Hearing Level / Hearing Loss

Providers and Local Public Health

Next Steps: After Diagnosis

Next Steps: After Diagnosis Home

Children and Youth with Special Health Needs (CYSHN)

Next Steps: After Diagnosis

Hearing Level / Hearing Loss

Taking Action: Introduction to Early Intervention

On this page...

Introduction to Early Intervention
Six Developmental Areas
Family Participation
Decision Making Process
Goals and Expectations
Commitment
Frequently Asked Questions

INTRODUCTION TO EARLY INTERVENTION

Early intervention services are for children from birth to three years old. The goal of early intervention is to reduce the impact of a delay or disability on a child's development. These services focus on a child's vision, hearing, nutrition, thinking, movement, language, self-help, and social-emotional developments. Federal legislation supports early intervention services. This legislation is called Part C of the Individuals with Disabilities Education Act. In Minnesota, this program is called Help Me Grow.

Early intervention professionals are trained to work with children from birth to three years old and their families. These specialists work with families to provide therapy as part of their child’s daily routines. For example, identifying body parts is included as children are learning how to get dressed. Families use these procedures to extend therapy throughout the day.

Babies with hearing loss need early intervention services. Early intervention minimizes the impact that hearing loss has on communication development. Services can begin as soon as your baby's hearing loss is diagnosed. Children learn quickly at a very young age, so early intervention focuses on teaching your baby to communicate their wants and needs and on developing a communication system they can use the rest of their life. The optimal time to learn a skill is called the “window of opportunity”. The window for communication development is from birth to three years old.

SIX DEVELOPMENTAL AREAS

Girl sitting on a jumping ball There are six areas of child development:

Physical (vision, hearing, and nutrition)
Cognitive (thinking)
Motor (movement)
Language
Self-help
Social emotional

Skills in these areas develop at a specific rate with each skill developing in a predictable age range, not at a specific age. These age related skills or stages are called developmental milestones. It is important to know what to expect in each of these areas as your baby gets older. In fact, thirty percent of children who have hearing loss also have delays in other areas. Language delays left unchecked can lead to cognitive, self-help, and social-emotional delays.

Your baby's skills in one of the developmental areas may affect another developmental area - like the way hearing affects language development. That is why it is important to think about the overall development of your baby. Your early intervention team can help you learn about the stages of development.

Physical Development
Hearing, vision, and nutrition are included in the category of physical development. Your baby's ability to communicate depends specifically on his or her ability to hear and see.

Cognitive Development
Your baby's ability to learn, create, and problem solve are important to communication development. A baby's thinking skills are directly related to his or her communication skills. Children with typical cognitive abilities can be expected to have age appropriate language skills.

Motor Development
Gross motor skills refer to skills such as balance, sitting, crawling, and walking. Fine motor skills require smaller movements such as picking up cereal with two fingers or using a coloring crayon. Your baby's motor skills may be affected because the hearing and balance systems are connected.

Language Development
Language development refers to both “talking” and “signing” for babies who are learning to communicate. These are stages that babies go through when they learn to communicate. Babies that are learning to talk and sign will have meaningful cries, babble, use word approximations, use one word and two word phrases and eventually make up sentences. There are several methods that are used to help your baby learn to communicate. These methods are discussed in the Communication Methods section. To explore communication milestones click on Communication Methods in the menu on the left. It is helpful to know what to expect of your baby's communication development for each stage.

Self-Help Development
The goal for many parents is to teach their child to become as independent as possible. Self-help skills are important for independence. The self-help skills that your baby will be learning include helping with undressing, dressing, eating from a fork and spoon, bathing, and toileting. Self-help skills change as your child grows and develops.

Social Emotional Development
Social skills are the skills that your baby learns to use when interacting with other people. Emotional development refers to the way that your baby “feels” about people, places, and things. It also refers to the way that your baby “feels” about situations and events. Social skills are important for your baby because they reflect the connection your child makes to others. Keeping a strong bond between parents and baby can be difficult when their baby has a hearing loss. Often parents will not communicate with a baby with a hearing loss because they think the baby cannot hear. It is very important that parents use oral and visual language to communicate with their baby as often as possible. In fact, early communication is essential for the development of the child's self-esteem and relationships.

The early intervention team will help the family to use strategies for encouraging healthy social emotional development.

Developmental Milestones for Communication

0- 3 Months	Cry Startle at loud sound Quiets to familiar voice Moves in response to voice
3-6 months	Smile Coo and gurgle Turn head toward familiar voice Communicate hunger or discomfort
6-9 months	Laugh Waves bye-bye Attends to music or singing Babble and respond to familiar faces
9-12 months	Learning body parts Engages in verbal play Understands simple questions Looks at familiar objects when named
12-18 months	Says or signs first word Understand simple commands Enjoys rhymes and finger plays Finds familiar objects not in sight Recognizes family member's names
18-24 months	Understands “no” Identifies body parts Identifies familiar pictures Learns new words easily Follows two step commands
24-30 months	Imitates words Asks for help when needed Puts two or more words together Responds to family member's names Points to action words in pictures
30-36 months	Names colors Says or signs first and second name Responds to simple questions Answers yes and no correctly

FAMILY PARTICIPATION

Kids playing jump rope Early intervention services are based on your family's needs and goals. Your family's beliefs are reflected in your goals and values. Each family is unique, and everyone in your family will be a part of the community in which your baby develops. Parents and siblings assist the baby's development within the most natural learning environment - at home with the family. Grandparents and other extended family members also play an important role in the child's development.

High levels of family involvement are a key component to your baby's success. Including immediate and extended family members in the process can help support choices that are made. One goal of early intervention is to help your family work together to provide the best learning opportunities for your baby.

