Support for deaf children aged 0 to 5 years: Guide

Hitchins, A. Lewis, S. Holmans, A. Grover, A. Wakefield, T. Cormier, K. Rowley, K. Macsweeney, M. | View as single page | Feedback/Impact



Many families choose an oral/aural approach for their child as they are hearing themselves.  With support from their local services, their children access mainstream pre-school settings and develop natural speech through learning to listen. Early intervention, professionals and the family working together and the consistent use of the appropriate technology play a key part. There are several organisations who advocate their own specific oral/aural approach to communication.

Natural Auralism is based on what we know regarding language acquisition in hearing children and what parents do to facilitate this – it builds on this research to recognise that parents have within them the skills to do this.

However, when a hearing loss is confirmed parents often consider they need to talk in different ways to their child than if they had not been deaf.  Professionals who wish to use this approach and who are working with families will try to ensure the ‘natural‘ features of parent/family interaction and language input come to the fore.  As a holistic approach, it is essential, for example, that the first language of the home be used with the child as the ‘natural’ intimacies will be spontaneous and identical to those used with siblings and family members alike and ensure that the child is totally immersed in the culture and life of the family at every opportunity.

Further explanation of the Natural Auralism approach can be found here.

More information about a Natural Aural approach can be found here.

Auditory Verbal (AV) therapy

  • Auditory Verbal therapy is a highly specialised family-centred, coaching programme which equips parents and caregivers with the tools to support the development of their deaf child’s speech and spoken language through listening. 
  • Auditory Verbal therapy works by stimulating the auditory pathways in the brain so, through optimally fitted hearing technology (such as hearing aids and cochlear implants), deaf children can learn to listen and develop spoken language. By supporting and coaching parents and caregivers with strategies to stimulate the pathways, their child’s listening and spoken language is developed through play-based activities that can be used in everyday routines and life. It is continually tailored to the family and based on formal and informal assessments that allow for progress to be monitored and evaluated in a way that is meaningful for the family.
  • It is most effective when it is begun early, ideally before three and a half, and parents and caregivers are supported in the approach as soon as possible. 
  • More information about an Auditory Verbal approach to communication can be found here.
  • More information about the evidence base for an Auditory Verbal approach to communication can be found here.
  • See here for videos of children listening and talking.

Multi-Sensory Oral Approach, developed by the Elizabeth Foundation, supports the development of listening and spoken language skills in children with hearing loss.  This approach encourages the development of speech, language and listening by using all of the child’s senses in a natural, fun, child centred environment.  The Elizabeth Foundation website provides more information.  The Foundation runs an online programme, 'Let's listen and Talk' for parents to follow.