Speech Language and Hearing Expectations for Children with Hearing Loss and Multiple Impairments

Your child needs to wear his or her cochlear implant(s)/hearing technology all waking hours. A typically hearing baby listens for 10 waking hours a day, 365 days a year. A typically hearing toddler listens for 12 hours a day 365 days a year. This is vital for your child to access language and to make adequate progress.

1 Month Hearing Age

  • Head turn and other physical response to sound (both speech and environmental, examples: microwave, car horn, etc.)
  • Response to Ling 6 sounds (ah, oo, mm, ee, sh, ss)

3 Months Hearing Age

  • Imitate 3 of 6 Ling sounds (or use speech device to imitate if nonverbal)
  • Pattern perception (long versus short, etc.)
  • Recognize different intensity and pitch (loud versus soft, high versus low)
  • Imitate or use speech device 3 to 5 Learning to listen to sounds (ex: meow, vroom vroom)

6 Months Hearing Age

  • Complete comprehensive speech/language/hearing evaluation (Celf-P 2, GFTA, ROWEVT, Auditory Placement Test, Functional Communication Profile etc.)
  • Tell the difference between consonants and vowels
  • Recognize pattern for 1-,2-, and 3-syllable words
  • Identify at least 1 or 2 nursery rhymes with hand motions ( Wheels on the Bus, Itsy Bitsy Spider)
  • Understand 3 to 5 familiar phrases ( ex: sit down, give to mom or dad)

9 Months Hearing Age

  • Identify at least 1 critical element in a message (Touch the ball, Feed the cat, etc.)
  • Imitate 10 to 15 Learning to Listen sounds (or use customized speech device)
  • Identify familiar Learning to Listen sounds by sound (ex: moo, meow, etc.)
  • Identify familiar nursery rhymes by picture pointing from a closed set
  • Imitate variety of consonants by manner( b,p,m,n,h,w)

12 Months Hearing Age

  • First spoken words (about 10, or ten core words on speech device)
  • Imitate animal sounds (expand imitation of Learning to Listen sounds)
  • Identify 3 to 5 body parts (on self, in book, or on speech device)
  • Label familiar objects (ball, car, etc.)
  • Identify familiar pictures in a book by pointing (or on Bits Board or speech app)
  • Identify early developing prepositions (on, in, etc.)

18+ Months Hearing Age

  • Advanced vocabulary development
  • Advanced spoken words (Use of Core Words or word combinations on speech device)
  • Readily uses power words and familiar phrases (help me, etc.)
  • Answers “WH” questions (what, where, when, why)

Complete Speech/Language re-evaluation completed every 6-12 months to monitor progress while child is enrolled in speech therapy. Annual Speech/Language evaluation thereafter. Minimally, evaluations scheduled at transition points - entering elementary school, middle school, high school, and post-secondary schooling.

Progress and prognosis are affected by age of identification, early intervention, type and degree of hearing loss, other contributing disabilities, cognition, communication choice, family involvement, etc.