27 February 2018
For those that know a little about our services you might have heard us say that children begin their listening and spoken language therapy at the Centre from 4 weeks of age. You may also have heard us say children who are profoundly deaf and are cochlear implant candidates normally won’t receive cochlear implants until around 10 months of age.
It may seem counter-intuitive to begin teaching a child whose brain is only receiving minimal auditory input to listen. In fact, this very early intervention is vitally important to build the foundations for future development.
Hiking trails and neural pathways
Children who are born profoundly deaf and have an intact auditory nerve still have some access to the auditory pathways in the brain. This means that the nerve that takes sound to the brain still works, it’s just that a lot of sounds don’t get through to the nerve for various reasons.
Picture the pathways in your brain as trails through a forest. Now imagine hikers as messages or stimulation that travels along that trail. The trails that are regularly used by hikers are easiest to follow as the ground becomes trampled down by the many feet passing through and creates a clearly visible path; this then makes it easier for more hikers to pass through successfully. The trails that are not used become overgrown and less accessible, thus less hikers make it through. Similarly, the more we use the auditory pathways in our brains, the stronger these pathways become and the more likely it is for messages get through.
It is important to remember that even a tiny amount of sound that is heard can strengthen neural connections and set a foundation for listening, which helps prevent further delays in speech and language.
“There is greater neural plasticity in young children than in older children and adults. It follows that children who have auditory stimulation early in life will develop better neuronal connections, which should result in improved use of audition” (Madell, J.R., 2001).
Spotting the response
At such a young age it can be hard to see any visible responses to sound, but the lack of perceptible response does not necessarily mean that no message is getting through. Therefore, we cannot know what exactly is being heard (even at a minute level) and what is not.
Creating the habit
We also must consider that listening and spoken language therapy is focused on teaching parents to support their child’s listening and spoken language acquisition in everyday life. By learning the techniques, including Ling sounds, songs and strategies for reading books from the very beginning, families will find it easier to incorporate these techniques into everyday routines later. By the time of implantation all these things will have become habit and a natural way of the family interacting with their child.
Children: creatures of habit
Starting the listening and spoken language therapy early means that children become familiar with Ling sounds and toys, as well as the routines that come with the associated songs by the time of implantation. This familiarity helps reinforce helps once implantation occurs and the children are beginning to access the sounds.
Determining the future
Prior to receiving a cochlear implant, children must be assessed to determine their suitability for receiving the technology, until that time children wear hearing aids. Throughout these early listening and spoken language sessions therapists work out what benefit the child is receiving from the hearing aids. This information can be passed to the family audiologist and help determine whether the child is a candidate for a cochlear implant.
As you can see there are many reasons that we start therapy sessions with a child who has been diagnosed with a profound hearing loss. The months prior to possible implantation are important to set foundations for future development.Yes, we believe that they aren’t physically hearing the sounds, but we are helping prepare them for the time that they do and ensure the best possible access to at that time.