Listen and Talk Blog

Theory Of Mind

by Brynne Powell, M.E.D.



A component of hearing loss that is often overlooked is the development of theory of mind. This can be found in a child’s ability to make friends, participate in pretend play, have a conversation, and tell a story!  Theory of mind is the ability to put yourself in another person’s shoes or to be able to take their perspective. Children with typical hearing enter Kindergarten with a basic theory of mind while most often, children with hearing loss do not (Tucci, 2016).  When a child acquires a theory of mind, it allows them to predict and explain how a person’s behavior is affected by their emotions and feelings. The development of these interpersonal skills is predicated on the development of a person’s cognitive and affective skills.  


Theory of mind is necessary for a child’s success in conversational, educational, and social settings.  It allows children to understand linguistic cues, increase their critical thinking, expand on conversational skills, and maintain relationships with friends.  Through the use of more abstract words, words used about thoughts and feelings, we can assure that a child will be ready to succeed in Kindergarten with a theory of mind.  Think about separating the words that you use into three categories: intention, belief, and desire. Intention is an action in pursuit of a goal, belief is one’s perspectives, opinions, and expectations, while desire is one’s needs, likes, dislikes, and hopes.  When we use more abstract words, we not only expose our children to more complex language, but we also expect them to acquire an understand of these words and generalize them into their everyday language.

It is easy to incorporate theory of mind into everyday conversations!  Below are strategies to aid in the development of your child’s theory of mind:

  • Read a book (i.e. narrating how a character is feeling)

  • Have a conversation about wants/feelings (i.e. ask your child ‘how’ another person may be feeling)

  • Make predictions during movies, television shows, or books

  • Talk about past and future experiences

  • Play games that include predicting behavior and feelings (i.e. Hide and Seek, Taboo, Charades)

  • Incidental learning (Set up opportunities for your child to overhear conversations about feelings, behaviors, etc.)

  • Create crafts that include recognition of feelings

  • Participate in pretend play (i.e. play with dolls, characters buying and selling in a store)

  • Talk about routines

  • Exhibit non-predictable behavior and talk about why/how it happened

  • Set your expectations (Repeat a sentence that your child said with more abstract words)


Set a goal for yourself and your family at home to try to incorporate theory of mind at least five times in your day!

Alumna Interview PART 2: Emily

by Dr. Yoko Ishii, AuD, CCC-A


Transitioning from high school to college is a time fraught with excitement, anxiety, anticipation, and, hopefully along with it, a healthy dose of optimism about new and wonderful opportunities that lie ahead. New friendships, new social situations, determining a career path to sustain you for a lifetime: all of this change has the potential to be be particularly overwhelming!

If you add hearing loss into the mix, you have an additional layer of complexity to take into account. Previously, the school district and the associated service providers have all taken a role in helping to facilitate the services and accommodations that are needed to foster a learning environment that is as close to ideal possible. Now, your academic environment is changing along with everything else. All of a sudden, you are solely responsible for seeking out and accessing your own services and accommodations.  Where do you even begin?! Self-advocacy now takes on a whole new meaning!

In our previous discussion with Emily, we got to know more about her perspectives on self-advocacy and a bit about what her day to to day life is like. During the second part of our discussion, she imparts her knowledge and experience regarding resource seeking, navigating, and obtaining the supports that she taps into to optimize her learning experience in the collegiate lecture hall.

Here is Part II of our conversation with Emily:

Ashley: [During the panel discussion at the Loeb Family Symposium at Seattle Children’s Hospital] You talked about your experience with Disability Resources for Students (DRS) (at the University of Washington). How did you find out about this support?


Emily: A few times a year back in high school, I would meet with my counselor to go over my 504 plan to make sure that everything was complete as I needed it to be. And one of the last meeting, I told her, “Hey it looks like I am going to UW! I hadn’t totally committed yet, but we figured I was going there.” And I said, “Do you know who is available to talk to about my ears?” and she told me about DRS, Disability Resources for Students. So, I went home and emailed, and we kind of had this conversation back and forth to find out what I needed. Then we set up an appointment for me to go into their office so that I could talk with them.


