In the Home

INTRODUCTION TO THIS SECTION
Now that you have completed a foundation class, you have a general understanding of the Cued Speech system as it applies to English. As your instructor probably told you, you are now able to cue anything you want to cue in the English language. While this might be true, it may also be true that you cannot cue everything you want to cue in a complete sentence and at a conversational rate.

Cueing for Communication
Try not to let your lack of cueing fluency negatively impact your communication with your child. Continue to speak to your child. Use facial expression, touch, gestures, and whatever tools are at your disposal to get your point across and to connect with your child. Strive to incorporate cueing as much as you can. Push yourself to cue a bit more than you did the week before. Jot down words and phrases that trip you up. Practice these when you can so that the next time they come up, you will be just a bit smoother.


When you have planned a trip or event, make a list of the words or phrases that might come up. Practice these. If you are going to Grandma’s house, make sure you can cue everyone’s names to your child. Practice phrases that will be the most useful during your visit. Make your practice fit your life rather than trying to learn everything all at once. It’s ok to not be perfect. Take a manageable piece and then add more as you go.

Becoming Fluent
Fluency is the process of becoming more automatic with your cues. Practice and time will assure that you will eventually be able to cue more rapidly without having to think through e-ver-y sy-lla-ble in a painstaking fashion. However, clarity and accuracy are not guaranteed. It takes a conscious and concerted effort to cue correctly. For accuracy, it is a good idea to practice your cueing at a slow pace when you are not using it to communicate with others. This will be your time to practice. Make it enjoyable, not a chore. Choose a song you really like and try cueing just a few of the words slowly so that you are clear and deliberate. Then push yourself a bit. Do you think you can cue two or three words of the song in a row?

Learning to Cue Read
Learning to cue read, is a separate skill from cueing what you say. Similarly, when learning a foreign language, one practices speaking, listening, as well as reading and writing. With cueing, hearing people who wish to cue read will have to devote time, practice, and training if they are to learn to do it.

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FAMILY DYNAMICS

A Note for Caregivers
The birth of a deaf child into a hearing family can certainly change family dynamics.  Parents may have questions about how they can make sure that all of their children are receiving enough attention and opportunities in life.  It is important to be aware of everyone's needs, including your own.  All children need loving caregivers, and stable environments.  All caregivers need outlets and time to look after themselves as well.

A Note about Siblings
Professionals never hesitate to remind parents of the many things they must do for their deaf child. In the rush to expose your child to as much language as possible and tick off any speech and listening goals, sometimes it is hard to remember that you're not a case worker, but part of a family. It’s easy to appreciate that our hearing children's language needs are getting met. Remember that all of your children need some attention from you. From time to time, schedule little one-on-one outings with your other children. Let them choose what they’d like to do, and let them have a turn receiving your undivided attention.

A Note about Spouses
Sometimes you may put so much energy caring for your children, that you and your spouse may feel somewhat disconnected.  It is natural for parents to worry about their children's futures, and this can be stressful on relationships.  Share your worries with your spouse, but also share the moments that make you feel happy, proud, and hopeful.  Make time for one another.  It is okay to go out to dinner and leave your children with babysitters once in a while.  It will help you revive yourself so that you can be better parents for your children, and better partners for each other. 

Create and Nourish Your Support System
You are going to need an outlet. You may find the support you need from friends and family. Sometimes, however, those who are not in the same position as you have difficulty listening and empathising with your feelings. Instead they focus on what you should be doing. Their well-intentioned aim to be helpful might not the kind of help you need. Seek out other parents who are dealing with the same things you are. Attend Cued Speech Summer School. Take the time to get to know some people and reach out and keep in touch with new friends. Sometimes no one can understand feelings of guilt, anger, isolation, confusion, or whatever you might be feeling if they haven’t walked a mile in your shoes.

Getting everyone to cue
It is extremely beneficial to your deaf child if he/she can communicate with the important people in his/her life.  It is important that siblings, grandparents, and any other close family or friends can communicate with a deaf family member.  Just imagine being at a family gathering on a holiday, and not being able to communicate with anyone.  You might feel left out, or ignored.  This is why cueing is so wonderful.  It can be learned quickly, and can turn an uncomfortable situation into a pleasant one.  Consider offering babysitters or other people who care for your child incentive to learn to cue.  Pay a little extra for babysitters who are willing to learn how to cue by learning from you, or attending classes or workshops at local colleges. 

Remember:
Communication should be FUN and enjoyable for babies and children. 
Sometimes if you learn to cue after babyhood your child may have developed some bad habits through lack of understanding and frustration at not being able to communicate.  Resist the temptation to use your new found communication skills to tell them off.  Deaf children quickly learn to shut their eyes if they do not want to ‘listen’ and then you will be the frustrated family member!  Use ‘positive reinforcement’ to encourage them to pay attention to you.  Practice cueing: “well done”  “great work” “good boy/girl” and any other positive phrases your family use. 

