Throughout childhood, the family is the most influential presence in a child’s life. And because so much learning happens at home, the Clarke team coaches families how to create language-rich environments in all areas of a child’s life. With Clarke’s support, families learn various listening and spoken language (LSL) strategies to support language development through play and age-appropriate activities, and share experiences and questions with other families in Clarke’s programs.
But many families feel unsure of their ability to execute a series of rigid clinical strategies at home—a sentiment often expressed to the Clarke team.
“First thing’s first,” responds Sherri Fickenscher, MS, LSLS Cert. AVEd, education support specialist at Clarke, “whether your child has a diagnosed hearing difference or not, you already know how to communicate with them! Take a deep breath and relax… you got this.”
Importantly – as Clarke professionals frequently emphasize – families are already equipped with many of these skills. A significant number of LSL strategies are intuitive, mirroring how adults naturally interact with babies and young children. Many families are already using these strategies without even realizing it.
“What do you do when your baby cries?” says Sherri. “You go and pick that baby up! That’s responding to the way they’re communicating their need to you. If we respond to children by engaging in turn taking, regardless of the level of their hearing loss, then we are already building strong communication partnerships.”
To further support this important work, we’ve compiled a collection of tips and strategies—sorted by developmental stage—which can serve as a resource for families and caregivers eager to establish (or enhance) their learning environment at home. This is not an exhaustive list and your Clarke team member can certainly expand on this list, so feel free to share it and ask questions!
In using this list, please keep in mind that all children learn differently, and for children who are deaf or hard of hearing, development will always be related to three critical areas:
- Age when child began using hearing technology full-time
- Access to qualified professionals (like the Clarke Team)
- Level of parental involvement and engagement in the LSL process
Tips and strategies, by developmental stage
For children who are deaf or hard of hearing, this time period is defined as 6-12 months after they’ve established full-time use of their hearing technology. Full-time use of technology is directly correlated to a child’s ability to reach their full potential, so to make the most of this crucial time period, young children should have access to sound as soon as possible. The strategies listed below are meant to optimize a child’s auditory skill development and are a good starting point. These LSL strategies are critical to your child’s overall develop and are chosen to activate the auditory centers of your child’s brain. If these strategies are in place and you feel confident in utilizing them, feel free to move to the strategies listed in the other areas of development.
Here are LSL strategies to support this developmental stage:
- Studies show that regardless of age, ethnicity or socio-economic status, most adults use this type of speech with infants or toddlers. Even children as young as 2-3 years of age use motherese when talking to babies or their baby dolls. This type of speech typically includes a higher pitch voice which emphasizes vowels (the first sounds babies produce) sing-song tone of voice, and lots of natural inflection. Research has shown that this practice helps children ‘crack the code’ of language. (Parentese/Motherese is also a form of acoustic highlighting which will be discussed later in this article.)
- Pointing out sounds in the environment
- This is often accompanied with pointing to the ear, showing excitement on the face and stating “I heard that! I heard Mommy calling your name”
- Suggested activity: Take a “listening walk” around the house to listen to everyday sounds that we take for granted (e.g., toilet flushing, water running, microwave beeping, footsteps). Sherri suggests checking out The Listening Walk, by Paul Showers, as an accompaniment to this activity.
- Does your child have one ear that has more hearing than the other? Be sure to position yourself on that side whenever possible.
- Keep your child in the “listening bubble.” This means speaking when your child is within three feet of you. The best distance will depend on their degree of hearing, but closer is always better for a beginning listener.
- Monitor the listening environment
- Children with typical hearing learn early to tune out background noise, but children who are deaf or hard of hearing are not able to do this very easily. Television, music, multiple speakers in the same area create a difficult listening environment for them. The optimal listening environment is one where there are not many sounds all vying for your child’s auditory attention. Keeping it quieter will make it easier for your child to hear those quiet speech sounds like ‘s,’ ‘sh’ and ‘f,’ for example.