We took some of my hearing stuff, like my old Roger system and we took a copy of my 504 Plan that my high school counselor had given me, and we basically talked through my 504 Plan. Some things stayed on my accommodations list at UW and some got taken off. Also something got added. There were a lot of emails going back and forth until we figured things out. Then they showed me the student part of their website where I can view my classes and I can select which accommodations I wanted for which classes.

Some accommodations like closed captions were applied to classes where I am viewing a lot of media, apparently that was my nutrition class. Yep, and it does not apply to my precalculus class. So I picked and chose which accommodations for which class and DRS has this thing that automatically generates and sends emails once you do that. After that, DRS told me, “We send out the list of accommodations, and we can talk to people if students are harassing you or the teachers are ignoring or do not understand (the accommodations), but it’s on you to kind of start the discussions.”

What I did in the first few days of class was I went up to my professors before class and said, “Hey I am Emily and I am student in your class and I am really excited to be in the class.” And I told them that I am deaf and so here is the two things that I am doing in class, like sitting in the front. And I introduced them to my Roger system and showed them how to wear it. They would say, “how do I turn this thing on?” and I would tell them “Don’t even worry about that. All you’ve  got to do is wear it.” My teachers have been really good about that, which is really nice.

Ashley: It sounds like the resource center was really good about telling what your rights were as a student, which is super nice to know when you are responsible for advocating for yourself. What were some situations that were more difficult for you during the transition to college that you didn’t foresee?

Emily: One thing that I knew in my head but did not really grasp was the fact that seating charts really do not exist. In high school, I relied on those. In college, it’s literally first come first serve. I guess ,afterwhile, you have a spot that everybody knows you sit in, but the first few days were a little bit scary because I have to be there really early to get a good place to sit.

Ashley: Is there anything else that surprised you or caught you off guard?

Emily: Something that surprised in a pleasant way, was that a sheer amount of options that I discovered I had with DRS, like current captioning, lecture notes, students taking notes, recordings of lectures. Some of the things like recordings are available to everyone, but there are a lot of things that are available through DRS only. So I was like, wow! That is a lot of options. It’s kind of overwhelming trying to learn and figure out what would be right for me. Actually, we had one option on my list of accommodations that I don’t use, it’s called a “smart pen”. And it is essentially a pen that records while you write. Just because, it’s kind of clunky to use. It’s really cool in theory. I’ve seen people using that actually, but it just wasn’t for me.

Yoko: When you were talking about your Roger system and having a teacher use the transmitter, it got me thinking if you are able to hear other students asking questions or sharing their opinions when they don’t have a pass around mic or transmitter.

Emily: Yeah, fairly well. It’s the mixing ratio, I guess. It can be a little hard, but my accommodations actually have a thing that teachers repeat questions before they answer. My nutrition professor has been best at this, and she would say, “the question was” and she would answer the question.

Yoko: Do you use any accommodations other than the Roger system?

Emily: Yeah, the Roger system is huge!  I also get preferential seating. I have a CART captioning in my nutrition class, which was so helpful. Another accommodation is copies of the slides and lecture notes, but most of the professors actually post those for the whole class. And then captions on any videos that are shown in class, sometimes that’s just as simple as clicking on the caption button. And sometimes my professors would send the video to DRS and DRS would caption it and send it to me and one another person who is also hard of hearing. So we both get it, and we both have an option to watch it with caption.

Ashley: Are there any “words of wisdom” that you could share with us, the kids we work with, or their parents?

Emily: My parents did not hold me or my brother back from stuff that we wanted to do, aside from skiing. That led to me doing nine productions with my theater group, me playing guitar (I actually play at least once a week now with my house community), me taking three years of French and led my brother also taking French. Actually, he got a special invite on the football team to play varsity for the playoff.

For kids, I would say do what you want to do, if you want play the guitar, play the guitar, if you want to learn a language, learn a language, if you want to do theater, do theater. Parents, don’t hold the kids back, just because they are deaf. Are they going to be the world’s best singer? No. Are they going to be completely fluent in a language after six months of learning it? No. But if that’s something they want to do, they cannot not be good at it.

Yoko: That is so powerful.

Ashley: That made my day.

Thanks again, Emily, for sharing your experience. Navigating new environments and services can be extremely intimidating, but you have definitely given us insight about what to expect  and some helpful tips for figuring out what is available for individuals with hearing loss in their future after high school, and as they climb higher towards their aspirations and goals!