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PLAY
Why is play important?
Through play, children are introduced to language.  Play is an essential aspect of childhood, and reinforcing play activities with rich language content can enhance children’s communication skills.  It is important for a parent to provide language modeling during play activities to encourage communication.  The following information provides ideas on how to cueing into children’s play. [2]

Types of Play:
Social Play: Children enjoy interacting with adults - smiling, looking and laughing. Language should revolve around objects the child can see.  Simple games such as ‘peek-a-boo’ and ‘pat-a-cake’ and ‘I’m-coming-to-get-you’ are easy to cue.

Filling and Dumping Play: Children tend to enjoy knocking over objects, filling up containers and dumping them out.  Naming objects is encouraged because children are making direct associations with objects around them. Parents should comment about the object the children are playing with at the time. [1]

Functional Play (relational play): Children enjoy simple activities with imaginary things, like eating pretend food or drinking imaginary juice. Parents should continue to make comments about what the children are doing but should begin introducing other stimuli and cues into the immediate play environment.

Simple Dramatic Play: As children grow, they have fun acting out simple sequences of pretend play: having a tea party, bathing a baby or doing dishes or acting like a superhero.  This gives children the opportunity to use language in a more interactive and complex way. For example: a superhero could destroy, rescue or vanquish. Feel free to build on their actions and add additional cues to their vocabulary. [1]

Games with Rules: This is the most sophisticated form of play because it is the most adult-like.  Children are able to share expectations, share procedures and compete with one another.  Children are starting to learn the rules of social interaction and they realize that their actions have direct effects. It is important for the parents to provide a flexible environment for the children to socially experiment with competition and interact with others while cueing. Children also can learn to take turns during this type of play activity.[2]

References
[1] Brown, D., & Strand, K. Play development: Definitions of stages. Children’s Hospital, Boston, MA
[2] Paul, R. (2007) Language Disorders: From Infancy Through Adolescence. St. Louis: Mosby Inc, 243-245.

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LANGUAGE BASICS
Follow the child’s lead when introducing language.  Being in tune with your child’s needs will encourage communication and language development. These are basic tools to use when cueing to your child and can be used in any situation.

Onomatopoeia
Some words resemble the sounds we hear “Moo”, “crash”, “splat”, “baa.” These words can also be a fun way to encourage children to reply (e.g. “What does a kitty cat say? Meow, meow.”)

What the child sees (Referential)
Language should revolve around what children can directly see.  Make use of objects and actions taking place in front of them as the material for interacting through language. [1]

Turn-taking and Imitation
Start by observing children’s behavior and facial or body movements and then imitate them back to them.  You should continue to “match” the movement of the children until they respond and provide another gesture.  This imitation game is a fun way to develop the ‘back and forth” nature of conversation. [1]

Repetition
Cueing words or phrases repeatedly increases children’s awareness of language and helps them understand that a specific cue stands for a specific object. Repetition is a great way to reinforce cues for chilren who is beginning to understand language.

Re-word (Re-cast)
If children incorrectly cues a word or sentence, you should correct the utterance for them.  Simply restate what they cued and correct the error in the production. [1]

Call to Action (Verbs)
Being concrete is important for children who are learning their first language. Remember to call attention to what you are doing using verbs.  Verbs refer to an action (do, break, walk, etc.) or a state (be, like, own).  Verbs can be tough for children and so be sure to put a name to the things you are your family do together.

These are a few examples how you can demonstrate action words:

You’re cleaning up!
Put that away.
Hand it to me.
Let’s go walking.
Are you playing?

Joint Attention
Follow the children’s gaze and look at what is holding their interest. Once they realise you are also focusing on the same object you can cue to them about that item.  Cues should describe or label the features of the object. [1] 


This can be quite hard to do if the deaf child’s attention is on the object because they can’t look both at you and at the object.  You might have to wait till they look at you and cue a key word then follow with a whole sentence if you still have their attention.  Sometimes this may be almost impossible (e.g. at a firework display) in which case it might be better for every-ones temper to take photos and talk about this later with the photos for reference.  But do try to talk about as much as you can at the time and be aware when you are unable to do this.  

Routine activities (Anticipatory Sets)
These sets are daily routines that parents and children share together: getting up, getting ready, bath time, preparing snacks, bed time and simple games.  These routines provide a set of predictable items, vocabulary and language that increase learning.  They also are good opportunities to increase your cuing fluency. 

