A baby with a hearing loss is first of all a child. Babies need help to develop the security and appropriate behaviour that will let them grow into happy and responsible children, teenagers and adults. As parents, you want to give them that help, but how do you accomplish your goal? Most parenting is based on communication, and you and your baby may be finding that communication is a challenge. In this section, you will review some effective parenting techniques and learn how they can be adapted to fit the communication needs of your family.
In the first few months of life, babies have some basic but very important needs. When we respond to these needs, babies develop a sense of security and trust. This becomes an essential foundation for later learning, loving and growing. What are these early needs?
After 6 months of age, babies get smarter and start moving everywhere it seems! Babies are naturally curious, so they start to reach out and touch all sorts of things. This sometimes means trouble. As your baby starts to move about, use gentle ways to remove him from dangerous situations and to guide him. The Parenting guidebook says, "Most of baby's so-called bad behavior isn't fueled by a desire to annoy you. Babies get into trouble because it's their job to explore every cranny, to poke every button, to grab every interesting thing they see." (p. 258)
But as babies begin to move, we often wish that they would stop doing things, or not do something. Of course, growing up is really about learning what we should do. To encourage your baby or toddler to behave appropriately, you have to provide things that babies need. One of those is positive attention. Babies need attention, and you have control over the kind of attention that you give. When your baby frequently has your attention there is less reason to try inappropriate or irritating behaviours in order to get it.
You will give different kinds of positive attention as your baby's age changes. With infants, parents establish eye contact, smile, hug, cuddle and rock to provide attention. Parents of hearing children also sing, hum, play music, talk in an interesting voice or read simple stories, even to very small babies. How can you be sure that your baby gets the benefit of that kind of attention?
As you turn on your baby's hearing aids in the morning, try singing a little song. The rhythmic patterns of the song should attract baby's attention. As you repeat the song, your baby will start to recognise it and even expect you to sing it. He may show pleasure when he hears it. Once this song is old hat, try introducing other melodies. Your baby will enjoy rocking with you to soothing music or bouncing to the rhythms of an energetic song. Your baby learns early lessons about rhythms, pitch, oral communication and your language by listening to music and to your voice. When you call your baby's attention to the source of the sound, or accompany your vocalisations with interesting facial expressions, you encourage the baby to concentrate and hear even soft sounds. See the Learning through Play section of the website for additional ideas.
If your baby does not use amplification, early verbal communication still happens. It happens visually instead of through listening. Deaf mothers sign to their infants in special ways, just as hearing adults change their speech when talking to babies. Deaf parents make slower and larger movements in their signs, they move the signs into the baby's line of vision, and they add pleasant, loving facial expressions. Sign language has its own rhythms, emphasis and early communication forms, and your baby can learn important lessons from them because they are easy to see. These techniques will support you in giving positive attention in clear ways.
Toddlers love to have parents' attention. You can plan ahead to have special times together, playing or reading or pretending. This positive attention can include lots of natural language stimulation. Remember to follow your toddlers' lead and talk about what interests him. In a busy day, we don't always have time to give our undivided attention, and little ones may find inappropriate ways to try to get it. With some children, it can be effective to ignore certain behaviours, but others may need to be channelled to a different activity. It is good to consider why he is trying to get your attention. Have you been very busy? Do you need to show him another way to get your attention? Can you spend more quiet time with him?
Positive attention is more than just smiling when your baby pleases you. Babies need positive attention when they experience feelings. Although you would like to help your baby avoid certain feelings, learning and developing involve frustration and disappointment as well as excitement and pleasure. By naming your baby's feelings you will be preparing him to find positive ways to express those feelings later on.
Try these ideas out:
Your baby is playing peacefully in his booster seat, repeatedly hitting his mobile. As it sways, it brushes his nose and scares him. He begins to cry.
|Pick which responses seem best||Practice what you might say|
|(a) Move the mobile away.||Ouch!|
|(b) Pick the baby up and cuddle. Reassure him.||That scared you. Mummy is here. It's okay.|
|(c) Don't let him play with mobiles.||No more mobile. Put it away.|
|(d) After he settles down, play together with the toy and show
him it will not hurt.
|You like your toy. See, it is fine. Let's play|
Did you pick (b) and (d)? These responses give positive attention. They express what the baby is feeling and help him calm himself down.
