6 early intervention Activities for Children With Hearing Loss
Children with hearing loss that have recently received cochlear implants or hearing aids benefit from robust language and listening experiences throughout their day. Therefore, professionals working with this population should provide language and listening opportunities that are integrated into age appropriate toys and routines. Once a child is able to consistently detect the sounds in their environment, children learn that sounds are different and have different meanings. A key aspect of intervention is to provide access of sounds/words that vary in suprasegmental properties such as pitch, duration, and intonation. There are many ways to integrate this goal into common toddler play activities, which make carryover for parents and caregivers manageable, practical, and functional. Below are some ways to incorporate early listening targets into common activities for toddlers.
Blowing bubbles is a sure way to engage any young child. This activity is easy to use to target early listening as well. You can provide input of long sounds (such as "blowwww") and short, intermittent sounds (such as "pop pop pop"). Blowing bubbles also lends itself well to presenting sounds that vary in pitch, such as saying "up up up" using rising intonation as the bubbles are blown upward, and "downnnnn" with a lowering your pitch as the bubbles fall.
Playing with baby dolls is a familiar play routine that offers lots of opportunities to input language and sounds. While pretending to feed the baby, you can use sounds such as “num num num” for spoon-feeding in contrast to a long slurping sound for when the baby drinks. When the baby is sleeping, you can whisper “shhhhh” and loudly say "wake up!" when the baby awakes, providing contrast in loudness.
BLOCKS OR STACKING CUPS
Creating and knocking over towers of blocks or stacking cups is an important cognitive and developmental milestone for toddlers. During this play activity, parents and professionals can also use speech and language to input various types of sounds. For example, as you and/or the child carefully stack each block, you could say "another block . . . another block . . . another block" with pauses between each phrase in anticipation of the next block being added. Once the tower has been created, you could use a toy truck to knock over the tower by placing the truck several feet from the tower and saying one elongated "GO!" using a louder voice to contrast with the more quiet "another block" phrase used repeatedly while building the tower.
Using paper and crayons (or markers) is a quick activity to input sounds of various duration, pitch, and loudness. Assist the child in making several small dots with their crayon, while saying "dot dot dot" with a steady pitch, which can be contrasted with drawing larger circles and saying "around and around and around" with more varied vocal intonation. You can also do this activity while drawing with a finger in paint or shaving cream, or on a sensory bag (as shown here). If you're curious, I made this one with just flour, water, and food coloring in a freezer bag.
Water play is always a hit with kids! Some children with hearing loss may not have waterproof devices or accessories that enable them to participate in swimming or baths while being able to hear, so I encourage (controlled) water play as a listening activity at home or in therapy. Using a small bucket or tub of water and towels you can "wash" and "dry" various plastic toys and figurines. You can use longer words or phrases in a sing-song voice such as “dryyyyy off" or "pourrrrr", as well as 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.
Another versatile activity for toddlers is play dough. The actions of playing with play dough lend themselves to using words and phrases of varied duration. For example, you might say "rollllll" (a long sound) while rolling a ball or "cut cut cut" (a short intermittent sound) while slicing the play dough with a play knife. Additionally, you can choose play dough cut-outs that have a natural sound/object correspondence as many animals and vehicles do. This will often include Learning to Listen sounds such as "moooo" for a cow, "ahhhh" for an airplane, and "hop hop hop" for a bunny.
Please note: The ideas in this post use short words or phrases to highlight various suprasegmental aspects of speech. This is not to say that natural language (full sentences) shouldn't be used. In fact, it is critical that children with hearing loss are exposed to grammatically correct, complete sentences throughout activities (and their day!) as well, just as you would provide to any other child. So for example, when playing with the play dough, you might say, "I am going to use the rolling pin to roll the play dough. Here I go! Roll.......roll........roll." When feeding a baby doll you could say, "My baby is hungry. I am going to feed her. Num num num." It is important to keep this in mind when applying these ideas to your practice.
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. There is no science to the words and phrases that I have discussed here. You are encouraged to identify words/phrases that naturally highlight suprasegmental differences within the activities you're already doing with kids!
To learn much more about why and how to integrate suprasegmental variation into your therapy and parent coaching, check out this webinar!