● Studies repeatedly demonstrate that children identified and receiving intervention before 6 months of age perform significantly better on measures of vocabulary, grammar, comprehension, and expressive language than those who begin later. PubMed+2PubMed+2
● Cochlear implantation before age one is associated with substantially better language outcomes—both receptive (understanding) and expressive (speaking)—compared to implantation later. Wiley Online Library+2PubMed+2

Social well‑being encompasses self‑esteem, peer relationships, experiences of inclusion,
psychological well‑being, and participation in activities. Multiple studies show that children
with HI can achieve social outcomes close to those of their hearing peers, especially when early
intervention is in place. BioMed Central+1
● For example, children identified early via newborn hearing screening, with early auditory access (via technology and therapy), report rates of bullying, victimization, social difficulties, and self‑reported distress that are similar to hearing peers. PubMed

November Article 2025

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In the Early Childhood section:

The post Early Childhood: Infants, Toddlers, Preschool first appeared on Supporting Success For Children With Hearing Loss.

Communication skills are at the heart of our concerns about the development of young children who are hard of hearing or deaf.

We need easily administered, functional, and fun ways to assess children’s development and to plan needed intervention.

Check out some of the ways we recommend gathering information on the communication of active children in early intervention to preschool!

• Do you work on communication needs with families of infants and toddlers with hearing loss?
• Are you part of an evaluation team assessing children with hearing loss exiting early intervention services?
• Do you sometimes have preschoolers on your caseload and need a place to start?
• Would you like functional assessments for young children that have been used with children who are deaf or hard of hearing?

Read on for Ways to Gather Functional Information and Plan Intervention

1. Early Listening at Home Curriculum

This is a curriculum for early intervention providers working with parents of children from birth to age 3 who are deaf and hard of hearing and beginning to learn listening and spoken language. It outlines skills and strategies to support parents and caregivers, including techniques for effective coaching, planning, and reflecting. There are 47 one-page activities for families to practice early listening skills and a simple form to track and follow up on progress. Transition to preschool with this information solves the question about the need for auditory skill development and appropriate goals. It also offers practical, shareable resources in English and Spanish and a tool for EI providers to help parents help their child become comfortable with hearing device use during all waking hours.

2. Carolina Curriculum

The Carolina Curriculum is a long-time staple in providing assessment and intervention to infants, toddlers, and preschoolers with special needs. The curriculum comes with two parts, one for infants/toddlers (0-36 months) and one for preschoolers (24-60 months). Each item on the assessment tool is linked directly to a curriculum item that describes procedures for teaching the assessed skill. Assessment is linked to intervention through hierarchies of developmental tasks that are both relevant to typical routines and pertinent to long-term adaptation—thus integrating the intervention in a meaningful way into the child’s life. The Carolina Curriculum provides a comprehensive picture of the child’s development and helps teachers to clearly track child progress. There are domains of focus in the curriculum: personal/social, cognition, communication, fine and gross motor skills. Where the DRIP-EY and Early Listening at Home curriculums focus on the communication needs of young children with hearing loss, the Carolina Curriculum provides a broader context of overall development, which is key for planning appropriate placements.

3. MacArthur Communication Development Inventories – customized for young children who are Deaf and Hard of Hearing

Larry Fenson, author of the MCDI, has very generously allowed use of communication development inventories that have been customized for children with spoken, signed, or cued expressive language – at NO COST. These simple inventories are provided to families to indicate the growth in expressive language over time, from 8 months to 36 months. Each of the inventories has been customized so families can indicate expressive language that is spoken, signed or cued, so that a complete picture of growth across modalities can be captured and compared to typically developing peers. The MCDI is an integral part of many early intervention programs. Download these customized inventories and the norm graphs from Teacher Tools Takeout. Part of the Teacher Tools Library!

4. Parent Interview Progress Report

If a family wants their child’s language to progress at appropriate rate of development, there are some basic things they need to be aware of and include in their daily lives to facilitate communication. This free checklist is designed to allow the interventionist to discuss the child’s progress in language within the context of their consistency in providing communication access. Can be combined with the Formula for Success Contract, which helps clarify the responsibility of the family, and the early interventionists, in facilitating child communication development.

5. Early Intervention Kit

The Early Intervention Kit is a great supplement to the hearing-loss-specific materials you already may be using (i.e., DRIP-EY, Early Listening at Home). Whether you are new to early intervention or a seasoned veteran, this Kit has ‘grab-and-go’ information that you will find yourself using with families again and again. Effectively address assessment, intervention, and documentation for pre-linguistic skills, speech and language development, and sound production. Filled with intervention techniques and skill hierarchies, the Kit will be a good resource for planning your intervention services and is complete enough to be a useful text for university programs. The Therapy Guide has information on assessment, goals, treatment, and documentation. The Activities Book is a gold mine of intervention objectives, goals, and specific suggested activities, for Pre-Linguistic Skills, Expressive Language Skills, Receptive Language Skills and Sound Production Development. Ages: Birth-3 Grades: Birth-PreK.

Children who are deaf or hard of hearing are not ‘just kids with language delay who use hearing devices or sign’. They require the involvement of interventionists with a deep knowledge of how hearing loss impacts communication and other areas of development. In turn, these professionals need to have the tools they need to appropriately assess, plan intervention, and work with the families of these children. These 7 items all contribute to appropriate services for young children who are deaf or hard of hearing, birth to 3, and to gather information for preschool transition and beyond.

The post Ways to Gather Great Information for Early Intervention to Preschool first appeared on Supporting Success For Children With Hearing Loss.

Can face-to-face intervention

The centerpiece of Part C Early Intervention services is that they occur, to the maximum extent possible, in natural environments or settings that are typical for a same-aged infant or toddler without a disability. Having a parent at home full-time with an infant or toddler is no longer a societal norm. Early interventionists often struggle to find a time in the schedule of a busy family with working parents to provide early intervention services. In present times, with parents who are Millennials and widespread communication via media devices, there may be little familiarity in inviting someone into your home to exchange information.

Research² has clearly illustrated that young children have significantly better language scores at age 5 years when they have been enrolled early in intervention services AND when the family is highly involved in carrying out the strategies recommended by early interventionists. Many parents would feel the need to ‘make their home presentable’ before having someone outside their family circle come and visit. This on top of the demands of a young family and working parents often can lead to delayed or missed intervention appointments. If families do not feel comfortable having someone in their home then the success of early intervention may suffer, even with the most highly trained and dedicated interventionist.

Even as early as 2013³, research indicated that tele-intervention is a promising cost-effective method for delivering high quality early intervention services to families of children who are deaf or hard of hearing. In fact, even then the children who had families who received tele-intervention scored significantly higher on an expressive language measure as compared to the in-person group. A measure of Parent Engagement was also statistically better for families involved in tele-intervention.