Elaborate
Expanding children’s utterances help them understand language and how to broaden the length of their cued sentences. If they cue “dog” or “dog walk” use this chance to expand their sentences and word use. As a parent you could cue “yes, that is a dog in the yard” or “yes, see that dog is walking in the park.” 
References
 [1] Paul, R. (2007) Language Disorders: From Infancy Through Adolescence.  St. Louis: Mosby Inc, 243-245.

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ROUTINES
Why Routines?
Language learning is an active and interactive process. As a parent, you are the most influential language model for your child because you have the greatest potential to provide language enrichment. The more communication opportunities and exposure you provide, the richer your child's language learning experience will become. A routine is one communication activity that can enhance language development. Daily routines are an easy and effective way to boost your child's language skills. Additionally, routines give you and your child a chance to spend quality time together!

An effective routine will have the following components:

  • Beginning and Ending
  • Have a result (Outcome)
  • Meaningful
  • Predictable
  • Sequential or Systematic
  • Repetitious

Sample Family Routine for a child with some language: 
Baking a Cake 

Beginning:  Say, "Let's make a cake!"

Materials:  Recipe, Baking Utensils, Ingredients

1)  Begin with a simple cue.  "Let's make a cake!" Try to show enthusiasm so your child associates this learning experience with enjoyment.

2)  See if your child can make any predictions about what ingredients or materials you might need for the task. 


3)  Have your child read ingredients aloud. If your child cannot read, you should read it to your child, making sure he/she is following along.

4)  The first time you bake together, model the gathering of the materials for your child by saying the name of an item, its location, and its function while cueing. Try to direct your child's attention to objects and actions. For example, you can say, "The spatula is in the drawer next to the sink.  We're going to use the spatula to scrape all of the batter out of the bowl before we put it into the cake pan."  Once your child becomes more familiar with the items, you can expect him/her to do this independently.

5)  If your child can read, have him/her read each step of the recipe and explain it in his/her own words. 

6)  The child should complete any steps that are child-safe.  For example, the child can use a wire whisk to mix the batter. Model descriptive language, using words like, "lumpy" or "smooth". You want to teach words that your child can make use of often to accomplish his/her social goals. Children should understand that words like these can be applied in many settings.

7) Praise your child for his/her effort, and encourage him/her to ask questions.
Each baking experience is an opportunity for your child to learn something new as well as a time to engage in conversation.  If you focus on the function of the materials one week, you can focus on the functions of the ingredients the next week.  For example, you can explain how the oil makes the cake moist, or yeast makes it rise. 

Most importantly, have fun!

Sample Family Routine for a baby with very little language: 
Washing dirty hands

  • Beginning and Ending “Your hands are dirty”  “they’re clean now”
  • Outcomes Desired: your child understands how to co-operate, the difference between clean and dirty, starts to understand the vocabulary involved
  • Meaningful: one-to-one time with carer, developing the skills of washing, enjoying feeling clean.
  • Predictable: before meal times after ‘dirty’ play
  • Sequential or Systematic and repetitious : tuning tap on, getting soap, getting wet, naming fingers, thumbs, drying.

Other Sample Routines
Story Time

Beginning and Ending: Cue, "Do you want to read a book?" Finish book: "The end!"
Outcomes Desired: points at pictures, labels pictures, turns pages
Meaningful: your child's favorite book, time together
Predictable: read to every night before bedtime
Sequential or Systematic: choose a book, name it, turn pages, label pictures, put it away
Repetitious: turning pages, labeling pictures

Grocery Store Visit
Beginning and Ending: Cue, "We need to buy some food!" Finish: "Time to pay!"
Outcomes Desired: points at food, labels familiar items, helps pick out items
Meaningful: need to have food to eat
Predictable: go same day each week
Sequential or Systematic: go to store, get a cart, get familiar items, go to cashier
Repetitious: picking out food and putting it in the cart

Trip to the Farm
Beginning and Ending: Cue, "Let’s visit the farm!" Finish: "We saw a lot of neat animals today!"
Outcomes Desired: knowing sounds animals make (onomatopoeia), knowing what each animal produces, understanding where produce comes from
Meaningful: farms provide us with dairy and produce that we eat all the time
Predictable: take a field trip at the same time each month
Sequential or Systematic: decide ahead of time which animals you will see and, if possible, the order in which you will see them
Repetitious: name the animal, name the sound it makes, discuss its use on the farm

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HELPING YOUR CHILD BE READY TO READ
Sometimes teachers will call this reading readiness, early literacy, or emergent reading.
It is important to consider a child's developmental level when choosing appropriate activities and goals. Early and enjoyable pre-reading experiences set the stage for a child's desire to learn. By picking books the child is actively engaged in, centered around their favorite things, the child gains knowledge that will serve as the foundation for further learning as he or she enters the school system.