Your baby is cranky and tugging at her hearing aid. She pulls it out and tries to put it in her mouth.
|Pick which responses seem best||Practice what you might say|
|(a) Take the hearing aids off and put them away for the rest of the day.||No, no.|
|(b) Grab the hearing aid from her and put it right back in.||No eating. You need to wear this.|
|(c) Gently take the aid and hug and calm her.||It's okay sweetie. Are you bored? Did that bother you?|
|(d) Give her something fun to mouth and explore and then slip the aid back in.||Here's your rattle. Oh, you like to taste it.|
(c) and (d) look like obvious choices, don't they? We want the baby to wear the hearing aid as much as possible so putting it away for the day is not the best option. We also want to respond in a gentle and matter-of-fact way when putting it back in. We can give positive and loving attention to calm her, then give her something to do while we put the aid back in.
Your deaf baby is irritable in her baby seat and seems ready for a nap but will not settle down. She is irritable but doesn't want the bottle.
|Pick which responses seem best||Practice what you might say|
|(a) Pick her up, smile and sign to her. Touch her to soothe and quiet her.||You want mummy? Mummy loves you. You are sleepy.|
|(b) Show her favourite toys and try to stop her whingeing.||Here, let's play a new game.|
|(c) Ignore her because she may just drift off to sleep.|
|(d) Rock her and sign simple ideas.||I love you. Bedtime? Sleepy girl.|
(a) and (d) seem to be the best choices. They give positive attention through face, signing and touch. Offering favourite toys may be overly stimulating if the baby is tired. Ignoring her misses an opportunity for closeness that will help your baby go to sleep.
Even very young children want to have a little control over what happens in their environment. Babies cry, smile, vocalise and gesture in order to explore or to make things happen. Between 10 and 12 months of age, infants express their wants in very intentional ways. They lift their arms to be picked up or point to a desired object, or hand something to mummy. This happens because these infants have figured out that their actions cause adults to act. This important discovery opens up a world of communication. Toddlers quickly learn which actions or language allow them to gain some power. Of course, parents have to decide just how much control any child can have over himself or herself or the family. Studies of parents of children with a hearing loss show that if parents and children communicate easily, then parents can find positive ways of helping children take part in decision-making. If communication is difficult, then parents tend to make many more of the decisions. When this happens, young children can begin to use inappropriate behaviours to demand some control.
Communication is the key to helping children begin to make choices independently, so your family's choice of communication strategies is very important. You can give your baby or toddler the chance to make a choice even without words or sentences, however. When you bring a toy in response to a cry and hold it near the baby's hand, you are essentially saying, "Do you want this, or do you want something else?" When your baby reaches for the toy or smiles, that is a choice. If you hold two toys out to a slightly older baby, and the baby reaches for one or the other, your baby has made choice. You can talk or sign about that choice, saying, "Oh you want teddy."
You will know which choices you tend to offer your baby the most often. If you are signing, put the signs for those choices on your list of Signs to Learn Right Away. As your baby grows and attends to more and more, your list will grow, too. If your baby is learning to listen, emphasise the idea of choosing and the words for the choices. Be sure that your baby knows what is happening. You will need to use language like, "Which one?" and "You picked _______." The situation, your questioning face and voice, and the result of getting the selected item or action will help your baby learn the language for making choices.
Of course, the choices you offer your baby are real choices. Water or juice can be a real choice of something to drink. Walking or riding in the stroller can be a real choice for a toddler. Daddy playing with blocks or reading a story can be a real choice of special together time. When your baby is deaf, you must be sure that the choices are not only real, but are clearly understood. Misunderstanding can lead to false hope or confusion. Until you and your baby clearly understand the speech or signs for your choices, you can support the language by having real objects to point to, or gestures that represent actions.
Opportunities to make choices help children gain independence and confidence. Choice making is a useful positive parenting tool for avoiding behaviour problems. Giving choices is respectful to your child, too. It recognises a growing capability and the right of children to have at least a small "say" in their own lives. It also helps a child learn to make decisions and express preferences.