A 2017 multi-state study⁴ that evaluated the benefits of early intervention via telepractice also found that children in the tele-intervention group scored significantly higher on language measures. Analysis of video recordings of tele-intervention versus in-person home visits resulted in higher scores for provider responsiveness and parent engagement. A 2018 review of 23 peer-reviewed studies⁵ found that 18 viewed the use of tele-intervention positively while the remaining 5 reported mixed conclusions and the need for more data. Current evidence in the literature indicates that tele-intervention can be an effective model for delivering family-centered early intervention for children who are deaf or hard of hearing.

The knowledge base to provide early intervention services, whether provided remotely or in-person, can be daunting as demonstrated by the following list of Areas of Knowledge and Skill.

Resources for Skills and Strategies

NCHAM, or the National Center for Hearing Assessment & Management¹, is a centralized wealth of information for anyone who is starting to provide early intervention services, or to keep informed of the latest trends and research.

The NCHAM eBook, Chapter 18⁶: Early Intervention for Children Birth to 3: Families, Communities & Communication is a primer for the basics, and the nuances, of providing quality early intervention services.

The NCHAM Early Intervention Resource Pages include the following links:

• Early Intervention System Information
• Early Intervention Guidelines and Requirements
• Importance of Early Communication and Communication Options
• Hearing, Amplification, and Cochlear Implants
• Assessment Tools for Communication/Language and Auditory Development
• Early Intervention Curriculum and Training Materials
• Additional Early Intervention Materials, Web Sites, and Presentations

NCHAM also has a Practical Guide to the Use of Tele-Intervention in Providing Early Intervention Services to Infants and Toddlers Who are Deaf or Hard of Hearing⁷.  NCHAM established a tele-intervention learning community comprised of providers and researchers to share experiences, address challenges and systematically address relevant issues. Contact this thriving community by sending a message to Facebook.

References

1. 1. http://www.infanthearing.org/earlyintervention/
2. 2. http://depistageneonatal.be/pro_surdite/articles/Moeller.pdf
3. 3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4352990/
4. 4. https://journals.lww.com/iycjournal/toc/2017/04000
5. 5. https://doi.org/10.1177/1357633X18755883
6. 6. http://www.infanthearing.org/ehdi-ebook/2020_ebook/18%20Chapter18EarlyIntervention2020.pdf
7. 7. http://www.infanthearing.org/ti-guide/index.html

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The 2015 Outcomes of Children with Hearing Loss research² on children with permanent mild to severe hearing loss (25-75 dB) was a large-scale longitudinal study that followed children from six months of age to seven years old. There were 317 children who were hard of hearing and a comparison group of 117 children without hearing loss from 17 states. Almost all had permanent bilateral hearing loss and hearing aids. Three fourths were identified through newborn hearing screening. Assessment occurred every 6 months from age 6-24 months and annually thereafter to groups of children.

Summary of OCHL Findings:

In general, this collection of articles has now proven what experienced early interventionists know – for children who are hard of hearing, hearing aids need to be well fit and worn consistently and families need to know how to communicate effectively with their child to maximally develop spoken language. The richness of the parent’s talk with the child influences the child’s language outcome. This ‘formula for success’ for children who are hard of hearing is now supported by strong research.² To accomplish these ends requires very knowledgeable interventionists who have the time to provide continued support to families throughout early childhood and the involvement of someone with expertise in the educational impact of hearing loss once the child is in school.

The National Center for Hearing Assessment and Management (NCHAM) reports that detecting and treating hearing loss at birth for one child saves $400,000 in special education costs by the time that child graduates from high school.³ The amount saved can only be realized with the investment of early, appropriate services from experienced interventionists working to support families over time.

Early Intervention “Curriculums”

There is no single resource that will impart all the knowledge needed to adequately support families of young children with hearing loss. The interventionist must have a sufficient background in hearing loss, understanding audibility/speech perception, language development, the continuum of communication choices, and adult learning – as a start. The following are resources that have materials that can be easily shared with families to enhance intervention. The best intervention is reactionary, in response to the current concerns of the family, that builds skills over time in relation to the child and family’s needs. That said, it is very helpful to have resources at hand to draw from as you respond to different family learning styles and needs.

SKI*HI is perhaps the oldest and most recognized EI curriculum resource, especially for persons just starting to work with families of young children with hearing loss. The 2-volume, 2200-page resource includes information suitable to all degrees of hearing loss and exploration of and starting skill building in all communication choices. The visuals provided in the SKI*HI curriculum are something that interventionists use all the time!

EI Resources for Families Choosing to Use ASL

Gallaudet has some informational webcasts that will be of benefit to early intervention providers assisting families in learning sign language to use with their young children. Refer to the list of EI webcasts, online learning resources and publications here.

To learn any language, a child must be surrounded by fluent language users who dynamically involve the child in 2-way communication. Therefore, teachers of the deaf/hard of hearing who are highly skilled in the use of sign language and/or adults who have hearing loss and use sign language (Deaf Role Models) are the optimal choice for facilitating the family’s effective use of sign language.

Referencing sign language dictionaries such as Signing Fun, the Gallaudet Children’s Dictionary, and ASL Basics for Hearing Parents of Deaf Children is often very useful to families. It is important for EI providers to understand the developmental hierarchy for learning sign language. ASL developmental hierarchy information can be found at the end of this White Paper.

EI Resources for Families Choosing to Use Listening and Spoken Language

Listen Little Star is a tried and true resource from Australia that has 12 lessons for the family of infants (0-12 months). It is easy to use and has a DVD with professional grade video clips to accompany each lesson.

The Learn To Talk Around The Clock Toolbox is organized around a set of principles and provides hundreds of suggestions for natural practice in the family’s home or child care setting in an orderly presentation of skills known as “Signature Behaviors.” Author Karen Rossi, DHH teacher and LSLS, has an incredibly helpful website to support families, early interventionists, childcare and into preschool. The Language Development Knowledge Cards have many applications.

The Listening Room (Advanced Bionics AB4Kids) features three sections with content created specifically for age groups: Infants & Toddlers, Kids, Teens & Adults. Register to be able to see and download free activities and resources to support the development of speech, language, and listening skills. AB4Kids also offers the Baby Beats (video) app to develop listening and communication skills in young children. They also provide wonderful resources for preschool and school-aged children.

Cochlear Corporation has provided extensive, incredible resources with Sound Foundation for Babies and Sound Foundation for Toddlers. Designed for 12 months and up, the skills for babies start at a beginning auditory awareness level are applicable to children who are hard of hearing identified in the first few months along with those who are recently implanted. Babies Babble, Toddlers Talk, and Children Chatter are all videos that support the Listen, Learn, and Talk book. The Cochlear suite of materials is helpful to any interventionist or teacher working with children with useable residual hearing. There are also resource for parents of school-age children and could selectively provide some basic information for teachers. It is great to have this bank of resources videos at your fingertips.

MED-EL cochlear implant company also provides resources to purchase that will support listening and communication development.  Their free offerings include Ling Cards (set of 7 cards, 3” x 5”), Little Listeners comprehensive guide for preverbal speech, language and auditory development, Little Listeners in Spanish and other resources that can be ordered for free, or downloaded as PDFs.

