hearing-photoPart 15 – Communication Methods for Children with Hearing Loss

According to the American Academy of Pediatrics “Children who are deaf or hard of hearing face a potential developmental emergency and should be identified as quickly as possible so that appropriate intervention services can be started.” Parents will be asked to determine what communication method/option they would like to utilize to teach their child language and communication skills. In 2012-2013, the Oklahoma Newborn Hearing Screening Program (NHSP)/Early Hearing Detection and Intervention (EHDI) system partnered with the National Center for Hearing Assessment and Management (NCHAM) at Utah State University, Boys Town National Research Hospital, and the University of Oklahoma Health Sciences Center – Department of Communication Sciences and Disorders to conduct a nationwide survey with state specific information to understand what physicians think, know, and feel about newborn hearing screening and follow up.

When Oklahoma providers were surveyed, only 16.8% of participants indicated their training prepared them to adequately meet the needs of infants with permanent hearing loss. Of the remaining, 83.2% of Oklahoma medical providers responding, 30.1% indicated they were not sure and 53.1% answered they were not prepared adequately. Similarly, only 16% indicated they were very confident in discussing communication methods with parents. An additional 36% of survey participants indicated they were somewhat confident. Finally almost half, 48%, reported they were not confident at all. To assist Oklahoma providers in preparing parents to make educated choices about communication methods for their child with hearing loss, resources have been provided below.


Lori Watson & Petra Teel, Deaf Educators/Early Interventionists

What core information do I need to know about communication opportunities for children with hearing loss?

Families should be made aware of all communication options and available hearing technologies in an unbiased manner. We believe that the language and communication approach chosen should be based on an informed decision made by the child’s parents/family and based on their own unique circumstances.  The chosen approach will depend on culture, family interests, and desired communication outcome.  It is critical that families have early access to professionals with specialized education and training in the desired language or communication method. Sooner Start has a mechanism in place for ensuring that families have access to all available resources and information that is accurate, well-balanced, comprehensive, and conveyed in an unbiased manner.

What are the options for communication for children with hearing loss?

ASL/Spoken English Bilingual Approach – An approach designed to facilitate early language acquisition in both a visual language (American Sign Language) and a spoken language (English).  You may also see this approach referred to as an ASL and English bimodal-bilingual approach, with bilingual referring to learning two languages and bimodal, referring  to language acquisition in two modalities, visual and spoken. This approach can be planned and implemented to meet the individual needs of the children with varying levels of hearing loss and varying levels of benefit from listening technologies.

Listening and Spoken Language – This approach has evolved over many years and is preferred by parents who want their child to listen and talk in the primary language of the home. This approach advocates for the early detection and diagnosis of hearing loss, aggressive use of hearing technologies and audiological management to ensure the brain’s access to sound and early intervention services to guide and coach parents on how to teach a child with hearing loss to listen and talk. Listening and Spoken Language Specialists (LSLS®) are licensed speech-language pathologists, audiologists, or educators of the deaf who have become specialists in supporting children who are deaf or hard of hearing develop spoken language and literacy primarily through listening. You can locate a local LSLS here:  http://www.agbell.org/find-LSLS/

Total Communication (TC) is philosophy of educating children with hearing loss that incorporates all means of communication; formal signs, natural gestures, fingerspelling, body language, listening, lipreading and speech.  Children in TC programs typically wear hearing aids or cochlear implants.  The goal is to optimize language development in whatever way is most effective for the individual child.  Families are encouraged follow their child’s  lead in what way they communicate successfully.  Total Communication is truly a philosophy rather than a methodology.  As a result, the implementation of the TC philosophy with one child may look entirely different than its implementation with another child.

Cued Speech is a mode of communication using the mouth and hand to visually distinguish the building blocks (phonemes) of a spoken language to promote the development of language and literacy visually for those who do not receive sufficient input through listening or assistive devices. The cues represent the phonemes of English language. Cued Speech can be taught in 12-15 hours and the user will leave the class knowing how to cue anything they want to say, albeit slowly. Research indicates that Cued Speech users have excellent language, superior lipreading skills, have an internalized understanding of English language and its structure, and have good writing skills.

How can a medical home provider connect a family with SoonerStart services?

The PCP has an important role in connecting families with essential early intervention services.  It is also helpful for providers to know general information about pediatric hearing loss and various options for communication available. The National Center for Hearing Assessment and Management (NCHAM) has a brochure that provides information to assist parents of children with hearing loss on the journey ahead.  Topics include Quick Facts, Hearing Technology Options, Communication Options, and Windows of Opportunity. An electronic version of the brochure is located at: http://communicatewithyourchild.org/brochures.html

Providers can also receive a copy from the Oklahoma Newborn Hearing Screening Program. The OKAAP E-Newsletter previously published Articles 13 & 14 which included information regarding Early Intervention services, additional resources for communication methods for children with hearing loss, and phone numbers for Part C Early Intervention services statewide. To receive a copy of a copy of the NHCAM brochure or previous articles, please send an email to NewBornScreen@health.ok.gov 

Lori Watson, MS, CED, is the Deaf and Hard of Hearing Regional Consultant serving central and western Oklahoma.  Certified as an early childhood teacher and a teacher of the deaf, Lori has been working for SoonerStart for over eleven years counseling families and providing early intervention services to families with hearing loss in rural and urban Oklahoma.

Petra Teel, MA, CED, LSLS Cert. AVT is the Deaf and Hard of Hearing Regional Consultant serving Tulsa Metro and eastern Oklahoma. Certified as an Educator of the Deaf and as a Listening and Spoken Language Specialist, Petra has been serving families with children who have hearing loss for ten years in early intervention, has been a classroom teacher of the deaf for nine years, and is an adjunct instructor at The University of Tulsa in their Deaf Education Program and Gallaudet University in their Infant, Toddlers, and Families program.