Children with hearing loss, with early and appropriate amplification and intervention, demonstrate gains in speech, language, and literacy skills. Despite these improvements many children continue to exhibit disturbances in cognitive, behavioral, and emotional control, self-regulation, and aspects of executive function. Given the complexity of developmental learning, educational settings should provide services that foster the growth of skills across multiple dimensions. Transdisciplinary intervention services that target the domains of language, communication, psychosocial functioning, motor, and cognitive development can promote academic and social success. Educational programs must provide children with access to the full range of basic skills necessary for academic and social achievement. In addition to an integrated curriculum that nurtures speech, language, and literacy development, innovations in the areas of auditory perception, social emotional learning, motor development, and vestibular function can enhance student outcomes. Through ongoing evaluation and modification, clearly articulated curricular approaches can serve as a model for early intervention and special education programs. The purpose of this article is to propose an intervention model that combines best practices from a variety of disciplines that affect developmental outcomes for young children with hearing loss, along with specific strategies and approaches that may help to promote optimal development across domains. Access to typically developing peers who model age-appropriate skills in language and behavior, small class sizes, a co-teaching model, and a social constructivist perspective of teaching and learning, are among the key elements of the model. Keywords cochlear implants, children, educational settings The ProblemDespite appropriate amplification and early and intensive intervention, many children with hearing loss continue to lag behind their peers in some aspects of speech and language development, socioemotional and behavioral development, specific areas of cognitive development, and sensory-motor development. Pisoni et al. (2008) assert that significant cortical reorganization has likely already taken place in the brains of young children with hearing loss prior to cochlear implantation because of sensory deprivation. They contend that neural reorganization, particularly in the frontal cortex, affects aspects of speech and language development, other cognitive processes, such as executive function and cognitive control processes, and neural systems. These can explain variance in performance outcomes among children following implantation. Children with cochlear implants have been found to have slower verbal rehearsal speeds, scanning rates, and shorter digit spans when compared with hearing peers despite intelligence in the normal range (Burkholder & Pisoni, 2003), differences the authors attribute to sensory deprivation. Some children with hearing loss now compare favorably with hearing peers in some domains, but r...

Neurocognitive skills, specifically cognitive sequencing, serial ordering, and auditory-verbal memory may be targets for therapeutic intervention. Intensive cognitive and educational habilitation and in milieu intervention may improve language learning in children with CIs.

Purpose The importance of early intervention for fostering language in children with hearing loss has been well documented; those that facilitate parent engagement are particularly effective. Listening and spoken language outcomes among children with hearing loss continue to fall short compared to hearing peers, despite improvements in hearing technologies. The current study evaluated the effectiveness of parent–child interaction therapy (PCIT) as a behavioral intervention for children with hearing loss and its applicability as a language intervention. Method PCIT effectiveness was evaluated for children with hearing loss (PCIT treatment group: N = 18). For a subset of the treatment group (matched experimental group: n = 6), pretreatment and posttreatment language samples were compared to a matched control group ( n = 6). Results Significant changes were observed in parent skills and child behavior from pretreatment to posttreatment for the PCIT treatment group. A subset of the treatment group (matched experimental group) with available matched controls (matched control group) demonstrated a significant increase in utterances and a trend toward significant increase in receptive vocabulary compared to the control group. Conclusion PCIT is a promising intervention for children with hearing loss that empowers parents to engage in optimal indirect language stimulation, improves parent–child interactions, improves child behavior, and promotes spoken language skills.

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