Hearing Loss and Speech Development Delay

Jan 17, 2022 It has always been recognized that hearing and speech go hand-in-hand; each playing a crucial role with each other.

Hearing successfully leads to speech and language development, communication, and learning. Children who have been diagnosed with a hearing loss, of any severity, my display weaknesses in the above mentioned areas, as well as difficulties with learning and auditory processing. 

The earlier a hearing loss occurs in the child’s life, the more severe the consequences will be. This is because if a hearing loss occurs at age 5, the child has already been exposed to plenty of language and has learned how to successfully form speech sounds correctly to speak fluently and clearly. If a baby is born with hearing loss, they never have the chance to hear how language is formed. Similarly, if the child is diagnosed early and receives intervention as soon as possible, the impact to their social, communication and learning will be less affected. 

Delay Versus Disorder

When a child is diagnosed with a developmental delay, that just means that they will learn the skills that are currently deficient; however, it might be at a slower rate than their same-aged peers. If a child is diagnosed with a disorder, that means that their speech, development or cognition is developing differently than other children and is not following the “normal” pattern. 

4 Major Ways a Hearing Loss Affects Children

1. Delay in the learning of expressive and receptive language development (speech and language)

Expressive language is the persons’ ability to speak clearly, effectively and concisely. This area of language also encompasses writing.

Receptive language is a person’s ability to understand information. It involves understanding words and what they mean in a variety of different contexts.

2. The language deficit causes learning problems that result in reduced academic achievement.

When a child cannot hear sounds or language clearly, they won’t understand in whatever setting they are placed. If a teacher is lecturing to them in front of the class and they can’t hear what is being taught, they will miss valuable lessons and will begin to fall behind in comprehension and carryover. This may also lead to frustration and a sense of failure. 

3. Communication difficulties may lead to social isolation and poor self-regard

Children interact just like adults do – by participating in a give-and-take conversation. If a child cannot appropriately respond to another child’s questions or comments, this may lead to the “typical” child not wanting to interact as much with the child who has a hearing loss. This will, eventually, begin to affect the child who is diagnosed with a hearing loss in the area of self-confidence. They will shy away from conversation, which only exacerbates the social communication deficit.  

4. It may impact vocational choices

Not all of the time, but sometimes, children do not receive proper rehabilitation for their hearing loss. This will impact their ability to function in the classroom setting and may impact their choice of career upon graduation. If they have proper amplification, they can go on to have ANY career that they choose!

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Specific Effects on Development 

Vocabulary

• Vocabulary develops slow in children who have been diagnosed with a hearing disorder.
• Concrete words like, dog, cat, mom, blue are easier to learn that abstract words like before, than, after, since. In addition, children who have hearing loss may have difficulty understanding and utilizing words like a, an, and the. 
• The gap in vocabulary between hearing and non-hearing children widens with age. Children with hearing loss do not catch up later in life. This is why newborn hearing screenings are very important!
• Multiple meaning words are difficult. For example, the word bank can mean the edge of a river or a place where we put money. 

Sentence Structure

• Children with hearing loss create shorter and choppier sentences than children who can hear. 
• Complex sentences, such as “The ball, which was thrown by John, bounced across the court and landed in the bushes,” are difficult to read, understand and write. In addition, sentences that are written in the passive voice (e.g., “The cupcake was eaten by Sally”) are challenging. 
• The endings of words such as the -s or -ed endings are difficult for children with hearing loss to catch. This leads to misunderstanding and misuse of plurals, verb tense and nonagreement of subjects and verbs. 

Speaking

• Quiet speech sounds like, “f,” “s,” “k,” “t,” and “sh” are difficult for children with hearing loss to hear. This will lead to mispronunciation of words when speaking. Their speech may also be difficult to understand.
• When speaking, children who cannot hear well, cannot judge their own vocal volume. This will lead to them either talking too softly or too loudly. They may also have a higher pitched voice and may even mumble because they can’t hear the way they sound.

Academic Achievement

• Areas such as reading and mathematics are difficult for children who have hearing loss. 
• Children who have a mild to moderate hearing loss, achieve one to four grades lower, on average than their peers, unless appropriate modifications and interventions occur.
• Children with a severe to profound hearing loss, achieve no higher than the 3rd or 4th grade level, unless appropriate educational intervention occurs. 
• Level of achievement is directly related to parental involvement, quantity, quality and timing of when services are provided. 

What You Can Do

Studies have shown that children who are diagnosed with a hearing loss early, have the ability to learn and develop language (whether verbal or sign) in line with their age-matched peers. If hearing loss is detected in your family, early intervention should begin immediately. An audiologist, a medical professional that will be crucial in diagnosing and suggesting remediation, will evaluate and suggest the most appropriate audiological intervention plan for your child and family. A speech-language pathologist will also work with you to determine the best way to communicate with your child!

Download Speech Blubs for some additional strategies that you can use with your child!

Reference: ASHA – Audiological Information Sheets, 2015.