For children with hearing loss to succeed in classroom they need a variety of skills. And learning those skills needs to start when hearing loss is identified – hopefully within the first few weeks. So lets talk about what we think needs to be learned.
Detection and Discrimination
In order for children to succeed in the classroom they need to hear what is happening in the classroom. They need to know if the teacher is calling their name and be able to turn and respond. They need to be able to understand what the teacher is saying. If she asks for the blue truck our child with HL needs to know what that is and to respond. They need to understand conversation and be able to follow 2-3 step directions by first grade and more as they get older.
For children to learn, they need to be able to discriminate vowels (which is usually relatively easy for children with hearing loss) but they also need to be able to understand consonants because, in fact, consonants carry most of the detail of information. It is essential to discriminate phonemes that are not similar (shoe/door) and phonemes that are similar (cap/cat or top/cop or cot/got/hot/tot). We need to be sure that children can discriminate in both initial and final position.
Discriminating in Noise
Wouldn’t it be great if classrooms were quiet? If children on the playground or in the lunchroom could easily hear? Well, they are not, so we need to be sure that children hear well in those conditions. We need to provide practice listening in noise so they children have the opportunity to build those skills
Using the discrimination skills to learn
We are not developing discrimination skills just to develop them. We are using auditory skills to get information. This includes listening to the teacher, building vocabulary, and developing critical thinking skills. We have to have auditory skills to develop vocabulary, and vocabulary is the first step in developing critical thinking skills. Children need to be able to listen to a story, follow the detail, answer questions about the story, and learn from discussion about the story. It is important that we help children use their auditory skills to develop critical thinking.
So what is our goal?
- First, children need to be well fit with technology so that they can hear what they need to hear to learn.
- We need to remember to use remote microphone technology as needed (and they are needed a lot.)
- We need to work on developing auditory skills so that children can use audition to learn
- We need to remember that the goal of good auditory skills is learning language so most of the work we do with children needs to be directed at language development
- Language development is complex and it needs to include teaching children to think about what they hear. We need to help children understand and answer questions, they need to think about what they hear and be able to ask questions to get clarification.
When does listening therapy stop?
This is a complicated question. In my view it can’t really stop. It may take a back seat for awhile but, in my experiences, as language and academic skills get more complicated, work on listening often takes a back seat to other language activities. Be careful. We need to keep an eye on what a child with hearing loss is able to do. Listening skills need to be monitored constantly. Evaluation every three years is not enough. Audiologists can help. Since audiologists see children at least annually (and hopefully more often, audiologists can do very specific and complex speech perception testing in quiet and in noise, monaurally and binaurally, which would provide critical information. If a child shows problems listening, reinstate some listening therapy.