Hearing Impairment and Language Development

Early identification of a hearing impairment is critical to a child's overall language development and speech intelligibility, factors that will play a significant role in the child's ability to socialize, as well as to succeed in school. Most children with hearing impairments can develop good oral language skills that are not substantially different than those of their hearing peers if these crucial elements are present:

1. The hearing loss is diagnosed before the child is 6 months old
   
2. Intervention begins immediately.
   
3. The child has the services of such professionals as speech-language pathologists, audiologists, and teachers with special training in the education of children with hearing impairments.
   
4. The child uses appropriate hearing aids.

This is especially true for the child if the hearing impairment is not profound, cognitive abilities are intact, and no other developmental disabilities are present.

Early Intervention

Early intervention can significantly limit (and in some cases prevent) the need for more extensive services as the child enters and progresses through school. This is especially true for children with hearing impairments who enter school with an intact language system. Although these children will continue to need some management and communication therapy, they may not experience academic problems that require remediation.

On the other hand, a child with impaired hearing and unresolved language concerns will often find it difficult to learn reading, writing, and arithmetic. These children will require special education services in these basics, as well as ongoing communication therapy. Children who have an atypical phonological (speech) system, even though their language abilities are intact, may also find it hard to learn to read and are at greater risk of developing reading disorders.

Interventions

Before appropriate therapy objectives and teaching methods can be identified, the severity of the hearing impairment must be assessed. For example, if a child cannot hear herself, or others, speak, then teaching will focus on visual and tactile aids to teach speech sounds, and not on having her imitate the sounds she hears.

Children with hearing impairments who can hear themselves and others often cannot hear clearly, even with the most appropriate hearing aids, because of the damage to the auditory system. They also need special assistance.

Often a child with a hearing impairment is taught to use sign language. Ideally, this begins early in the first year of life, immediately following the diagnosis of hearing impairment. The two best-known forms of signing are:

• Manually coded English--Manual signs that correspond to English words, and that use the same grammatical structure as spoken English. This is the form of signing that is used in most Iowa schools.
  
  
• American Sign Language (ASL)--A manual sign language system that differs significantly from spoken English in its grammatical structure. For example, one ASL sign can represent a concept that requires many English words to express.

Total Communication

Individuals who use manually coded English will speak and sign simultaneously. This combination of oral language (talking) and manual signing is often referred to as a "total communication approach." The child must also use hearing aids to tap any residual hearing, and may lip read as well. Total communication is often the first approach to be recommended, for it encourages a child to use every available mode of communication to both receive and convey messages.

Signs of Undetected Impairment

Children sometimes exhibit speech or language patterns that suggest an undetected hearing impairment. For example, a child may omit certain sounds, such as saying "ca_" for "cat." A child with impaired hearing may watch a speaker's face more intensely than other children in order to gather visual cues about what is being said. The voice of a child with hearing impairments may be erratic in pitch and intensity because the child cannot hear and monitor voice output.

Most children with hearing impairments will demonstrate difficulties with morphemes, such as:

Summary

To communicate is a basic human need. When a child has a hearing impairment, early intervention is essential to meet this need--whether the child will ultimately learn to communicate by manual signing, oral language, or a combination of both. Contrary to popular belief, during their first year infants with hearing impairments will not only attach meaning to signs, but will use signs to "babble" just like their hearing peers. The windows of opportunity that open during this critical first year must not be blocked, their potential unrealized, because a child's hearing impairment has gone undetected.

Last Reviewed 2005

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Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.