Children With Hearing Loss: Developing Listening and Talking, Birth to Six

Third Edition

Elizabeth B. Cole, Carol Flexer

Details: 486 pages, B&W, Softcover, 6" x 9"

ISBN13: 978-1-59756-566-0

© 2016 | Available

The third edition of Children With Hearing Loss: Developing Listening and Talking, Birth to Six provides updated information from the previous two editions for both professionals and parents facilitating spoken language through listening (auditory brain access, stimulation, and development) in infants and young children with hearing loss. Also addressed is auditory brain development, audiologic technologies, auditory skill development, spoken language development, as well as family-focused intervention for young children with hearing loss whose parents have chosen to have them learn to listen and talk.

Additionally, this new edition is expanded to reflect important and rapidly evolving changes that have developed in the past five years, including:

  • Application of neuroscience research to our knowledge of the foundations of listening and talking (Chapter 1)
  • Current information on vestibular function in infants and young children (Chapters 2 and 3)
  • Essential technology updates (Chapter 5)
  • Expansion of the discussion of types of services a child with age-appropriate skills needs to sustain a positive academic trajectory (Chapter 6)
  • Discussion of the use and efficacy of coaching and other parent guidance strategies (Chapter 10)
  • Updated resources (Appendix 6)

This text is intended for undergraduate- and graduate-level training programs for professionals who work with children who have hearing loss and their families. This third edition is also a valuable resource for parents, listening and spoken language specialists (LSLS), speech-language pathologists, audiologists, early childhood instructors, and teachers. Furthermore, much of the information in Chapters 1 through 5 and Chapter 7 is beneficial to individuals of all ages with hearing loss, especially newly-diagnosed adults.


"With the availability of newborn hearing screening, the landscape of pediatric audiology and communication development has changed and continues to evolve. This book provides concepts that integrate knowledge and practice from audiological and educational perspectives.[Cole & Flexer's] book, intended for both parents and professionals, is written with enthusiasm from their experience about maximizing spoken language outcomes for families and their children with hearing loss. The language, illustrations and layout would be accessible to a wide audience. The book is very well referenced with over 36 pages of journal articles and texts for further reading. Much attention is given to meaningful interaction and communication with discussion of parent-child attachment, shared attention (joint reference), turn-taking and communicative intent. Strategies to enrich the language environment for the child involve analysis of characteristics of caregiver talk, but also sensitive awareness of the emotional state of parents and understanding the preferred learning styles of parents. This is useful for parents and professionals to consider together."
—Lois Grant, in Audiology Now (2016)

"Each chapter features small anecdotal inserts or sketched-style images which help break down the science. The book recognises the changes that have occurred in audiology following the advent of universal newborn hearing screening. Furthermore, it recognises that while outcomes for children with hearing impairments are improving, professionals still have a changing landscape ahead of them - this book is a useful reference point."
James Harrison, Clinical Lead Paediatric Audiology, Sherwood Forest Hospitals Trust UK, ENT & Audiology News (Jan/Feb 2017)


Chapter 1.Neurological Foundations of Listening and Talking

Typical Infants: Listening and Language Development
Auditory Neural Development
New Context for the Word Deaf
Hearing Versus Listening
A Model of Hearing Loss: The Invisible Acoustic Filter Effect
Think about Hearing Loss as a Doorway Problem
Summary: The “Essential Question” That Drives Technological and Intervention Recommendations

Chapter 2. The Audiovestibular System

The Nature of Sound
Unconscious Function
Signal Warning Function
Spoken Communication Function
Audibility Versus Intelligibility of Speech
The Ling 6-7 Sound Test: Acoustic Basis and Description
Audiovestibular Structures
Data Input Analogy
Outer and Middle Ear
Inner Ear to the Brain
The Vestibular System: The Sensory Organs of Balance