There is a direct relationship between the level of family involvement and the development of babies with hearing loss. Decisions about amplification, communication, or services are easier when immediate and extended family members are involved in the process. When you pay attention to the input that other family members may have, you are providing the emotional security that will help them feel like they have contributed to the decision making process.

DECISION MAKING PROCESS

Decision making is an ongoing process. Your family will be faced with making many decisions about your child's care and services. It is important to realize that you will make the best decision possible at the time with the information that you have available. Decisions are not carved in stone. As new information becomes available, you may be faced with reconsidering an earlier decision.

The choices you make should support your family's beliefs and values. While parents are responsible for any final decisions, it is important to discuss the options with grandparents and older sisters and brothers. A strong sense of commitment from the entire family is important for the child to develop into a contributing member of the family.

You may have no previous experience with hearing loss. It would be helpful for your family to meet and share experiences with other parents who have a baby with hearing loss. Ask your child's early intervention team about parent support groups or other opportunities in your area. There are also support networks on the internet. Sometimes it is easier to make a decision when you can talk to others who have been in your situation. However, base your decisions on your child's needs and your family's preferences.

GOALS AND EXPECTATIONS

Deciding which communication method to use for your child is one of the first decisions you will make. There are a number of ways to teach your child to communicate. Teaching your child to communicate is difficult regardless of which method you choose. Professionals can help you choose realistic goals based on the abilities of your child that are in line with your desires. Read each of the following goals to determine which are important to you. You may have some additional goals that are not listed. Know that your goals and expectations may change over time depending upon your child's progress.

I want my child to be able to communicate his/her wants and needs to me, family members, and friends in a variety of situations.
I want my child to grow up to be a happy self-supportive adult who can make independent choices and become a productive member of society.
I want my child to have a meaningful educational experience that best suits his/her abilities.
I want my child to have meaningful relationships with other individuals with and without hearing loss.
I want my child to be able to use speech and language to communicate with family members and other individuals.
I want my child to be able to use sign language to communicate with family members and other individuals.

COMMITMENT

Look for an approach that works best for your child, you, and your family and don't become discouraged. Be flexible and willing to make modifications to your child's program as you feel the need.

The way you view hearing loss has an impact on the decisions that you make. Thinking about hearing loss as a challenge instead of a disability is a positive way to think about it. Most children with hearing loss are typically developing children. Motivation to meet the challenges you face is an important skill.

Professionals in early intervention help you focus your goals. They can also give you timelines to analyze your child's capabilities, gather information, and re-evaluate your decision periodically based on the available information.

Trust your instincts as a parent about what is right for your child and your family. Know that you will expend a lot of energy and that you will face frustration. Also know that there will be many successes to celebrate! When communication is important to a family, early intervention becomes equally important.

FREQUENTLY ASKED QUESTIONS

What if I don't think my child really has a hearing loss?
If you don't really believe that your child has a hearing loss, get a second opinion. Make sure that your child's hearing is evaluated by professionals that have expertise in testing the hearing of infants and young children.

What can I do to communicate with my baby right now?
Communicate with your baby through touch, vision, and sound. Many infants with hearing loss have some useable hearing. These babies can partly hear voices even without amplification or even if words cannot be understood. Talk and sing to your child the same way you would talk or sing to a child without hearing loss.

Rock your baby and hold your baby close to show your baby your feelings.
Look at your baby, smile, laugh, or hug your baby to let him or her know you are happy.
Use gestures by extending your arms to tell your baby you are about to pick him or her up.
Touch your baby or keep in your baby's sight to tell him/her that you are there.

What can I do while I am exploring intervention options?
Even before you get hearing aids or a cochlear implant or while you are exploring other intervention options, there are many things you can do.

Be responsive to your baby's communication:

If he or she looks at you, smile and make eye contact.
If he or she touches you, respond by touching and looking at him or her.
If he or she makes vocal sound, respond positively.

Improve the environment so your baby can use the hearing he or she does have:

Try to minimize competing noises in the room. Turn off the TV and radio when you are talking to your baby.
Make sure that the room is not too dark or that the lights are not too bright.
Move close to your baby and talk to your baby at a distance no greater than 3 to 6 feet away.
Maximize the visual information that your baby has access to by placing him or her in a high chair where he or she can watch the family.

What are the intervention and treatment options?
Kids playing ring around the rosie Professionals are responsible for providing families with information about the full range of intervention and treatment options so that informed choices can be made. The “best” choice for each family is complicated and changes over time. It may involve the use of different options at the same time. It may involve changes over time as new approaches become available or as the child grows and develops. Sometimes the family system changes require a different approach.

Where can I find information about treatment or therapy for my baby's hearing loss?
You can find information about early intervention programs in your area through an audiologist, speech-language pathologist, or a local school for the deaf. Audiologists and speech-language pathologists can be found through hospitals, universities and clinics. These professionals will help you find information about service options in your area. It is important to inform yourself of all the possible services available in your area and come to the decision that is most comfortable for you and your family.

Go to> Communication Methods
Go back to> Cochlear Implants

Information on this web site was obtained from the Infant Hearing Guide developed in a cooperative project between the University of Arkansas for Medical Science, Arkansas Children's Hospital and the University of Arkansas RRTC and we would like to acknowledge their work.

THIS INFORMATION DOES NOT PROVIDE MEDICAL ADVICE. All content, including text, graphics, images and information are for general informational purposes only. You are encouraged to talk with your doctor or other health care professional with regard to information contained on this web site. After reading this information, you are encouraged to review the information carefully with your doctor or other healthcare provider. The Content is not intended to be a substitute for professional medical advice, diagnosis or treatment. NEVER DISREGARD PROFESSIONAL MEDICAL ADVICE, OR DELAY IN SEEKING IT, BECAUSE OF SOMETHING YOU HAVE READ ON THIS web site.