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Children who are deaf or hard of hearing need to be able to hear all the sounds of speech in order to develop listening and spoken language. This requires a true partnership between the parent, early interventionist, and pediatric audiologist. This journey to listen and talk requires the commitment of the LSL team and for parents to constantly monitor their child’s access to sound. Let’s take a peek inside the story of one mom as she learns about her child’s access to sound and about the progress she is making toward helping her child develop Listening and Spoken Language (LSL) skills.
Ben is 15 months today. We’ve spent countless hours singing, enjoying fingerplays, and action rhymes together. We know singing is important because it helps Ben develop inflections, will help improve the clarity of what he says, and will help him remember words. Ben giggled, moved his hands and body, and acted out the rhymes when he heard me singing, often before I began the actions. He is now joining in and singing some of the words. I can tell he is understanding and I am thrilled!
Time spent with Grandma today was discouraging. She commented that she couldn’t understand what Ben was saying. Her comments caused me to listen closer as he sings. Grandma is right. Ben tries to sing some of the melody to the beat and he has a few vowels. He’s an expert at acting out the spider, but today I listened and now I agree that when I look away I don’t know if it’s “Itsy Bitsy Spider” or “Twinkle, Twinkle Little Star.” I'm thankful for Grandma's observations.
This morning, I pondered what our LSL interventionist shared about critical sounds. The goal is for Ben’s hearing technology to make it possible for him to hear all the speech sounds so that auditory information can get to his brain, which then powers so many things, including listening, language development, literacy, and academic and lifetime success.
We reviewed the audiogram Ben’s audiologist shared with us at his last hearing test. She plotted the results on an everyday sounds audiogram with the speech banana and the string bean. It shows us the speech information and sounds Ben hears with or without his hearing aids at different pitches and loudness levels, as well as the sounds that he is missing. So much to think about!
We saw our interventionist today. I had a list of questions. I shared that I know Ben needs to hear all of the sounds, even in the high pitch range, and that I believe Ben doesn’t have access to those sounds, even with his hearing aids. I’m wondering what comes next.
It’s making sense now that when we sing “Itsy Bitsy Spider,” Ben’s favorite rhyme, he only hears the low-frequency intonation patterns such as the stress, rate and inflection. He uses some vowels but they all sound alike. He uses some consonants such as /m/, /b/ and /d/ but not the higher frequency consonants, especially the critical /s/. I am learning so much about speech and language development - including new vocabulary words and concepts.
I now understand more. The reason Grandma couldn’t understand Ben is because he IS missing high frequencies. He has the beat but is missing most of the speech sounds in “Itsy Bitsy Spider.” The rhyme has many soft speech sounds he cannot hear, even with his hearing aids.
Our LSL interventionist also shared that missing soft speech at about 35 dBHL means that Ben is not “overhearing” family and friends. This limits his incidental learning and distance hearing when people aren’t directly talking to him, which has a negative impact on learning language and later on will make it harder for Ben to learn to read.
I’ve been thinking about our last audiology appointment. She shared that Ben isn’t receiving sufficient auditory access with his hearing aids. He isn’t hearing the high frequencies. I remember shaking my head because I didn’t understand how much this would affect him. Ben’s progress now makes sense. He is talking like he hears.
I had hoped that if Ben wore his hearing aids all waking hours, and if I talked, read stories, sang songs, and played with him more, he would develop speech and language skills similar to children his age who don’t have hearing loss. I’m now realizing that if Ben’s brain isn’t getting full access to sound with his current hearing technology, he won’t reach the goals we have for him.
I am on a quest for Ben to hear all of the critical sounds. I am ready to learn more about the cochlear implant technology our audiologist is recommending. I want Ben to have access to all of the speech sounds. I am ready for the next step on this LSL journey.
I can imagine the future with Ben singing and talking with clear speech and language that even Grandma can understand.
Toddler Fingerplays and Action Rhymes
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