- This doesn’t mean you can’t listen to music! The Clarke team encourages a good dance party, so turn on your favorite tunes and dance away. Watch what your child does when the music stops!
- Singing is considered a technique~ a way of doing something with a goal in mind but no specific way of doing it (a strategy is specific in how it is carried out). Singing is natural for most parents~ until the diagnosis is confirmed and suddenly parents find themselves quiet at a time when their child needs exposure to language. Singing gives your child the benefits of parentese/motherese (see above) when it might seem difficult or unnatural to parents. Singing exposures children to natural vocal rhythms and has a way of capturing attention. Singing and listening to music is a tremendous activity to tap into the listening brain while having fun too!
- Auditory sandwich: We use this strategy to encourage children to rely on auditory information, rather than visual information. When we use the auditory sandwich, we engage the listening centers of the brain prior to engaging the visual centers of the brain. Here’s how it works:
- Present a sound/word in three stages: First without an accompanying visual cue, then with a visual cue, finally without the visual cue again.
For example, a caregiver might say, “A cow says ‘mooo.’” Then they’d repeat the sentence while showing a toy cow. Lastly, they would remove the image and repeat the sentence a third time.: “A cow says ‘moo’”
Before children begin talking, they indicate their understanding of spoken words. Many caregivers expect to move directly to talking, but this is an important phase. Babies typically listen for a full year before saying their first word, so the child who is deaf or hard of hearing often needs that full year of listening before saying their first word too. This waiting can be filled with anxiety for families as they’re eager to hear their child speak. However, if the focus is solely on the first expressive word, then caregivers may miss all the exciting milestones that lead up to that first word—like watching a child learn to understand receptive language, or the first time a caregiver says “bye-bye” and sees the child wave. These events reveal important information: the child’s technology is working! Sound not only has meaning, but words have meaning too. These are reasons to celebrate, as a child who is deaf or hard of hearing is preparing to talk.
This pre-talking phase is also defined by babbling (putting a consonant and vowel sound together) and jargoning, or vocalizing. Every once in a while, caregivers may even hear a true word!
Once the child has worn their technology for 6-12 months, and depending on their age, but as close to 10-14 months as possible, we are hoping to hear that first word. Until we hear that word, and even after, we can continue to focus on the child’s understanding of the spoken word (receptive language).
Here are LSL strategies to support this developmental stage:
- Take turns
- Research is abundantly clear: turn taking between a child and their caregivers build stronger brains! Another term often used for the idea of this back-and-forth volleying is ‘serve and return’ as the image of a tennis match is a great analogy for all to keep in mind when we are interacting with our children and others as well. When someone hits you a ball, your goal is to return that ball. The same is true for interactions with others.
- Caregivers learn to wait for a non-verbal or verbal response from a child before they take another turn in the communication exchange.
- Infants may coo or kick their feet as a conversational turn, while a three-year-old child is expected to give an appropriate verbal response. The goal when adults take turns is to elicit participation from the infant or child.
- With infants this can also involve imitation. When a baby coos at the caregiver, the caregiver can take a turn by cooing back imitating the baby or the adult can pretend to have a conversation with the baby even though there are no true words. For instance:
- Baby coos
- Adult coos back imitating baby
- Baby coos
- Adult says “Wow! Tell me more about that!”
- Baby smiles
- Adult “oh...did that make you happy when that happened?”
- The content of the turn taking will eventually become more complex and this LSL strategy should always be in use even when you child becomes an established conversationalist. The sooner professionals, parents and caregivers practice this vital strategy, the great the growing power of the brain. And who doesn’t want a stronger brain?
- Share Joint attention/ Follow the child’s lead
- Joint attention is when a child and adult share the same focus on an object, action, or person. When joint attention is occurring, and the adult adds the language to match then communication and learning can occur. Research tells us that a child's vocabulary increases at a faster rate when joint attention is established and the caregiver attempts to immerse the child in the language they believe matches the child’s thoughts. A child begins to establish joint attention between the ages of 6-9 months of age and is considered a building block for social competence. Sharing joint attention is a form of communication, so pay attention to your child’s eye gaze and talk about what they are looking at. This can also be referred to as following the child’s lead.
