Teaching parents specific strategies
A way to support communication for toddlers with hearing loss.
Did you know?
Advancements in technology have brought us devices that can improve hearing in children with hearing loss. These include the availability of cochlear implants and improvements to hearing aids. While these devices can help children with hearing loss access sound, many of these children still have a greater difficulty with language skills compared to kids their age without hearing loss.
Why might this be?
Young children learn to communicate by interacting with their parents. Children with hearing loss can have difficulty learning language from their parents because the amount they hear may be limited. On top of that, most children with hearing loss have parents who can hear (compared to having parents who are Deaf). Parents who can hear might not use as many visual cues that could help their children learn, because they are used to sharing information through sound.
What was the study?
Nineteen children with hearing loss and their mothers participated in a study to see whether training mothers to use language support strategies would help their children’s communication. All of the children used hearing aids in both ears and none of them used cochlear implants. Children and mother pairs were randomly assigned to get intervention or to be in a control group. The control group received testing and continued receiving any speech services they were already enrolled in. The group of pairs who were in the intervention group received their usual speech services and an additional treatment. The treatment focused on training mothers one time a week for six months. Some of the skills mothers were taught included:
- Visual (for example sitting face to face with the child and using gestures within the child’s line of sight while communicating)
- Interactive (for example following the child’s lead and playing with the toys that interest them)
- Responsive (for example responding to the child’s sounds and gestures and adding wait time to give the child a chance to try communicating back)
What did they discover?
Both the mothers and the children in the group that received intervention made improvements! Mothers increased the amount of language support strategies that they used while communicating with their child. Also, children who got intervention used more prelinguistic communication than children that didn’t get intervention. Prelinguistic communication includes behaviors such pointing, gesturing, and using eye contact. These are often ways that young children communicate with others before they begin saying words. Over time, these stronger prelinguistic skills may lead to later spoken language skills.
The findings tell us that teaching parents strategies to support communication with their very young children with hearing loss can work! It suggests that early language therapy for children with hearing loss should involve a parent training component rather than only working directly with the child.
Tips for parents
- Get face to face with your child! Playing while facing each other can give your child more visual information.
- Use gestures as well as language! Gestures will show your child what you’re talking about, especially when it’s hard for them to hear.
- Follow your child’s lead! If your child is engaged and interested, he/she will be more likely to learn.
- Count to three after you say something to your child to make sure you are giving him/her enough time to communicate.
Tips for clinicians
- Coaching parents is effective during early intervention with lots of children—including kids with hearing loss.
- This study used a teach-model-coach-review framework to train parents! You can learn more about it here (https://pubs.asha.org/doi/10.1044/2014_JSLHR-L-13-0113).
- This article is accessible for ASHA members! You can learn more about the intervention and strategies here (https://pubs.asha.org/doi/abs/10.1044/2018_JSLHR-L-18-0079).
Roberts, M. Y. (2018). Parent-implemented communication treatment for infants and toddlers with hearing loss: A randomized pilot trial. Journal of Speech, Language, and Hearing Research, 1-10.