’s auditory cortex or “listening brain” while waiting for more powerful hearing technology. This means that when the technology (such as a cochlear implant) does arrive, the child is in a better position to make sense of the new sounds they are hearing.

“How long will my child need to come for speech and language therapy?”

Every child is different and progresses at his or her own rate. Therapy plans are tailored to the individual child as well as the family’s wishes, with the aim of helping the child to reach his or her full potential.
Depending on the age, strengths and needs of your child, he or she may come for regular therapy sessions (ranging from monthly to fortnightly), or may see the therapist less often on a review/monitoring basis (for example, at 3 or 6-monthly intervals). Some children take a short break following a “block” of therapy sessions (e.g. 8 sessions), followed by a review of the progress they have made.
If speech and language therapy is necessary for you child, your therapist will help you to see how s/he is moving forward to reach his or her full communicative potential. In consultation with your therapist, you will decide when you are happy for your child to “graduate” from speech and language therapy – for example, when s/he has reached his or her full listening and communication potential.