Communicating with deaf or hearing impaired people can be difficult, and children with hearing impairment invariably have some degree of speech and language delay. There are a number of ways to help childen develop their speech and language skills, and these depend on several factors:

• How hearing impaired is the child?

• What are the wishes of the parents?

• What is child’s first language (sign or spoken)?

• Does the child have hearing aids or a cochlear implant?

• What type of school the child attends (deaf or hearing)?

If the child is part of the deaf community and/or his parents are also deaf, it is possible that he may not follow an “oral / aural” route of language development and use sign language. Sign language is a proper language encompassing a wide vocabulary and grammatical structure and also involving facial expression. Individual countries have their own signs and often areas in a single country will have some regional differences (like having a local dialect or accent).

Other children with hearing aids or cochlear implants will follow an oral / aural route and have auditory training and learn speech sounds. There are different approaches to help with speech and language development. An effective habilitation and treatment for many cochlear implant wearers is Auditory-Verbal therapy. This approach focuses on listening and sound awareness as this is the most natural and efficient way that children learn speech. Auditory–Verbal therapy takes advantage of every possible opportunity to listen and learn through the day, using the child’s environment as a learning tool.

Children with mild to moderate losses may require more conventional speech therapy, although will benefit from some sound awareness and discrimination work.

Although not encouraged with auditory-verbal therapy, some children with severe hearing loss and standard hearing aids may also learn some sign language alongside some speech work.

Visit our Downloads Centre to find more information about strategies to facilitate speech and language development for children with hearing impairment, hearing aids and cochlear implants.

Changing the communication environment at home and school

As well as helping the deaf child to communicate, everyone around the child must also have a heightened awareness of their own communication and the communication environment. As communicators with deaf children we must be aware of a number of our own behaviours, including facing the hearing impaired child when communicating, talking clearly so they can see our lip patterns, and when needed, using gesture, sign or visuals to help (with auditory-verbal therapy, you may actually not follow some of these processes, as you are trying to teach the child to listen and discriminate). We must also pay attention to the environment and communicate in an area that is well lit and where there is less background noise.

Tips and strategies when communicating with hearing impaired children
There are many things we, and those around us, can do to make life easier when hearing impairment occurs:

• Explain to those around you that you have difficulties with hearing. This will allow others to compensate for, and understand your difficulties

• Avoid important discussions when you are in an environment with lots of environmental background noise, or background noise at home (e.g. the washing machine or the TV is on)
  

• Look at the person when you talk to them, often facial expressions and lip movement can give you lots of cues to tune into certain words
  

• If you are talking to someone with hearing impairment, speak clearly (but not exaggerated) and use your hands to gesture and add cues for the hearing impaired person
  

• Look after your hearing aid. It is a complex piece of equipment and needs care and maintenance
  

• When you first start using a hearing aid, you may find it a strange sensation and it may take a while to get used to it. Persist with wearing the aid because you will get used to it and see the benefits
  

• Investigate local support groups to find out about hearing impairment and the support services available
  

• Investigate what other equipment is available to help with hearing impairment such as vibrating alarm clocks, enhanced doorbells, services to help with the telephone calls etc

The deaf community

It is important to note that the deaf community has a very strong identity and many do not feel hearing impairment is an impairment. They have their own language (sign language - legally recognized in many countries) and social networks. Many people in the deaf community feel that there is an ethical issue with cochlear implants (see the previous section), because the young child is not given a choice to be part of the deaf community. Anyone wanting to work with hearing impaired children should spend time within the deaf community to learn about their culture.