Hearing-impaired children are commonly mistaken to be like myopes who require prescription glasses to live normally. However, hearing aids are reasonably different from eye glasses. Hearing-impaired children who wear hearing aids are affected by various factors, including background noise, distance from the speaker, accents, and speech patterns. Despite having similar expressive, age-appropriate language skills, children with hearing impairment adopt different mechanisms to cope with communication difficulties (Lin. Psychological Publishing, 2014).
At 8 years of age, children with normal hearing can typically employ conversational repair strategies when they cannot hear others well (Owens. Merrill, 1996). However, hearing-impaired children of the same age either do not possess sufficient repair skills, or are unable to use these skills smoothly. When talking to others, hearing-impaired children may have problems in exchanging information or suffer from communication interruptions caused by their hearing impairment, language idiosyncrasies, or other communicative behaviors (Volta Review. 1995;97:105 http://bit.ly/2u2ZEge). If they cannot use communication repair strategies appropriately, their motivation to communicate may decrease, and the unsuccessful interaction may result in misunderstandings. Thus, it is important to empower hearing-impaired children with diverse conversational repair skills early on.
REQUEST FOR REPETITION
When we cannot understand others, we usually use nonspecific requests for clarification such as “Huh?” “What?” or “Pardon?” However, hearing-impaired children should be able to communicate their specific needs rather than merely request repetition of something they have missed. For example, they can ask speakers to modify their manner of speech like to speak slower and a bit louder when repeating a statement. This way, speakers would have an idea of how to adjust their pace and volume when interacting with a hearing-impaired child.
REQUEST FOR SPECIFIC CLARIFICATIONS
Teaching hearing-impaired children how to properly request specific clarifications can help them communicate successfully by asking the speaker to restate or elucidate his or her message using different words and grammatical constructions. The following approaches can guide children in asking for clarifications in diverse communication settings (Anderson & Arnoldi. Butte Publications, 2011; Am Ann Deaf. 2003;148:308 http://bit.ly/2u36Rgh; Tye-Murray. Singular, 2006. ):
a) In other words
It is important for hearing-impaired children to understand how the meaning of a message may remain unchanged even when it is stated using different words and grammatical constructions. For example, a hearing-impaired child may say “Stackle, I want!” (a grammatical error). The caregiver can modify the sentence and respond, “Do you want to play Stackle?” Then encourage the child to repeat the correct words.
When hearing-impaired children do not clearly understand what you have said, they should be taught to say “Excuse me?” or “Pardon me?” to politely indicate that they want the words to be repeated. However, if they still do not grasp the meaning, revising the sentence might be more useful than multiple repetitions.
Using short words to stress keywords can be effective. For example, if a child asks for help in picking a story book, caregivers can take this opportunity to let the child describe the features of the book. If the child says “I want the big, big, big story book,” the caregiver can respond with the more appropriate word to confirm and repeat the child's request: “Do you want the biggest book?”
If a child does not hear you clearly, add certain information to your original statement. For example, if a child says “I enjoy this game,” the caregiver can ask “You say you enjoy playing on the swings?” and let the child reply.
In another example, a caregiver may tell a child, “Playing on the swings is so exciting!” but the child doesn't catch the words. In this case, the caregiver can add details that the child may know from previous experiences and say, “Playing on the swings is so exciting—it swings up and down. We played it on the playground last week!” Adding familiar information will help hearing-impaired children better link words and phrases with meanings.
Provide other details and clues to help children verbalize more complete descriptions. For example, if a child says “Mom lost,” the mother can reply “What did I lose?” The child should be encouraged to describe causes and effects, such as “When mom picked up the toy block, it fell down, so mom lost it.”
e) Proposing topics
Stress the most important vocabulary. For example, a mother and her child are tidying up blocks of a certain color. The child says, “Mom, pass me the red blocks.” The mother could ask “Which color?” to make the child confirm and repeat. Encourage children to spell some key words. If a child says “ball” in an unclear manner, the caregiver can respond, “Can you spell it?” for the child to spell out the indistinct word.
RECOGNIZE NONVERBAL CUES
Hearing-impaired children also need to understand nonverbal requests for clarification when conversing with others, like changes in facial expressions. In the same way, these children must be taught how to appropriately use certain body language, pictures, and written words to support communication.
In auditory-verbal practice, the aim of all therapists is to help hearing-impaired children achieve fluent communication. Apart from having basic listening and speaking abilities, these children need to develop the most essential skill of “portable communication” to help them use these communication repair strategies even in the most challenging contexts such as crowded settings or conversations with fast talkers.