Early Intervention Materials

Early Language Development Handouts and Activities with Bonus CD  This inexpensive resource provides 25 informational and activity-based handouts that will help you tell parents and caregivers at home how they can stimulate language development in their young ones. Copy the black and white handouts or print color versions from the CD.

Early Intervention Kit – Teaching Guide, Activities Book, Sign Language Cards While this is not a DHH-specific resource, this kit has the essential information and tools for successful early intervention services. Effectively address assessment, intervention, and documentation. The Activities Book is a gold mine of intervention objectives, goals, and specific suggested activities, for Pre-Linguistic Skills, Expressive Language Skills, Receptive Language Skills and Sound Production Development. 

Listen Little Star is for families of infants newly diagnosed with hearing loss. It is excellent for families to obtain and use independently as a supplement to their early services. It is even more effective when used as a family-friendly guide to early intervention whether used by a provider with limited background in DHH or a veteran early intervention DHH teacher. This colorful 160+ page guide is divided into 12 lessons and also includes an extensive Baby Response Checklist data gathering tool and other resource materials at the end.

A DVD with professionally recorded video lessons provides a description and video showing the lesson being done by a parent and child. It is an excellent way to teach the skill in the printed or digital guide.

Achieving Effective Hearing Aid Use in Early Childhood

The purpose of this guide is to further the understanding of children’s development, how developmental stages will affect hearing aid wear, and what families and early intervention teachers can do to achieve full-time hearing aid wear. By using the information in this guide, hearing aid retention accessories and specific age-appropriate strategies, it is hoped that families will be better prepared to manage their child’s hearing aid wear. The guide is 88 pages long and is available in digital or paper versions. Information written in this guide is directed toward parents, which makes it ideal to use as an intervention guide while providing services to families of infants, toddlers and transitioning preschoolers.

The Developing Child with Unilateral Hearing Loss

20%-30% of all infants diagnosed with hearing loss have unilateral hearing loss (UHL). The result is hundreds of

families of babies with unilateral hearing loss who are seeking assistance to understand what the hearing loss may mean to their child’s future and to receive direction on how they can best influence their child’s success.

The publication is a step-by-step guide to early intervention for children with UHL. It is available in digital and paper versions. The early intervention material is based on a 100-slide PowerPoint Presentation that explains what should be discussed at each of the first 5+ early intervention sessions along with family-friendly information to address each key point. Handouts have been drawn from the slide groups to serve as a summary of key concepts.

Social-Emotional Evaluation/Assessment Measure (SEAM)

The SEAM is an in-depth, easy-to-use tool, to reliably assess and monitor social-emotional development in

infants, toddlers, and preschoolers at risk for delays or challenges. The two-part SEAM™ assessment reveals

detailed qualitative information on children’s social-emotional competence – and identifies their caregivers’ strengths and areas of need. Easy to learn and implement, SEAM can be used by a wide variety of early childhood professionals, including those with little or no training in mental-health or behavioral interventions.

APPS!

There are literally thousands of apps available, with varying quality and effectiveness. Without any recommendations, the following are some resources regarding apps for babies/young children with hearing loss:

References

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In 2012, Jane Madell, PhD and I sent out a survey to a variety of groups of parents of children who are hard of hearing or deaf, asking them what strategies they used to keep hearing aids on their children when they were very young. We also asked them to rate the various hearing aid retention accessories that are available. The results provide valuable information for families to know and for audiologists and early intervention professionals to share with the families they support. Jane and I then developed the information into three 2-page brochures that can be provided to families based on the age of their child. Again, thank you parents for sharing your expertise. Karen L. Anderson, PhD, Director.

Downloadable Keeping Hearing Aids On Brochures for Families

The brochures address why and when hearing aids are needed; basic problems keeping hearing aids on for children in that age range; and hearing device retention accessory information. Print out as a two-sided document and fold as a brochure. Provide to families as their child grows throughout early childhood. Audiology clinics and early intervention programs are encouraged to print brochures to have copies readily available for families when hearing aid retention issues are discussed.

Download and print your brochure information now! Select the brochure below and print! Both sides is suggested, using 28# or 30# paper.

Babies and Hearing Aids – 0-12 Months: 0-3 months; 4-6 months; 6 months; 9 months; 12 months; how to keep hearing aids out of your baby’s mouth; how to discourage his practicing the skill of yanking off the hearing aids

Toddlers 12 to 24 months: during the second year; about 20 months; how to discourage your child from yanking off the hearing aids; checking the hearing aids daily with toddlers

Preschoolers and Hearing Aids – 2-5 Years: the terrible twos; the curious threes; the sensitive fours; checking hearing aids daily with preschoolers

Spanish version of the 3 brochures

Can’t print and want to receive a copy of each brochure by mail? to receive the three brochures, sent in an envelope to you at no cost (English version, US only).

Also available: Oticon USA has made the content of these 3 brochures available in one brochure called the Children’s Retention brochure (#15500-3025). It is available for ordering through pediatrics@oticonusa.com. You can request up to 10 free per order or download them from the Oticon website at: https://www.oticon.com/your-hearing/children-with-hearing-loss/why-childrens-hearing-is-important Spanish version also available! Thanks Oticon!

Ear Gear was rated top by families for effectiveness for keeping young children’s hearing aids on and safe! Once this finding was evident, a special price was negotiated with Ear Gear for families/professionals who wish to try Ear Gear!

• Hearing Review Article: Improving Hearing and Hearing Aid Retention for Infants and Young Children: A practical survey and study of hearing aid retention products. This lead article in the February 2014 Hearing Review is for professionals, describing the survey, results based on parent and audiologist responses and acoustic transparency information for hearing device retention accessories. By Karen Anderson & Jane Madell
• Advance for Speech and Hearing article: If We Could Improve Just One Thing: Getting the Most Out of Early Hearing Loss Identification, by Karen Anderson is an easy to read summary of the information, appropriate for professionals and families.
• Hearing Aid Retention for Infants and Young Children: Jane Madell & Karen Anderson, Volta Review Article, Sept/Oct, 2014. For families describing the Children’s Hearing Aid Retention Project survey and results.
• Understanding Limited Use of Amplification in Infants and Children who are Hard of Hearing: Ryan McCreery, Elizabeth Walker & Meredith Spratford. ASHA SIG 9 Perspectives in Hearing and Hearing Disorders in Children, 25, 15-23
• Hearing Aid Use for Children with Hearing Loss: A Literature Review: Karen Munoz & Melanie Hill. ASHA SIG 9 Perspectives in Hearing and Hearing Disorders in Children, 25, 4-14.
• Trends and Predictors of Longitudinal Hearing Aid Use for Children Who are Hard of Hearing: Walker, EA, McCreery, RW, Spratford, M. Ear and Hearing, 36(Supplement 1), Nov/Dec 2015.

Summary information on hearing aid retention survey results and acoustic transparency click here

When the kids were little, one of the strategies we used to keep their aids in their ears was to let them decorate their aids with stickers, charms, and colorful tubes. Letting them personalize their aids was a great way to help them connect with their aids and make them their own. Parent of two children with hearing loss.

