Caregiver-child interactive behaviours: a clinical procedure for the development of spoken language in hearing-impaired children.

Much recent research emphasises the importance of pre-verbal communicative behaviour in the language development of children. A child normally becomes a competent user of spoken language through communicative interaction with caregivers in the course of everyday activities and play. When acquisition of spoken language is problematic due to hearing loss, the need to restore and/or maintain the integrity of the caregiver-child interactions is acute. However, relatively few attempts have been made to organise our knowledge of pre-verbal behaviour so that it can be used in developing spoken language in hearing-impaired children. This paper presents a clinical procedure for analysing caregiver-child interactive behaviours, which was derived from language acquisition research and literature. The procedure is intended for use by teachers/clinicians with hearing-impaired children prior to the use of conventional words in connected sentences. A videotape analysis is developed to meet two clinical aims. The first aim is to identify systematically those elements of the interaction which promote the child's communicative development, as well as those which are counterproductive to it. The second aim is to use this information to facilitate communication between caregiver and hearing-impaired child. Illustrative examples from analyses of caregiver-child dyads are provided to demonstrate the clinically useful information which results.