1. Early Speech Development Suprasegmentals (voice patterns) Vocalization (voice on/voice off) Duration Loudness Pitch Vowels 1

2. Later Speech Development • Vowels • Consonants • Voiced/voiceless distinctions (“d” v. “t”) • Consonant Blends (“br” “spl”) last to develop

3. Audiogram Showing “Speech Banana”(Mehr, 2002) 3

4. Speech Expectations With consistent early amplification, voicing will occur With consistent intervention, speech sound patterns will be reinforced With parent involvement and collaborative teamwork, language will emerge 4

5. “Is my baby too young to wear hearing aids?

6. Resources for obtaining Hearing Aids Hearing Aid Loaner Bank Blue Ridge Care Connection for Children Provide hearing aids and FM systems up to age 18 Loan for 6 months while in process of obtaining permanent ones Contacts: Lisa Powley or Sandra Woodward 866-596-9367 6

7. Financial Assistance for Hearing Aids • www.audientalliance.org/ Audient An Alliance for Accessible Hearing Care • www.sotheworldmayhear.org/ So the World May Hear • www.paiojd.org/hike/ HIKE Fund, Inc. • www.dmas.virginia.gov/ Department of Medical Assistance Services (Medicaid)

8. Assist families withHearing Aid challenges Feedback When nursing or feeding, turn off aid on that side When baby is sleeping, may remove aids Replace ear molds as infant outgrows them (6 – 8 wks) Keeping aids on the baby Critter clips Toupee tape Water wings Pilot cap Ear Gear 8

9. Purchasing Hearing Aids • Things to be aware of: • Find a pediatric audiologist with experience in working with very young children • Request for a trial period before purchasing • Get insurance coverage for the aids if lost or broken • Product guarantees in writing • Be an advocate for hearing aid care, routine evaluations, and new ear molds

10. Process of Cochlear Implants Candidacy Hearing Aid trial (3 months) Surgery (as early as 12 months) Activation Therapy

11. What Can You Encourage Families to Do? Become comfortable with listening devices and learn to troubleshoot Develop a schedule if necessary to increase wearing time of hearing aid/fm system/cochlear implant Draw the child’s attention to environmental noises throughout the day Ensure that the audiologist is part of your team! 12

12. Provide enriching listening experiences in the home Add language to baby’s play routines (ex. - Pair a sound with a toy each time they play with it (see Sindrey) Speak to baby in an interesting, animated voice. Talk about what baby is playing with or looking at; describe what she sees. 13

13. Helping Families to Make Informed Decisions Provide Communication Choices Consider amount and quality of functional hearing (Oticon & ADA) Observe child and determine the method that seems to fit his needs – consider additional challenges Family must be willing and able to use method(s) effectively and consistently (lifestyle and values) 14

14. What you can do Stay informed (www.asha.org) Learn about other successful programs (for example: www.beginningsvcs.com) Become an advocate Form or join parent support groups (Parent to Parent) Don’t allow a wait and see attitude 15

15. Websites • www.infanthearing.org/videos/index.html EHDI Educational & Training Videos • www.agbell.org Alexander Graham Bell Association, promotes oral education • http://jtc.org/ John Tracy Clinic Free services worldwide for parents of children with hearing loss • www.hearingjourney.com Activities for infants and toddlers to promote listening and speaking skills by Dave Sindrey, M.CI Sc.Cert. AVT • www.oraldeafed.org Free materials that promote oral education

16. Websites for Sign Language • www.lifeprint.com/index.htm American Sign Language • www.signingtime.com/ Signing Time signs for babies • www.mybabycantalk.com/ My Baby Can Talk Signs for babies • www.readysetsign.com/index2.html Sign Language Course

17. Virginia Department of Deaf & Hard of Hearing Contact: Pamala Richardson 804-662-9502 1-800-552-7917 Pamala.Richardson@vddhh.virginia.gov www.vddhh.org RESOURCE BINS EXCELLENT SOURCE OF MATERIALS MAY BE LOANED FOR 3-6 MONTHS 18

18. Learning to Talk Around the Clock © • Themes based on natural routines and activities • Talking points to share with parents • Scripted dialogue to help professional • Signature behaviors to promote language and listening

19. Listen Around the Clock Mealtime Getting Dressed Little Helper On the Go In the Garden In the Kitchen Celebrations Outdoor Play Playtime Bath Time Bedtime Thematic Units Learn to Talk Around the Clock ©

20. Assessment Tools • Cottage Acquisition Scales for Listening, Language and Speech (CASLLS) • MacArthur Bates Communication Inventory • SKI-HI Language Scale • Infant/Toddler Meaningful Auditory Integration Scale (IT-MAIS) • Early Listening Function (ELF)

21. A special thank you to Debbie Pfeifer and Ann Hughes for contributing invaluable information, advice and guidance for this presentation.