Parent’s Strategies Supporting Full-Time Hearing Aid Wear

What helps parents understand their child’s need to use hearing devices all his/her waking hours:

• Talking with other families that had children with hearing loss.
• Speaking with an adult or older child that has hearing loss/hearing aids/cochlear implants and/or viewing videos on the internet of these individuals describing their experiences/abilities.
• Understanding that early exposure to hearing actually develops structures in the brain that allows sound to be processed so it is meaningful – this time cannot be made up at a later age.
• Watching my child’s reaction to sound around him when he wears his hearing aids.
• Recognizing that children will not learn to language to speak or speak clearly until they can hear the speech sounds clearly and that these delays will affect readiness for school.
• The “math” of hearing aids: Babies listen for about a year before they say their first word. If a baby with hearing loss is awake for 8 hours day and only wears hearing aids for 2 hours then he will only be able to ‘tune in’ to the hearing world 25% of the time. It may take up to 4 years for his first word. A school-aged child is awake about 100 hours/week. If he only wears hearing aids in school, that is about 30 hours/week. If the child is only wearing hearing aids 30% of the time then the students can expect 30% achievement since listening and language development occurs all waking hours.
• Learning more about hearing loss by listening to simulations of my child’s hearing ability.
• Getting over my fear of putting the hearing aids into his ears and how to check them daily.

Parent strategies for keeping the hearing aids on the young child’s head:

• Put the hearing aids on first thing in the morning so they felt normal on the head; never, never take a day off!
• Sing whenever the child pulls off the hearing aid; child will want to ‘hear music’.
• Cap over the hearing aids with strings under the child’s chin, crisscrossed and then tied behind the neck so the child cannot easily untie the strings and pull the cap off.
• Clips to hearing aids attached to barrettes in hair; if child pulls off hearing aids it also pulls hair.
• Snugly fitting earmolds that have a tube that fits around the outer ear to make the hearing aid harder for the child to yank off the ear; cement the tubes into the earmolds.
• Toupee tape to help support a large hearing aid or FM + hearing aid on a tiny ear. Suggestions for tape:
  • Topstic – pre-cut strips
  • Phonak hearing aids Stick’n Stay – shaped like hearing aids
  • Hollywood Fashion Tape – can come in already pre cut strips and less abrasive than some wig tapes (from Amazon, Target, Walgreens, etc.)
• Use clips to the back of the child’s shirt or collar – even if he pulls out the hearing aids at least they won’t get lost
• Combine Ear Gear and toupee tape.
• Tube Rider collection as a fun way to keep a child interested and proud of her hearing aids.
• Make sure your child’s day care provider keeps the hearing aids on at all times. If you pick your child up and consistently notice that the hearing aids are off, find a new child care provider.
• Brightly colored earmolds and Ear Gear or SafeNSound name straps that the child can ‘show off’.
• Children are more likely to try to pull of their hearing aids if their hands aren’t busy doing something else!
• It helps to know that all children go through a phase where they take off their hearing aids. Persistence in putting them back in, using accessories to keep them on the child’s head and keeping the child distracted and ‘happily listening’ helps to get through these trying periods.
• Different strategies are needed as children’s dexterity changes. Tape/clips/Ear Gear alone or in combination.

Parent strategies for keeping the cochlear implant speech processor on the young child’s head:

• Sew baby socks on his undershirts for the battery packs of his CI.
• Snug-fitting caps or headbands to keep the headpiece/processor on the head.
• Taping the CI head piece with medical tape to his head – if he yanked it off it would pull a bit of hair as a deterrent.

Strategies for keeping devices on the child’s head while in the car:

• Wrap a blanket around her that has a Velcro strip so she can’t bend her elbows while she es in her carseat (only need to do this a week or less before most children won’t bother the aids anymore).
• Mittens! Use suspender clips and elastic and put through his coat sleeves. That way the mittens are always handy and it is more of a challenge for him to get them off. When he was concentrating on the mittens, he was leaving the hearing aids alone.
• Short Pringle can tubes over his elbows so it made it hard for her to reach her ears. Place special ‘car toys’ that she especially likes in her reach. They are only kept in the car so she will look forward to playing quietly in her seat.
• Inflatable “water wings” over his elbows.

Need more information to help your child or support families better? Consider Achieving Effective Hearing Aid Use in Early Childhood, an in depth 80-page guide by Karen Anderson, PhD.

Parents may be interested in:

One-page handouts: Relationship of Hearing Loss to Listening and Learning Needs

• 16—25 dB Hearing Loss
• 26 — 40 dB Hearing Loss
• 41 — 55 dB Hearing Loss
• 56 — 70 dB Hearing Loss
• 71 — 90+ dB Hearing Loss
• Unilateral Hearing Loss
• Fluctuating Hearing Loss
• High Frequency Hearing Loss
• Reverse Slope or Mid—Frequency Hearing Loss
• Spanish version of Relationship of Hearing Loss to Listening and Learning Needs, all handouts together

Parents may also be interested in:

Communication Building Blocks There are a multitude of resources available that describe the different communication choices or continuum of communication modalities that may be used by children and their communication partners to develop language. This resource presents different aspects of communication as building blocks that can be combined and recombined based on the child’s learning style, desired mode of the family and changing communication situations. It is meant to introduce the concept of communication choices in an unbiased manner and emphasizes that any choice of communication modality can change as the child develops.

Updated January 2016.

The post Strategies for Keeping Hearing Aids on Young Children first appeared on Supporting Success For Children With Hearing Loss.

Printable version of Emailable Tips for Teachers – Specific Early Childhood Tips

Monica Cegelka has worked with students with hearing loss for over 25 years, most of them spent as an itinerant teacher helping to support hearing impaired students (and family and staff) who attend school in their home district. She is employed by CREC Soundbridge in Connecticut.

These early school-age tips were developed as a way of reinforcing and adding more detail to information presented at the school’s staff fall workshop. Early school-age children must have the opportunity to develop listening and language skills all waking hours, and these tips provide helpful strategies to assure the best possible acoustic learning environment.

Monica uses a group e-mail to send out one tip a week to the staff (including paraprofessionals), administrator, and parents. The memo line reads “your student with hearing loss.” Teachers are told to hit “reply” to ask any questions or report any concerns they may be having. Not all tips apply to all students and some may need to be modified for individual needs. Generic tips (also available on the website), as appropriate, are also sent in conjunction with the early school-age children tips.

Recipients have reported that getting one tip at a time has been an effective strategy for implementation. Focusing on one strategy each week reduces anxiety and results in an improvement in best practice techniques for their students with hearing loss.

Tip 1
You are receiving this e-mail because you have a student with hearing loss in your class.

NOTE: It is of the utmost importance for the young school-age child to be wearing amplification/listening devices all waking hours (in and out of school/daycare)

This week’s tip is:

• You are a very big link in the chain of people supporting your student with hearing loss in her quest to become the best listener, language user, advocate and learner she can be. The weekly tips you will be receiving are suggestions on how to better address her needs relevant to her hearing loss. It is not meant to stifle your individual style or creativity; rather, it is meant to support you in creating an educational setting in which a child with hearing loss has the best possible opportunity to succeed using audition and spoken language.

