Response written by Ellen A. Rhoades, Ed.S., Cert. AVT, CED
These questions are very important to parents. They
want their child to express feelings and thoughts so that they talk with
each other. The child, however, cannot talk unless s/he first
learns how to hear, to listen, and understand language. As a result of
auditory-verbal therapy, hearing will become integrated into the child’s
personality. Then the child will understand the language parents speak
before speaking the language him/herself. One might think of a child as
a vessel; parents pour language into that vessel and, eventually, the
words overflow and the child will be talking.
Therefore, equally important related questions are:
"When will the child be understanding his/her parents and other people?"
and "When will the child understand normal speech?" Responses to these
questions are dependent upon many conditions, including: the child being
able to consistently hear conversational speech with an effective
hearing aid or cochlear implant, having an intact neurological system,
and parents who diligently provide an excellent speech and language
model. Under these conditions, the baby should gradually learn to
understand language and then to talk just like children with normal
hearing. This is especially true when the child is very young and the
language delay is minimal when beginning auditory-verbal therapy. Child
development research findings indicate that babies begin to talk about a
year after hearing, so a baby who is hearing-impaired is expected
to start to talk no later than approximately one year after beginning
auditory-verbal therapy. Some babies talk later and some start talking
much sooner.
If the child is not a baby, however, then when
the child will first understand language and later start talking will
depend largely on the child’s chronological age (CA) and hearing age
(HA). HA dates from the time the child begins to consistently hear with
either hearing aids or a cochlear implant. The greater the difference
between the child’s HA and CA, the longer it may take the child to talk.
Auditory-verbal therapy, therefore, must be started
as soon as possible. The sooner the child begins to use appropriate
hearing aids and/or a cochlear implant, the sooner the child will learn
to listen and understand speech. The sooner the child understands
speech, the sooner the child will talk. Even without effective hearing
aids or a cochlear implant, it is wise to start therapy immediately
because there are auditory-verbal skills that can be encouraged which
will help the child adapt more rapidly (or, if you prefer, "more
effectively") to the hearing aids or cochlear implant.
From the initial evaluation in therapy, the
auditory-verbal therapist guides parents in an active working
partnership for the benefit of the child. The auditory-verbal therapist
shows parents many effective ways to respond to the child and to
encourage the child to listen and talk. Parents, child and therapist
will enjoy themselves with the many games, songs, toys, and activities
that are part of each auditory-verbal therapy session.
Regardless of the child’s age, it is important that
parents do not stop talking to the child just because of the newly
diagnosed hearing impairment. The playful and natural communication that
parents had with their child before diagnosis should not stop. The
give-and-take of vocal exchanges at a normal conversational level needs
to continue. Even though the baby may not yet be hearing well, he/she
will still ‘read’ the parents’ body language. Parents need to talk very
close to the baby’s ear – this is talking "within earshot." If the baby
is not yet using hearing aids or cochlear implant, parents need to speak
naturally and directly into the baby’s ear. If the baby is using hearing
aids, adults need to speak within 6 inches of the microphone. This will
give the most audible and intelligible auditory signal.
Parents will encourage the baby to listen to their
vocal play. They will repeat the sounds that the child makes and show
much pleasure when the child vocalizes so that s/he will vocalize even
more. Meaningful repetitions will teach the child about the world, as
parents explain and expand on what is happening. A clear and loving
voice will demonstrate the meaning of what the child is experiencing.
Like most mothers, parents will use short, simple sentences when
conversing with the child, use words to name the things in the child’s
environment, sing when dancing with the child, and recite rhymes just
for the pleasure of it. The joy in and of the parents’ words will be
conveyed to the child.
Parents and their babies will engage in many
fun-filled activities that promote speech and language such as reading
books together and playing with animal and transportation toys and
dolls. They will also engage in many physical activities that can easily
be done anywhere such as throwing balls, jumping up and down, turning
around and pushing and pulling things. They will have great fun together
as they play silly games like using toes for piggies, or opening up
their arms wide upon saying, "How big is baby? So-o-o big!" The
bonus to all these activities is that the baby will learn to understand
the words. Parents are encouraged and reminded to allow their children
the full and total experience of childhood.
Playing games, whispering, blowing raspberries, and
tongue trilling are some pre-speech activities that stimulate a baby’s
eagerness to talk well. The baby needs to practice moving all the parts
of his/her face with ease, so that speech will come easily.
Parents will also be developing an "auditory schema"
in the baby. They will repeatedly expose the baby to many different
sounds of the language and the environment and will encourage the baby
to babble. Babbling is a natural step in the development of speech.
Eventually, the baby will use jargon as he/she intersperses ‘real’ words
with nonsense syllables. From then on, the baby will use less jargon and
more ‘real’ words and eventually be talking!
A nonverbal child knows how to make his/her needs
known. Parents intuitively know how use natural body language, natural
gestures, pictures, and words, to make their needs, thoughts, and
feelings known to the child. Parents who take great pleasure in playing
with their children while talking to them are not likely to have
frustrated children! Someday, when their child is talking a mile a
minute, the parents will wonder why they were ever worried about what to
do. Following the guiding principles of the auditory-verbal approach,
therapists work as part of a comprehensive team to help parents get
started as quickly as possible in helping their child listen and talk
and guide them in ways to communicate effectively at each stage of the
child’s development.
