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A Good Start: Suggestions for Visual Conversations with Deaf and Hard of Hearing Babies and Toddlers

By Patricia Elizabeth Spencer, Ph.D.

Full paper in PDF format


Researchers have found that children whose hearing loss is identified while they are still babies tend to learn language more easily and more completely than those whose hearing loss is identified later (Yoshinaga-Itano, Coulter, & Mehl, 1998). Procedures for testing hearing have improved recently, with many states testing for hearing soon after birth. This means that many children are discovered to be deaf or hard of hearing during the important first few months of life. In many cases, this gives their parents a great advantage in seeking and providing the kind of support that enables their children to learn language naturally and on time.

Until recently, little information was available to help parents with this task. However, during the 1980s and 1990s several groups of researchers around the world studied babies and toddlers with hearing loss. The research teams watched the babies grow, measured their achievements, and identified the kinds of interaction with parents and other adults that gave them the best start.

One of the most active groups of researchers worked at Gallaudet University at the Center for Studies in Education and Human Development. As a member of that group, my special interest was studying how babies learn to communicate and use language. I also studied the babies' mothers, noticing things they did that gave the babies especially good support for language development.

More than 100 families participated in this research while their babies (hearing, deaf, or hard of hearing) were between 3 and 28 months old. Some of the parents were hearing and some were deaf. Thanks to the willingness of these families to participate in research, much better information now exists about the development of deaf and hard of hearing babies and toddlers.

Research from around the world confirms three important ideas:

    1. Deaf and hard of hearing babies (just like hearing babies) learn language best in natural situations with people who care about them and know them well.
    2. Both hearing and deaf parents have natural "instincts" about the kinds of behaviors to use with a baby (Papousek & Papousek, 1987; Koester, 1992; Erting, Prezioso, & Hynes, 1994). They know how to play with babies, how to show their babies how much they love them, and how to communicate with their babies even before the babies can use language. Most of these special parenting behaviors match the needs of all babies: deaf, hearing, or hard of hearing.
    3. Deaf parents emphasize some kinds of communication behaviors more than most hearing parents do. These special modifications in parent communication are particularly helpful for babies with hearing loss. When hearing parents adapt these communication behaviors to those they already know, babies who are deaf or hard of hearing seem to pay attention better and learn language earlier (Erting, et. al, 1994; Harris & Mohay, 1997; Mohay, 2000; Waxman & Spencer, 1997).

These three ideas — and suggestions based on them — are discussed in greater detail, beginning with specific suggestions for ways to communicate with deaf and hard of hearing babies and going onto additional information about the suggestions and how to put them into practice. The information comes from research, made more practical through discussions with parents and teachers.

Although many parents who read this document may have decided to use signed language with their babies, the suggestions are not limited to that communication option. Parents using spoken language or a system like Cued Speech should also benefit from these suggestions.

In this document, the suggestions generally follow a developmental order. That is, suggestions for communicating with younger babies (about birth through 5 or 6 months of age) are given first. Suggestions for older babies and toddlers (6 to 9 months to about 2 years of age) appear later. However, babies develop at different speeds; any or all of the suggestions may be helpful regardless of the age of the baby or toddler who is special to you.

In the Appendix, you will find a list of references for suggested additional reading material. These are references to more technical papers that will be helpful if you want to read in more detail about the research discussed here.

About the Author

Patricia Elizabeth Spencer has bachelor and master's degrees in education and a Ph.D. in Communication Disorders from the University of Texas at Dallas. She has worked at Gallaudet University for more than 22 years. During that time, she has been a diagnostic/prescriptive classroom teacher at Kendall School, the coordinator of a national assessment center for deaf and hard of hearing children, and a research scientist in the Center for Studies in Education and Human Development. As a research scientist, she was involved in longitudinal studies of the development of deaf and hard of hearing infants and toddlers.

She is currently an associate professor in the Department of Social Work where she specializes in teaching research and evaluation courses. Spencer is a frequent speaker at local and national conferences. She has published numerous journal articles and book chapters about her research and recently co-edited a book entitled The Deaf Child in the Family and at School.