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Tuesday, September 15, 2009

Teaching social language

Repetition and consistency is very important. Repeat things as often as you can so that she learns the association between the object and the sound. It may take a very long time, with seemingly constant repetition of simple words and ideas, but it really important that you persist. Try to be consistent with the words you use for objects; for example, decide on your family word for toilet/loo/lavatory/bathroom.” (Newman, 2004, p107).

When I first met Isaac* I was warned that I would have to look out for him. He was very rough with other children, pushing, shoving and grabbing toys. I was told that all the disciplinary measures (eg time out, praise, encouragement) were not working. And staff at his preschool were concerned because he was due to go to school next year.

Isaac had a cochlea implant, implanted when he was two years old. Having a cochlea implant does not mean that the child is then “cured” and everything is fine. There will be some delay in terms of language experiences and vocabulary learning missed in the very early years. Further, while a cochlea implant enables a child to hear, it does not act in exactly the same way as our ears (Moore, 1997). For children learning to “listen” with cochlea implants it can be hard to differentiate between important sounds (eg. the words of someone talking directly to you) and unimportant sounds (someone talking close-by or other background noises).

So Isaac had difficulties with learning how language worked in social situations. He saw children sharing, children joining in each other’s play, children interacting. He wanted to be part of this. But he wasn’t picking up the important phrases that made the play work. The give-and-take of social language was difficult for him to catch. It was too quick, there was too much background noise and movement to distract him, and the actual words used weren’t always the same.

So instead of asking to share toys, he would take them. To him, it looked like this is what other children were doing.

Instead of asking if he could join in a game, or call a child’s name to get their attention, he would bump into them, or pinch them, or hit them. Not to hurt, but to get their attention.

And, while he was told not to do this, he didn’t know any other way to achieve the same thing. And his speech was often hard to understand as he was still learning how to articulate them clearly.

But, taking ideas from his speech therapist and early intervention teacher, we worked out a way to help change Isaac's behaviour.

Whenever Isaac went to barge into children’s games, we would jump in and follow this routine:

- Stand beside Isaac and draw his attention by putting a hand on his arm.

- Draw his attention to your mouth by first putting your open-palmed free hand to his chin, then bringing it back to your chin.

- Model how to get another child’s attention by looking at them and calling their name.

- Get Isaac to mimic this by bringing your open-palmed hand to his chin and saying, “Your turn!” and repeating the name.

- Repeat the process until the peer responds (use a physical prompt like tapping the peer on the shoulder to speed up the response if Isaac is beginning to lose interest).

- When the peer looks at Isaac (or yourself), bring Isaac’s attention to this by using the open-palm gesture as described previously.

- Then get Isaac to pay attention to your mouth using the open-palmed gesture.

- Model the words, “[peer’s name],Can I play?” [use exactly the same words every time]

- Get him to repeat this through the same process identified above

- Then get him to repeat it again whilst making eye-contact with the peer by drawing his attention to them using the open-palm gesture, then repeating the phrase, “[peer’s name], can I play?” and then saying, “Your turn!”

- Give lots of praise for his attempt, encourage the peer to respond.

- Wait until the child responds (help Isaac to wait and listen by cupping your hand around your ear and maintaining eye contact with the peer – whilst maintaining your hold on Isaac’s arm :) ).

- If the child says, “Yes” help Isaac get involved in the play appropriately. If the child says, “No” re-direct Isaac to a different game. This will be a natural reward for his language attempts.

This process took a little while for Isaac and his peers to get used to, but we persisted and did the same thing all the time, with specific care to keep the words and gestures exactly the same. This repetition helped Isaac understand.

And we were amply rewarded.

One day I was watching and playing with the children on the playground and distinctly heard Isaac say, “Can I play?” I watched as he persistently repeated this and kept moving to where his peer could see his face until the peer responded. Luckily, the answer was, “Yes”. And Isaac joined in with no help from an adult.

*While this story is built from my experiences with children who have hearing impairments, the names and some details have been changed.


Moore, B.C.J. (1997). An Introduction to the Psychology of Hearing. Academic Press: San Diego.

Newman, S. (2004). Stepping Out: Using Games and Activities to Help Your Child with Special Needs. London: Jessica Kingsley Publishers.


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