The importance of early intervention in developing language and communication

It is essential to provide intervention as early in the child’s development as possible following the identification of the child’s hearing loss, while also considering the preferences of the family[1]. 

There is no ‘one size fits all’ approach to supporting language and communication development for deaf children and their families, and different children thrive with different approaches. What is of crucial importance is that all deaf children get the best start in life and flourish at school and beyond.

Early and effective support to develop language and communication is vital whether a family wish to use spoken language, sign language or both.

For those families that want their child to learn to listen and talk, studies demonstrate how crucial it is for an effective early intervention programme, comprising optimally fitted hearing technology (i.e. hearing aids or implantable hearing technology, such as cochlear implants) together with effective early support for communication, needs to be in place as early as possible. Ideally within the first three and a half years to optimally support the brain development required for listening and spoken language development[2].

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The importance of listening

Children’s earliest experiences in life are foundational to brain development[3]. Optimal development of speech and language skills is preceded by developing optimal listening skills. Listening is dependent upon the stimulation and development of the auditory cortex in the brain. Throughout the first three years of life, children generally receive this stimulation in the form of interactions with their parents and this allows them to start learning language[4]. We now know there is a sensitive period during which the central auditory system remains maximally plastic.

By the age of three and a half, the human brain has completed 85% of its physical growth, meaning the first three years of life are critical for developing spoken language through listening[5]^,[6].  

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The importance of language

Approximately 50%[7] of the global population is multi-lingual, and we now know that excellent outcomes for spoken language can be achieved if children with hearing loss are fitted expertly with the most appropriate technology and if their families are provided with effective early intervention[8]. Research has shown that children who receive a cochlear implant below the age of 2 years old obtain higher mean receptive and expressive language scores than children implanted over the age of 2 years[9].

Optimal language acquisition depends upon engaged parents [10]^{,[11],[12],[13]}. Permanent hearing loss extending beyond the early school-age years without adequate auditory stimulation may result in significant re-organisation of the brain, with additional areas of the auditory cortex becoming involved in visual processing^33,[14]. If parents desire listening and spoken language outcomes for their child with hearing loss, a communication approach that emphasises early development of auditory brain pathways through listening and spoken language is necessary^37,[15].

Research also shows that language development before two years can predict educational outcomes^38,[16]and a population study of the emergent literacy skills of pre-schoolers found that children enrolled in early intervention before age 6 months had consistently higher scores in emergent literacy components over time compared with children enrolled at or after age 6 months[17].

Studies have also shown that early access to language is the decisive factor that drives development forward and provides good social-emotional functioning[18].

For families wanting their children to communicate using spoken language, this represents a neurological emergency to access meaningful sound as early as possible.

Auditory Verbal therapy is an early-intervention, family-centred, coaching programme which equips parents and caregivers with the tools to support the development of their deaf child’s speech through listening and has proven strong outcomes.