**1. Introduction**

116 Hearing Loss

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Early intervention is defined as "a set of services for children six years of age or younger who are at risk of or who currently have developmental delays or social emotional problems" (Guralnick, 2005, as cited in Mahoney & Wiggers, 2007). The underlying premise for early intervention is that children's developmental or social-emotional problems can be either prevented or remediated through specialized services and activities designed to maximize their developmental learning (Bailey, et. al., 1998; Baguley, et al., 2000; Bluebanning , et. al., 2004). Early intervention is grounded in the conviction that the first five years of life are a span during which there is unique opportunity to prevent or reverse children's developmental problems. The rapid brain growth that occurs at this time of children's lives is believed to be associated with critical periods during which children are uniquely prepared to benefit from developmental stimulation that is matched to their individualized needs and abilities (Mahoney & Wiggers, 2007; Ryugo, Limb & Redd, 2000). In other words there are clearly defined times when the physiological readiness of the organism must coincide with the occurrence of specific externally derived experiences (Ryugo, Limb & Redd, 2000).

Many early intervention programs, particularly programs for children up to age three, provide comprehensive services to families, including social support, service coordination as well as information about child's development (Brown & Arehart, 2000; Brown & Nott, 2005; Mahoney & Wiggers, 2007). Generally it is believed that services that reduce the burdens and stressors families experience can make it easier for parents to focus on the needs and care of their children (Bailey, et. al., 1998; Childress, 2004; Dunst, 2002; Kratochwill, et. al., 2007; Odom & Wolery, 2003). It is also argued that parents must play an active role in their children's development. The argument rests on research results which indicate effectiveness of early intervention services is related to the effect they have on the way parents care for or interact with their children (Bailey, et. al., 1998; Clark, 2007; Kaiser & Hancock, 2003; Mahoney, 2009; Rice & Lenihan, 2005). Therefore it is suggested that professionals who work in early intervention services should collaborate with parents instead of directly shaping children's developmental skills.

Early Intervention with Children

more on "nurture".

**3. Language development in infancy** 

Who Have a Hearing Loss: Role of the Professional and Parent Participation 119

Language development is one of the most remarkable achievements in childhood. Sometime during their second year most children begin to talk and apparently little time is required in using language to address their needs and carry on social interactions. During the last 50 years language acquisition has been studied with respect to what is learned, when it is learned and what factors or variables seem to explain the process of acquisition. While no single theory provides complete and irrefutable explanation of language acquisition, each theory contributes significant ideas and concepts which over time has clarified the awareness of the ways language is acquired (Bloom, 1993; Otto, 2006; Pine, 1994; Rice, 1996). Theories which try to explain the language acquisition can be summarized under four broad categories. The nativist and the cognitive developmentalist perspectives emphasize the contributions of "nature" whereas the behaviourist and interactionist perspectives focus

*Nativist* perspective emphasizes inborn or innate human capabilities as being responsible for language acquisition. Linguist Noam Chomsky is the major theorist associated with the nativist perspective. He contends that all people inherently have the capacity to acquire language due to cognitive structures that process language differently from other stimuli (Otto, 2006). A major focus of the nativist perspective is on the acquisition of syntactic knowledge. Semantic knowledge is also considered with respect to its relation to syntax (Pool, 2005). Chomsky proposes that universal grammar which is "the system of principles, conditions and rules that are elements or properties of all human languages" (Chomsky, 1975, as cited in Otto, 2006). As evidence of the universality and instinctive nature of language it is argued that no mute civilizations have ever been discovered throughout history. Since language exists in every culture it is concluded that it must arise from human

*Cognitive* developmental perspective is based on the work of Jean Piaget (Baldwin, 2005). The emphasis of this perspective is that language is acquired as maturation occurs and cognitive competencies develop. While the nativist perspective emphasizes the inborn language mechanism, the cognitive developmental perspective assumes that cognitive development is a prerequisite and foundation for language learning. This perspective proposes that language is learned using the same learning mechanisms that the child uses for other learning. Thus there is no unique language mechanism. The close relation between the cognitive development and language is based on the belief that, for language to develop,

*Behaviourist* perspective states that learning occurs due to associations established among stimuli, responses and events that occur after the response behaviour. Language is learned as a result of these associations. The child is considered to be a "blank slate" and reinforcement of a child's verbal and nonverbal responses to language directed at him is responsible for language learning. Thus language is "taught" through situations in which children are encouraged to imitate other's speech and to develop associations between verbal stimuli and objects. Reinforcement often takes the form of attention, repetition and approval. This kind of learning is called operant conditioning. The use of the word "operant" acknowledges the child's active role in the learning process. It occurs when environmental consequences occur that are contingent on the specific behaviour. For example when an infant is producing sound and says "ma-ma" the parent may rush to the

biological instinct rather than from the existence of the culture (Otto, 2006).

specific cognitive growth must occur first (Baldwin, 2005; Bloom, 1995).

Like other areas of special education the necessity for early identification and intervention for language development of children with a hearing loss has long been realized and auditory oral/verbal programs have offered intervention for parents to development of spoken language of their children. However progress in universal newborn hearing screening has altered the age range that professionals used to work with. They have to deal much younger children than the past. The advancement in hearing technology has increased the hearing capacity of these young children. Digital hearing aids and cochlear implants provide richer stimuli than ever. Therefore it seems necessary to reconsider the intervention approaches regarding the age of these children and the new role of the professional.

In this chapter the basic issues on the early management of a hearing loss and the rationale of family based services will be described, the professional's role as a partner with parents in early intervention for babies with a hearing loss will be discussed and the factors which facilitate language development and their use in intervention process will be summarized.
