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Services for children who are Deaf or hard of hearing

Children born Deaf or hard of hearing, or who develop permanent hearing loss while they are very young, are at risk for delayed language development.

Research shows that delay in language development can affect cognitive, emotional and social development: how well a young child's language is developing is related to whether that child will be ready to learn when he or she starts school. The earlier a child's hearing loss is identified, and the sooner the child can receive support, the better opportunity that child will have to succeed in school.

The Ontario Infant Hearing Program (IHP)

The Infant Hearing Program is dedicated to serving the needs of children who are Deaf or hard of hearing and their families.

The Infant Hearing Program:

  1. Offers universal hearing screening for all newborns, in order to identify infants who are born deaf or hard of hearing, or who are at risk for developing hearing loss in early childhood.
  2. Provides services for infants and young children who are Deaf or hard of hearing, and their families, to support language development.

When you know your child is Deaf or hard of hearing

Your audiologist has told you that your baby is Deaf or hard of hearing. Now it's time to find out about the services offered through the Infant Hearing Program for your child and for your family. Making full use of these services, and continuing to use them as your child grows, is important to your child's future. The Infant Hearing Program will support your child's healthy development and preparation for success in school when he or she enters Grade 1.

Audiology services: hearing re-assessment

All babies referred from hearing screening have their hearing assessed by an audiologist.

Audiologists are specialists in the assessment of hearing and in working with technology such as hearing aids to help improve communication for people with hearing loss. The Infant Hearing Program audiologists have received advanced training in the latest methods, techniques and equipment for assessing the hearing of infants and young children.

Hearing assessment of infants is based on electrophysiological measures, which use special equipment and a number of tests. An assessment may take several hours to complete, because of the amount of information the audiologist needs to determine hearing levels. Babies usually sleep through the entire process.

The assessment provides:

As children grow older, other assessment techniques are used to monitor hearing over time. Ongoing audiology reassessment is important because it allows changes in hearing over time to be identified. Hearing aids can be adjusted and changes in services can be made as appropriate.

Audiology services: amplification

When parents know that their child has a permanent hearing loss, they may choose for their baby to use a hearing aid or other device used to improve hearing. Infant Hearing Program audiologists have specialized training in selecting and fitting hearing aids for infants. The audiologist will do an evaluation, and will select a device based on information about the child's hearing loss and other needs.

The audiologist – or a hearing instrument specialist who has been trained by the Infant Hearing Program – will show parents how to use and care for the hearing aids.

Your child's hearing will continue to be monitored, and adjustments will be made to the hearing aids as needed. These frequent services are provided by audiologists and hearing instrument specialists located as close to home as possible.

Infants who meet certain criteria will be eligible for the province's Cochlear Implant Program. Audiologists from the Infant Hearing and Cochlear Implant programs work together to assess the needs of the infant, and to decide whether an implant might be an option.

If your family chooses a cochlear implant for your child, you can become involved with one of the province's three pediatric cochlear implant programs as soon as possible after the identification of hearing loss. Your audiologist can help with a referral.

Language development: services to support you and your child

You will receive information about the services and supports for communication development that are available to you and your baby from your audiologist. These include:

Specially trained service providers, including speech language pathologists and ASL and literacy consultants, will give you ongoing language development services and support:

As your child grows older, Infant Hearing Program professionals will continue to assess and monitor his or her language development, and may recommend changes in service delivery or approach. It will always be possible for families to choose different approaches to language development, different service providers, or additional supports, depending on the needs of their child.

Regardless of the approach chosen by families, the goal is for children who are Deaf or hard of hearing to develop language that is age-appropriate by the time they begin school, so that they will have the same opportunity as other children for academic success.

Family support

The Infant Hearing Program provides support services to parents as they adjust to the knowledge that their child is Deaf or hard of hearing. These services are provided by trained specialists, called family support workers. Family support workers are social workers who have received additional information on hearing loss, and on the implications of hearing loss on language development. Your family support worker will help to connect your family with the service providers you wish to meet. He/she will connect you with other community agencies, and will help to ensure that all of your needs as a family are met.

Developmental milestones in American Sign Language (ASL)

Listed below are some of the milestones that mark the progress of young children as they learn to communicate in American Sign Language (ASL). Also listed are some suggestions for what you can do to help.

Most children learn language in a predetermined order. Research indicates that children using ASL as a first language pass through the same stages of language development as hearing children using spoken language. You can look for these milestones as your child learns and grows.

Sign Language milestones

Birth to 3 months

What you can do

3 to 6 months

What you can do

6 - 9 months

What you can do

9 - 12 months

What you can do

12 - 18 months

What you can do

18 - 24 months

What you can do

Developmental milestones in spoken language

Listed below are some of the milestones that mark the progress of young children as they learn to communicate in spoken language.

These milestones are based on a child's hearing age – the length of time the child has been consistently wearing hearing aids and/or a cochlear implant.

Based on hearing age and other variables, children will pass through the same stages of listening, speech, language and cognitive development as children with typical hearing.

By 6 months

By 9 months

By 12 months

By 18 months

By 24 months

By 30 months

Babies like it when you:

Toddlers like it when you:

These materials are available at no cost from your regional Infant Hearing Program:

  • Brochure: A parent's guide to hearing aids
  • DVD set: Auditory-verbal therapy for you and your child / Sign language for you and your child