Adults and children use language(s) (e.g., English, Spanish, French, American Sign Language, British Sign Language) to express their ideas and to communicate with others. Babies and parents share a common language so that they can understand each other. Hearing babies begin to pay attention to the language(s) around them in the first few months of life. Similarly, deaf babies who have deaf parents also begin to pay attention to their parents’ use of sign language in the early months of life. These natural models in the home (spoken or signed) encourage the child to learn language.
When parents are hearing and their babies are deaf or hard of hearing, they need to find effective ways to communicate and model language for their babies.
Because each baby and family is different, decisions about how to communicate must be made carefully, based on your baby's and family's needs. Approaches vary in the amount of emphasis placed on listening, spoken language, and/or visual approaches. Sometimes one approach works for children. Sometimes combinations of communication styles are more appropriate. Decisions about how to communicate are not usually “either-or” (either this one or that one); many families combine various approaches in response to the child’s needs over time.
Any decisions will require commitment from you and from the professionals on your baby's team. You may see people refer to this as "communication modalities." This means whether communication will be through auditory, visual, or combined routes. The list of common communication approaches below is ordered from most auditory to most visual.
We often think of these approaches on a continuum from auditory (A) emphasis in learning to visual(V) emphasis in learning. By considering the child's unique learning strengths and needs, parents and communicators can use the best approach(es) for the child. Children might start at one place on the continuum and move to different points on it as their needs change.
This type of program focuses on maximum use of hearing and hearing technologies to develop . The approach fosters the reliance on spoken language for communication and learning. Professionals seek specialty certification in LSL from the Alexander Graham Bell Association. For more information on the LSL approach, visit www.hearingfirst.org.
Many programs emphasize development of listening and they may support that with visual cues from speechreading. Like LSLS, the primary goal is for the child to develop spoken language. Your baby will need good technology (hearing aids, cochlear implants), a quiet environment, rich language stimulation, and help from you and your infant/family specialist in order to develop speech and language through spoken language.
This is a visual approach to communication that uses handshapes and placements in combination with the mouth movements of speech to make the sounds of spoken language look different from each other. For example, look in a mirror – if you turn off your voice and say "mom, pop, or Bob," you cannot tell these apart on the lips. Cued Speech adds visual information to make these and many other confusable sound combinations clear. Many sounds look alike on the face. Cued speech is a way of showing English clearly. More information about cued speech.
Manually Coded English is a way of using specific signs and signed word endings to represent the English language on the hands. Signs are used in combination with spoken English. Some families use a manual code of English as a tool for their children to learn English grammar. Some examples of MCE are Signing Exact English and Signed English. For more information, visit: www.handsandvoices.org and seecenter.org
American Sign Language is the predominant sign language of the Deaf Community in the United States. Any idea that can be expressed in English can be completely expressed visually in ASL. Parents who want to learn ASL benefit from meeting and interacting with people who are fluent in ASL. Bilingual-bicultural approaches include an emphasis on ASL, learning English, and learning about Deaf cultural traditions and perspectives (see the Bilingual-bicultural section for more detail).
Sometimes families will find a single form of communication works best, and other families may use more than one form. For example:
*McConkey Robbins, A. (2001). A sign of the times: Cochlear implants and total communication. Advanced Bionics Loud & Clear (4)2, 1-7.
*Nussbaum, D., Scott, S., Waddy-Smith,B., & Koch, M. (2004). Spoken language and sign: Optimizing learning for children with cochlear implants. Paper presented at Laurent Clerc National Deaf Education Center, Washington, DC.