Symposium on sensorineural hearing loss in children: early detection and intervention. The rationale for early...

The normal hearing child utilizes auditory data to trigger his innate propensity for language learning and begins to use these stored auditory images long before he says his first word. The auditory modality appears to provide the input from which he abstracts and regularizes the rule of grammar both from outside sources and in an auditory feedback arrangement from his own utterances. The development of expressive language appears to occur rapidly once the first word is said, and by age three he appears to be using all the basic structures of speech. The child with severe hearing impairment, on the other hand, deprived of auditory input, either does not develop speech or may with some training develop very limited speech. Since most hearing impaired children can benefit from amplification, hearing aids can provide a means to maximize the auditory channel. Many such children, however, do not receive hearing aids until three to four years of age, and so have already been deprived of these key years in language development. They have already missed the critical periods in language learning and thus are apt to remain severely depressed in language skills at best. The results of one study reported in this discussion appear to substantiate the observation that a good program of early intervention, including effective parent training and early use of hearing aids to exploit auditory potential, can help hearing impaired children to generate spontaneous spoken language more comparable to that used by their normal hearing peers in both type and level of utterance. Although this language may be more immature or less syntactically and morphologically correct than that of their normal hearing peers, it compares in syntactical structure much more favorably than does the language of hearing impaired children who have not received such special help until about two years later. The study further demonstrates the importance of early intervention and illustrates the positive effects of a good early management program on the language and resulting educational achievement of hearing impaired children.