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For the Best Outcomes, Educate Families First

6 min read
One-year-old Kenzie (front left), has a severe to profound hearing loss and began receiving services from Clarke when she was four months old. Her family benefits from customized coaching remotely at their home in Bermuda.

“The development that occurs during [the first three years of life] is breathtaking. One million new neural connections form every second. And this period is critical to laying the foundation for an entire lifetime of learning.”

At Clarke, we often say that families and caregivers are the most influential presence in a child’s life. And during a child’s early years, that influence is colossal.  

Dana Suskind, MD,—pediatric otolaryngologist, founder of the University of Chicago Medicine’s Pediatric Hearing Loss and Cochlear Implant program and author of the 2022 book Parent Nation—notes that 80-85% of brain development occurs during the first three years of life. “The development that occurs during this time is breathtaking,” she says. “One million new neural connections form every second. And this period is critical to laying the foundation for an entire lifetime of learning.” 

Dana Suskind with a caregiver and child
Dana Suskind, MD, pediatric otolaryngologist and founder of the University of Chicago Medicine's Pediatric Hearing Loss and Cochlear Implant program (right), with a family.

“While our brains remain plastic throughout our lives,” Dana adds, “they will never be more so than in the magical and essential early years.” 

The “plasticity” Dana describes, also known as neuroplasticity, is the brain’s ability to adapt and reorganize itself in response to external stimuli and experiences. From birth to the age of three, this neuroplasticity is at its peak. Infants and toddlers are primed to learn, even as newborns.  

When an infant is diagnosed with a hearing loss, this season of life becomes even more important. It’s also complicated by the many varied and valid responses families may have to the news.  

Meeting Each Family’s Needs

“This is a super emotional time for families,” says Devin Ellsweig, MA CCC-SLP, speech-language pathologist at Clarke. “Families need a lot of support during this time. Most adults in that baby’s life have never met someone else with hearing loss, so LSL [listening and spoken language] professionals need to be able to support an entire family or caregiving team during these really challenging times.” 

“Shock, fear, confusion are common and understandable reactions,” adds Dana, “particularly because 90% of children born with hearing loss are born to parents with typical hearing. These parents may not be familiar with the journey ahead, and they should give themselves lots of grace and remind themselves that they are exactly the right parent for their child.” 

Kim, mother to thirteen-month-old Kenzie who has a severe to profound hearing loss, recalls their experience soon after their daughter began receiving services from Clarke. “Kenzie received hearing aids at four months, and we immediately contacted Clarke,” she says. “My first conversation with Nell [Rosenberg, Clarke’s National Director of Teleservices] instantly removed a mountain of stress off my shoulders when I realized that she was an expert in this field, and she could debunk many of the extreme worries caused by my constant scrolling [online].” 

While families and infants may work directly with a Clarke team member once or twice a week, the time babies spend with their families and caregivers is the bulk of their learning experience.

In addition to providing that assurance and emotional support, Clarke’s early intervention specialists, speech-language pathologists and teachers of the deaf set up families to establish language-rich environments as soon as possible. While families and infants may work directly with a Clarke team member once or twice a week, the time babies spend with their families and caregivers is the bulk of their learning experience. 

In the average week of an infant or toddler, they’ll spend 97 hours asleep, 71 hours awake and—at most—two hours in early intervention sessions. Families and caregivers are essential to making the most of their time with their children.

“Forty-five minutes to an hour per week with a speech pathologist is essential but won’t suffice if the caregiver isn’t also supporting listening and language learning each day,” says Devin. “So, our goal is to increase caregiver confidence and their ability to use auditory strategies. Because that’s what has the biggest impact, and that’s what yields the best outcomes going forward for the littlest people that we work with.” 

Kim remembers the process after Kenzie received her cochlear implants at nine months. “[The Clarke team] reassured us, walked us through what we should expect before, during and post-surgery and activation, provided tools and activities for us to assist our child at home, explained expected milestone timeframes for a child with hearing loss… We are so thankful for technology and our ability to get Kenzie assistance at a very early age. Due to the time frame of her receiving access to sounds we hardly see any significant delays.” 

Talking the Talk

How can families start this important work at home? Narrate.  

The most important [auditory] strategy is talking all the time,” says Devin. “The more language you expose your baby or toddler to—the better!” 

“Everything we’ve designed and developed [at the TMW Center for Early Learning + Public Health] is based on the fact that nurturing talk and interaction between caregivers and infants lays the foundations for brain development,” says Dana.  

“The most important [auditory] strategy is talking all the time. The more language you expose your baby or toddler to—the better!”

For example, if you’re preparing food in the kitchen, talk about each step along the way. And don’t worry if it doesn’t seem like your toddler is paying attention. 

“Even if it doesn’t feel like your baby’s listening, they’re absorbing language from their auditory environment,” explains Devin.  

She also recognizes that this is a significant lifestyle adjustment and may feel very strange to some families and caregivers.  

“For some families it does not feel natural to talk to a baby who we don’t yet expect to talk back,” Devin says. “But there are different ways that we can support them and create opportunities that do feel more natural. It’s never like flipping a switch. It’s figuring out how we can meet families where they are and make them feel supported in exposing children to language.” 

Learn more LSL strategies to use at home here: 

Expanding the Village of Helpers

There are significant benefits in teaching the other adults in a young child’s life to do this work as well—beyond just the core family members or direct caregivers at home. 

“As we like to say,” says Dana, “all adults—no matter their level of education, wealth or profession—can master the essential techniques for optimally building a child’s brain. They represent an incredible untapped resource. We actually encourage anyone who participates in one of our programs [at the TMW Center for Early Learning + Public Health] to ‘spread the words’ to the other adults in their child’s life.” 

Devin shares an example of a mother she coached through the process of transitioning her toddler into a daycare setting. After establishing an ideal auditory environment at home for her daughter, she was anxious that a new setting would be detrimental to her progress. Devin coached the mom on what the child would need to thrive in daycare, and she passed this information along to the care providers.  

“She worked so hard on making the auditory environment ideal for her baby to learn language, and she was so nervous about going to daycare,” recalls Devin. “We worked together to help her be the primary communication with daycare, to take all this information that she knew—and that she had become so confident with at home—and share it with them. And she figured out that she knew it so well! She was able to both relay it and to teach someone else how to do all of these things that she had worked so hard to learn.” 

‘Enjoy Your Baby’

With so much emphasis on the essential language-building they’re focused on at home, how can we ease the potential pressure on a family to get it right?   

“I always tell families, if it feels like work, then I’m not doing my job well,” says Devin. “And while I think it’s critically important that these [LSL] strategies are built into everyday routines, I don’t want to change their play or their routines with their babies. I want them to enjoy their days with their babies.” 

Dana adds, “I tell [families] that this is actually a golden age for children with hearing loss. Because of advances in both technology and therapy, with early intervention, children born with hearing loss today can often achieve all that they would have achieved with typical hearing… And most importantly, I want parents to know that all the hopes and dreams they had for their child before the hearing loss diagnosis can still be their hopes and dreams after.” 

Devin Ellsweig, MA CCC-SLP, speech-language pathologist at Clarke, with two-year-old Holden and his parents, who receive both virtual and in-person services through Clarke’s Birth to Age Three Program.

To learn more about Clarke’s Birth to Age Three Program—providing both in-person and remote services—go to

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