Teletherapy in Children Who Are Deaf and Hard of Hearing

Access to speech-language teletherapy will be provided as a supplement to Usual Care for subjects randomized to this group. Access is provided by way of 1) direct referral by the clinical team to a teletherapist; 2) availability of a teletherapy slot. All teletherapy providers will be licensed speech-language pathologists (SLPs) and/or credentialed teachers of the deaf (TODs) with specialized training to work with children who are D/HH using an LSL approach. Fluent English and Spanish speaking providers will be matched to the child's home, native language. Teletherapy itself is within routine clinical care and is not considered a research activity. Children who randomize to the Low TT study arm will receive access to an 18-month course of weekly teletherapy, in accordance with the centers' standard of care. The exact details of the therapy course and frequency will be determined based on individual family needs.