How Exactly Does a Child with Hearing loss learn to talk?

When a child gets hearing aids or a cochlear implant, he is able to hear but the sounds don’t mean anything to him. Auditory-verbal (AV) therapy teaches the child to listen purposefully and begin to attach meaning to sound. Over time, the child is able to develop spoken language. Listening skills form the foundation of this approach. Let us watch the first video clip and then continue with the description


AV therapy uses a natural language approach. Though therapy is provided only once or twice weekly, it continues during all waking hours of the child. Just like the normal-hearing child, our child develops his language and communication skills during the process of daily living. We call it “all day, every day”.

Another important feature of the AV approach is parent empowerment. Parents are not helpless onlookers but central participants in this therapy. During the therapy, parents are trained and provided the knowledge,, skills and tools required to help the child in the home environment. Through the training, they become adept at developing the child's skills through cooking, washing, playing, and other activities they may do with the child on a daily basis. Let us watch the second video clip.


Thus, in this approach, first the child learns to listen, and then he develops language and speech in an integrated fashion. That is, he does not learn language like a tourist in foreign country, knowing only the meaning of individual words; he learns language as the basis of rich, complex communication between human beings, and is able to express intricate ideas and feelings using spoken language.

How Long will it Take for My Child to Learn to Talk?

Learning to listen and talk takes time. Children with normal hearing typically take a year to begin saying a single word and almost 4 years to be able to have a conversation using long, complete sentences. A child who is identified with a hearing loss before the age of 3 and starts receiving therapy immediately will take at least another 4-5 years to develop age-appropriate spoken language (that is, being able to listen and talk at the same level as a normal-hearing child of his age). If your child is identified and begins learning to listen between 3-5 years old, count on it taking at least another 6 years before the child can reach age-appropriate levels of understanding and talking. Babies who are identified and begin listening (with their hearing aids or implant) before 12 months of age, will learn much faster and learn to listen and talk like their normal hearing peers by the time they are 3 to 3.5 years old. (All the above scenarios assume the child does not have additional disabilities and receives regular therapy from a qualified professional).

A child with hearing loss will follow essentially the same stages of development as children with normal hearing, but will take longer and need systematic help. The first year of listening can be very slow and it might seem as if your child is not making much progress, but it is not true. Just like nine-tenth of the iceberg is submerged under water and is not visible, your child's progress in the first year happens in his listening rather than talking skills and so is not striking. When a solid foundation of listening has been laid, your child will learn faster and faster, until he has devloped 'typical' understanding and talking for his age.

The above time frames are estimates. There are many factors that affect how long it might take in a specific case. Some of these factors are outlined in the next section.

What Factors Can Affect A Child's Success ?

1. Age at which your child was identified
The earlier your child was identified, the easier it will be to teach your child to listen and talk. The later a child is identified, the longer he will take.

2. Age at which your child began wearing amplification all the time
Sometimes, a child may have been identified early, but it takes a long time to get hearing aids due to financial, distance or other constraints. The later he begins wearing hearing aids, the longer he will take to learn to listen and speak.

3. The type of program and instruction
Children whose lessons focus on helping them listen and talk (rather than teaching academics such as the alphabet, numbers, and other classroom lessons ) learn faster. This is especially true for older children, where there may be anxiety about teaching math, science etc. The correct strategy is to focus on developing the language building blocks the child will need to understand the academic concepts, and teach these concepts in the context of teaching him to listen and talk. If we focus totally on teaching the academic concepts, his development of spoken language will suffer and, in the long run, he will not have developed the language foundation necessary for understanding school subjects in the higher grades.

4. The presence of additional disabilities
Obviously, if a child has additional disabilities it takes much longer to learn to listen and talk. The important thing to remember is that you shouldn't limit a child because of additional disabilities. Working one step at a time and addressing all areas the child requires help with will lead to faster progress in spoken communication.

