Teach Pragmatic Skills To Children With Hearing Loss

Pragmatic skills are the tools we use in social contexts, such as using the appropriate language in a conversation and knowing how to respond to someone you’re talking with. This includes everyday situations such as requesting an object, talking about how we feel, or asking to join in a game. A child with normal hearing would acquire these skills naturally after the age of three years. For a child with hearing loss, specific rehabilitation activities are needed to teach the appropriate pragmatic skills, which will help your child in their interactions with friends and family. Here are 9 examples of activities you can do with your child to teach them pragmatic skills.

1. Requesting Objects

Encourage your child to always say the name of the object and include “please” and “thank you” during and after the communication.

2. Asking for Help

Watch for cues that your child wants assistance and prompt them to use an appropriate phrase. For example, they may hold up a toy or point to an object. Prompt them to use a phrase like “Help me, mummy”, or “Can you put her dress on, please”, depending on their language skills.

3. Identifying and Describing Emotions

Provide a wide range of words describing emotions to help your child be more specific when they are explaining how they feel. Talk about feeling excited or nervous before an adventure, feeling weary and exhausted after a big day, or being grumpy and cross if you are unhappy about something. Modelling the use of these terms will help your child to understand their meaning. Gain inspiration from the books you are sharing. For example, “How is this character feeling?” or “How would you feel if this happened to you?”

4. Seeking Clarification if They Didn’t Hear or Don’t Understand a Comment

Watch for cues that your child isn’t following the conversation. Encourage your child to use a phrase such as “Could you say that again?” or “What did you say?” It’s important that your child knows they are not the only person who has trouble hearing or understanding a conversation. Show this by setting up a situation at home with other family members, where you mishear something in a conversation and ask for it to be repeated.

5. Answering Questions

This skill requires your child to understand a question, and know how to answer it. Examples include being able to give their address if they are lost, making a choice between two treats offered by a grandparent, or being able to respond when someone asks them if they are having fun. You may need to observe your child interacting with family, friends and the wider community and note when they have difficulty responding to enquiries. Try to provide opportunities for your child to learn how to respond to questions by encouraging them to talk with family members in a safe environment.

6. Asking to Join a Game or Activity

This will be very important in social settings like school or the playground. Engage peers and siblings to help your child rehearse these skills. Using dolls and puppets will also allow you to practice using the appropriate language, before trying it out in a real-life setting.

7. Initiating a Conversation

Your child may be used to having your full attention at home as you engage with them to teach language. You may need to teach them how to gain a person’s attention before starting to talk, such as standing next to the person, waiting for a break in conversation and saying “excuse me, can I show you my toy” or “can I tell you about my trip to the zoo?”. It is important for your child to recognise the break in the conversation which you may need to rehearse with siblings and peers.

8. Apologizing

This is a very important social skill that your child will need when interacting socially. They first need to recognise when to apologize. Some examples you could use are if they drop or break something, arrive late, don’t finish a task, or hurt someone. It’s important for your child to also understand the correct format to use. For example, apologizing to an adult will be more formal than to a sibling or friend.

9. Describing an Object or Toy

This skill can come in handy particularly around birthdays and holiday periods. Your child may be asked what they would like to receive, and you can help them practice this before the celebration occurs.

Always try to make the learning sessions fun so that your child’s social interactions are positive and natural. Good luck!

This post was written by Diana Zegg, a Rehabilitation Manager working for MED-EL. Diana has been working for many years in the Rehabilitation Team being involved in the process of developing resources and materials to support children and their families as well as teens and adults with hearing impairment. She is currently training to become an Educator for Children with Hearing Impairment at the University of Birmingham, United Kingdom.

1. Goberis, D. (1999) ‘Social communication skills- Pragmatics checklist (adapted from Simon, C.S., 1984).
2. Yoshinaga-Itano, C. (2015) ‘The missing link in language learning of children who are deaf or hard of hearing: Pragmatics’, Cochlear implants international, 16(1), pp. S53–S54. http://www.tandfonline.com/doi/full/10.1179/1467010014Z.000000000237

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