Alumna Interview: Emily

by Dr. Yoko Ishii, AuD, CCC-A

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Yoko and Ashley attended a symposium titled “Improving the Classroom Listening Environment for Children who are Deaf/Hard of Hearing” presented by Seattle Children’s Hospital Childhood Communication Center on Saturday, October 27. It was a wonderful learning and networking opportunity for both of us, and we enjoyed connecting with clinical and educational audiologists, teachers of the deaf, and speech-language pathologists from all over the state. It was great to be with a diverse group of colleagues, and we felt very fortunate to be part of the vibrant clinical and educational communities that are united by the goal of serving children with hearing loss.


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Courtesy of Lisa Herber, Seattle Children’s Hospital Childhood Communication Center


However, the most impactful message of the day did not come from the professionals presenting their scientific findings, clinical recommendations, or teaching approaches. Instead, it came from six children and young adults, age 12-18, who comprised a patient panel to share their perspective of what it is like to go about their academic and extracurricular activities with a hearing loss.


Since what they shared during the panel discussion was so inspirational to us, we thought that the families at Listen and Talk would benefit from their unique and poignant perspectives. We invited one of the panelists, Emily, to share a bit more about her experience. Emily is now a freshman at the University of Washington, who also happens to be a Listen and Talk alumna! She was gracious enough to carve out a few moments from her busy schedule to talk with us via FaceTime. As you read the following interview, we imagine that you will see why we found her perspective to be particularly inspiring.


We will be sharing her interview with two blog posts. Here is Part I :


Yoko: Could you tell me a little bit about yourself?


Emily: I am Emily. I am a freshman at UW right now. I am bimodal. I use a ReSound hearing aid for my right ear and Cochlear Nucleus 7 implant for my left ear.


I am fairly active. I have an ultimate frisbee game coming up in a couple of days with my house, and I am planning on playing on an intramural team this spring. I also enjoy pranking people. Like, I get in a lot of pranks in a week. When I am not active, I like to write and draw, and hang out with my pals around the house.

Yoko: How are you affiliated with Listen and Talk?


Emily: I went through the Birth-to-Three program, and it was really helpful because my parents didn’t know too much about raising a deaf or hard of hearing child ‘til Listen and Talk. Though I did not go to the preschool program, my little brother (who also has a hearing loss) went through the Birth-to-Three program and preschool program, and my little sister went along with him to the preschool as a hearing peer. We have been through Listen and Talk quite a bit.

Yoko: What are you studying at UW right now?


Emily: I am not in a major yet since I am in my first quarter at college, but I want to major in molecular biology. My eventual goal is to be a researcher in a genetics lab for cancer and autoimmune diseases and stuff, but UW does not have a genetics major. So I figured molecular biology is the closest thing to it.

Yoko: What was it like to be on the panel in front of so many people last Saturday?


Emily: I was in performance arts throughout high school and did nine shows, but I still got stage fright. Probably not as bad as some other panelists. It was sort of scary, but I am kind of used to being in front of people.

Yoko: What you said during the panel discussion about how important self-advocacy skills are and how critical it is to use them educationally and socially was very powerful and impactful. Could you reiterate that, please?


Emily: Sure. Self-advocacy is literally standing up for yourself, and if you need something, ask for it politely and make people aware that you have the need like you need to have the seat in front of the class or notes for a lecture or something. For example, it’s not on my (accommodation) plan that my math professor reserves me a seat in front of the class every Friday, but because I have a class right before the math class, I needed that. So I emailed the math professor and we got it figured out that he would reserve a spot that I usually sit in. Now even when I walk in after everyone has taken a seat, I would still have the seat in the front.


It’s hard to self-advocate. When I was an underclassman in high school it was difficult for me. I was really shy, but I had a few bad experiences when I didn’t, because people were not aware when I was sitting in the back of the class or when I didn’t have an FM system. So I was like, “Ok, I cannot hear. I am not doing so well in class. I need to talk to my teacher and work something out with my teacher.” Over time it just became a habit that I would introduce myself to the teacher, and I would say, “I am Emily, and I am deaf so here is something that I would really appreciate it if you would do”. Typically just to wear a FM system. And over time, it just became a habit.