Chapter 3. Hearing and Hearing Loss in Infants and Children

Degree (Severity): Minimal to Profound
Timing: Congenital or Acquired
General Causes: Endogenous, Exogenous, or Multifactorial
Genetics, Syndromes, and Dysplasias
Connexin 26
Inner Ear Dysplasias
Medical Aspects of Hearing Loss
Conductive Pathologies and Hearing Loss
Sensorineural Pathologies and Hearing Loss
Mixed, Progressive, Functional, and Central Hearing Losses
Synergistic and Multifactorial Effects
Auditory Neuropathy Spectrum Disorder (ANSD)
Vestibular Issues

Chapter 4. Diagnosing Hearing Loss

Newborn Hearing Screening and EHDI Programs
Test Equipment and Test Environment
Audiologic Diagnostic Assessment of Infants and Children
Test Protocols
Pediatric Behavioral Tests: BOA, VRA, CPA, Speech ::Perception Testing
Electrophysiologic Tests: OAE, ABR/ASSR, and Immittance
The Audiogram
Configuration (Pattern) of Thresholds on the Audiogram
Formulating a Differential Diagnosis
Sensory Deprivation
Ambiguity of Hearing Loss
Measuring Distance Hearing

Chapter 5. Hearing Aids, Cochlear Implants, and FM Systems

For Intervention, First Things First: Optimize Detection of the Complete Acoustic Spectrum
Listening and Learning Environments
Distance Hearing/Incidental Learning and S/N Ratio ::ANSI/ASA S12.60-2010: Acoustical Guidelines for Classroom Noise and Reverberation
Talker and Listener Physical Positioning
Amplification for Infants and Children
Hearing Aids/Hearing Instruments
Bone Anchored Hearing Aid Implants (BAI) for Children
Wireless Connectivity
Hearing Assistance Technologies (HATs) for Infants and Children: Personal-Worn FM and Sound-Field FM and IR (Classroom Amplification) Systems
Cochlear Implants
Auditory Brainstem Implant (ABI)
Measuring Efficacy of Fitting and Use of Technology
Equipment Efficacy for the School System

Chapter 6. Intervention Issues

Basic Premises
Differentiating Dimensions Among Intervention Programs
Challenges to the Process of Learning Spoken Language
Late to Full-Time Wearing of Appropriate Amplification or Cochlear Implant(s)
Disabilities in Addition to the Child’s Hearing Loss
Ongoing, Persistent Noise in the Child’s Learning Environment
Multilingual Environment
Educational Options for Children with Hearing Loss, Ages 3 to 6

Chapter 7. Auditory “Work”

The Primacy of Audition
The Acoustics-Speech Connection
The Effect of Hearing Loss on the Reception of Speech
A Historical Look at the Use of Residual Hearing
The Concept of Listening Age
Auditory “Skills” and Auditory Processing Models
Theory of Mind and Executive Functions
How to Help a Child Learn to Listen in Ordinary, Everyday Ways
Two Examples of Auditory Teaching and Learning
Scene I: Tony
Scene II: Tamara
Targets for Auditory/Linguistic Learning
A Last Word

Chapter 8. Spoken Language Learning

What’s Involved in “Talking”?
How Does a Child Learn to Talk?
Relevance for Intervention Decisions
How Should Intervention Be Organized?

Chapter 9. Constructing Meaningful Communication

The Affective Relationship
The Child’s Development of Interactional Abilities
Joint Reference, or Joint Attention
Turn-Taking Conventions
Signaling of Intention
Characteristics of Caregiver Talk
1. Content: What Get’s Talked About?
2. Prosody: What Does Motherese Sound Like?
3. Semantics and Syntax: What About Complexity?
4. Repetition: Say It or Play It Again
5. Negotiation of Meaning: Huh?
6. Participation-Elicitors: Let’s (Keep) Talk(ing)
7. Responsiveness
Issues About Motherese
How Long Is Motherese Used?
Motherese: Why?
Motherese: Immaterial or Facilitative?