Here are some examples of giving choices to babies at various ages.
6 month old (spoken language)
Baby turns away from a toy she and dad were playing with. Dad notices that she is losing interest. He brings out a different favourite toy and makes sound with it. Baby looks interested again and dad says, "Oh, you hear it. You like your clown." As baby reaches for it, dad comments, "You want clown."
6 month old (sign language):
Baby turns away from toy she and dad were playing with. Dad notices she is losing interest. He offers a brightly coloured set of toy keys. He brings it into her line of vision and signs on the toy, "Your keys. See? Keys." When baby grins and grabs, he signs, "You want keys!"
10 month old (spoken language)
Your infant is reaching up toward the toy shelf. You are not sure what she wants. You pick two toys from the shelf and offer this simple choice. You bring the toys into your baby's line of vision and say, "You want your doggie or the mirror?" As the baby picks one, you affirm the choice saying, "You want the mirror. See the baby? Hi baby!"
10 month old (sign language):
Your infant is reaching up toward the toy shelf. You are not sure what she wants. You pick two toys from the shelf and set them on a lower shelf. You sign near the toys, "you want doggie? Or mirror? Which? Your face conveys a question expression and your body makes a shift to show the choice you are offering.
12 month old (spoken language)
It is breakfast time and you offer some toast to your baby. He shoves it away. You say, "you don't want toast. Want some peaches? Yummy. Mmmmm. Here comes the airplane aaaaaaaaaaa. Open up!" In this example, you just gave your little one an alternate food and respected his "don't want." You also gave nice opportunities to listen.
12 month old (sign language)
It is breakfast time and you offer a bite of toast to your baby. He shoves it away. You shake your head and sign, "you don't want." Then you bring the peaches up in his line of vision. You sign, "Good peaches! Want a bite." He opens his mouth and you smile and give him a bite commenting, "Yummy peaches." In this example, you have respected his don't want and have made sure to present his new choice visually with supportive body language.
18 month old (spoken language)
Your toddler is playing with Lego blocks and is tired of stacking. You sit down and offer a verbal choice. "Can we make an aeroplane? Or a choo choo? Look, my aeroplane goes up up up! I hear your train say choo choo." Toddlers start to do a lot of pretending on a fairly realistic level at this age. You can encourage this pretending by showing the child your pretend and talking about it. You will also be exposing the child to some good language and listening models.
18 month old (sign language)
Your toddler is playing with Lego blocks and is tired of stacking. You sit down and offer a signed choice. "Want to make aeroplanes? Watch! Aeroplane up up up. You want to try it?" Sign aeroplane right on the toy as the little one begins to pretend. Next sign, "now hook them. Look a train!" Sign train right on the Lego. Toddlers start to do a lot of pretending on a fairly realistic level at this age. You can encourage this pretending by showing the child your pretend and talking about it. You will also be exposing the child to some good visual language models.
Children increase behaviours that get our attention, whether the attention is pleasant, happy, excited, or even angry. The behaviours you praise in your baby will tend to be appropriate. When your baby smiles, plays with a toy or engages you in a communication exchange, you tend to respond with enthusiasm. That is the beginning of praise. As your baby develops more control over actions and behaviours, you will want to encourage cooperation in eating, willingness to go to bed, or sitting in the car seat on a drive. If you pay attention to behaviours that you want to encourage, you will find yourself praising them.
When your baby has a hearing loss, you have to remember that using praise has no effect if the baby doesn't know it is happening. Your baby needs to see your face, attend to your voice, or look at your signs. Your baby needs to connect your praise to the behaviour. You know what you are praising, but does your baby? As with other types of positive parenting, think about the behaviours you are encouraging and the language that naturally accompanies them. "You are in your seat. Good job." "You ate your cereal. Yummy." Learn and emphasise that language each time you see the appropriate behaviour. Move into your baby's field of vision. Point to the car seat and the baby. Point to the empty cereal bowl and lick your lips. Your smile of encouragement is nice, but when your baby understands what you are encouraging, then you will see it happen again.