 Reading readiness is very individual. There is no "one right answer for everyone' in terms of solutions. A parent or teacher may need to use several techniques before finding the most suitable method for the particular child.
 Skills that indicate whether a child is ready to learn to read include:

  • Appreciation of stories and books;  
  • Understanding of basic print concepts (for example, printed text represents spoken words; spaces between words mean something; pages written in English are read left to right starting at the top of the page; books have a title and an author).
  • Understanding of the alphabetic principle (letters represent the sounds or individual cues of language)
  • Ability to distinguish shapes (visual discrimination)
  • Ability to identify at least some letters of the alphabet

RESOURCES
Book list:
The following is a list of books that are great for young readers. They contain vital elements such as repetition and bright colors. Many of these books also encourage the child to use their imagination by filling in the blank and taking an active role in the story

Children's Books (with sample words cued)
The Very Hungry Caterpillar by Eric Carle
Philomel Books
ISBN 0-399-22690-7
[See key words cued]
Thomas the Tank Engine Coming and Going: A Book of Opposites based on the Railway Series by Rev. W. Awdry
Random House
ISBN 0-679-88880-2
[See key words cued]
Where's Spot? by Eric Hill
Puffin
ISBN 0-14-050740-X
 Additional Children’s book titles:
• Allan, Nicholas. (2000). You’re All Animals. London: Random House Children’s Books
• Benchley, Nathaniel. Ill. By Arnold Lobel. (1964). Red Fox and His Canoe. New York, NY: Scholastic Books Services
• Boynton, Sandra. (1982). But Not the Hippopotamus. NY: Little Simon Books
• Bridwell, Norman. (1984). Clifford’s Kitten. New York: Scholastic Inc.
• Bruna, Dick. (1986). I Am a Clown. NY: Methuen Children’s Books
• Bruna, Dick, (1986). When I’m Big. NY: Methuen Children’s Books
• Carle, Eric. (1994). The Very Hungry Caterpillar. NY: Philomel Books
• Coats, Laura Jane. (1993). Alphabet Garden. New York, NY: Macmillan Publishing Company
• Crews, Donald. (1999). Cloudy Day, Sunny Day. Orlando, Florida: Harcourt, Inc.
• Crump, Fred. (1970). Ringo the Raccoon. US: Ideals Publishing Corporation
• Fox, Christyan and Diane. (2002). What Shape Is That Piggy Wiggy? NY: Handprint
• Galdone, Paul. (1968). Henny Penny. NY: Clarion Books
• Horban, Tana. (1983). I Read Signs. NY: Greenwillow
• Horban, Tana. (1974). Where Is It? NY: MacMillan Publishing Co. Inc.
• Isadora, Rachel. (1985). I See. NY: Greenwillow Books
• Jonas, A. (1986). Now We Can Go. NY: Greenwillow Books
• Karlin, Nurit. (1997). I See, You Saw. USA: Harper Trophy
• Martin, Bill. (1967). Brown Bear, Brown Bear, What Do You See? NY: Henry Holt and Company
• Miller, Margaret. (1990). Who Uses This? New York: Greenwillow Books
• Murray, W. Illustrated by: Martin Aitchison. (1977). I Like To Write. Maine: Ladybird Books
• Raschka, Chris. (1993). Yo Yes? New York: Orchard Books
• Resnick, Jane and Susan Postcanser. A Sunshine Storybook: Fun Time. New York: Modern Publishing
• Ryder, Stephanie. Illustrated by: Stephanie Ryder (1992). Bath Time. England: Brimax Books
• Staw, Jenny. (1992). The House That Jack Built. NY: Dial books for young readers
• Smith, Mavis. (1997). Mind Your Manners, Ben Bunny. Toronto: Scholastic Inc.
External Links
http://www.literacytrust.org.uk
and particularly:
http://www.literacytrust.org.uk/talktoyourbaby/TTYBhearingimpairmentresource.html
http://www.sil.org/lingualinks/literacy/ReferenceMaterials/glossaryofliteracyterms.htm
http://www.kidzone.ws/preK_wrksht/reading-readiness/index.htm
http://specialed.about.com/od/readingchecklists/p/prereading.htm

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These resources were largely developed by a team of Speech and Language Therapy students as part of a project for the Language Disorders class at the Massachusetts General Hospital Institute of Health Professions. 

We would like to thank the team of Janine Pedro (Team Leader), Caroline Shannon, Ashley Schuler, Ramya Shyam, Caitlin Schlauch and Tom Shull for their time and dedication.  Special thanks go to Cued Speech Transliterator Tom Shull who inspired the other students to pick Cued Speech as their project.