Following optimal amplification (either hearing aids or cochlear implants) your child should have access to all of the sounds around them, especially the sounds of speech. This is when we begin the clock of expectations for language development. It is important to remember that normal hearing babies listen to the language around them for about a year before they begin to talk. To expect a child who has just been amplified to begin to talk right away, would not be fair. It takes time for the brain to learn how to use the auditory information that it is just beginning to hear.
Listening and language therapy are critical to helping your child learn how to make sense of what he hears. Auditory therapy focuses on moving your child from detection (hearing a sound) to discrimination (telling the difference between sounds), to identification (know what sound it is that he hears), and finally, to comprehension (understanding meaning). It is only after comprehension, that your child will begin to use words to communicate.
Speech is a Complex Act
For some children, the step to spoken language takes a little longer than others. It takes a lot, to verbally express our thoughts, something we all probably take for granted. First, the child must have a thought to verbalize. In the beginning, this is usually expressing a want or need (i.e. “Milk” or “I want milk”). Then, she must recall the label for that object (or person or action). Once the brain has the label, it must send a message to the muscles of the mouth, telling it how to sequence and execute the movements in order to form the word. Assuming the motor pattern is correct, a word is spoken.
How You Can Help
When our babies are newborns, we pride ourselves in “knowing” our babies, learning their cries and anticipating their needs. We begin to put them on a schedule and are able to feed them a snack, even before they are hungry. For the parent of a typically developing child, this might work. But for a child with hearing loss just beginning to talk, it is important to create situations that necessitate the use of verbal language. Three strategies for doing so include, using modeling and repetition, wait time and sabotage.
In the very beginning it is important to model simple single words for your child throughout the day. Repetition is key. A child needs to hear a word MANY times before saying that word. Label objects or simple actions, then look at your child expectingly and wait for an attempt at a repetition.
As speech production is a complex motor act, it is so important to provide wait time. This means giving your child the time to verbalize. Don’t answer for your child or let siblings do so. After asking a question of your child (i.e. “What do you want to drink?”), pause and wait. If you don’t get an answer, rather than asking about a specific item (i.e. Do you want milk?”), provide choices (i.e. “Do you want milk or juice?”). Then wait again. You have now provided your child with the labels and the auditory patterns for the words that they can match. This is helping with the act of speech, but still requiring the use verbal language.
As your child begins to possess a vocabulary repertoire for objects and actions, another great strategy that can be used throughout the day is sabotage. Set up situations which require your child to need to ask for help. You can give them cereal at breakfast without a spoon, take the straw off the juice box, give only one sock, turn a jacket inside out, or give a pencil with a broken tip. To ensure that your child realizes there is a problem, use non-verbal language (i.e. a shrug), suggest they complete the task (i.e. “Drink your juice.”) or say “What’s wrong?”. Then wait for a verbal response. If you find situations that are motivating for your child, you will have the best success.
Be patient. Learning to talk takes time!