- In order to follow a child’s lead, adults in their environment act as keen observers and acknowledge what seems to be of most interest to the child. Caregivers are usually aware of favorite toys or activities of a child. Use these preferred activities as a springboard for things to talk about. A classic example of this is when a child receives a gift and is way more interested in the bow or wrapping paper than they are in the gift! Typically, the adult tries to change the child’s focus to the gift, but what if the child was allowed to explore the bow or the wrapping paper that really interests them and the adult layered on the language (following the child’s lead) while sharing joint attention. It might look something like this:
- Child: rips paper
- Adult (pointing to their own ear or the child’s ear): Oh I hear that paper ripping. That is fun isn’t it?
- Child: puts paper in mouth
- Adult: Hmmmm. Does that taste yummy? Paper is for ripping, not eating. Let’s rip some more (taking the interaction back to what the child was previously interested in, so acknowledging what the child showed attention to, but attempting a shift)
- Child: rips paper again and excitedly waves their hands with paper in it
- Adult: wow! You are holding tight on that paper. Let’s listen to it again as we rip it. That is noisy, isn’t it?
- Narration/Model language
- Talk, talk, talk about purposeful and meaningful occurrences throughout the day. Early intervention professionals will often use the analogy of a sports commentator who announces play-by-play what is happening on the field. During diaper changing for example, the caregiver can narrate: “Ooh, I think your diaper is wet. We need a new diaper. Up you go (picking child up). Let’s go upstairs. Up-Up-Up we go. We are going up the stairs. Where are those diapers? You need a new diaper.” This can be exhausting, and it isn’t necessary all day with every activity, but the pre-talking child needs to hear lots of words to understand language. “Feed their brain just like you feed their bodies,” says Sherri.
- Try both kinds of narration -- self-talk and parallel talk.
- With self-talk, the caregiver talks about what they’re doing. “I’m stirring your cereal. Your cereal looks hot! I will blow on it to cool your cereal. [blow] That’s better.”
- Using parallel talk, the caregiver describes what the child is doing. “You are watching Grammy stir your cereal. You see the cereal, don’t you? It looks yummy. Watch me stir the cereal.”
- “Mr. Rogers is one of my favorite examples of how to best speak to children” says Sherri. Consider when listening to Mr. Rogers how easy he is to understand. This is because he speaks at a good rate for children, and adults, to be able to process what he is saying. He is calming and annunciates when he speaks. So slow it down a bit (just not too slow) when you are speaking to your child and be mindful of the noise in the environment as well as how you annunciate your words. Remaining true to who you are and remaining natural are key, however, so if Mr. Rogers just doesn’t connect with you consider a person you might know who you always seem to hear and understand, perhaps a public figure, then consider their rate of speech and how clearly they are understood.
- Wait time
- Waiting isn’t just hard for children, it’s hard for adults too! While slowing down and taking time can be difficult, it yields great results.
- Wait time is the pause used between an adult’s interaction with a child and the child’s expected response. This pause allows the child the necessary time to process the auditory information and formulate a response. The amount of time to wait before continuing a response varies, but most professionals agree that 8 seconds is the minimum. When you are waiting and remaining engaged with your child, 8 seconds can seem really, really long but when your child responds, it is certainly worth the wait. Some things to consider when using this LSL strategy:
- Maintain eye contact
- Raise your eyebrows to indicate you are interested and waiting for a response
- Lean your body in towards the child
- Count to 8 slowly in your head
- Think about taking a nice deep breath as you wait
LSL strategies all build on each other. Without using wait time, taking turns becomes difficult. This is a life-long communication skill that we are never too young (or too old)