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How Hearing Differences Can Affect Communication

How a child is affected by a hearing differences depends on a number of factors:

  • Type of hearing difference 
  • Degree of hearing difference
  • Configuration of hearing difference

Other factors, including:

  • family involvement
  • the age at which hearing difference occurs
  • the age at which hearing difference was identified
  • the age at which intervention was provided
  • the child’s other health conditions

Hearing differences in a child are different than hearing differences in an adult.  This is because a child has not yet learned a formal language. Adults with hearing differences can sometimes get by without hearing aids because they know and can apply the rules of language to daily conversations with others. For a child, even a mild hearing differences can affect his ability to develop speech and language skills. Children need to hear all of the sounds of their language in order to learn how to talk.

Children with severe to profound hearing difference often need to learn some form of visual communication, such as sign language, because even with a hearing aid, they may not be able to hear all the sounds of speech. This is not to say that children with severe to profound hearing difference will never learn to talk. Rather, they may need to get speech and language information in ways other than hearing alone.

Children with milder degrees of hearing difference may also benefit from knowing some form of visual communication. There may be times (e.g., swimming, bathing) when a child is not wearing her hearing aids, but needs to communicate.

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Frequently Asked Questions About Communication Options

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Communication Milestones

EHDI supports all forms of communication for a child diagnosed with hearing differences, deafness or deafblindness. The earlier a child can start communicating, in whichever form the child and family decide upon, the more opportunities the child has for behavioral, communicative, social and emotional development. No child learns to communicate the same way, so families need to have a wide variety of communication tools to be aware of as their child develops. Some forms of communication involve established languages, such as American Sign Language (ASL) or spoken English. Some forms of communication combine established language and other tools, such as cued speech, Signed Exact English, tactile signing, pro-tactile signing, touch cues or augmentative devices to help in language development. Some families need to establish other forms of communication, such as gesture dictionaries or picture cues. Families may choose auditory methods that involve amplification to support their communication goals. Other families and children may opt for visual communication forms. Children may have sensory needs that create the need for more individualized communication the family can develop, either with or without the support of an Early Intervention Team. Regardless, children and families communication styles and needs should be respected by all care teams, as all families communicate differently. Additionally, communication choices may change over time based on the needs and resources of the child and family.  Families should also be encouraged to have their child’s hearing tested early so they can develop the most appropriate communication for their family as soon as possible.

Below are several resources for Communication Milestones to help guide professionals and parents in developing communication tools for children with hearing differences.  There are some established milestones for visual and spoken languages that can help guide families in knowing if their children are developing communication similar to children with typical hearing. There are also several resources for establishing communication that help lead parents through the process, but there are no exact timelines. If you feel your child or a child you care for is not displaying signs of communication, your child has stalled in their communication growth, or just feel that something about their communication development is “not quite right,” please contact the Iowa Family Support Network to refer a child for Early ACCESS.

Please note that using ASL or another communication mode(s), along with spoken language, while waiting for hearing testing to be completed WILL NOT STUNT communication skill growth and may help your child.  

Check the list below for communication milestones, guidelines and resources currently available.  Note, this is not an exhaustive list.  Please see Iowa’s current LEAD-K law regarding communication access for children with hearing differences.

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Types of Communication Options

Below you will find the most commonly used communication options. When choosing a communication method for your child and family, there are some things to consider: your family’s preference, your child’s development, your family support, your community services, and the expertise of the professionals working with your child. Work with your provider to determine which option is best for your child.

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Available Hearing Amplification Technology Options

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