Parents want their babies to grow up knowing that they are loved, no matter what. Children are not judged as good or bad based on their cooperation. What we praise, or don't praise, is a child's behaviour. When you praise the act, you give your child some guidance about exactly what you liked. If you say, "Good!" when your baby hands you a juice bottle instead of throwing it, your baby knows that you are pleased. If you say, "You gave me the bottle. Good girl!" with a big smile as you hold up the bottle and point to it, then your baby knows that giving is a good idea. It doesn't really matter, when children are very small, whether or not they know at that moment that the alternative behaviour - throwing - is "bad." You will be dealing with throwing at some point, but why call attention to it when it didn't happen?
Telling your baby what behaviour you liked is called descriptive praise. You describe just what you see and feel. "Good walking. By yourself!" You name the behaviour so that your baby knows exactly what you liked. You are genuine, not gushing. A scribbled crayon pictures has many colours, and you really like it. "You are the best artist in the world" is a lot less meaningful than "Many colours! I like it!"
Standing by yourself! So big!
You are drawing. Pretty colours.
At first, describing feels like a lot of language to learn, for parents and for babies. Start by commenting on behaviours such as standing or drawing. Keep a list of words you want to sign or emphasise when you speak. Doing so can help you to quickly learn to communicate. Now add to your list words you can use for praise, or to expand the name of the behaviour, such as "I like it. Pretty colours." Learn to talk about things that might actually happen in your family, or that you love to see your baby do, such as "Walking to daddy! Wow!" If you are signing, let yourself learn the language you want gradually as your baby does more and more appropriate things.
Remember to match your facial expression to what you are saying or signing. If you are excited by what your child does, show an excited expression. To be sure that you are not the only one "in on" the communication, call attention to the act or items being praised, emphasise the important language, and add gestures to help make the message clear.
|Situation||Try descriptive praise|
|Toddler entertains herself with the plastic containers in the kitchen cupboard while dad cooks.||You are having fun! Playing by yourself. Daddy likes that. (Point to the objects)|
|Baby takes a bite of food after much coaxing.||Good eating! MMMM. Yummy carrots. (Lick your lips)|
|Toddler hands daddy a small screw he finds on the carpet.||Thank you! Not a toy. Good job. (Put the screw up high.)|
A positive way to prevent many behaviour problems is to keep your baby or toddler informed of what is happening next. Transitions can be particularly hard when babies and toddlers don't know what to expect. A sleeping baby is less likely to be frightened and cry if wakened gently than if an overhead light suddenly flashes on and a huge face looms close over the cot side. A toddler playing with a toy is likely to stop willingly when the parent holds up a bib and a spoon, saying "Time for lunch!" Parents tell hearing children where they are going in the car, or how much time they have left before it is time to stop a favourite activity. Children with a hearing loss want to know that, too. In fact, it is even more important for you to keep your baby informed, because hearing loss can eliminate or reduce many of the other cues to changes in activity, such as bath water running, the car door, the telephone, the doorbell, or someone calling from another room.
Notice that signalling a transition can be as simple as giving an object cue. Hold the rubber ducky and towel and say or sign, "Time for bath." The object cues will help the 12 month old understand what you mean. She will begin to put two and two together to understand the phrase "Time for bath."
Some parents find it helpful to use picture cues to help toddlers understand transitions. They show a picture of grandma and remark, "Let's go to grandma's house." One family put pictures of important places, such as church or synagogue, local supermarket, etc. in the car visor. Once the little one was buckled in, the parent would show the child which location they were going to first. This helped the child anticipate and learn the language for important places. As you go regularly to places like church or synagogue, the supermarket, grandma's house, or a restaurant, you can take snapshots of each one to make a notebook or a refrigerator gallery that your baby or toddler can recognise. Gradually, you will be able to say or sign, "We are going to the supermarket. Let's get your sandals," and let your child find the picture.
As the child gets a little older, you can use a small, two or three minute hourglass egg timer. Until the language and difficult concept are familiar ("You need to stop in three more minutes," or "Almost time to stop"), the egg timer supports the idea that a transition is about to happen. Then, you can use an object, a gesture, or a familiar word or phrase for the next activity, developing an understanding of "...then we will_______."
