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Early Speech Early Speech DevelopmentDevelopment

• Suprasegmentals (voice patterns)Suprasegmentals (voice patterns)– Vocalization (voice on/voice off)Vocalization (voice on/voice off)– DurationDuration– LoudnessLoudness– PitchPitch– VowelsVowels

Later Speech Development• VowelsVowels• ConsonantsConsonants• Voiced/voiceless distinctions (“d” Voiced/voiceless distinctions (“d”

v. “t”)v. “t”)• Consonant Blends (“br” “spl”) last Consonant Blends (“br” “spl”) last

to developto develop

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Audiogram ShowingAudiogram Showing “Speech Banana” “Speech Banana”

(Mehr, 2002)(Mehr, 2002)

Speech ExpectationsSpeech Expectations

• With consistent early amplification, With consistent early amplification, voicing will occurvoicing will occur

• With consistent intervention, speech With consistent intervention, speech sound patterns will be reinforcedsound patterns will be reinforced

• With parent involvement and With parent involvement and collaborative teamwork, language collaborative teamwork, language will emergewill emerge

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““Is my baby too young to Is my baby too young to wear hearing aids?wear hearing aids?

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Resources for obtaining Resources for obtaining Hearing AidsHearing Aids

Hearing Aid Loaner BankHearing Aid Loaner Bank

Blue Ridge Care Connection for ChildrenBlue Ridge Care Connection for Children• Provide hearing aids and FM systems up to age Provide hearing aids and FM systems up to age

1818• Loan for 6 months while in process of obtaining Loan for 6 months while in process of obtaining

permanent ones permanent ones

• Contacts:Contacts:• Lisa Powley or Sandra WoodwardLisa Powley or Sandra Woodward

• 866-596-9367 866-596-9367

Financial Assistance for Hearing Aids

• www.audientalliance.org/ Audient An Alliance for Accessible Hearing Care

• www.sotheworldmayhear.org/ So the World May Hear

• www.paiojd.org/hike/ HIKE Fund, Inc.• www.dmas.virginia.gov/ Department of

Medical Assistance Services (Medicaid)

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Assist families withAssist families with Hearing Hearing Aid challengesAid challenges

• FeedbackFeedback– When nursing or feeding, turn off aid on that sideWhen nursing or feeding, turn off aid on that side– When baby is sleeping, may remove aidsWhen baby is sleeping, may remove aids– Replace ear molds as infant outgrows them (6 – 8 Replace ear molds as infant outgrows them (6 – 8

wks)wks)

• Keeping aids on the babyKeeping aids on the baby– Critter clipsCritter clips– Toupee tapeToupee tape– Water wingsWater wings– Pilot capPilot cap– Ear GearEar Gear

Purchasing Hearing Aids

• Things to be aware of:

• Find a pediatric audiologist with experience in working with very young children

• Request for a trial period before purchasing

• Get insurance coverage for the aids if lost or broken

• Product guarantees in writing

• Be an advocate for hearing aid care, routine evaluations, and new ear molds

Process of Cochlear Implants

Candidacy

Hearing Aid trial (3 months)

Surgery (as early as 12 months)

Activation

Therapy

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What Can You Encourage What Can You Encourage Families to Do?Families to Do?

• Become comfortable with listening devices and learn Become comfortable with listening devices and learn to troubleshoot to troubleshoot

• Develop a schedule if necessary to increase wearing Develop a schedule if necessary to increase wearing time of hearing aid/fm system/cochlear implanttime of hearing aid/fm system/cochlear implant

• Draw the child’s attention to environmental noises Draw the child’s attention to environmental noises throughout the daythroughout the day

• Ensure that the audiologist is part of your team!Ensure that the audiologist is part of your team!

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• Provide enriching listening Provide enriching listening experiences in the homeexperiences in the home

• Add language to baby’s play routines Add language to baby’s play routines (ex. - Pair a sound with a toy each time (ex. - Pair a sound with a toy each time they play with it (see Sindrey)they play with it (see Sindrey)

• Speak to baby in an interesting, Speak to baby in an interesting, animated voice. animated voice.

• Talk about what baby is playing with Talk about what baby is playing with or looking at; describe what she sees.or looking at; describe what she sees.

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Helping Families to Make Helping Families to Make Informed DecisionsInformed Decisions

• Provide Communication ChoicesProvide Communication Choices• Consider amount and quality of functional Consider amount and quality of functional

hearinghearing (Oticon & ADA)(Oticon & ADA)• Observe child and determine the method that Observe child and determine the method that

seems to fit his needs – consider additional seems to fit his needs – consider additional challengeschallenges

• Family must be willing and able to use Family must be willing and able to use method(s) effectively and consistently (lifestyle method(s) effectively and consistently (lifestyle and values)and values)

What you can doWhat you can do• Stay informed (www.asha.org)Stay informed (www.asha.org)• Learn about other successful programs Learn about other successful programs

(for example: (for example: www.beginningsvcs.com))• Become an advocateBecome an advocate• Form or join parent support groups Form or join parent support groups

(Parent to Parent)(Parent to Parent)• Don’t allow a wait and see attitudeDon’t allow a wait and see attitude

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Websites• www.infanthearing.org/videos/index.html

EHDI Educational & Training Videos • www.agbell.org Alexander Graham Bell

Association, promotes oral education• http://jtc.org/ John Tracy Clinic Free

services worldwide for parents of children with hearing loss

• www.hearingjourney.com Activities for infants and toddlers to promote listening and speaking skills by Dave Sindrey, M.CI Sc.Cert. AVT

• www.oraldeafed.org Free materials that promote oral education

Websites for Sign Language

• www.lifeprint.com/index.htm American Sign Language

• www.signingtime.com/ Signing Time signs for babies

• www.mybabycantalk.com/ My Baby Can Talk Signs for babies

• www.readysetsign.com/index2.html Sign Language Course

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Virginia Department of Virginia Department of Deaf & Hard of Hearing Deaf & Hard of Hearing

Contact: Contact: Pamala RichardsonPamala Richardson

804-662-9502804-662-95021-800-552-79171-800-552-7917

Pamala.Richardson@vddhh.virginia.govPamala.Richardson@vddhh.virginia.govwww.vddhh.orgwww.vddhh.org

• RESOURCE BINSRESOURCE BINS

• EXCELLENT SOURCE OF MATERIALS EXCELLENT SOURCE OF MATERIALS

• MAY BE LOANED FOR 3-6 MONTHSMAY BE LOANED FOR 3-6 MONTHS

Learning to Talk Around the Clock ©

• Themes based on natural routines and activities

• Talking points to share with parents• Scripted dialogue to help

professional• Signature behaviors to promote

language and listening

Thematic Units Learn to Talk Around the Clock

©

• Listen Around the Clock

• Mealtime• Getting Dressed• Little Helper• On the Go• In the Garden

• In the Kitchen• Celebrations• Outdoor Play• Playtime• Bath Time• Bedtime

Assessment Tools

• Cottage Acquisition Scales for Listening, Language and Speech (CASLLS)

• MacArthur Bates Communication Inventory

• SKI-HI Language Scale• Infant/Toddler Meaningful Auditory

Integration Scale (IT-MAIS)• Early Listening Function (ELF)

A special thank you to Debbie Pfeifer and Ann Hughes

for contributing invaluable information, advice and guidance

for this presentation.