Effects on speech and language acquisition
Time of onset of hearing impairment and loss is likely the major variable that determines the acquisition of speech and language. The child who has never had the benefit of sufficient auditory exposure to speech and language is unlikely, except under the most extraordinary circumstances, to develop these sufficiently to communicate normally in a hearing world. The child who is in the process of developing speech or language or who has already developed the skill is likely to retain the ability except under the most dire conditions, such as total loss. Even then, the possibility exists for retention of what has already been gained.
Of greater significance is that the child who has already acquired speech and language has the benefit of developing ideational or cognitive processes appropriate to the living environment, whereas the child who is born deaf or hearing impaired is deprived of the opportunity to relate to the world cognitively. In the first case, a communicative relationship has already been established between parent and child, tapping at cognitive resources. When speech and language has not been learned, a crucial ingredient necessary for the parent-child relationship is lacking. Only through gesture and use of body language is it possible to establish a relationship, but in the case of profound hearing loss, this is mired in what Ramsdell (1960) describes as the “primitive level” of hearing. Only through the earliest and most intensive intervention efforts is it possible to ensure that the child will be in the mainstream of the communication world of the hearing, but even then, other variables will influence the outcome.