Keeping your baby informed also means telling what is going on. Sometimes as hearing people, we don't think about subtle ways that we are leaving the deaf child out. For example, when the phone rings you leave your play with the baby and run to get it. Your baby wonders where you went, why you left, and if you are coming back? A simple "I hear the telephone. I'll be right back," will help, especially if the word telephone has been close enough for the child to hear or feel the ringing. The phone may be hard to hear if it is far away. When it rings, tell your baby, "Listen. I hear the phone." Take your baby closer to the phone and give her an opportunity to hear it before you answer. If you have a mobile phone, helping the baby hear the phone will be easy.
Sometimes the information your baby needs is that a behaviour is not appropriate and has consequences. Throwing blocks means that the blocks will be put away. You can warn your baby with gestures, firm headshakes, or simple words, following through the first time your warning is challenged.
What visual strategies could you use to help your child understand what is happening next? Match the event in the left column with the best visual strategy in the right column.
|Baby is absorbed playing with blocks, but it is time for dinner||Give your little one a warning. "Two more minutes to read. " Turn over the sand timer.|
|Your infant is sleeping, but you need to wake her to go to see the audiologist.||Your infant is sleeping, but you need to wake her to go to see the audiologist.|
|Your two year old does not like bedtime. She likes to stall and keep looking at books.||Hand baby her favourite blanket. Say or sign, "nap time, sweetie."|
|Your one year old is having fun in the kitchen. It is time for her nap.||Show the picture of Grandma. Say, "Let's go see grandma. You and me pick up."|
|Your 18 month old needs to help pick up and get ready to visit grandma.||Point to the dinner table. Say or sign, "let's go eat!" Show excitement.|
Problems are much easier to prevent than to stop or solve. Household routines help to prevent problems. Almost everything is new in your baby's world, especially at the beginning. A routine allows your baby to anticipate what is going to happen and experience fewer surprises. Routines help children cooperate, because they come to expect certain ways of doing things. For example, the toddler figures out that naptime happens after lunch, and goes along with the routine.
Household routines also give you and your baby something positive to do. Many babies have a set activity that is part of someone else's routine. Dishwashing time may be when your baby crawls to the bottom drawer in the kitchen that holds dozens of big plastic lids, and carefully unloads and chews on them until the last dish is done. Going in the car seat to pick up big brother or sister from school is the time when certain padded or cardboard books come out of the nappy bag. Other active routines may involve the parent and baby directly, for example, changing nappies, feeding and getting ready for bed. The routine is a time for positive attention and communication.
At the beginning, when you are not sure that your child is understanding your speech, or that you have enough signs to get your message across to your deaf child, one of the easiest ways to deal with behaviour is to say or sign, "No!" or "Stop it!" Unfortunately, if we use these words too much, they stop being effective. By the time babies are toddlers, they love to use "No!" themselves! We have to begin early to set limits, because they are in our child's best interest. What are some other ways to stop inappropriate behaviour and encourage appropriate behaviour?
And here are some additional hints based on Anne Krueger's Parenting: A Guide to Your Baby's First Year (1999) Ballentine Books: New York.
Babies and young children do not have tantrums just because they are deaf. All children have them when they are hungry, tired, frustrated or upset. When children are deaf, they may have tantrums when they do not have the words to express what they need, want or feel. As you learn to communicate clearly with your baby, many of these tantrums will disappear. Behaviour management becomes easier as communication strengthens.
We need to avoid attributing too many behaviour problems to hearing loss. Children with normal hearing have tantrums, too. We can use many of the same techniques to help hearing or deaf children behave well, including the following:
Your baby will find that positive attention is much more interesting than having a tantrum, unless the tantrum itself is the best way of attracting your attention. Stay calm, ignore as much as you can, and make other times more interesting. Most of all, keep on learning to communicate.
More information from www.babyhearing.org
Information supplied by:
Boys Town National Research Hospital and
The National Institute on Deafness and Other Communication Disorders (NIDCD).
Reproduced with permission.
Disclaimer: The information contained on this website is not intended as a substitute for independent professional advice.
08-Nov-2015 1:36 PM (AEST)