I felt like I was being very demanding before, but I reminded myself that I was not. I have a disadvantage that not a lot of other people have, and it’s up to me and nobody else to make sure that the disadvantage is overcome.

Thank you so much for sharing your thoughts with us, Emily! More to follow in the Part 2 of the interview!

Fall Sound Walk

by Kristin Wilson, MA, CCC-SLP, LSLS Cert. AVT


As I walked to work today, I found myself smelling fires in fireplaces, feeling the cold breeze on my face, hearing car tires as they turned on the wet pavement, seeing the bright colors of the leaves changing amid the gray skies.   I could hear chickadees calling, “feebeefeebee!”  Fall has arrived and with it, my senses are heightened to the change in seasons. 

I remember a couple of years ago, we did a sound walk at Listen and Talk with our staff.  We were at the beach.  We closed our eyes and just listened for five minutes.  I remember hearing the crunching of someone walking across the sand, the water lapping over the rocks, a plop, plop, plop on the water as a fish jumped up from the surface of the water, the leaves rustling in the trees, and the birds singing (and trying to identify a heron, an eagle, or a sea gull just from the song).  Closing my eyes and taking a moment to just listen heightened how I experienced the world with my other senses.  That said, I remember trying to focus on the sounds surrounding me and how they shaped my sense of what the world is like and what it meant to be at the beach. 

While sounds may be more difficult for children with hearing loss to detect and attend to, we know that if we can draw their attention to the sounds surrounding us and them, they can experience a greater understanding of the world around them. For example, I often talk with families about working on helping children use their listening for safety.  Having children attend to what it sounds like for a car to be approaching, be right next to us, and then pass by us until we no longer hear it builds an awareness of the environment and how to stay safe in different situations.  Listening doesn’t always need to be tied to safety, but it does bring greater depth to our life experiences.

Each season brings with it different sounds and fall is one of my favorite times to listen to sounds that I haven’t heard in a while!

Consider going on a sound walk and take some time to stop and listen.  Here are some of my favorite sounds to listen for:

  • Leaves rustling
  • Kids playing
  • People singing
  • Dogs barking
  • Birds chirping
  • Swishing of jackets as you run/walk
  • Car/Bike tires turning on the wet pavement
  • Vehicles going by
  • Swings squeaking
  • Metal clicking on a flag pole (or tether ball pole)
  • Balls bouncing
  • Feet running
  • Water splashing
  • Mud squishing
  • The beeping of a large vehicle backing up
  • Music playing
  • Heat turning on
  • Dishwasher running
  • Microwave beeping
  • Doorbell dinging
  • Phone ringing
  • The rain on roof
  • Water running
  • Dripping from overflowing gutters
  • Whistles blowing during outdoor sports
  • Cracking of sticks, crinkling of paper, and the striking of a match on a match box to light a fire
  • Chopping of wood

As fall becomes more entrenched, all of our senses become a little more alert to the changes in the season!  The air feels a little colder, the rain begins, and the leaves change.  Now is the time to get out and play with your little ones to help them experience all the fun of the season.  What are your favorite sounds?


By Kristin Wilson, MA, CCC-SLP, LSLS Cert. AVT


The Importance Of Reading To Your Child

by Becky Turner

What do Pete the Cat and The Very Hungry Caterpillar children’s stories have in common?

They both have the power to introduce your child to new worlds, to spark their imagination, to teach them about change, and promote general knowledge and understanding about the world.

As a parent and now a grandparent, one of my favorite parts of the day was and is reading books before bedtime. More than just a cozy cuddle at the end of a long and busy day, did you know that reading to your child has a whole host of benefits.

Benefits Of Reading To Your Child:

  • Improves the lifelong skills of concentration, discipline, and attention span.
  • Teaches children how to manipulate a book. Books have a cover and a back, they open, and we read from left to right. Helps children make the connection that the letters on the page are the words they are hearing.
  • Encourages a thirst for knowledge and leads to questions about the world we live in.
  • Develops a child’s imagination as they begin to think about the setting, the characters, and make predictions about what comes next.
  • Helps a child develop empathy as they imagine what it would be like to be in different situations.
  • Teaches children about important social skills such as sharing, being kind, coping in times of stress, and diversity.
  • Introduces children to letter and sound recognition, the basic rules of grammar and sentence formation.
  • Develops a love of reading and a positive association with books.
  • Offers children an opportunity to practice listening. Daily reading provides opportunities for hearing spoken language. It helps expand your child’s vocabulary beyond day-to-day experiences.
  • Creates a lifelong bond between parent (grandparents and caregivers too!) and child.

