By Ms Akshya, Clinical Audiologist
The children with ample care will develop adequate physical, emotional, speech, language, auditory and cognitive development; will perform better in school; will be able to access health and other essential services. Being a parent of a child with hearing impairment, additional care should be provided for the child’s wellbeing. Are you being bombarded with various intervention options? To overcome the misperceptions, let us discuss in detail for better understanding.
“Let us sacrifice our Today, so that our children can have a better Tomorrow” — Dr. A. P. J. Abdul Kalam
Habilitation is a process which helps the children with disabilities attain, keep or improve skills and functioning for their well-being.
Have You Ever Heard of the Term – Aural Habilitation?
If not, you are in luck because here I am going to help you with a thoughtful explanation.
Rehabilitation vs Habilitation
The term ‘habilitation’ is more appropriate than ‘rehabilitation’ for the children with hearing impairment due to certain reasons. The foremost reason is that ‘Rehabilitation’ focuses on restoring a skill which is lost in any stages of life. Yet, in the children with hearing impairment, a skill may not be present initially, so it has to be developed. Therefore, the services provided would be termed as ‘Habilitation’ not ‘Rehabilitation’.
What is Aural Habilitation Program?
Aural Habilitation program is an intervention for children with hearing impairment which aims to maximise the communication abilities of the child predominantly through auditory mode.
The onset of hearing impairment in childhood disrupts learning speech and language. The early detection and early use of amplification has a positive effect on the language acquisition abilities of a child with hearing impairment. Infants who had been identified with a hearing impairment by 6 months can be expected to attain language development on a par with hearing peers. Hence, the aural habilitation should be initiated as early as the child is provided with an amplification device.
The below-mentioned factors are taken into consideration for customising intervention for the child with hearing impairment during the enrolment in aural habilitation program which will influence the progress in enormous ways:
- How old is the child?
- How old were they when they lost their hearing?
- How bad is their hearing loss?
- What type of hearing loss do they have?
- How old were they when they first used hearing aids?
Infants and young children born with hearing impairment have not learned to listen and talk. They need to learn these skills with the help of aural habilitation program. It comprises the following ways:
Finding Ways for Your Child to Communicate
- Learning speech and language
- Learning to listen
- Training on how to take care of hearing aids and other devices
Finding a Way to Communicate
Treatment will focus on the way you want your child to communicate. Some of the ways include:
Listening and speaking: Listen using hearing aids and learn words.
Cued speech or cued language: Hand movements are used near the mouth as we speak. These movements show sounds and words. They help the child understand what others say.
Indian Sign Language, or ISL: The hand and body movements are used for speaking.
Total communication: The child will talk, sign, fingerspell, lipread, and listen.
Training in auditory perception: To increase awareness of sound, identify sounds, tell the difference between sounds (sound discrimination), and attach meaning to sounds. Ultimately, it increases the child’s ability to distinguish one word from another using any remaining hearing. It also includes developing skills in hearing with hearing aids and assistive listening devices and how to handle easy and difficult listening situations.
Using visual cues: All forms of visual cues are utilised which provides meaning to a message such as the speaker’s facial expression, body language, and the context and environment in which the communication is taking place.
Improving speech: A skill is developed to produce speech sounds (by themselves, in words, and in conversation), voice quality, speaking rate, breath control, loudness, and speech rhythms.
Developing language: Developing language understanding (reception) and language usage (expression) according to developmental expectations. It is a complex process involving concepts, vocabulary, word knowledge, use in different social situations, narrative skills, expression through writing, understanding rules of grammar, and so on.
Managing communication: To make the child understand the hearing loss, develop assertiveness skills to use in different listening situations, handle communication breakdowns, and modify situations to make communication easier.
Managing hearing aids and assistive listening devices: As the children are fitted with hearing aids at young ages, early care and adjustment is done by family members and/or caregivers. It is important for children to participate in hearing aid care and management as much as possible. As they grow and develop, the goal is for their own adjustment, cleaning, and troubleshooting of the hearing aid and, ultimately, taking over responsibility for making appointments with service providers.
Other Programs
Services for children can occur in the context of early intervention (ages birth–3) and school services (ages 3–21) through Individuals with Disabilities Education Act.
In early intervention, an Individualised Family Service Plan is developed and may include audiology services, speech-language pathology services, the services of teachers of the deaf and hard of hearing, and the services of other professionals as needed.
When the child turns 3, an Individualised Education Program (IEP) is developed. The services provided are designed to maximise the child’s success in the general education environment and transition to postsecondary education programs (vocational, higher education, technical). Again, the IEP may specify audiology services, speech-language pathology services, and the services of teachers of the deaf and hard of hearing. Each professional has a role to play in the child’s educational achievement and success.
