Young children with hearing loss who have recently received cochlear implants or hearing aids benefit from robust language and listening experiences throughout their daily routines. Therefore, professionals who are providing early intervention to children who are deaf and hard of hearing (DHH) can facilitate language and listening opportunities that are integrated into age-appropriate play and activities.

Goals of Early Intervention for Children with Hearing Loss

For children learning language through audition, the initial goal is for the child to learn to detect sounds and speech in their environment. Once a child can consistently detect sounds, they begin to learn that sounds and speech are different and have different meanings.

Suprasegmental Features of Speech

A key component of early intervention for new cochlear implant recipients is to provide listening experiences of sounds and words that vary in suprasegmental properties such as pitch, duration, and intonation. The best part is that while providing this auditory input, you're also providing tons of language, too!

Incorporating a variety of prosodic features doesn't need to be complicated. Modeling a variety of pitches, durations, and intonations can be incorporated into common toddler play activities. Not only does this make therapy fun and engaging for the child, but it also makes home carryover for parents and caregivers manageable, practical, and functional.

Early Intervention Activities for Children with Hearing Loss

Below are some favorite activities for young children that can be used to model language and incorporate early listening using suprasegmental changes.

Blowing Bubbles

Blowing bubbles is a sure way to engage any young child, but the activity is easy to use to target early listening as well.

• Provide input of long sounds (such as "blowwww") and short, intermittent sounds (such as "pop pop pop").

• Present sounds that vary in pitch by saying "up up up" using a rising intonation as the bubbles are blown upward, and "downnnnn" with a lowering pitch as the bubbles fall.

Playing with Baby Dolls

Playing with baby dolls is a familiar play routine that offers lots of opportunities to provide auditory and language input.

• While pretending to feed the baby, use sounds such as “num num num” (short and intermittent) in contrast with "mmmm" and a slurping sound (both long).

• Providing contrasting loudness when the baby doll is sleeping. Whisper “shhhhh” then loudly say "wake up!" when the baby awakes.

• Model differences in loudness while making the baby doll cry (loud cries contrasted with quiet whimpers).

Stacking Blocks or Cups

Creating and knocking over towers of blocks or stacking cups is an important cognitive and developmental milestone for toddlers that can be used to input various types of sounds.

• While carefully stacking each block, say "Another block... another block... another block..."

• Slightly raise the pitch with each block.

• Once the tower has been built, place a toy truck several feet from the tower and loudly say, "GOOOO!" as you move the truck toward the tower and knock it over.

Coloring or Painting

Coloring or drawing on on paper with crayons (or markers) is a quick activity to input sounds of various duration, pitch, and loudness. You can also use a finger in paint or shaving cream, or on a sensory bag (as shown here).

• Assist the child in making several small dots while saying "Dot! Dot! Dot!"

• Draw larger circles and say "around and around and around" with a varied vocal intonation.

• Draw a line upwards while saying "uppppp" (with rising intonation) or "downnnn" (as the intonation falls).

Playing in Water

Water play is always a hit with kids! A small bucket or tub of water and towels can be used to wash and dry various plastic toys and figurines.

• Use longer words or phrases in a sing-song voice such as “dryyyyy off" or "pourrrrr" in contrast with shorter words/phrases such as "wash wash wash," "splish splash", and "drip drip drip".

• Small water spills also make for a great opportunity to input “uh oh” and "clean up" which are both common early words/phrases for children and have recognizable inflections.

Creating with Play-Doh

Another versatile (and often preferred) activity for young children is Play-Doh. The actions of playing with this modeling substance lend themselves to using lots of words and phrases with suprasegmental variation.

• Say, "rollllll" (a long sound) while rolling a ball.

• Say, "cut cut cut" (a short, intermittent sound) while slicing the Play-Doh with a play knife.

• Choose animal and vehicle cut-outs that have an associated sound (the Learning to Listen sounds) such as "moooo" for a cow, "ahhhh" for an airplane, and "hop hop hop" for a bunny.
  

Monitoring Language Complexity in Early Intervention

As you may have noticed, many of the above ideas use short words or phrases to highlight various suprasegmental aspects of speech. This is not to say that complete, grammatically correct sentences shouldn't be used.

In fact, it is critical that children with hearing loss consistently be given access to appropriate syntax models throughout their day. Teachers, parents, and SLPs should learn to monitor their language complexity to balance a child's auditory comprehension demands with their language development.

For example, when playing with Play-Doh you might say, "I am going to roll the Play-Doh. Roll... roll... roll." When feeding a baby doll you could say, "My baby is hungry. I will feed her. Num num num."

As you can see, there are many ways to integrate sounds and words of varied intonation, pitch, and duration into age-appropriate activities that young children are already doing. These are just a few ideas, and you can identify words and phrases that naturally highlight suprasegmental differences within the activities you're already doing with kids.

Get lots more ideas for incorporating suprasegmental properties into early intervention for children with hearing loss in this one-hour webinar.

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