Reading together for just 15 minutes a day can be a great way to wind down, relax and bond with your child, it gives them the skills needed to succeed when they start to read themselves. Did you know that children who enjoy reading not only do better in language and literacy subjects, but in all subjects as well.

Life is busy and sometimes it is challenging to fit one more thing into the day. Here are some tips to get a reading routine started if you do not already have one:

  1. Pick a cozy reading spot and a quiet time, bedtime is our favorite.
  2. Ask your child’s teacher or B-3 provider for age appropriate book recommendations. Your child’s teacher will also be able to give you book suggestions that relate to the monthly classroom theme.
  3. Make visits to the Public Library part of your weekly or monthly routine. Let your child know that the library is a fun place to visit!
  4. Look for books with engaging illustrations that follow the storyline. Pause often to ask your child what they think is happening and will happen next.
  5. Repetition is your friend! You may get tired of reading the same book over and over but it helps your child learn vocabulary and sentence structure.
  6. Read aloud in an engaging manner, silly character voices are encouraged.

When your child sees and experiences your love of books, they will begin to love books too, setting them on a path of life-long reading. “Children are made readers on the laps of their parents.” - Emilie Buchwald

Summertime Success For New Listeners

by Brittany Scott

kids in sandbox


What is your favorite memory of playing outdoors as a child? Do you remember the smells, sounds, sights, tastes and emotions of summer vacation? Outdoor exploration and learning has a long-lasting effect on a child’s overall development and emotional well-being. Spending time learning outdoors…

  • Nurtures creativity and imagination
  • Supports the development of a healthy lifestyle
  • Makes learning more engaging and relevant
  • Develops learning through play and exploration
  • Develops an interest in the environment and greater surroundings

Using the outdoors to fulfill basic childhood needs—jumping, running, climbing, swinging, racing, yelling, rolling, hiding, and making a big mess—is what childhood is all about! For many obvious reasons many of these things cannot usually occur indoors, yet children must have these important experiences! Today, kids are more and more contained and controlled by small apartments, earlier academic instruction, busy schedules and tense, tired, and overworked parents. Outdoor environments fulfill children’s basic needs for freedom, adventure, experimentation, risk-taking, and just being kids.

Children need a variety of learning opportunities and experiences in order to learn and maintain these skills, especially children with hearing loss. Having multiple interesting areas to explore will help children generalize learned skills into any situation they might find themselves in. When designing your outdoor play space, try to include…

  • Multipurpose open-spaces (grassy field, stage, raised deck, etc.)
  • Anchored play equipment (jungle gym, playhouse, climbing structure, etc.)
  • Natural elements (Flowers, vegetable garden, sandbox, water table, etc.)    
  • Risk and challenge (Wheeled toys, balance beams, stepping stones, etc.)
  • Cultural decorations/elements (wind chimes, totem pole, flags/banners, etc.)

Many of your child’s favorite outdoor activities can easily be modified into a listening task to help maintain skills throughout the summer. Use an activity that is highly motivating to your child and adjust it to fit the child’s listening goal. When listening outside, it can be difficult to hear and focus, so assistive listening devices (FM, DM, MiniMic, etc,) will make playing outside more enjoyable for everyone. Below are some simple ways to engage kids in listening activities while enjoying the sunshine and warm weather:

