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Speech and Language

Deafness

 

 

Most deaf children are born with the same ability to develop language (whether signed or spoken) as any other child. Whatever their stage of development, the way you communicate with your child can make a big difference. 

The term deaf can be used to describe all levels of hearing loss in children, from mild to profound. Hearing losses are common in children. Although the cause and severity can vary, and may be temporary or permanent, all children with a hearing loss will have to work harder to listen and learn.

earSensorineural deafness is a hearing loss in the inner ear. This usually means that the cochlea in the inner ear is not working effectively, and this is a permanent type of hearing loss.

Conductive deafness means that sound cannot pass efficiently through the outer and middle ear into the inner ear. This is often caused by blockages such as wax in the outer ear, or fluid in the middle ear (glue ear).

Glue ear is a very common condition, especially in pre-school children. 8 out of 10 children will experience glue ear before the age of 10. Children with a cleft palate or Down Syndrome can be particularly susceptible to glue ear. Most conductive losses such as glue ear are temporary, but some can be permanent.

What You Might Notice:

  • Your child may not always respond to their name being called
  • They might struggle to hear and follow instructions or may misunderstand them
  • They may appear easily distracted and need support to remain focused
  • They are likely to find it harder to hear or listen in noisier situations, such as in groups, when there is background noise
  • They might appear tired or frustrated – your child is having to work harder to listen than their peers
  • Your child may watch others before carrying out activities themselves.
Universal Strategies

Environment

Help your child’s hearing and listening by making your home as listening friendly as possible by:

  • If possible, have some areas with soft furnishings such as carpet, curtains or rugs, as these reduce noise, so make listening easier.  
  • Reduce background noise, for example turn the TV off when you’re not watching it with your child. This is important for children with all levels of hearing loss, including glue ear.  
  • Support others in the family to take turns so that it’s easier for your child to listen to who’s speaking.
  • Try to be close to your child when you’re speaking and get down to their level.  

Creating a good communication environment

Hearing Equipment

There are many different types of technology that can support your child to access sound. You can find out more about what is available using the link below

Hearing aids and implants

While this equipment can significantly improve your child's hearing, it cannot completely replicate the process of hearing sounds, so extra consideration will still be needed to support them at home and in any setting. 

  • Check that hearing equipment is working every day - like a mobile phone, this equipment needs to be charged daily.
  • Use the equipment as advised by your child's Teacher of the Deaf/cochlear implant team - this includes if the child has use of a radio aid which may be used to help in noisier situations. 
  • If your child is struggling with wearing their hearing aids or implant processor, try to encourage the wearing of them at quieter/less busy points in the day, such as for story time or when in a quieter place and then gradually build this up. 

Use the link below for more tips and advice on keeping your baby or young child's hearing technology on:

Keeping hearing technology on babies and toddlers

Interactions

Gain your child's attention before you start to speak by calling their name or tapping them gently on the arm, so that they have the best chance to hear and understand what you’re saying.  

  • Make the most of everyday routines, such as washing hands, bathtime and meal times. They are great opportunities to support your child’s language development on a very frequent basis! 

    BBC Tiny Happy People - washing hands - chatting and learning
  • Use visuals, gestures, signs and facial expressions to support their understanding. 
  • Face your child when talking and get down to their level so that they can lip-read and see your facial expression. This will help them to understand you.
  • Avoid doing things that make it difficult to lip-read, so stand still when talking and avoid talking with your hand in front of your mouth.
  • Allow extra thinking time if needed – it may take your child more time and effort to filter out additional noise and process language in order to think of an answer.  
  • Speak naturally and clearly. Speaking slowly or too loudly makes lip-reading much more difficult.
  • Check that your child has heard and understood you, if they haven’t you may need to rephrase or use a different word or sign.
  • Strategies such as pausing, expanding on what your child says and giving choices will all support your child’s communication skills.  

 

  • Make listening fun! Listening can be challenging for deaf children and for children with glue ear whose hearing can be inconsistent, so play fun listening games and sing action songs to engage them with listening.

BBC Tiny Happy People - go on a listening walk

Vocabulary 

Repeat, repeat, repeat! Deaf children will need to hear new words again and again, in different situations. Talk about what they are doing or looking at.

 

Make the most of opportunities such as routines to model language. For example, washing hands can include action words like 'wash', 'dry' and 'turn', object names including 'tap', 'water' and 'soap' and concepts like 'wet', 'dry', 'full', 'empty', 'all gone', 'hot', 'cold', 'clean', 'dirty', 'on' and 'off'. Choose 1 or 2  to focus on for a while and when the child is sure of those, you can introduce some more. 

BBC Tiny Happy People - washing hands - learning and chatting

New vocabulary can be challenging for children with hearing difficulties, as they can miss a lot of language that other children hear many times. Specifically teach new vocabulary – draw their attention to new words and explain their meaning. It is also important to check that they have accurately heard and remembered new vocabulary. 

  • Ask in pre school/school about any new topics they are due to start, so that you can explore them beforehand with your child and help them with any new key words. They will then be able to more fully take part and understand the topic when it is introduced to the other children. 
  • When introducing concepts, such as clean or dirty, hot or cold, focus on one at a time. For example, use the word empty and create lots of opportunities to reinforce empty and contrast with not empty if needed. When they are sure of that concept you can introduce the opposite - full. If both are introduced at the same time they can confuse the words. 

 

  • Watch your baby’s behaviours and respond to them, for example copy the sounds and facial expressions your baby makes
  • Spend time in close face-to face interaction with your baby 
  • Use your voice and touch to gain your baby’s attention - make your voice fun to listen to
  • Try singing while feeding or bathing your baby
  • Talk and play in quiet situations – turn off background noise where possible, to make it easier for them to hear you
  • Everyday routines are great opportunities for chatting, singing, or playing games such as “peep o” with your baby/child

National Deaf Children's Society - communicating with your deaf baby or toddler

BBC Tiny Happy People - top tips for 9 to 12 months

Communication

Targeted Interventions

Children with a hearing loss may need extra support to develop their speech, language and communication skills. Please look at relevant levels of the pyramid for further information on specific areas of communication.

Targets might include:

  • To wear hearing aids throughout the session.
  • To be able to request “more” using sign/speech and/or core board.
  • To take turns in an activity with a peer.
  • To be able to sort objects by categories (e.g. food vs clothes).

Who Can Help?

You can access Speech and Language support by calling Just One Number on 0300 300 0123. Our opening hours are 8am-6pm Monday-Friday (excluding bank holidays).

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