It is not possible to offer any guarantee regarding outcomes for your baby. However, research strongly demonstrates that babies with hearing loss who receive early and effective intervention, as close to birth as possible and particularly in the first six months of life, listen, learn and talk.
At Sound Steps AVT, babies who begin receiving services before eighteen months of age, in the absence of additional difficulties and whose families follow up appropriately, tend to develop age appropriate learning and levels of functioning, within two to three years of receiving services.
Babies born with hearing loss are like rather than different from babies their age.
Auditory-Verbal Therapy is an early intervention approach for children with hearing loss by which they develop spoken language skills via listening alone. Families choose Auditory-Verbal Therapy to raise their baby to listen, learn and talk. In choosing to stimulate their baby’s hearing from infancy, they opt for Early Intervention. This early and enriched stimulation is crucial in helping the baby’s brain grow, in the same manner as that of other babies the same age. The decision to intervene early and effectively enables the auditory pathways to the baby’s brain to be appropriately stimulated so that they remain open and the baby continues to learn by listening alone.
Auditory-Verbal Therapy recognises that the family is central to the nurture of the child. Auditory-Verbal Therapy guides each family to adopt a way of life that primarily uses their baby’s audition to develop early listening, learning and speech. The LSLS professional coaches and guides families to use techniques, strategies and procedures to develop these skills in their child, following patterns of development in children with typical hearing. In every Auditory-Verbal Therapy session, parents are guided to focus on the areas of Audition, Language, Cognition, Speech and Communication in order to achieve age appropriate levels of development in their child.
Auditory-Verbal Therapy focusses on achieving age-appropriate levels of functioning for the young child with hearing loss. Once age appropriateness is achieved and the family is stable and confident, they continue to chart their child’s future, on their own, having graduated from the service, in keeping with the philosophy of early intervention.
90% of what children with typical hearing learn is acquired through over-hearing conversation. (Beck D.L, Flexer C. Listening is where hearing meets brain…in children and adults. Hearing Review. 2011; 18(2):30-35) Listening therefore is inextricably linked to the development of spoken language in children, world-wide. Typical hearing children absorb the spoken language of their environment through passive listening that is not specifically taught to them. The presence of hearing loss does not facilitate the spontaneous development of skills such as listening, whispering and over-hearing, as in typical hearing children. Babies need to be taught to listen and then to use that listening to understand spoken language. Once they become confident listeners, they will use their listening to acquire skills, vocabulary and concepts even though they have not been specifically taught to them. They will keep track of sudden changes in conversation. They will use their listening to remain connected to the world of sound and to the even more exciting world of Conversation!
Auditory-Verbal children learn to understand spoken language via listening alone. As they grow up with listening, they learn to self-monitor and modulate their speech, to fine-tune it to match the accent of their environment, making themselves independent in the communities of their choice. Listening connects them to their social environment, making them members of the “cool” club of trendy teenage talk and keeping them abreast of current jokes and music. All of this assumes that the environment is one that supports listening. Listening in noisy environments will continue to be tiring and challenging; far more so than it is for those of us with typical hearing.
Auditory-Verbal Therapy nurtures the synchronous development of children in the many areas that comprise their personality: audition, language, cognition, speech and communication. Finally, Auditory-Verbal Therapy guides families to nurture their child’s potential so that they understand how best to achieve it.
A Listening and Spoken Language Specialist (LSLS) is a professional who has committed herself to the development of age appropriate spoken language in babies and young children with hearing loss based on the use of their audition alone without relying on either lip-reading and/or sign language, in accordance with international standards as set by the A G Bell Academy for Listening and Spoken Language (USA).
The LSLS professional must meet high level academic and clinical requirements and must undergo rigorous study of Auditory-Verbal Therapy with a mentor accredited to the AG Bell Academy and must also sit a written examination.
The LSLS professional is committed to guiding and coaching parents to develop age appropriate listening, learning and speech skills in their babies, infants, toddlers and young children with hearing loss based on audition alone as also the development of parent advocacy and education.
Fitting appropriate hearing aids on babies and young children or activating their cochlear implants provides them with tools they need to access the world of Sound. The hearing device (hearing aid or cochlear implant) does not make the hearing loss go away.