  • “Silent or loud?”
    • Collect items from the yard and place them in a box one at a time. Shake the box while listening and try to decide if the item is silent or loud. You could also try and guess what kind of item might make that type of sound
  • “Sound walk”
    • Go for a walk around the neighborhood and listen for a variety of sounds (birds, trucks, dogs, music, bugs, etc.). Keep a list of everything you heard and try to imitate the sounds for your friends and family at home
  • Hopscotch:
    • Draw a hopscotch with sidewalk chalk and throw a bag or a rock to a square. Practice producing speech sounds with each hop on the way to pick up the item.
  • Parachute games and songs
    • Making Waves: Children can make small, medium, or large movements to make various types of "waves." You can incorporate a story about a ship on the sea, weather, etc. &/or use your voice as a tool to emphasize directives.
    • All Change: The teacher calls out birthday months, pre-assigned numbers, colors, etc, and those children swap places under the chute before it falls, and run to an empty space.
  • Outdoor “cooking”
    • Everyone loves mud pies! Use natural materials to create a meal for friends or family. Old plates and silverware is all you child needs to create a gourmet meal of grass, sticks and flowers
    • Ask your child for special kids of food or to follow cooking directions (e.g. stir, pour, choose, dump, etc.)
  • Scavenger hunt or “Safari”
    • Play hide and go seek around the yard with preferred toys or search for animal toys on “safari”
    • To find the object, the child has to listen for clues and follow directions in order to successfully achieve the goal
    • Give your child the opportunity to try and trick you by hiding an object and describing where or how to find it.

There are many activities you can make up on your own as well. So get creative this summer! Connect with us on Facebook or email us at and let us know what strategies you used to help your child reach his or her listening goal.


Travel Checklists For Kids With Amplification Technology

by Yoko Ishii, AuD, CCC-A

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I am checklist-dependent. I have learned that if I don’t make a checklist for my trip, I will inevitably forget something, usually something important. When my son was a baby, I forgot his baby blanket that he could not sleep without on a weekend trip. It was a very sad and sleepless trip for all of us. There was also a ski trip when I forgot my ski jacket and my daughter’s snow pants. Now I make checklists and I don’t forget things. The problem is, I became so dependent on them that I even go through a checklist when I step out the door every morning. I think: 1. Wallet, 2. Phone and 3. Keys. It’s a small list, but nonetheless I go through it every morning to make sure that I am ready to take on the world - or at least get to my office. Checklists are very important to me.

My love for checklists got me thinking that I would like to make some summer travel checklists for the families that I work with, particularly for the Listen and Talk Pre-K families. This is the season that I have to say goodbye to many families that I have worked with and grown to care very deeply about. I truly wish that I could just keep those Pre-K kids in our little preschool forever and ever, but alas they grow up and they are all so ready to fly away to the next and bigger stage in life - kindergarten! For those who are moving up and moving on, I will miss your bright smiles, your eagerness to share your funny stories, and your wonderful families who touch our hearts with their love for you in so many ways. And I dedicate the following summer travel checklists to you, with lots of love. Wishing you all fun adventures this summer!



For Care And Maintenance

  • Rechargeable batteries and battery charger and/or disposable batteries and battery covers
  • Cleaning supplies - such as a small towel to wipe down the processor and a small brush to clean the microphone and/or replacement microphone protectors
  • A drying kit - like Dry and Store
  • A hard carrying case
  • A pair of monitor earphones

For Summer Fun

  • Retention devices - such as Snugfit
  • Swimming and sport accessories - such as Aqua+
  • Remote Mic or DM system - helpful in crowds and for the in-flight entertainment
  • A hat and/or a hoodie in case of rain

Just In Case

  • Spare parts - such as coils and cables
  • Backup sound processors
  • Patient ID card
  • The contact phone number for the CI manufacturer for equipment issues

Other Helpful Tips

  • A power strip is always helpful for plugging in your battery charger, remote mic and phones
  • Depending on where you go, international plug adapters are a must



For Care And Maintenance

  • Disposable batteries
  • Cleaning supplies - such as a small towel to wipe down the hearing aids, a small brush to clean the microphones and a wax loop for the earmolds
  • An air blower to dry moisture in the tube
  • A listening tube
  • A dry aid jar
  • A hard carrying case

For Summer Fun

  • Remote Mic or DM system - helpful in crowds and for the in-flight entertainment
  • A hat and/or a hoodie in case of rain

Just In Case

  • Spare parts - such as tubes and earhooks, which might require a pin removal tool, depending on the type
  • Backup hearing aids, if available
  • Backup earmolds, if available, or comply tips
  • The contact information of the clinical audiologist

Other Helpful Tips

  • A power strip is always helpful for plugging your battery charger, remote mic and phones
  • Depending on where you go, international plug adapters are must


My sincere gratitude to the two wonderful audiologists, Kerri Corkrum, AuD, CCC-A, at Seattle Children’s Hospital and Marissa Valdez, AuD, CCC-A, at Seattle School District, for checking my checklists for me.

