Speech through a listening lens

by guest blogger Elizabeth Rosenzweig MS CCC-SLP LSLS Cert. AVT

It’s 2017, the beginning of a new year!  You may be making resolutions and committing to all kinds of changes this month, but allow me to add another one to your plate.  This year, will you join me in my quest to encourage all professionals who work with children with hearing loss to think about the development of speech skills through the lens of hearing?

When we think about helping children who are deaf or hard of hearing express themselves using intelligible speech, it’s tempting to emphasize the physical aspects of articulation: where to place the lips, tongue, or teeth to achieve the desired sound.  But instead of focusing on the output to achieve clear speech, I invite you to think about the input instead.  How clearly a child hears is directly related to the clarity of speech he is able to produce.

Why is this important?  Think about how a typically-hearing baby learns to talk.  She babbles in her bassinet, playing with her articulators (lips, palate, teeth, etc.) and hearing the sounds that she can make.  Often, she makes a noise unintentionally, but the sound is so amusing, either to her or the adults giving her feedback, that she figures out how to make it again.  As she grows, she begins to imitate the sounds and words of the language she hears around her.  Barring any articulation disorders, a typically-hearing child learns to talk by soaking up the sounds of language and making the speech that comes out of her mouth match the speech she hears.  Skills grow in a natural, developmental sequence.  Why should it be any different for children with hearing loss?  With today’s hearing technology, it doesn’t have to be!

So how do we achieve this?  How do we help a child learn to talk through listening?  It starts with ensuring high-quality auditory access.  We can’t expect a child to use audition to develop speech unless we’ve given him the tools to do so!

What does this look like?  It means using hearing technology all waking hours — be it hearing aids, cochlear implants, an FM system, or a combination of these —  to make sure the child can hear across the frequency spectrum of speech in quiet and in noise.  Aided thresholds alone are not enough, though.  Those tell us what the child’s brain is doing with tones, but speech is not single-frequency tones, it is far more complex!  This is why speech perception testing (in quiet and in noise) is key to understanding how the child is able to process spoken language input.  A quality pediatric audiologist is your best friend here.

Once we have established that the child has good access to sound and the tools necessary to perceive spoken language, we can look at speech development through a “listening lens.”  Often, with excellent access to sound and a stimulating environment, a child with hearing loss can develop the sounds of speech naturally through a developmental sequence much like his hearing peers with little direct intervention.  But if errors do occur, don’t rush for the mirror and the popsicle sticks just yet!  Here are some questions to consider that might help you:

  • Can the child detect this sound? Does he have auditory access?  If the answer is “no,” go back to the audiologist to ensure auditory access before beginning.
  • Can the child discriminate this sound in a minimal pair (e.g. If the child is producing /t/ for /k/, can he tell the difference between “key” vs. “tea”)? Again, if the answer is “no,” go back to the audiologist to ensure auditory access before beginning.
  • Is this sound developmentally appropriate? Check out a chart of speech sound development norms for your language.  Consider both the child’s chronological age and hearing age, as well as the fact that boys and girls develop speech sounds at slightly different rates.
  • How can I put this sound in a facilitative context to help the child hear and produce it better? This may mean acoustic  highlighting, placing the target sound in a familiar word or a shorter word, or thinking about the properties of the surrounding phonemes that may make your target sound easier (or harder) to produce.  For example, it’s easier to put the /s/ in snake than in skate, because /s/ and /n/ are made in the same place in the mouth.

So add another resolution to your list and put on a new set of lenses for 2017 — think about developing speech through listening.

Elizabeth Rosenzweig MS CCC-SLP LSLS Cert. AVT is a Speech-Language Pathologist and Listening and Spoken Language Specialist, Certified Auditory Verbal Therapist in private practice.  She works with families around the world via teletherapy and writes on all things hearing loss on her website: www.AuditoryVerbalTherapy.net.

7 replies
  1. Sara Z.
    Sara Z. says:

    Hi Ms. Rosenzweig,

    Thank you for creating this post, as it definitely provided me with a good reminder of how important speech input is to the development of a child’s communication skills. I am currently a first year graduate student in speech-language pathology and I’ve learned that one of the first things to do when assigned to a client is to make sure that there aren’t any problems with hearing. This is important for a client of any age, but is extremely crucial for younger clients who are still learning language. You mentioned how discriminating minimal pairs could be an indicator that a child could have problems with hearing. In my articulation disorders class, I’ve learned that one of the first things a clinician should do is recognize if there is a problem with perception or production. If a child has difficulty perceiving a sound, it is likely that he/she will have difficulty with production. Seeing if a client has difficulty with perception and if it is due to hearing is a great start for learning speech and language.