Auditory-Verbal Therapy guides families to teaches babies to listen and to use that listening ability to develop spoken language. Auditory-Verbal Therapy allows babies to learn at their pace, facilitating more than twelve months progress in twelve months time so that eventually they learn alongside typical hearing children their age.
As these children learn to sharpen their listening ability, their cochlear implants are fine-tuned in MAPping sessions, so that they enjoy better and better access to spoken language. The better children hear, the quicker they learn and the more clearly they talk.
Research suggests that all babies enjoy being sung to especially by the adult who cares for them. Singing helps the auditory systems of babies grow and mature and it stimulates them to pay attention early in infancy. Singing creates a bond between baby and caregiver that lays the foundations of trust, security and confidence.
The melody and rhythm of songs represent supra-segmental information that babies can detect, including those with a profound hearing loss. Supra-segmental information refers to information about loudness, duration, melody and pitch. Hold your baby close and sing; your baby hears the love in your voice.
All children learn through play. Your Auditory-Verbal therapist will guide you on how to weave your targets for the week into your play, household activities and family conversations, so that your child receives the enriched language input he or she needs to listen, learn and talk.
Research suggests that babies are ready to be read to as soon as they can sit up supporting themselves. Typically, babies achieve this developmental milestone by the age of six months.
Your paediatrician will guide you on how to prop your baby up so that he or she is best positioned to be able to see the pictures in the books you read from. Choose large picture books with large colourful pictures preferably one to a page or even one large picture to a double page. Position yourself so that you are at baby’s ear level: keep baby in your lap or propped up against a big pillow or in a high chair. Talk about the picture before you show it to your baby so that you have alerted him or her to listen, with your voice. As with singing, you will hold baby’s attention with your voice. Reading old favourites again and again helps embed both spoken language and verbal sequence in baby’s brain and in time your baby may even predict the next picture.
Auditory-Verbal Therapy benefits children with unilateral loss because it guides families to provide the enriched language input their child needs to develop early listening skills. These skills lay the foundation in developing age-appropriate spoken language skills in young children with unilateral hearing loss. Auditory-Verbal Therapy will help monitor the child’s unilateral hearing loss so that an appropriate decision may be taken on whether or not s/he should be fitted with a hearing device.
Children with a unilateral hearing loss do have hearing difficulty. Auditory-Verbal Therapy will track their development, closing any lag and allow children with a unilateral hearing loss to learn alongside typical children their age.
Hearing impairment in children may be managed differently by their families. Auditory Habilitation services for deaf children may include the following among others:
1. Auditory-Verbal Therapy as the name suggests, uses audition exclusively to teach children with hearing loss to listen, learn and talk. Auditory-Verbal Therapy becomes a way of life for the families that adopt it, developing spoken language in the baby via listening alone, all day, every day, throughout the baby’s waking hours. Families are guided to follow a systematically planned programme of Auditory-Verbal Therapy steps that mirror typical development in children with normal hearing.
2. Auditory-oral Habilitation focusses on providing visual access in developing spoken language in children with hearing impairment via lip reading. It also focusses on listening activities that develop sound awareness and identification, done for a finite period of time, the rest of the day being spent on developing spoken language via lip reading. Auditory-oral habilitation aims at developing listening skills in deaf children but not exclusively and allows the child to rely on lip reading.
Hearing loss in children may occur in families with no history of hearing loss. The only way to check your baby’s hearing is to have it tested.
That is why it is important that all children be screened for hearing at birth. The newborn hearing screening test identifies whether your baby’s hearing is at risk. This test is called the automated otoacoustic emission test (AOAE) and is both quick and non-invasive.
It may be that clear responses could not be obtained for this first test. This does not necessarily mean that your baby has hearing difficulty; however a second test will need to be done. This may be the same as the first test or it may be another type of test called the Automated Brainstem Response(AABR) test. This test too, like the OAE is safe and will not harm your baby.
Newborn hearing screening is highly recommended. However, you may choose not to have it done.
You may find the checklists that you are given helpful in monitoring your infant’s auditory development, as s/he grows.
At Sound Steps AVT, parents make informed decisions. Parents who feel the need for support beyond that received in therapy ask how they can best receive it. The LSLS professional may recommend it to certain others. Discussion on these and related issues allow parents to make the decision of whether or not they need to attend counselling.