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.
Frequently Asked Questions About Communication Options
No single communication method is right for every family. The communication options that you choose for your child should take into consideration his individual characteristics as well as the needs of your family. It is important that all the members of your family learn to communicate with him or her. Different communication options have advantages and disadvantages in terms of ease of use and ease of learning.
It is important to understand that no two families are the same, and no two hearing differences are the same. Even though two audiograms may look the same, the children with those hearing losses may function very differently. Ask the professionals working with your child for resources about communication methods and ask what is available in your community. If possible, contact families or individuals that have personal experience using different communication options.
It is very important to begin communicating with your child as soon as possible. You will be encouraged to choose a communication option very soon after her hearing loss is confirmed. Her degree and type of hearing difference will play a major role in the decision you make. Professionals working with you on the speech and language development of your child can provide information on her progress. They can recommend another option you can change to if you feel this is in the best interest of your child and family.
Many professionals will be involved with your child and family throughout their education. They can offer guidance on ways you can help your child learn. What you as a parent can do is to continue interacting with your child as much as possible.
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 thatusing 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.
** Please note that children who need tactile support for communication systems may not follow ages for specific milestones, as learning is not passive for children who experience both vision and hearing concerns. Please watch Megan Mogan’s video with the Arizona Deafblind Project and Perkins Institute on individual and tactile communication for deafblind learners:
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.
American Sign Language uses the placement, movement, and expression of the hands, face, and body. ASL is a complete language with its own grammar and syntax. ASL is another complete language just like English is a complete language. It is considered by many members of the Deaf community to be the native language of people who are deaf. Children born to parents who are deaf learn ASL in the same way that hearing children learn spoken language from hearing parents. Since ASL is not a “method” of learning English but a separate language, hearing parents must work with those fluent in ASL to learn the language and to provide their child with the opportunity to learn ASL.
Aural refers to hearing; oral, to speaking. In the aural-oral method, listening is the primary means for learning language. Speech is the primary means of expressing language. The use of whatever hearing a child has is very important. Children are encouraged to wear hearing aids or a cochlear implant during their waking hours. For this method to be effective, these devices must allow the child to hear speech sounds.
In addition to listening, a child is encouraged to watch the speaker to get additional information from speech reading (lip-reading), facial expressions, and gestures. Hearing through hearing aids or a cochlear implant, even in the best of circumstances, is not the same as typical hearing. Early intervention services need to include specific strategies that emphasize listening and communication.
The auditory-verbal method is based on a specific philosophy within the broader aural-oral category. Again, the development of language through listening and the use of residual hearing are central. The use of hearing aids or a cochlear implant will be the same as in the aural-oral method, but there is little if any emphasis on visual cues such as speech reading or gesture. Parents participate in all therapy sessions and use the techniques they learn with their child at home. Families who use an auditory-verbal approach are encouraged to place their children in regular preschool and general education classes, rather than special education or deaf education classes.
A person is described as bilingual when they are fluent in two languages. For a person in the United States who is deaf, these two languages are usually ASL and English. When a child is born to parents who are Deaf, the language of the home and the first language of the child is usually ASL with English as a second language. When a child is born to parents who are hearing, the language of the home and the first language of the child would typically be English or whatever language is spoken in the home. In a bilingual method, the hearing family learns and uses ASL in addition to English. In some programs, the family uses English and the school program uses ASL in the early years, adding English as a second language as the child gets older.
Cued speech uses English in a way that can be seen as well as heard. It uses a combination of speech reading, hand shapes, and hand positions near the face to communicate speech sounds. For example, when you speak, p, b, and m all look the same on the lips. As a result, the words pat, bat, and mat all look exactly the same to someone who is speech reading. Using different hand shapes for the p, b, and m allows the listener to understand which word is being said.
The Manually Coded English method uses a visual form of the English language, or sign language. English is represented (coded) by signs made with the hands. Several different systems for manually coding English exist. Each one has its own rules and variations. Most use American Sign Language (ASL) signs as a base and English word order. Manually Coded English follows English language rules. All sign language methods require a commitment from all family members to learn and use signs for communication with the child. If the family chooses this method, it is important for parents to learn sign as quickly as possible. That way, their children can learn language from them in the same way children with hearing learn from their parents. Systems of MCE include: Signed Exact English1, Signed Exact English2, and Rochester Method. Pidgin is a Contact Sign Language which typically uses ASL signs but in English word order.
The simultaneous communication method combines spoken and signed communication. Parents are encouraged to both speak and sign when they communicate with their children. Some form of manually coded English is used for the sign system. Children wear hearing aids or a cochlear implant and are encouraged to use their hearing as well as sign and speech.
With the total communication philosophy, a child with hearing loss uses all forms of communication available to develop language skills as early as possible. These may include child-devised gestures, formal sign language, speech, speech reading, finger spelling, reading, and writing. The child may also use individual or group amplification systems to utilize residual hearing as much as possible.
