**5. Effects of a hearing loss in interaction**

Studies in the past conducted with children older than 18 months of age showed that parents of children who have hearing loss undergo controlling, discouraging and negative interactions with their children which provide a less facilitative environment for language acquisition and for social and cognitive development (Schlesinger & Meadow, 1972). Some studies argued that linguistic competence of the child would determine the parent's interaction with the child. If the child's language level is behind their chronological age parental control, simplicity and directivenes in language are increased and becomes different than the language used while addressing normal hearing children at the same age. (Gregory, et. al., 1979). Even in the earliest stages, differences in interactive behaviour were reported. Meadow, et. al. (1981) indicated that deaf infants of three, five and eight months had more physical contact with their mothers than hearing infants, suggesting that mothers of deaf children exploit the tactile kinaesthetic channel for gaining and holding attention rather than well known child directed speech features such as shorter utterances. Hughes and Huntington (1986) reported distorted speech and phonologic/prosodic characteristics in some mothers' of deaf children. They were easily recognized by listening to audiotaped voices during their interaction with the child. It is argued that distorted speech and altered intonation make the speech even more difficult to understand since they effect the second formant information. These kind of interactive differences possibly had negative effects on language development of children with hearing loss in later ages.

Early identification, amplification and intervention provide a chance to prevent deviances from normal interaction by providing auditory information to the child and supporting parents in their interactive skills immediately. Indeed it becomes possible to follow normal developmental patterns in language development without considerable delay and in most cases with no delay at all (Brown & Arehart, 2000; DesJardin, et.al., 2006; Moller, 2000; Hoberg-Arehart & Yoshinago-Itano, 1999; Houston, et.al., 2003; Robinshaw, 1995; Spencer, 2004; Wallace, et.al., 2000; White, 2006, Yoshinago-Itano & Apuzzo, 1998). Starting with the diagnosis of the hearing loss, parents should be encouraged to follow normal interaction patterns during their daily life.

Daily activities such as feeding, cleaning, dressing and simple play routines provide excellent opportunities of language learning for babies younger than one year old. The repetitive nature of the daily routines consolidates the experience and the language that accompanies them. By talking about the things they do during these activities parents are most likely to provide meaningful language input to the child. Following the baby's gaze and responding to his/her vocalizations help parents to regulate turn taking and to understand his/her intentions. (Brown & Nott, 2005; Clark, 2007).

The professional should guide and coach the parents in such a way that they come to realize that listening and speaking are a way of life for development of language in babies with a hearing loss. The parents' awareness should be heightened on how much they are already doing naturally and to encourage them to do more of it. The idea is not to intrude into the child's self-absorbed exploratory play in order to engage him/her in talk every waking minute, but to select or create opportunities for verbal interaction (Cole & Flexer, 2007). Auditory stimulation is the base of these kind of intervention and if language acquisition through audition is attempted, correct use of hearing aids or cochlear implants throughout the day has the utmost importance.