Thank you for all that you do to help support your student with hearing loss.

Tip 2

You are receiving this e-mail because you have a student with hearing loss in your class.

NOTE: It is of the utmost importance for the young school-age child to be wearing amplification/listening devices all waking hours (in and out of school/daycare)

This week’s tip is:

• When you are using the FM, a “U” seating arrangement (when practical) with the student with hearing loss sitting at the top of the curve of the U is best practice for preferential seating. A circle works too. When working with the child individually, try sitting next to her to challenge her by reducing visual cues from speechreading and having her focus on listening. If you are using FM, be sure that you have correct mic placement. If no FM is being used, speak at the child’s ear level and as close to the hearing aid or cochlear implant as possible (about 6 – 8 inches away is ideal).

OR

• compose your own instructions based on your student’s needs

Thank you for all that you do to help support your student with hearing loss.

Tip 3

You are receiving this e-mail because you have a student with hearing loss in your class.

NOTE: It is of the utmost importance for the young school-age child to be wearing amplification/listening devices all waking hours (in and out of school/daycare)

This week’s tip is:

• Because little ones are still learning to listen, they may not report or even recognize problems with their amplification. Batteries, for example, can go dead. Your school needs a trained troubleshooter to perform a daily listening check to catch and fix problems with amplification or to troubleshoot with an expert via the phone.

Thank you for all that you do to help support your student with hearing loss.

Tip 4

You are receiving this e-mail because you have a student with hearing loss in your class.

NOTE: It is of the utmost importance for the young school-age child to be wearing amplification/listening devices all waking hours (in and out of school/daycare)

This week’s tip is:

• Do not assume your student with hearing loss has your auditory attention. Call her name (several times may be needed depending on noise level and listening experience) and wait for eye contact before you begin your interaction.

Thank you for all that you do to help support your student with hearing loss.

Tip 5

You are receiving this e-mail because you have a student with hearing loss in your class.

NOTE: It is of the utmost importance for the young school-age child to be wearing amplification/listening devices all waking hours (in and out of school/daycare)

This week’s tip is:

• Your student with hearing loss is at risk for missing incidental information and details embedded in the message. Check often for comprehension by asking lots of Wh questions. (e.g. What color crayon are you supposed to use?) When you think your student can handle it, change one facet of your routine instruction to determine if your student with hearing loss noticed the novel information (e.g. Usually your directions state, “Line-up at the door.” Change the directions to, “Line-up at the water fountain.”)

Thank you for all that you do to help support your student with hearing loss.

Tip 6

You are receiving this e-mail because you have a student with hearing loss in your class.

NOTE: It is of the utmost importance for the young school-age child to be wearing amplification/listening devices all waking hours (in and out of school/daycare)

This week’s tip is:

• Children with hearing loss often need extra input to understand the thoughts and feelings of others. Use language like, “He’s thinking that…” and “She feels _______

because… “ to help your student with inferential thinking and point of view.

Thank you for all that you do to help support your student with hearing loss.

Tip 7

You are receiving this e-mail because you have a student with hearing loss in your class.

NOTE: It is of the utmost importance for the young school-age child to be wearing amplification/listening devices all waking hours (in and out of school/daycare)

This week’s tip is:

• One of the important bits of incidental knowledge that your student with hearing loss may miss is the names of her classmates. She may need an individual lesson to learn these and staff members’ names.

Thank you for all that you do to help support your student with hearing loss.

Tip 8

You are receiving this e-mail because you have a student with hearing loss in your class.

NOTE: It is of the utmost importance for the young school-age child to be wearing amplification/listening devices all waking hours (in and out of school/daycare)

This week’s tip is:

• The child with hearing loss may require more time to absorb and process language than his typically hearing peers. Give him time by counting to 5 and then requiring the correct response. If it is clear that the child did not understand, rephrase rather than repeat the information.

Thank you for all that you do to help support your student with hearing loss.

Tip 9

You are receiving this e-mail because you have a student with hearing loss in your class.

NOTE: It is of the utmost importance for the young school-age child to be wearing amplification/listening devices all waking hours (in and out of school/daycare)

This week’s tip is:

• Let the child with hearing loss rely on his hearing when you give directions. When initially giving directions, make sure you do not use visual cues such as pointing or gesturing. As stated previously, give plenty of processing time. Add visual cues only if it is apparent that a rephrase did not result in a correct response.

Thank you for all that you do to help support your student with hearing loss.

Tip 10

You are receiving this e-mail because you have a student with hearing loss in your class.

NOTE: It is of the utmost importance for the young school-age child to be wearing amplification/listening devices all waking hours (in and out of school/daycare)

This week’s tip is:

• Talk naturally to the child with hearing loss. Do not talk too loudly or over-articulate words. Use complete phrases and sentences (NOT, “Come-tie shoe.” but rather, “Come here and let me tie your shoe.”). Using acoustic highlighting (emphasizing key vocabulary by making the word a little louder or pausing in front of the word) is a great way to naturally draw attention to the salient information.

Thank you for all that you do to help support your student with hearing loss.

Tip 11

You are receiving this e-mail because you have a student with hearing loss in your class.

NOTE: It is of the utmost importance for the young school-age child to be wearing amplification/listening devices all waking hours (in and out of school/daycare)

This week’s tip is:

• Require the child to use language. Make sure the child has the opportunity to attempt to verbally request an object or an action. Don’t try to predict what he wants and simply comply beforehand. Model the appropriate language, being aware that you may need to supply a label for his idea. Expect the child with hearing loss to repeat your model. Similarly, the language of negation (i.e. “I don’t want chocolate milk. I want white milk instead.”) may need to be modeled and then repeated by the child.

Thank you for all that you do to help support your student with hearing loss.

Tip 12

You are receiving this e-mail because you have a student with hearing loss in your class.

NOTE: It is of the utmost importance for the young school-age child to be wearing amplification/listening devices all waking hours (in and out of school/daycare)

This week’s tip is:

• Seize and expand language! When your student with hearing loss generates a short bit of language like, “Susie swing,” model and expand a more appropriate version like, “Susie’s swinging up high!” Have the child repeat your more developmentally appropriate model.

Thank you for all that you do to help support your student with hearing loss.

Tip 13

You are receiving this e-mail because you have a student with hearing loss in your class.

NOTE: It is of the utmost importance for the young school-age child to be wearing amplification/listening devices all waking hours (in and out of school/daycare)

This week’s tip is:

• Don’t pretend to understand your student with hearing loss if you really don’t. Work toward understanding by speaking educated guesses, but require the student to repeat the correct language after your model. Although getting needs met is a great motivator, it is important to not expect perfection at first. Require more accurate speech and language as the child progresses.

Thank you for all that you do to help support your student with hearing loss.

Tip 14

You are receiving this e-mail because you have a student with hearing loss in your class.