To Be Humble Or To Be Nimble

by Tara Ellis, M.Ed, MS, CCC-A


TaraAs a Birth-To-Three Provider for Listen and Talk, I often think about vocabulary.

In fact, I drive around in my car thinking of lists of words. It’s part of my daily ritual as I bounce around from one family’s house to the next. On some days, depending on the numerous variables that can alter one’s arrival time, my word bank can be exorbitant. I think about how first words emerge and how imperfectly perfect they are. I also think about how different those words can be depending on the babe who is speaking them, and how few or how many that I may be in store for once I cross the threshold of another family’s living room.

Also, I think about the number of words that have made their way from the mouths of caregivers, to technology worn by the child. I question the integrity of that message as it travels through back ground noise, reverberant rooms, a microphone, and traverses the auditory pathways to the listening centers of the brain. What have they missed? What was unclear? Are the words floating around with no meaning? I think deeply about the threat that an imperfect sensory system may have on a language-rich interaction due to its faulty delivery mechanism.  And then I think of the questions, what did you hear? What did you understand?  How can we adjust to compensate for what may be lacking?

I then refer to Dr. Dana Suskind, Founder and Co-director of the Thirty Million Words Center for Early Learning, whose work highlights the importance of rich language environments, responsive caregivers and adult-child exchanges. She has also published a book, Thirty Million Words: Building a Child’s Brain, where she highlights the “Three T’s” of communication. Tune In, Talk More, and Take Turns.  Dr. Suskind describes how to reach the goal of 30 million words, “One word at a time” through every day routines and activities that serve as opportunities for brain building and language development.

The other striking side of this story is the words that come from the parents of these precious families to their birth-to-three provider. Their words categorically are similar. They are emotionally driven in most instances and depending on the day, can be laden with excitement, hope and joy or with overtones of uncertainty, anxiety or sadness.  The dance that takes place between “coach”, caregiver, and child can be as complicated as a grand jeté or as simple as a shuffle-ball-change.  As a coach, I figure I have two plays that I can always fall back on, one is to be humble, the other, is to be nimble. And then at the end of the day I think about how fortunate I am to share in this journey.

Some days we hobble, some days we run, and then I remind myself that it isn’t a race.  Most importantly, our job is to help parents understand that they can make a positive difference in the architecture of their child’s brain.  One word at a time.

Understanding Our Ears

by Ariele Matkov

Students pretending to be audiologists

May is Better Hearing and Speech month, which means a lot to the professionals who work with kids with hearing loss. This year, I wanted to think about how I could make this month meaningful to my classroom students.

My students are 4 years old, so I had to find a way to make it accessible and fun for kids their age. I started by asking myself a few questions…

  1. Do they understand their technology?
  2. Do they know the proper names for everything?
  3. How can we learn about sounds and the way our ears work?

The biggest question I had was am I going to accomplish this and what is the end goal?

I set out to find different ways of incorporating sound and hearing technology into our daily classroom routine. Our classroom library was stocked with books about sounds and hearing. It also included some books that featured characters with different hearing technology.

This month, our snack mats featured pictures of the technology they use on a daily basis! There are a lot of different pieces of technology we use everyday; sound field, transmitter, receivers. The list is endless! This helps increase their vocabulary and build their language around each important piece of equipment.

Our whole group lessons focused on loud vs soft and high vs low pitch sounds. The kids learned about sound waves and how they travel.  The students experimented with making different sounds on instruments, which included rhythm sticks, a tambourine, and a guitar. Our educational assistant, Megan, even showed off her talent when she brought in her oboe. The kids loved pushing the keys while Megan played!

Our classroom’s dramatic play area was turned into an audiology office, complete with a sound booth for hearing tests. The kids were also able to explore different types of technology by “fitting” their “patients” with their new hearing aids, cochlear implants, or bone anchored hearing aid. They really enjoyed pretending to be audiologists. It was awesome to see how much they understood the different parts of an audiologist’s job through their play. They even cleaned the hearing aids and cochlear implants to make sure they are working properly. One of our favorite moments was watching them use the listening hoop to give each other the Ling sound test.

