Why auditory skill development is essential for children with hearing loss

By Jennifer Manley, MS, CED

Many people equate a hearing aid or cochlear implant for children with hearing loss as someone needing glasses to see clearly.  However, this analogy isn’t the same.  Children with hearing loss need to be taught how to listen with a hearing aid or cochlear implant.  Their brains need to be taught how to make sense of the spoken language and environmental sounds they hear.  Once children who need glasses put them on, their brains can immediately recognize and identify what they see.

The process in which teachers of the deaf and speech-language pathologists teach children to use listening devices to make sense of verbal and nonverbal sounds is called auditory skill or listening development.  This process should begin with intention.  Auditory skills of children with hearing loss do not develop at the same rate or in the same way without intentional, specific teaching.  Children using hearing aids and cochlear implants need to hear speech or sounds and attach meaning to it.

Consider a school-aged child who is receiving a cochlear implant after consistent hearing aid use for a number of years.  Because of the difference in how sound is delivered with these different devices (in addition to many other factors), the child will not hear speech and sounds in the exact way as with hearing aids.  He will first need to detect sound with the new devices.  He will also need to listen to the suprasegmental aspects, or stress, duration and intonation of speech.  For example, he may not recognize all the words in a song, but he can recognize the melody. With time he will also learn to listen to the words and identify them in the song, so he can sing along.  Along the way, professionals are needed to teach him strategies to do this.  And it takes time. With this particular example, he may do this process more quickly because he has learned to listen with hearing aids first and has some auditory connections made.

Instead of the glasses analogy, let’s use an analogy of an amputee getting a prosthetic leg.  As soon as he gets the prosthetic, we wouldn’t expect him to go out and run a marathon. We’d expect that he’d get training on how to develop his muscles to learn to walk first.  However, many are expecting children with hearing loss to “run marathons” with their devices without training their brains.  Instead let’s give them the training needed to develop their auditory skills.

Jennifer Manley served as a classroom teacher for students ages 3 to 12 at CID – Central Institute for the Deaf. She currently works in professional development giving presentations on auditory development and is co-author of CID SPICE for Life, an auditory learning curriculum and author of the 2nd edition of CID SPICE.

4 replies
  1. Shannon
    Shannon says:

    Hi Jennifer,

    Thank you for another insightful article. I am currently taking a course on aural habilitation, and my professor gave a similar analogy involving glasses, but to make the point of why children need to wear their amplification during all waking hours (not just while at school). She emphasizes that children should put on their hearing aids as soon as they wake up, just as when most people put on their glasses, and keep them on until they go to sleep, to ensure they receive the most auditory input.

    When explaining why children need to be taught to use their amplification, which differs from how children can simply receive glasses and use them, I think it’s helpful to point to the development of auditory skills. Typically developing infants begin hearing in the womb up to three months before birth, and their brains have had more time to learn how to process the sound than D/HH children who receive amplification at 6 months, for example. Similarly, the milestones with hearing and language (like a first word) are much different than with vision. I agree that if an analogy is needed, relating this to receiving a prosthetic limb may be more understandable.

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  2. Caryn Benjamin
    Caryn Benjamin says:

    An excellent, well-written article – thank you for sharing it. It’s a good quick explanation for why children with hearing loss need auditory training, and particularly addresses the false analogy of getting hearing aids or a CI vs. getting glasses. (I especially like the last paragraph). I’ve asked my supervisor to share it with the other teachers of the Deaf and hard of hearing in my department.

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  3. Stella
    Stella says:

    I think it’s really powerful to actively debunk misconceptions about this population. As someone who studies and works in the field, it’s so important to constantly be teaching the “outside world” what deafness really looks like and the complexities of the deaf and hard of hearing world, so as not to be complicit in fostering misconceptions and stereotypes. It’s interesting to see how people react to me saying I’m studying to be a TOD. Everyone says the same thing first “so you know sign language?” and I go into my spiel about different modes of communication and different choices parents make when it comes to deaf children. Similarly, everyone brings up the videos of “people hearing for the first time” with the fad of cochlear implant activations on youtube, and it’s important to also bring up the complexities behind those kind of “miracle videos,” noting that it’s not a magical fix but a beginning to a lot of training and active readjustment.

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  4. Ashley
    Ashley says:

    Really enjoyed this post! I have often thought about using this analogy because it does seem to make a lot of sense. What better and more simple way to explain this device to someone who has never heard of it or seen it. BUT, now I am seeing why using this analogy is no where near the same thing. I am glad I read this before I actually used it out loud with someone. The comparison that you make to the person who has received the prosthetic leg is much better, and easy to explain as well! You body cannot automatically know how to do something when it has never done it before. Intense training and therapy is needed for that person to be successful with their new device! Whatever it may be. Thank you for sharing this post! Really helped me see this comparison more clearly.

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