    -Sara

    Reply
  2. Ashley Machovec
    Ashley Machovec says:

    Hi Elizabeth!
    I really enjoyed reading this post, I am very interested in learning more about the ways that I can figure out how to come to the solution of a problem in this area. I have found myself wondering these things, but not knowing where to start or where to go back to when I want to try to tackle the problem. I definitely agree with you that the child’s speech production is related to the clarity of what they are hearing. If a child cannot hear certain sounds, how can we possibly expect them to produce them, and produce them accurately? Your steps to on how to progress when an error like this occurs is extremely helpful and are appropriate for all ages!
    Sometimes I feel that it can be easy to forget that even though a child is wearing hearing devices, it doesn’t mean that they are working properly! Checking them before every session is something that I find difficult to remember sometimes, especially when I am eager to get the session started! Being reminded of the importance of checking these devices is something I need, and having a simple checklist like this handy in my bag of tricks is great.

    I also really like how you talked about the fact that boys and girls speech development happens at different rates, and that we need to keep all of those minor factors about the development of speech in mind when trying to work with a child in the most appropriate and productive way as possible.

    Reply
  3. Ashley Machovec
    Ashley Machovec says:

    Hi Elizabeth!
    I really enjoyed reading this post, I am very interested in learning more about the ways that I can figure out how to come to the solution of a problem in this area. I have found myself wondering these things, but not knowing where to start or where to go back to when I want to try to tackle the problem. I definitely agree with you that the child’s speech production is related to the clarity of what they are hearing. If a child cannot hear certain sounds, how can we possibly expect them to produce them, and produce them accurately? Your steps to on how to progress when an error like this occurs is extremely helpful and are appropriate for all ages!
    Sometimes I feel that it can be easy to forget that even though a child is wearing hearing devices, it doesn’t mean that they are working properly! Checking them before every session is something that I find difficult to remember sometimes, especially when I am eager to get the session started! Being reminded of the importance of checking these devices is something I need, and having a simple checklist like this handy in my bag of tricks is great.

    I also really like how you talked about the fact that boys and girls speech development happens at different rates, and that we need to keep all of those minor factors about the development of speech in mind when trying to work with a child in the most appropriate and productive way as possible.

    Reply
  4. Brandi
    Brandi says:

    Hi Elizabeth, thank you for that great post! I agree that professionals working with children with hearing loss have to focus on both the output of the child’s speech and the hearing input of each individual child. I am currently working with preschool aged students who are all amplified, and I really appreciate you adding in what steps can be done if an error in a student’s speech occurs. I will remember to use this checklist next time I notice a difference in a student’s speech and be sure to tell the audiologist.

    Reply
  5. Nurul Akmar
    Nurul Akmar says:

    Hi Elizabeth. Thank you for this great post. I am currently working with 4th and 5th graders who are only recently amplified. Their hearing age ranges from 2 to 3 years old. I am working on initial consonant sound identification in words and am thinking to also introduce digraph because some of my students pronounce /t/ as /ch/ and /s/ as /sh/. Because they are at higher elementary school level, I am so tempted to get them to start blending sounds in CVC words at this stage. Do you think it would be appropriate? My students can write but most of their spelling of words are memorized. They do not have the tool to decode and encode words that they have never spelled, even though those words are in their listening and speaking vocabulary. It’s quite a challenge for me to determine their exact developmental stage and also to fulfill the requirement of learning words that are so above their language level (i.e. content-specific words in Science and Social Studies).

    Reply
    • Elizabeth Rosenzweig
      Elizabeth Rosenzweig says:

      Hello, Nurul!

      I agree, it is quite a challenge to help late-starters go back and build those foundational listening skills that they may have missed while still keeping up with age-appropriate content and academic work. My bias is toward building a strong foundation — it is a worthwhile investment of time and energy. Based on what you’ve shared about your students, I think some work on basic phonological awareness tasks (syllable and sound blending, segmenting, rhyming, etc.) might help them to be better able to detect and manipulate the sounds of speech in words.

      You may find some other useful suggestions in a webinar I did for the Cochlear Corporation called “The Catch-Up Game” about how to prioritize intervention targets for older children/late-starters. You can view it for free here: http://bit.ly/catchupgame

      I hope that helps!

      Reply

Leave a Reply

Want to join the discussion?
Feel free to contribute!

Leave a Reply

Your email address will not be published. Required fields are marked *