The kids work all year on identifying when their “ears” are not working. They now know when to ask for help with their technology and they know how to request to be connected to the transmitter of the speaker in the room. There are a mix of hearing aids and cochlear implants in this year’s classroom. Until recently, the kids did not recognize the difference between the different technologies. Through storybooks and group discussions, we’ve identified the similarities and differences of our amplification.

We’ve seen how increasing their awareness and advocacy skills during this unit has helped to strengthen their ownership, understanding, and pride about their special ears. In every stage at Listen and Talk, our ultimate goal is to help each child confidently talk to future teachers, classmates, friends, and family about their “special ears.”

Strategies For Improving Your Child's Listening Skills

by Kelli Koehnen, MS, CCC-SLP, LSLS Cert. AVEd




Children with hearing loss need rich input of language throughout the day, with repeated practice in order to make sounds meaningful. And of course they need to wear their hearing technology for the input to be beneficial!  Full time wear during all waking hours is goal number one. A good rule of thumb is that if your child is awake, their hearing technology should be on their ears.  It is important to strengthen listening skills to build a foundation for spoken language skills. This is the focus of listening and spoken language therapy.


Point Out Sounds Around You

  • Watch for your child’s reaction in response to sound:
    • Young children may pause when they hear a sound or widen their eyes. Pay attention to your child’s “listening behaviors.”
  • Prompt your child to wait and listen by pointing to your ear and saying, “Listen.”
    • Encourage your child to search and look for the sound.  When you see their reaction point to your ear and tell them, “You heard it!”
  • Talk about the sound and describe what they heard.


Introduce Learning To Listen Sounds

With new listeners, at first we practice many sound-object associations or Learning to Listen Sounds.  These include sounds, such as “ah” for airplane, “sh” for sleeping or “beep” for car. Click here for information regarding Learning to Listen Sounds from the Hearing First website.


Emphasize Key Words In Your Routine

The next skill for early listeners to work on is identifying key words that they hear in their daily routines.

  • Talk about what will happen next in your routine and watch for your child’s response (do they go to the kitchen when hearing, “It’s time to eat?”) Once your child identifies a word, try changing it up and say the information in a different way to build vocabulary skills (“I’m hungry, let’s get dinner ready”). Try changing the routine or throw in silly directions from time to time to make sure your child is listening.
  • When you are presenting auditory information, think of whether your child really needs to listen to what you say to follow the direction. If, for example, your child is always expected to find the same two items before leaving for school, your child may know what to find within context and not need to listen to your words to complete the direction. After you child learns the name of the item they need to find, try describing the item without using the name to continue to build vocabulary skills. For example, you could ask your child to, “Find something that you wear on your feet” before it’s time to go to school.


Increase Your Expectations

As the length of time increases with hearing technology, so should your expectations.

Work to increase the number of critical elements your child can identify. Critical elements are pieces of the message that children must listen to and identify to follow the direction. There has to be more than one choice for each part of the direction to make it a critical element. For example, while your child is playing with their stuffed animals you could see if your child could make their teddy bear go night night (vs. make their doll take a drink). Because there is more than one stuffed animal to pick from, your child must identify both the object and the action to complete the direction.


  • If your child is having difficulty you could try adding a familiar sound, such as “SH” to identify “night night.”
  • Or conversely, if you know your child knows the word “night night” you could try expanding their vocabulary by using a less familiar word first, such as, “The teddy bear is tired and wants to go to sleep.”

Another idea to practice 2 critical elements would be to have your child find 2 toys at a time while cleaning up or finding 2 objects to set the table. Once your child can identify 2 critical elements you can expand to 3. You can incorporate adjectives or location words into the direction. Keep increasing the complexity of the direction as your child continues to build their listening skills. Also, keep expanding your child’s auditory memory, when they miss part of the direction, repeat the whole direction back emphasizing the part of the direction that was missed.

Your child’s Listening and Spoken Language team members can help to identify goals and strategies to specifically  meet your child’s needs.


Several Resources:

Pediatric Audiologist, Dr. Karen Anderson has great resources regarding Auditory Skill Development on her website

The Oticon website has some good information about how to help young children wear hearing technology.

How much should your child be wearing their hearing technology?  Get the answer! - Hearing First

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