NOTE: It is of the utmost importance for the young school-age child to be wearing amplification/listening devices all waking hours (in and out of school/daycare)

This week’s tip is:

• When you can’t understand your student because of misarticulation, give him a choice between the misarticulated version and the correct version of the single word. (e.g. Did you mean “horfe or horse?”) Initially, the second choice should be the correct choice. When your student gets closer to the correct pronunciation, remind him that you can now understand exactly what he said.

Thank you for all that you do to help support your student with hearing loss.

Tip 15

You are receiving this e-mail because you have a student with hearing loss in your class.

NOTE: It is of the utmost importance for the young school-age child to be wearing amplification/listening devices all waking hours (in and out of school/daycare)

This week’s tip is:

• Songs, nursery rhymes and finger plays reinforce the natural prosody of speech. When new songs are introduced, demonstrate the song first without the music. Then while the recorded song is playing, sing into the FM microphone. The child can also use the audio patch cord to listen to the words and music from your media. Sending a copy of the words home for the family to practice is great reinforcement. If you are singing several songs in a row, announce which song will be sung next so your student with hearing loss can be involved right from the beginning. Be aware that fast paced songs may be a challenge.

Thank you for all that you do to help support your student with hearing loss.

Tip 16

You are receiving this e-mail because you have a student with hearing loss in your class.

NOTE: It is of the utmost importance for the young school-age child to be wearing amplification/listening devices all waking hours (in and out of school/daycare)

This week’s tip is:

• Even pre-schoolers can take some responsibility for their hearing loss. Talk with parents and your educational consultant for students with hearing loss to determine whether your student should plug in the FM system at the end of the day, independently boot receiver to hearing aid, or find other ways to become “the boss of his hearing loss.”

Thank you for all that you do to help support your student with hearing loss.

Tip 17

You are receiving this e-mail because you have a student with hearing loss in your class.

NOTE: It is of the utmost importance for the young school-age child to be wearing amplification/listening devices all waking hours (in and out of school/daycare)

This week’s tip is:

• Your student with hearing loss may lack the background information and/or vocabulary needed to understand the main idea or details of your book look. Having parents or school staff preview the concepts and vocabulary can help the student become connected to the story during your lesson. When reading, hold the book so that both it and your face can be seen straight on, not in profile, by your student with hearing loss. Be aware of your pace (slightly slower may be better at first) and the need for acoustic highlighting.

Thank you for all that you do to help support your student with hearing loss.

Tip 18

You are receiving this e-mail because you have a student with hearing loss in your class.

NOTE: It is of the utmost importance for the young school-age child to be wearing amplification/listening devices all waking hours (in and out of school/daycare)

This week’s tip is:

• To encourage conversation with peers, place the FM transmitter in the middle of the table during snack and other social times. Unless adequately supervised, students should not pick-up or touch the transmitter. Although the mic will not be 6 inches from the students’ mouths, it will be close enough to boost their voices above the background noise. If a student is showing and telling, either hold the top of the mic six inches from his mouth or appropriately clip the mic to his shirt.

Thank you for all that you do to help support your student with hearing loss.

Tip 19

You are receiving this e-mail because you have a student with hearing loss in your class.

NOTE: It is of the utmost importance for the young school-age child to be wearing amplification/listening devices all waking hours (in and out of school/daycare)

This week’s tip is:

• Be Ms. Obvious Woman and use everyday routines to introduce vocabulary and concepts. (e.g. “I see you hung your coat on the hook.”) Novel situations will always present the opportunity to develop language. (e.g. “That guy is called a juggler. He juggles the balls up in the air. What do you think he’s going to do with those apples? That’s right, he’s going to juggle them.”) Students with hearing loss often know the word for the whole item but may need more explicit teaching for the parts of the item (e.g. Your student knows “shirt” but needs to learn “cuff, collar, etc.”) Using lots of vivid verbs and precise nouns exposes your student to words he might not have been able to hear in overheard conversations but will be required to read in a later grade.

NOTE: Italicized words indicate acoustic highlighting. Work toward eliminating acoustic highlighting in subsequent conversations about the same topic.

Thank you for all that you do to help support your student with hearing loss.

Tip 20

You are receiving this e-mail because you have a student with hearing loss in your class.

NOTE: It is of the utmost importance for the young school-age child to be wearing amplification/listening devices all waking hours (in and out of school/daycare)

This week’s tip is:

• Require your student with hearing loss to answer stereotypical questions (e.g. How are you today?) and to answer in choral response questions posed to the group (“Tell me class, what did the gingerbread man say?”).

Thank you for all that you do to help support your student with hearing loss.

Tip 21

You are receiving this e-mail because you have a student with hearing loss in your class.

NOTE: It is of the utmost importance for the young school-age child to be wearing amplification/listening devices all waking hours (in and out of school/daycare)

This week’s tip is:

• If your student with hearing loss is looking at other students to determine what action he needs to take, he may be hearing but not listening. Likewise, although providing lots of visual clues may be necessary at first, if your student is to learn to listen, he must become less reliant on what he sees and more reliant on what he hears. Fade visual clues as soon as possible. It is easier for your student to tune-in to auditory information after he hears a carrier phrase like “OK Kindergartners, let’s all ….”

Thank you for all that you do to help support your student with hearing loss.

Tip 22

You are receiving this e-mail because you have a student with hearing loss in your class.

NOTE: It is of the utmost importance for the young school-age child to be wearing amplification/listening devices all waking hours (in and out of school/daycare)

This week’s tip is:

• Did you know it is easier for your student with hearing loss to listen to salient information at the end of a phrase? (e.g. “Give me the blue ball,” is easier than, “Give the blue ball to me.” When he’s ready, you can challenge your student with hearing loss by having him listen for salient information imbedded in the phrase.

Thank you for all that you do to help support your student with hearing loss.

Tip 23

You are receiving this e-mail because you have a student with hearing loss in your class.

NOTE: It is of the utmost importance for the young school-age child to be wearing amplification/listening devices all waking hours (in and out of school/daycare)

This week’s tip is:

• Feel free to resort to pictures or drawing if your student is having difficulty understanding consequences for behavior. Of course as you point to the visuals, you’ll want to attach the appropriate language.

Thank you for all that you do to help support your student with hearing loss.

Tip 24

You are receiving this e-mail because you have a student with hearing loss in your class.

NOTE: It is of the utmost importance for the young school-age child to be wearing amplification/listening devices all waking hours (in and out of school/daycare)

This week’s tip is:

• You may need to provide direct instruction in language and behavior for scenarios that typically hearing students can easily overhear. For example, the social language and behavior at noisy snack time can be a challenge for your student with hearing loss.

Thank you for all that you do to help support your student with hearing loss.

The post Emailable Tips for Preschool and Kindergarten Teachers first appeared on Supporting Success For Children With Hearing Loss.

