What is it about?

Children who are deaf and hard of hearing are now identified earlier than in previous decades due to hearing screenings offered in infancy. This allows for early fitting of hearing aids or cochlear implants and access to early intervention services. However, even with these advances, recent research indicates that children who are deaf and hard of hearing remain at risk for delays in language development. Parents are key in helping children learn to talk. However, little information exists on what strategies are effective for caregivers of toddlers who are deaf and hard of hearing to use to support children’s language learning. Similarly, interventionists have little information about how they can best teach caregivers to use the strategies with their children. This study was an early step in testing the effectiveness of an intervention (named COACH, which stands for Caregivers Optimizing Achievement of Children with Hearing Loss) that involved adapting evidence-based language facilitation strategies to meet the unique needs of children with hearing loss and teaching parents to use them. The results indicated that parents could learn to use the strategies, although not all parents learned at the same pace and some strategies were less likely to be used than others after the intervention ended. Children’s language skills also generally showed growth during and after the intervention, although more research is needed to see if this was because of the intervention.

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Why is it important?

The results from this study show that it is possible to teach parent of infants and toddlers who are deaf and hard of hearing strategies that are likely to help their children learn language. Caregivers reported liking the intervention and provided thoughts on how the intervention could be even better in the future. This indicates the intervention is worth further refining and testing and could eventually provide interventionists and families with the tools needed to improve the language skills of young children who are deaf and hard of hearing.


Although the intervention needs to be tested more, we think there are things interventionists and families can start using from the intervention now. Interventionists can learn more about how to use a coaching style in their intervention sessions. This can include using video feedback, where the interventionist records the parent and child interacting together and then viewing the video with the parent. Parents found this useful for seeing how what they did influenced how their child communicated during interactions. One language facilitation strategy that parents especially found useful was learning to match what they said to their child’s communication. This skill involved parents responding whenever a child communicated and responding specifically to what the child communicated about. It also helped parents make sure they weren’t talking so much that the child didn’t get a chance to talk. It is also important that parents understand that because their child has a hearing loss, their child may not learn word endings and other parts of speech that aren’t very prominent as easily as children with typical hearing. Parents should be coached to make sure they aren’t shortening their sentences in ways that leave out important parts of speech or that make the speech sound unnatural.

Sophie Ambrose
Boys Town National Research Hospital

Read the Original

This page is a summary of: Teaching Caregivers to Implement the Caregivers Optimizing Achievement of Children With Hearing Loss (COACH) Intervention, American Journal of Speech-Language Pathology, May 2023, American Speech-Language-Hearing Association (ASHA), DOI: 10.1044/2022_ajslp-22-00223.
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