PARENT/TEACHER POINTERS

1. Know what your child can hear. Talk to his audiologist so that you can acquire a good understanding of exactly what speech and environmental sounds your child should have the potential to hear. This knowledge can help you to help him develop auditory skills in his natural interactions with others.

2. Monitor amplification. Have a daily routine of checking your child's hearing aids and FM systems. By listening to it on a daily basis, you can become familiar with what it is supposed to sound like and this will make it easier for you to detect any changes. Ask your audiologist for a maintenance kit and a listening check routine that you can follow on a daily basis. Although it is important for older children to become more independent in maintenance of their equipment, they may be unable to detect changes like someone with normal hearing can.

3. Have your child use amplification faithfully. Provide consistent routines for putting on hearing aids (or FM at school) at the beginning of the day and leaving them on until bedtime (with the obvious exceptions of swimming, etc.) Even a child with a profound hearing loss can make use of the information that can be provided through amplification.

4. Know your child's abilities. Be very familiar with what your child can do easily, what skills are emerging, and what is beyond him. This way you will know what to expect, what specific models will be appropriate, and avoid frustration over situations that are beyond his reach. By knowing what your child has and needs next, you can tailor the focus of the language. Model structures which are at or slightly above your child's current level. If your models are too advanced your child will not understand or be able to take advantage of them and if too low, will not be stimulated by them.

5. Reinforce school communication goals. Keep in close touch with your child's teachers and speech language pathologist. Find out what you can do at home to help carryover current goals. These should be simple, light-hearted activities centered around communication behaviors with which your child will be highly successful (not teaching new, difficult material). It should always be readily apparent to you and your school-aged child what the current communication goals are.

6. Set up a communication notebook. Use a communication notebook with contributions from teacher, therapist, parents and others. Include events, concerns, accomplishments, activities, stimulus materials, tricky words, —content will vary greatly depending on the child. Older children should become increasingly responsible for the content and use of the notebook.

7. Help set communication goals. Although the professionals who work with your child have special expertise in understanding and teaching communication skills, don't underestimate your importance. The school professionals may not know that your toddler screams throughout the day at home to gain attention or that your adolescent has difficulty engaging in social conversations at the dinner table. Together you can identify critical areas of need and how to go about reaching the goals.

8. Audiotape your child's language. Make a tape recording of your child's language periodically (perhaps every 3 months for younger children, every 6 months for older kids) so that you have a permanent record of her progress. Try to do this during regular playtime or by engaging her in a conversation. Listen to this tape on occasion to see changes in your child's communication skills, and, if your child has enough residual hearing, have her listen to it, too.

9. Facilitate communication. Rather than intervening on your child's behalf, facilitate communication with other children by encouraging and modeling ("You tell him you want the truck. John, Mary has something to tell you.")

10. Measure successes and celebrate! In the vast arena of communication skills, it no doubt seems like there is always something more to work on, no matter what gains are made. Since the grand end point may not be evident, help your child see her smaller communication gains (e.g. use a bar graph to note progress on a specific skill) and when a pre-set criteria is reached, celebrate! (Hot fudge sundaes, anyone?)

11. Be patient. Wait for a response: especially with young children, adults tend to jump in too quickly to fill the void. Your child may need a little extra time to formulate and produce language.

12. Provide incentives. Promote carryover with incentives. Clear communication alone may not always be sufficiently motivating for a child. For example, you could try the old money method: Put a jar in the middle of the kitchen table (or whatever is the central location in your home). Add a penny for every good "s" you hear your child say. For an investment of $5.00 you can get 500 good responses. This works well for a behavior your child can do but just needs a little nudge to make it consistent.

13. Pick the right time for intervention. When a child is not at his best (tired, excited, angry), don't expect or demand that she use her best communication skills. Focus on specific communication behaviors during specific activities or times (e.g., when looking at his speech notebook and during calm, direct conversations when your child can attend well).

14. Converse with your child. In most activities, maintain a conversational atmosphere rather than a mood of testing and teaching. Strive for spontaneous output or responses from indirect models rather than imitation.

15. Use natural consequences. Use natural consequences to deal with communication breakdowns. If your child is capable of something but isn't using it, (e.g., /f/ production): you can (at the right time) act truly confused ("You caught a pish?"). This will aid self-correction.

16. Do the same activities but for different reasons. You may do the same activities with your children at different times but model different communication behaviors. For example, your child may practice "sh" as you discuss all the things you wash, he may learn basic vocabulary (bowl, plate, cup, spoon, hot, soap, dirty), or he might use two word phrases (dirty fork, clean fork). Older children might discuss what happens to the water when it leaves the sink or practice their skills of persuasion in a discussion about why they should not have to do the dishes.

17. Use language modeling techniques. These techniques are primarily used with young children learning language but could be used at a more sophisticated level with older children.

• parallel talk—talk about your child's actions and what other people are doing.
• expansion—add to what your child says (child:"doggy" - parent: "Yes, that's a doggy.")
• expatiation—expand on the topic by adding information (child: "Look at the truck." parent: "That cement truck is backing up. I can hear it - beep,beep,beep.")

18. Use real words. Baby talk may be cute initially but doesn't age well and no one else will know what your family terminology means.

19. Pair new and old vocabulary. Use new vocabulary items with old to help establish meaning in a conversational context. e.g., "1 like your turquoise shoes. They're sort of blue and sort of green - they're turquoise." "I was really angry (known). I was furious(new)!" Don't be content with using words the child already knows, but offer him new words as well to broaden his horizons. Make a purposeful effort to introduce new vocabulary on a regular basis: elaborate, expand, and enrich.

20. Use routine to reinforce language. Children benefit from hearing and learning certain expressions over and over which are applied to routine activities. (e.g., "Time for supper.") Young children can master these expressions earlier than novel expressions of the same complexity and may use them more readily.

21. Avoid routine to spark new language. Use objects or activities that are different from the usual or each other. (an odd color, out-of-character action, a broken object...) A child may be more likely to comment on the unusual rather than the routine.

22. Foster independence through self-evaluation. Your child is ultimately responsible for herself and her own communication abilities. No one likes to feel they are being corrected so the sooner your child monitors, evaluates, and self-corrects her speech, the better. Praise her self-evaluation efforts and encourage independence and responsibility in other areas as well.