Significant permanent hearing loss in children leads to delays in the development of speech and language, which in turn can limit academic and vocational opportunities.

Children with profound hearing loss have been shown to exhibit slower language acquisition rates and lower reading levels than hearing children with typical development. Individuals with significant language delays are a potential cost to the community due to lost or reduced employment opportunities, and their specialized psycho-social and educational needs.

It is well established that optimal development of communication skills in children with significant hearing loss requires:

• early identification of hearing loss and appropriate hearing device fitting
• an appropriate auditory learning environment for the child during critical periods for language acquisition (that is, in infancy)
• carers that have been coached to provide the optimum input to the child.

Whilst speech and language benefits for children receiving hearing aids and/or cochlear implants are promising, many children still fail to take full advantage of their auditory potential despite early intervention. The field of education of the deaf is fraught with poor adherence to protocols or guidelines, individual differences in therapy approaches and a lack of valid measurement of change that is directly attributable to the habilitation provided.