Developing Speech Skills for Children Who Come Late to Listening or Have Other Special Needs

By Perigoe, Christina | Volta Voices, November/December 2013 | Go to article overview

Developing Speech Skills for Children Who Come Late to Listening or Have Other Special Needs


Perigoe, Christina, Volta Voices


Children with typical hearing and development learn to speak by listening to those around them. In addition to learning the vocabulary (semantics) and grammar (syntax) of the language, children learn how to use it (pragmatics) and they learn their mother tongue's unique pronunciation of speech sounds and words-its phonology. Phonology is best learned through listening. That's why children will speak what they hear. They will speak like their parents, their siblings or their friends in the community.

Children with hearing loss will also speak the way that they hear. If certain speech sounds are not getting to the child's ears (and his/her brain) or if the sounds are not clear, then the child will have difficulty saying those speech sounds clearly.

With newborn hearing screening, early hearing detection and intervention (EHDI) programs, intensive audiological management, appropriate listening and spoken language intervention, and family support, infants and young children who are deaf and hard of hearing have an opportunity to follow the typical trajectory of listening, speech and language development. These children not only learn to listen, but learn to speak like their typically developing peers (Cole & Flexer, 2011).

However, some children with hearing loss may not be developing speech skills on par with their hearing peers. These children may be "late starters." They may have additional challenges. Or they may be children who are both starting late and dealing with additional special needs.

"Late Starters"

"Late starters" are children who have come late to listening due to a variety of reasons such as late, missed or ignored diagnosis; lack of universal newborn hearing screening in a particular geographic area or country; inconsistent use of amplification; or early emphasis on visual languages and later transition to an auditory-verbal approach. The latter sometimes happens after a child in a visual language program receives a cochlear implant.

For the child who is coming late to listening, but who is otherwise developing typically, speech remediation can be quite successful, especially when the child learns to use hearing to process speech and spoken language. The later the child starts receiving auditory input and speech remediation, the slower the progress will be.

Additional Special Needs

It is estimated that approximately 40 percent of children who are deaf and hard of hearing have additional identified special needs (Gallaudet Research Institute, 2008). These additional special needs may range from mild to very severe, as can their effect on the child's ability to process and produce speech sounds. Some possible causes include genetic disorders, prematurity, accidents or illnesses to the child or to the mother during pregnancy. Sometimes, the cause of the additional disability, as well as the hearing loss, is unknown. What is important to remember is that additional special needs may occur and be diagnosed at any age, with any amount of severity and in any combination. Often disabilities that are less severe are diagnosed later, since they are not as obvious.

Some additional special needs that may adversely influence speech production are related specifically to speech. These may be atypical speech structures (e.g., cleft palate), difficulty coordinating mouth movements (e.g., childhood apraxia/dyspraxia of speech), weak speech muscles and/or poor muscle movement (e.g., dysarthria), difficulty pronouncing words (e.g., articulation or phonological disorders), problems with vocal cords/phonation, poor sensory feedback in the mouth, or dysfluency (stuttering) (Daniel & Ritter, 2012). Others may be related to cognitive functioning or communication (e.g., autism spectrum disorder).

Understanding the child's additional challenges will help the professional determine the best approach for remediation of speech. A team approach is essential, so that parents, teachers and therapists have consistent goals and expectations. …

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