Characteristics of Children as Communicators

Communication Building Blocks There are a multitude of resources available that describe the different communication
choices or continuum of communication modalities that may be used by children and their communication partners to develop language. This resource presents different aspects of communication as building blocks that can be combined and recombined based on the child’s learning style, desired mode of the family and changing communication situations. It is meant to introduce the concept of communication choices in an unbiased manner and emphasizes that any choice of communication modality can change as the child develops.

Communication – whatever fits the child and family

The post Communication Choices first appeared on Supporting Success For Children With Hearing Loss.

The ears are just a way for sound to get in for processing by the brain (Carol Flexer).

Print Version

Hearing is a first-order event for spoken language, reading, and learning which is all based on early development of the auditory centers of the brain.

As of June, 2013, statewide data from North Carolina indicated that 92% of families wanted their child to listen and speak, whereas only 6% chose simultaneous communication, 2% chose ASL, and 1% chose Cued Speech. It is clear that parent choices have changed dramatically over time as 40% chose spoken language in 1995, which increased to 85% in 2005.  The success of developing age-appropriate speech and language skills is built on early, consistent auditory stimulation which is the foundation of development within the auditory cortex of the brain.

Brain Development and Hearing Loss handouts:
Written Format
Graphic Summary

The auditory cortex is the most highly organized processing unit of sound in the brain. This cortex area is the neural center of hearing, language and music, identifying the fundamental elements of pitch and loudness. The right auditory cortex is more sensitive to tonality, while the left auditory cortex is more sensitive to minute sequential differences in sound, such as in speech. The ability of the auditory cortex to function is highly dependent on the sounds encountered early in life. Importantly, the development of brain structures in the auditory cortex to process the minute and rapid changes in pitch and loudness necessary for speech and language development is secondary to consistent stimulation starting prior to birth (4 months gestation) and continuing throughout early infancy and early childhood. These changes to the auditory cortex last throughout the individual’s life. The same exposure to auditory stimulation outside of that period causes no lasting change in the development of brain structures to process pitch and loudness.

Thus, there is a critical window for auditory neural development. Studies in brain development show that sensory stimulation of the auditory centers of the brain is critically important and influences the actual organization of auditory brain pathways. The critical language learning window is secondary to the development of sensory input processing centers in the brain. This, this critical period extends from birth to approximately 3 years of age when brain neuroplasticity is the greatest.

Evidence indicates central auditory pathways do not develop normally in the absence of sound stimulation. This means that the historically poor speech and language skills in children with hearing loss have been due to underlying neurophysiologic deficits in central auditory development caused by the absence of early acoustic stimulation during optimum periods of central auditory system plasticity. Thus, hearing-impaired infants are at risk for abnormal maturation of central auditory pathways if they do not receive adequate sensory stimulation through amplification and, consequently, they will be at risk for delayed or abnormal speech and language development. Given that the central auditory pathways are maximally plastic only in the early years of development, there is a limited time frame for determining whether conventional amplification is providing the stimulation needed for auditory development. For example, it has been shown that congenitally deaf children who are fitted with cochlear implants late in childhood (after age seven years) show delayed central auditory maturation. On the other hand, children who are fitted with cochlear implants within a sensitive period during early childhood (by age 3.5 years) show normal central auditory maturation within six months of implant use.

As we look further into brain development, the foundation of the development of auditory cortex structures to process minute sequential differences in sound, such as in speech, occurs significantly earlier than 3.5 years. Early structures within the brain develop based on consistent sensory stimuli. When born, infants with typical hearing have brains with approximately 2500 synapses, or connections, per neuron. As a result of constant stimulation, the number of synapses grows to 15,000 per neuron by the time a child is 2-3 years old. At age 2-3 years “synaptic pruning” starts to happen. The weaker synaptic connections are eliminated while the stronger connections are kept and strengthened. Thus, if the synapses within the auditory cortex have not been constantly stimulated via amplification and frequent, effective communication with the young child by the age of about 2 years, the majority are likely to be pruned away in the next year or so in favor of the stronger visual processing structures.

To summarize, hearing is a first-order event for spoken language, reading, and learning. Consistent listening experiences in early infancy (birth through age 3) are critical for the development of speech and language in young children and sets the foundation of a strong spoken language base that is essential for reading.

For more information on research related to auditory maturation and the impact of hearing loss review the recent research, especially that by Anu Sharma

• http://pediatrics.aappublications.org/content/60/6/831.short
• http://www.sciencedirect.com/science/article/pii/S0031395505700778
• http://www.sciencedirect.com/science/article/pii/S0378595504004150
• http://www.karger.com/Article/Abstract/94646
• http://spot.colorado.edu/~gilley/pubs_pdf/Sharma_et_al_2005_JAAA.pdf,
• http://fitchlab.com/FitchLabBin/NeuroDev%20Downloads/17.Harrison.etal.2005.PDF
• http://journals.lww.com/neuroreport/Abstract/1996/12200/Auditory_system_plasticity_in_children_after_long.13.aspx

Posted by Karen L. Anderson, PhD, Supporting Success for Children with Hearing Loss, February 17, 2012.

The post Brain Development & Hearing Loss first appeared on Supporting Success For Children With Hearing Loss.

Evidence Base for Improving Outcomes of Young Children who are Hard of Hearing

The
November/December 2015 special supplement to

Ear and Hearing
provided a in depth, multifaceted longitudinal study of young children who are hard of hearing per the

Outcomes of Children with Hearing Loss Study.
Interventionists are strongly encouraged to review the specifics of this broad study. The 10 conclusions of this impressive study, as
identified, were:

1. 1. Children with mild-to-severe HL are at risk for depressed language development, and the risk increases with the severity of unaided hearing levels.
2. 2. Provision of well-fit HAs reduces risk and provides some degree of protection against language delay. Greater aided audibility is associated with better language outcomes in preschool.
3. 3. A substantial proportion (more than half) of children’s HAs were not fit optimally, which negatively impacted aided audibility.
4. 4. Early HA provision results in better early language outcomes, but later-fit children demonstrated accelerated growth patterns once aided.
5. 5. Consistent HA use provides some protection against language delay and supports auditory development.
6. 6. Qualitative dimensions of caregiver input influence child language outcomes.
7. 7. Both receptive language abilities and aided audibility influenced children’s functional auditory and speech recognition skills.
8. 8. Children who are hard of hearing appear to be at particular risk for delays in structural aspects (i.e., form/syntax) of language.
9. 9. Sole reliance on norm-referenced scores may overestimate the outcomes of children who are hard of hearing.
10. 10. In summary, aided audibility, HA use, and characteristics of the language environment interact to moderate the influence of HL on children’s outcomes.

Webinar: Maximizing Language Acquisition – ASL & Spoken English

Provided at no cost by Gallaudet’s Laurent Clerc National Deaf Education Center,
Maximizing Language Acquisition provides an evidence based rationale for supporting language acquisition in both American Sign Language and spoken English for young children who are deaf or hard of hearing. The webinar describes the results of research on language acquisition and clarifies misconceptions in deaf education. To learn more about the webcast click
here.

CHART: Characteristics of Children as Different Types of Communicators

Successful Outcomes Requires Commitment and Focus!

Refer here for an example of a contract between the family and early service provider(s):

Formula for Success Contract.

We had a situation recently, where one of our DHH parent infant teachers arrived at a home visit. The parent continued to play a game on her laptop and nod her head with half interest. The teacher said, “Am I interrupting your game? I made you and your child a priority today and I feel you’re not taking any of this seriously. I’m here for you. Do you want my help?! ” I was so proud of her declaring her commitment to her job and the family.
If this contract would have been done at a first home visit, the situation wouldn’t have occurred. Florida Early Interventionist

Setting Appropriate Functional Outcomes

Part C Early Intervention services require that functional outcomes be specified as part of developing the IFSP. Many people coming from a therapy background are challenged by developing outcomes that are functional, rather than therapeutic.

Examples of Functional Outcomes for Early Intervention Services for Young Children with Hearing Loss
was developed via a group discussion by early intervention providers serving families of children with hearing loss. It is important to recognize this resource is not a menu to choose from, but rather a list to inspire IFSP teams as they think about how to address the unique needs of children who are deaf or hard of hearing. Included are guidelines for how to develop appropriate functional outcomes.

Highly Qualified Early Intervention Providers

Sometimes the model of early intervention means that the family will be served by someone who does not specialize in the early learning of children with hearing loss.
This resource specifies why this is very important to the early (and lifelong) outcomes of the child. Even when the family receives services from a teacher of the deaf/hard of hearing, sometimes the services of a speech-language pathologist are denied – even if the family has made it clear that they want the child to learn to listen and speak.

Why Your Young Child with Hearing Loss Needs Speech Services
provides information on why it is important to insist that a speech language pathologist be an active part of the early intervention team, especially for families who want their child to listen and speak.

Early intervention takes place in the natural environment. Share information about the needs of children with hearing loss:
Welcoming the Child with Hearing Loss into Child Care

Hear to Learn Resource – a learning resource to help parents of young children support spoken language development. This online resource is free and it is available in
English and
Spanish.
Content is developed to be easily accessible (e.g., short video tutorial segments that are narrated and captioned). Easy to follow language activities can be downloaded. Parents can share their story, ask questions, attend webinars, and read about relevant research.

Early Language Development for Children with Hearing Loss –

Questions for Parents

Research data was used to develop some very basic, evidence-based questions that early interventionists or audiologists can ask families of infants and toddlers to quickly determine if obvious delays are present. Not a replacement for actual speech and language measures, this one-page handout it easy and clear to use, providing a good place to start your discussions with families about the expressive abilities of their child.

The
Central Institute for the Deaf offers free resources for those willing to enter their name and email. Download Guidelines for the EI Professional, An entire chapter of the early intervention book,
Small Talk, the Ling Sounds Check, Hearing Aid Checklist, and other resources.

Communication Building Blocks
There are a multitude of resources available that describe the different communication
choices or continuum of communication modalities that may be used by children and their communication partners to develop language. This resource presents different aspects of communication as building blocks that can be combined and recombined based on the child’s learning style, desired mode of the family and changing communication situations. It is meant to introduce the concept of communication choices in an unbiased manner and emphasizes that any choice of communication modality can change as the child develops.

THE RULES OF TALKING
– parents can hang this single sheet of reminders on the refrigerator to help them remember ways they can encourage your young child to talk.

Language Unlocks Learning
This resource was developed to explain to families their unique and critical role in facilitating language development throughout their child’s waking hours.

The article:

Parent Involvement: The Magic Ingredient in Successful Child Outcomes
(Hearing Review Nov 2002), provides similar information and refutes the perspective that a child only needs to have their hearing loss identified and wear hearing aids (sometimes) to learn what he or she needs to become an effective communicator. Actively involved families truly are the magic ingredient in successful learning outcomes.

Parent Interview Progress Report
It is very possible for a child whose hearing loss was identified early (1 month) and wears hearing aids consistently from an early age (by 2 months), with actively involved families, to be learning language at the same rate as their age peers. The Parent Interview Progress Report can be used by early intervention providers working with families to rate various activities that strongly influence the outcome of language development for children with hearing loss. It was written as a follow up to the Language Unlocks Learning handout and intended to be used as part of outcomes monitoring every 6 months, especially if a child has not gained 6 months of language development in that same period.

Setting Reasonable Expectations About Hearing Aid Wear
Attaining full-time hearing aid wear is a big challenge for many families of infants and toddlers with hearing loss. Having consistent sensory input at a young age is critical for
developing the brain’s ability to process sound meaningfully.
Recent information indicates that 40% of children use their devices less than 4 hours per day and that a typical young child (age 0-4 years)only has hearing aids on 5 hours per day with 2 hours of that spent listening in noise. Only about 10% of children ever achieve full time hearing aid wear (all waking hours). We recognize that use of functioning, well-fit amplification devices is the #1 most effective means of improving language outcomes in children with mild-severe degrees of hearing loss. This handout provides guidance to families on how to establish full-time hearing aid wear.

Auditory Skill Development

Go here for
Listening Training Resources

Auditory skills of children who are hard of hearing do not develop at the same rate or in the same way without specific teaching. The following checklists will guide interventionists and family members as they assess and build these important skills.

Sound Foundation for Babies and Toddlers
Cochlear Corporation has a suite of resources to assist with listening and language development from birth to 6 years of age. Free download! The Sound Foundation resources, by Nancy Caleffe-Schenck, offer week by week activities that can be shared with families as a recommended website, or to augment activities discussed during early intervention. Each week includes a video tutorial and attention specific to audition, receptive/expressive language, speech, songs, rhymes, etc.

Auditory Skills Checklist

Auditory skills develop sequentially in a hierarchy of increasing complexity. Most children without hearing loss will develop all but the most complex listening tasks by school entry, improving in their ability to listen in noise as their brain matures – until age 13-15 years. Children with hearing loss typically require attention to auditory skill development if they are to learn all of the skills in the hierarchy, especially if they are to compete with typically hearing peers in a classroom. Good technology and consistent use is a critical factor in the natural development of auditory skills, but cannot guarantee progress of skill development without specific attention. Early literacy is primarily based on auditory skills making attention in this area a priority. The Auditory Skills Checklist is a simplified summary of auditory skills, broken into 10 levels, each with 4 skills and examples. It is useful to track progress on auditory development as a part of early intervention over time.

Auditory Skills Checklist – Cincinnati Children’s Hospital Medical Center
is in an interview format that asks parents to rate skills in terms of whether their child often, sometimes or never/rarely displays use of the skill. Examples are provided to make the questions easy to understand. A numeric score is obtained so that use of this checklist over time will show progress in achieving the skills. Thanks to the Cincinnati Children’s Hospital for sharing this resource for use on
Supporting Success!

Track a Listening Child
is one of the Cochlear Corporation suite of resources for 0-36 months. Attractive and engaging for families.

See Also ASL Development

Updated January 2016.

The post Early Intervention Resources first appeared on Supporting Success For Children With Hearing Loss.