I am a friend and colleague to several talented speech-language pathologists in the Dallas area and would like to take a moment to highlight some of the ever-so useful knowledge they share on specialized subjects from time to time. Please enjoy the following guest post by Amanda England, M.S., CCC-SLP, Owner of Out and About Speech, PLLC. Enjoy!

Your child was diagnosed with a hearing loss. You have visited the specialists (ENTs, audiologists, speech-language pathologists, psychologists…), and with support from your team have decided on the best course of action for your child. Maybe your little one has already received hearing aids or cochlear implants. Now what? What can you do to support your child’s journey to improved communication?

One important step in this process is making sure you have a speech-language pathologist (SLP) on your team who is skilled in providing aural (re)habilitation services. This SLP will guide you as you learn how to become your child’s number one teacher and advocate! But what is aural (re)habilitation, and what skills and techniques should therapy address?

Aural (Re)habilitation – specialized services to help people with hearing loss improve their communication skills. For many adults with hearing loss, this means regaining skills that they have lost due to a reduction in their hearing (rehabilitation). For most children, this means developing skills that they were not born with (habilitation). Therapy will look different for every individual based on their needs! (This article focuses on listening & oral language skill development, which may not be the preferred method for your child or family. For more information on communication options for children with hearing loss, click here.

Photo by Markus Spiske

Although this process looks different for every child with hearing loss, many families prefer for their child to focus on developing listening and oral language skills (vs. sign language, lip-reading, etc.). For this approach, the speech therapist will model a variety of strategies during sessions and provide examples of how to use these techniques at home. The following techniques are often recommended for children who are developing their listening and oral language skills:

  • Use listening devices. From the time your child wakes up to when they go to bed, they should wear their hearing aids or cochlear implant speech processors at all times. (Exceptions are made based on physician recommendations or when the listening devices might be damaged – such as during bath time.) Extra batteries are always a good idea to make sure your child has access to sound during all waking hours!
  • Provide opportunities to listen! There are lots of ways to practice listening with everyday sounds in your home (for example, listening for the doorbell, microwave, or buzzing of the dryer). For early listeners, start by narrating the sound so that your child can understand what they are hearing and how they should respond. Hear the doorbell? Wait for the child to show that they heard a sound, then talk about what you heard. “Hey! Did you hear that? ‘Ding-dong!’ I think I hear someone ringing the doorbell. Let’s go see if someone is there!” For more examples as well as listening skills to look for, download a free household sounds listening activity checklist here.
  • Model and highlight. As your child develops their listening and language skills, continue to model language at a higher level than your child uses, so that they develop new skills through listening to you! If your child says “uh-oh” when they drop a toy, continue to expand on their utterances. “Did you drop a toy? Uh-oh! Let’s look for it. Where did it go?” You may notice that your child leaves off words or sounds as they continue developing language. Repeat what you heard them say and make certain sounds longer and louder to help your child recognize and correct these errors. For example, if they say “uh uh” for “up up”, you can respond by making the /p/ sound more exaggerated. “‘Uh uh?’ Do you want ‘uP uP?'” The speech-language pathologist you work with will demonstrate these techniques so that you are confident using them at home!
  • Repeat and narrate. Narrating your day takes practice. For lots of parents, this is not a natural skill. But don’t worry – your child will think it is great fun! Even though you may feel silly at first, remember that your child needs to hear you say a word many times before they start to use it. Begin to develop routines for bed time, meal time, getting dressed, etc. “It’s time for bed! Let’s read a story. Should we get a big book or a little book? Let’s get a big book! Wow! Look how big our book is!” Don’t be afraid of using the same word too many times, or of throwing in a more advanced word (like “enormous” or “huge” instead of “big”). Ask your child questions during the routines, and give them wait time to answer. They may not answer right away, but continue to give them time to process what you have said and respond. Even if they are not repeating or answering questions yet, they are taking in what you say!
  • Stay in touch with your team! There is so much for you (and your child) to learn during this process. Remember, your team members (including your child’s audiologist, ENT, speech-language pathologist, teachers, etc.) are there to support you and answer any questions you may have. Don’t be afraid to reach out to them! You can also support the specialists on your team by letting them know of any changes in your child’s behavior or speech and language development. Sometimes, these changes mean that an adjustment should be made to strategies used in therapy or the programming used in your child’s listening devices.

Keep these tips in mind while working with your child, but remember that this is not a complete list of strategies. Your speech-language pathologist will provide you with additional tools that may be appropriate for your child’s specific needs.

For more information on aural rehabilitation strategies and resources, visit these sites:

https://hearingfirst.org/learning-growing-lsl/lsl-strategies-techniques
http://www.cochlear.com/wps/wcm/connect/intl/home/support/rehabilitation-resources
http://www.speech4hearing.com/the-auditory-hierarchy-listening-from-the-beginning/

About the Author:

Amanda England is a speech-language pathologist who provides in-home therapy services in Plano, Texas. She specializes in aural rehabilitation, and has assisted children with hearing loss and their families since graduating from UT Dallas in 2013. She is the owner of Out and About Speech Therapy

(Photo by Beth Bernthal)


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