July 5, 2016

Child Speech Therapy: To Sign or Not to Sign

Last week, we discussed the benefits of baby sign language for hearing children. Baby sign language promotes parent to child interaction, early language development, and less communication breakdowns. Although sign language can be helpful for hearing children, it is not always encouraged for children with a hearing loss. For this article, we will be discussing different type of communication methods for children with a hearing loss.

Deciding on Communication Method

When a family first learns about their child’s hearing loss, they must decide on the type of communication method that would be best used for their child. There are 5 different types of communication modes:

  • Total communication– Includes signing, speech reading, listening and speech.
  • Sign– Children only use sign language to communicate.
  • Cued speech– System of hand cues that indicate consonants and vowels.
  • Auditory oral– Mainly focused on listening and speech development, but also allows for visual cues such as lip reading and facial cues. Does not encourage the use of sign language.
  • Auditory verbal– Only teaches listening cues and discourages visual cues.

The families determine the communication method during early intervention. The professionals working with your child will create methods and strategies around the family’s choice. The first decision of communication mode is not necessarily set in stone. If your child is not progressing or goals have changed, the mode of communication may be adjusted.

Making the Decision

There are many factors that influence the way language is learned. If a child is part of a deaf community, their family will most likely want him or her to learn American Sign Language. On the contrary, 95% of deaf children are born to hearing parents, so verbal language is usually top priority. For families that want to encourage verbal language, auditory oral and auditory verbal are used most frequently for early intervention. Children with hearing aids or cochlear implants are able to learn strong verbal skills with an intensive, auditory exposure. This includes auditory training and aural rehabilitation, which involves learning listening sills and teaching children how to incorporate those skills to use spoken language.

Teaching Sign Language

For families that want their child to use auditory oral and auditory verbal modes of communication, sign language is not taught as a mode of language. Some families choose to use early sign language before the cochlear implantation as a bridge to spoken language. Researchers have found that baby sign language with deaf children cannot hurt and may be beneficial while the child is waiting for their cochlear implants. Relying on sign language over an extended period of time may cause negative affects on the child’s capacity to learn spoken language. Families are encouraged to continue to provide auditory rich environments and verbalize each sign if using early sign language. That way, families will slowly decrease the use of signing and move toward listening and spoken language once the hearing aids or cochlear implants are working.

If your family needs assistant on creating a communication plan for your child with a hearing loss, contact Lumiere Children’s therapy and talk with one of our speech therapists!


Donaldson, Cheryl, CCC-S/LP. “Let’s Start With Babies.” Aural Rehabilitation for the Speech-Language Pathologist: CMDS. Kentucky, Louisville. 6 June 2016. Lecture.

Donaldson, Cheryl, CCC-S/LP. “Understanding and Working with Families.” Aural Rehabilitation for the Speech-Language Pathologist: CMDS. Kentucky, Louisville. 6 June 2016. Lecture.

Donaldson, Cheryl, CCC-S/LP. “Working with School- Aged Children.” Aural Rehabilitation for the Speech-Language Pathologist: CMDS. Kentucky, Louisville. 6 June 2016. Lecture.

Mellon, Nancy K., MS, John K. Niparko, MD, Christian Rathmann, PhD, Gaurav Mathur, PhD, Tom Humphries, PhD, Donna Jo Napoli, PhD, Theresa Handley, BA, Sasha Scrambler, PhD, and John D. Lantos, MD. “Should All Deaf Children Learn Sign Language? Pediatrics. 2015.” Pediatrics 136.4 (2015): 781. Web. 6 June 2016.

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