Adults and children communicate through language (e.g., English, Spanish, French, American Sign Language, British Sign Language). Babies and parents share a common language so that they can understand each other. Hearing babies begin to pay attention to language as soon as they are born. Deaf babies with deaf parents also begin to pay attention and learn as soon as they are born through sign language exposure.
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, the decision 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.
Any decision will require commitment from you and from the professionals on your baby's team. You may see people refer to this as "communication modality." This means whether communication will be through auditory, visual, or combined methods. 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 for the child. Children might start at one place on the continuum, and move along it as their needs change.
This type of program focuses on maximum use of hearing to develop speech and language. 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
Oral/Aural communication approaches
Many programs emphasize development of listening and they may support that with visual cues from speechreading. Like LSL, 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 family-infant 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 expressing 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:
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. To learn ASL efficiently, babies will benefit from access deaf adults who are fluent in ASL. Bilingual-bicultural approaches include an emphasis on ASL, learning English, and learning about Deaf cultural traditions and perspectives.
Sometimes families will find a single form of communication works best, and other families may use more than one form. For example: