by Ishini Ramachandra
In the complex process of childhood development, language is a fundamental medium that facilitates cognitive growth, self-expression and sociocultural interaction. However, becoming proficient in a language may pose particular challenges for children with hearing impairments, including delayed speech and language skills, communication limitations, and learning difficulties. As the foundations for learning and behaviour throughout life are set during the first five years of a child's language development, the earlier such an issue is identified and appropriate interventions are employed, the less serious the impact will be.
Understanding Hearing Loss and Early Interventions
Every child is unique with their personality, skills, and preferences, and in the same way, their hearing loss is also unique. According to Grindle (2014), hearing loss in children can be from birth (congenital) or develop later in childhood. Such losses can be due to many reasons: infections during mother's pregnancy, complications after birth, illnesses and other environmental factors like exposure to loud noises, etc while the degree of hearing impairment can also vary ranging from mild hearing loss to deafness. The focus of this article is specifically on hard-of-hearing children who typically retain some degree of residual hearing and may benefit from assistive listening devices and other technologies that amplify sound. Since children learn to speak and understand language mainly by listening to others, those with hearing impairments may not fully benefit from being exposed to language or from learning by overhearing conversations. Recent research indicates that children diagnosed as hard-of-hearing, if provided with early interventions, may attain language proficiency comparable to their peers with 'normal' hearing. Early childhood intervention, in this regard, involves early identification of hearing impairment, personalized treatment plans and therapy, and awareness sessions for parents to encourage communication and language development in their children.
Addressing the Underlying Issue
The early identification of hearing impairment in a child can significantly impact their language development in vocabulary, pronunciation, grammatical comprehension and word differentiation, as it becomes possible to resolve and mitigate the issue from early childhood. According to a study conducted by Shojaei et al. (2016) regarding the effect of early intervention on language development in hearing-impaired Persian children, a notable distinction between the linguistic skill development of children with early compared with late intervened hearing loss has been observed, where timely intervention had the potential to facilitate normal language development in hard-of-hearing children.
Several possible signs of hearing loss in children in this context are:
the inability to locate the source of sounds,
inattentiveness,
no reaction to loud sounds,
attempting to produce sounds even if they have stopped babbling, and
not moving to more understandable speech.
Therefore, since auditory sense is a prerequisite for speech-language and cognitive development, it is essential that children go through appropriate audiology consultation and intervention followed by early identification of hearing impairment.
Targeted Language Development Interventions
Early intervention programmes often include Auditory-Verbal Therapy (AVT) that focuses on developing spoken language through auditory stimulation, structured listening activities, and natural communication in different environments (Casoojee et al., 2021; Leigh et al., 2015). The use of sign language, visual aids (pictures, videos etc.) and other means of sensory substitution, such as lip reading, cued speech, and rehabilitative therapy are also aimed at improving receptive and expressive skills (speech and language) of hard-of-hearing children through systematic exercises and techniques. Besides, recommendations on hearing aids, captioning services, assistive listening devices (e.g. hearing amplifiers) and cochlear implants (when necessary) can also help the child’s ability to hear and understand speech better, thereby supporting overall language development involving vocabulary, sentence structures, pronunciation and comprehension. These visual, tactile and auditory modes of early interventions essentially provide access to enhanced hearing and spoken language input in hard-of-hearing children, optimizing their language learning and integration into mainstream educational settings.
Family-Centred Approach and Social Environment
The family-centred approach recognizes the active involvement of the family in all aspects of a hard-of-hearing child's care and intervention. This creates a nurturing, comfortable and supportive home environment that encourages parent-child interactions and responsive communication practices. As Hintermair (2006) and (Zimmerman et al., 2009) consider, the social environment - including relatives, friends and acquaintances - also plays a key role for primary social, emotional, linguistic and cognitive experiences. This is where the child learns to develop language skills through active listening and self-expression. Over the years, studies have established a strong relationship between hard-of-hearing children using language and their social context. Therefore, it is important to encourage parents to engage in frequent conversations with their hard-of-hearing children, read books, and tell stories, as these activities provide valuable verbal and auditory input to improve language development.
Overall, early interventions offer a holistic approach to support language development in hard-of-hearing children, addressing auditory, visual, and socio-emotional dimensions of communication. By increasing targeted strategies, resources and evidence-based practices, early intervention programmes empower hard-of-hearing children to overcome communication barriers, maximize their potential, and enhance learning performance.