Chapter 10. Interacting in Ways That Promote Listening and Talking

The Emotional Impact of a Child’s Hearing Loss on the Family
Adult Learning
What Parents Need to Learn
Components of Intervention for Babies and Young Children with Hearing Loss
When to Talk with Your Child and What to Talk About
A Framework for Maximizing Caregiver Effectiveness in Promoting Auditory/Linguistic Development in Children with Hearing Loss
Background and Rationale
Structure of the Framework
Getting a Representative Sample of Interacting
Discussing the Framework with Parents
Ways of Addressing Parent-Chosen Targets
Instructional Targets and Sequence
Teaching Through Incidental and Embellished Interacting
Teaching Through Incidental Interacting
Embellishing an Incidental Interaction
Teaching Spoken Language Through Embellished Interacting
Teaching Listening (Audition) Through Embellished Interacting
Teaching Speech Through Embellished Interacting
Preplanned Parent Guidance Sessions or Auditory-Verbal Therapy Sessions
Components to Be Accomplished in a Typical Preplanned Session
Sample Preplanned Scenario
About the Benefits and Limitations of Preplanned Teaching
What does the Research Say?

Appendix 1. How to Grow Your Baby’s/Child’s Brain

Appendix 2. Application and Instructions for the Ling 6-7 Sound Test

Appendix 3. Targets for Auditory/Verbal Learning

Appendix 4. Explanation for Items on the Framework

Appendix 5. Checklist for Evaluating Preschool Group Settings for Children With Hearing Loss Who Are Learning Spoken Language

Appendix 6. Selected Resources

Appendix 7. Description and Practice of Listening and Spoken Language Specialists: LSLS Cert. AVT and LSLS Cert. AVEd

Appendix 8. Principles of LSLS Practice

Appendix 9. Knowledge and Competencies Needed by Listening and Spoken Language Specialists (LSLSs)

Appendix 10. Listening and Spoken Language Domains Addressed in This Book


Elizabeth B. Cole

Elizabeth B. Cole, EdD, CCC-A, LSLS Cert. AVT, is the former Director of CREC Soundbridge in Connecticut and a former professor at McGill University in Montreal, and is now enjoying a very active semi-retirement.

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Carol Flexer

Carol Flexer, PhD, CCC-A, LSLS Cert. AVT, received her doctorate in audiology from Kent State University in 1982. She was at The University of Akron for 25 years as a Distinguished Professor of Audiology. Dr. Flexer lectures and consults extensively nationally and internationally about pediatric audiology issues.

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Cochlear Implants: Audiologic Management and Considerations for Implantable Hearing Devices

First Edition

Jace Wolfe

Details: 858 pages, Full Color, Hardcover, 8.5" x 11"

ISBN13: 978-1-59756-892-0

© 2020 | Available

Auditory-Verbal Therapy: For Young Children with Hearing Loss and Their Families, and the Practitioners Who Guide Them

First Edition

Warren Estabrooks, Karen MacIver-Lux, Ellen A. Rhoades

Details: 602 pages, B&W, Hardcover, 7" x 10"

ISBN13: 978-1-59756-888-3

© 2016 | Available

Auditory Perception Test for the Hearing Impaired (APT/HI)

Third Edition

Susan G. Allen

Details: Full Color, Spiral-Bound Test Book, 8.5" x 11", plus Guidebook and Companion website with supplementary materials

ISBN13: 978-1-59756-590-5

© 2016 | Available

Video-Based Aural Rehabilitation Guide: Enhancing Listening and Spoken Language in Children and Adults

First Edition

Linda L. Daniel, Sneha V. Bharadwaj

Details: 312 pages, B&W, Softcover, 8.5" x 11"

ISBN13: 978-1-63550-112-4

© 2021 | Available

Hearing Aids for Speech-Language Pathologists: A Guide to Modern Rehabilitative Audiology

First Edition

H. Gustav Mueller, Lindsey E. Jorgensen

Details: 445 pages, B&W, Softcover, 7" x 10"

ISBN13: 978-1-63550-214-5

© 2020 | Available

Educational Audiology Handbook

Third Edition

Cheryl DeConde Johnson, Jane B. Seaton

Details: 606 pages, B&W, Softcover, 8.5" x 11'

ISBN13: 978-1-63550-108-7

© 2021 | Available