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Hearing Impairment in Children

There are many misconceptions about pediatric hearing loss. It has been called “The Invisible Disability” because the impact is not immediately apparent. Children have specific learning needs if they are going to learn language through listening.

Many people relate their experiences with elderly people who don’t hear very well to children with hearing loss. People tend to think hearing impairment is the same in both situations. However, talking louder to an adult who lost hearing after having a spoken language is very different than it is for a young child. For the adult, it may in fact be helpful but it’s not the same for a child who is in the process of learning a language.

Hearing loss in children is NOT the same as it is in an adult

Adults are listening to RECOGNIZE words they already know. Children however are listening to language to learn it for the first time. As an adult you don’t need as much of the signal to recognize words. An adult brain uses what’s known as “Auditory Closure” to fill in the missing pieces. Children new to language and listening do not have that ability yet.

Once your brain has the grammatical structures of language built in you can fill in.

If I said “I need milk so I’m going to the XXXXX” you’d probably know what I was talking about. You would not even need to hear the last word at all.

These days a child with hearing loss can gain access to sound in one way (hearing aids) or another (cochlear implants). What they do with that access depends a great deal on US and the linguistic environment we create around them.

Obviously there are many variables on outcomes related to the child’s potential to learn. In this blog post I’m going to talk only about the things we CAN control to create the best potential for auditory learning. Future blog posts will discuss strategies and learning in more detail.

It’s important to understand that choosing listening and spoken language is a CHOICE. There are a variety of habilitative OPTIONS available for a family with a child who has hearing loss. Listening and Spoken Language is only one option for families to consider. Each family needs to be informed of ALL the options available. Then they can make a decision that feels comfortable for their own family.

At Language Launchers, it is our believe that PARENTS have that responsibility and the right to make that decision. We also believe that every professional involved with a family has the responsibility to provide parents information about ALL of the options.

A hearing loss acts like an acoustic filter where some sounds don’t reach the ear (the entry path to the brain). Even the best possible equipment isn’t a duplicate for the unimpaired human ear therefore, there will always be some acoustic information lost. In any given interaction the exact information might not seem all that important. However, the cumulative effect of missing information in each interaction over a period of time can become HUGE. Resulting consequences of losing bits of information over time can be limited general knowledge, poor vocabulary, social immaturity and academic underperformance related to cognitive potential.

Consistent access to sound through hearing devices is critical to long term outcome for learning to listen.

Parents of young children with hearing loss sometimes think if the child isn’t doing anything directly related to listening that there’s no harm if they don’t wear the hearing aids or implant processors. This couldn’t be further from the truth.

Children are learning all the time, either they are learning to process the world WITH sound or process the world WITHOUT sound.

Every minute with access to sound is working toward programming the auditory cortex of the child’s brain in a listening and spoken language approach. The child needs to learn if he drops a block it makes a crashing sound. The child needs to understand if a door closes it usually makes a noise. The child needs to become aware that there are sounds coming from outside the room or even outside the window.

EVERY auditory experience is valuable when a family is opting for a listening and spoken language pathway.

Just providing access through hearing aids or a cochlear implant is not enough for maximum auditory learning to occur either. The quality of the acoustic environment is also critical. Reducing background noise, positioning yourself close to the child when addressing him/her, and providing a rich linguistic environment are all necessary components to learning language through listening with a hearing loss.

Remember that filter effect I mentioned earlier? The cumulative effect of the filter is where the “invisible” parts of the disability come into play. When children’s auditory skills are showing limited progress they could stay at a level of remaining focused primarily on hearing the sounds of speech. When a child requires full on attention just to hear the words then there is potentially less brain power, or merely less attention, available to process the nuances and more abstract parts of language, the undertones, the humor, the more subtle aspects of an interaction.

The less “casual” the listening, the more dependent the child is on direct instruction of language. Direct language instruction typically tends to be more structured and somewhat less natural than what a child might get exposed to by overhearing others talk.

When a child achieves the ability to overhear conversation they are able to learn incidentally. This makes an enormous difference in the content that they take in over time.

The key is an early and consistent start!

Stay tuned for future posts as we discuss aspects of “learning to listen” in more detail.

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Pamela Talbot

Pamela is an ASHA certified Speech-Language Pathologist dually certified as a teacher of the hearing impaired. She is a Listening and Spoken Language LSLS-AVT. Pamela has extensive experience training parents and professionals at the international level.