5. Treatment Consistency
Progress can be affected by inconsistent efforts. For example,
a) the child receives lessons or therapy sessions on and off, without regular practice during the gaps.
b) some people expect him to listen and talk, others don't. For example, a child may face demand to use listening and talking from his parents but not at his school or preschool. At home, some family members (e.g., grandparents) may not insist that the child use spoken language (either due to impatience or a feeling that they should not be "too hard on the child")
c) the parents try one method after another, one program after another, not giving any of them enough time to be effective.

6. Parent Involvement
Of all the factors, this one is the most important. Over the years, I have found that when parents work with their child consistently and with determination over a long period of time, the child is able to overcome other limitations and is successful in learning to listen and talk. Such parents may know nothing about working with a deaf child to begin with, but are able to learn what to do and how to do it. Since your child spends most of his time with you (especially the mother), what you do with him throughout the day makes the most difference (with some professional help to guide you).

Will Using Sign Language Prevent My Child from Learning to Speak?

Sign language can take many forms but all introduce a visual way for the child to communicate. This does not include natural gestures which we all use when we speak. When we introduce signs, it takes away from the child's need to verbalize as well as reduces the demand we place on the child to listen and speak. Also, research has shown that sign language is processed in a different part of the brain and doesn't match spoken words and sentences. The bottom line is, once the child has established communication using sign language, it does make it that much more difficult for him to learn to listen and talk.

I am in no way suggesting that there is something wrong with sign language. Sign language is a perfectly valid mode of communication if that is what you have chosen for your child after due research. But if you have chosen spoken language as the mode of communication for your child and want him to achieve high levels of listening and speaking, my recommendation is to
not use sign language at all with your child.

How Much Time Should I Work with My Child Every Day?

There are some activities you will need to do where you sit down with your child to practice specific skills or teach new skills. These are called structured activities and you should spend at least an hour every day doing these lessons. This hour doesn't always have to be in one block. For very young children you may spend shorter amounts of time 2 or three times a day. Whatever you do, make sure you choose one way and stick to the same schedule.

Even when you are not doing structured activities, you will still be 'working' with your child throughout the day, using specific techniques and strategies to help your child practice the skills taught during structured activities. The lessons which you do as a part of your daily activities, or activities that are more natural, such as play and field trips are called
unstructured activities. This part of 'working' with your child will be all day long.

Don't worry about whether you can "work" with your child all day long. The lessons will tell you how to practice your child's skills during specific routine activities in your day. Just follow the lessons carefully and pretty soon, it will become a second nature to you to interact with your child all day long in a manner that teaches him to listen and talk.

Which is Better, Cochlear Implants or Hearing Aids?

These are two different devices for different degrees of hearing loss. If a child cannot hear conversational speech with appropriate hearing aids, then a cochlear implant is recommended. A child needs to be tested with and without his hearing aids to determine if he is benefiting from them, and if he is a candidate for a cochlear implant.

So it is not a question of which is better, but which is more appropriate for a child's degree of hearing loss. A child with appropriately fitted hearing aids is perfectly capable of learning to listen and speak, just like a child with a cochlear implant.

Will I Really Be Able to Teach My Child to Talk?

Yes! You don't need to worry about understanding everything and you don't need to become a therapist. Start with the structured activities and one or two techniques. The lessons will tell you how. As you do more and more lessons, and do them regularly, you will find that you are understanding how to work with your child without thinking about all the technical information.

You are still going to be doing all the things you would do with your child even if he didn't have a hearing loss. Now you will just do them in a different way, more systematically and more often. Again, the lessons will tell you how and guide you.

Yes, you can teach your child. So go ahead and take that first step. If you are ready to begin, go to the

My Child is Very Young; Shoudn't I Wait Until My Child is Older?

No. The time to begin working with your child is right now. The quicker your child learns that sound has meaning, and that speech he hears is a form of communication, the faster he will learn words and phrases and the sounds required to produce them.

The lessons give variations on how to work with a very young child where needed. When in doubt, ask in the Forum. There is no need to wait, and you can begin working even with your infant baby.

A translation of this web page contents is available as a .pdf file in