Children who are deaf or hard of hearing need to be taught healthy, effective coping skills.
Self-regulation, or emotional regulation, is the ability to manage feelings and respond appropriately — and it’s a vital skill for all children to learn. It allows them to focus in school, develop better social relationships and is generally beneficial for their mental health. But learning healthy self-regulation skills is an ongoing process — one that can be more challenging for children with hearing loss.
Melanie Austin, MS, CCC-SLP, director of Clarke Massachusetts in Canton spoke with Mainstream News about how caregivers and educators can support children who are deaf or hard of hearing develop this essential skill.
Self-Regulation by Ages and Stages
The first thing to understand about self-regulation is that it looks very different for children at different ages. For example, infants cannot self-regulate since they’re completely reliant on their caregivers to support them through co-regulation. Co-regulation, according to the US Department of Health and Human Services, is “the interactive process by which caring adults (1) provide warm supportive relationships, (2) promote self-regulation through coaching, modeling and feedback and (3) structure supportive environments.”
“But babies can still show difficulty with regulation,” says Melanie. “For example, if they have an inability to settle or soothe or are easily overwhelmed by routine things such as diaper changes, bath time or feeding.”
At the toddler stage, they’re a little more independent and rely less on co-regulation. But they generally will still be unable to understand and respond appropriately to big feelings. “This is especially present when they’re tired or hungry or there are high demands on them socially or cognitively,” Melanie adds.
By preschool, students are more able to self-regulate, but at the same time, the academic demands they face are also increasing. “At this age, dysregulation in the classroom can include a child acting out, being disruptive, showing an inability to sit still or talking at the wrong time,” says Melanie. She notes that children at this stage haven’t fully developed theory of mind — the ability to understand what someone else is thinking or feeling. “They don’t recognize that their behavior may bother other people. In these situations, they still need co-regulation to settle down.”
Melanie adds that as children mature, the methods that helped them during co-regulation become the basis for the strategies they employ to self-regulate — like taking deep breaths, using a quiet voice, finding a quiet space or dimming the lights.
Difficulties with Self-Regulation for Children who are Deaf or Hard of Hearing
Self-regulation is an important executive function — Melanie calls it the starting point for learning since a child needs to be engaged, motivated and attentive to acquire a new skill.
“Essentially, being self-regulated makes learning easier,” she says.
Hearing loss can impact a child’s ability to self-regulate in several ways, including challenges related to sensory overload and language delays.
Sensory Challenges
Melanie points out that any time one sensory system is taxed, the other senses need to pick up the slack. Doing so can cause those sensory systems to be overworked, leading to dysregulation. (Even adults can be challenged to self-regulate when they’re fatigued and/or stressed.)
Language Delays and Dysregulation
Also, children with hearing loss frequently have delays in developing theory of mind as well as their language skills. Both are important aspects of self-regulation.
“Many of the strategies we teach children to help them self-regulate are heavily language-loaded,” Melanie explains. “They need to recall and recognize the signs that they are even dysregulated. Working memory is another executive function that is an area of difficulty for individuals with hearing loss — such as recalling what their body should look like and feel like in a given context. And many of the strategies rely on self-talk to calm and reorganize themselves, but expressive language delays are prevalent in children with hearing loss.”
Additionally, if a student can’t hear a teacher’s directions or misunderstands a joke a classmate shares, that can lead to frustrating situations when dysregulation is more likely.
Supporting Students with Hearing Loss to Develop Self-Regulation Skills
Keep in mind: healthy, effective ways of coping are not developed instinctively, and children who are deaf or hard of hearing will need to be taught these skills directly.
Ways to develop these skills include:
- Dedicated Lessons and Social Stories
Educators can develop structured lessons about how children can calm themselves when they are frustrated and show them ways to build their toolbox of skills. And both educators and caregivers can create simple social stories to prepare and debrief children with hearing loss when they encounter new situations or changes to routine. - Reading Together to Build Language
It’s also important to read books about self-regulation together, to give children the vocabulary they’ll need to recognize their emotions. Having the skill to identify their emotions means children will be able to verbalize when they are dysregulated instead of behaving in inappropriate ways. “We often need to give them the language they need but can’t access while in a state of dysregulation,” Melanie says.Some books on emotional regulation for children include: Big Feelings by Alexandra Penfold, The Boy with Big, Big Feelings by Britney Winn Lee and Breathing Makes It Better: A Book for Sad Days, Mad Days, Glad Days, and All the Feelings In-Between by Christopher Willard.
- Optimized Auditory Access
“Another important way to set students up for success is to decrease the amount of work that their auditory systems need to do,” Melanie adds. Primarily, that means ensuring they’re wearing their hearing devices as much as possible to improve access to sound and using audiologist-recommended personalized HAT systems or sound field systems to reduce background noise and improve the presentation of the most salient information. Teachers and families should also allow listening breaks to combat the listening fatigue that can contribute to dysregulation.
While it’s generally easy to remember that students with hearing loss need accommodation to have the best possible access to sound in the classroom, less tangible challenges such as their ability to learn self-regulation skills may be dismissed as poor behavior not related to their hearing loss.
Caregivers and the educational team need to be mindful that hearing loss can impact many areas of a child’s ability to function in the classroom — and that ensuring they have access to sound and teaching them self-regulation skills can greatly mitigate those issues.
