Children and Youth with Special Health Needs (CYSHN)Next Steps: After DiagnosisHearing Level / Hearing Loss |
Taking Action: Communication Methods
On this page...Communication
Communication Choices
- American Sign Language
- Auditory/Oral
- Auditory/Verbal
- Bilingual-Bicultural
- Cued Speech
- Signing Exact English
- Simultaneous Communication
- Total Communication
- Other Sign Language Terms
Frequently Asked Questions
| COMMUNICATION |
You will have many questions after your baby is diagnosed with hearing loss. Many parents wonder how their baby will learn to communicate, but understand what their newborns want without any words at all. However, as babies get older they become very frustrated and unhappy when they cannot express their needs. Communication is the foundation of family life.
In the days and months ahead, your family will make decisions about how to help your baby express their needs and interact with the world. It will be important to learn about a variety of ways to communicate with your baby. Early intervention providers can help you in this process. They can help you learn how to teach communication skills to your child in a way that works best for your family.
Babies learn language early by experiencing the world around them with all their senses. Babies use both their eyes and ears to understand what someone is trying to communicate. Some babies will learn to rely more on one sense. Some babies will rely mostly on their hearing with hearing aids or a cochlear implant. Other babies will rely more on their eyes. The method that is used to teach your baby to communicate influences the way that your baby learns to use his or her senses.
| COMMUNICATION CHOICES |
There are several methods for teaching your baby to communicate. Each method was designed to maximize a child's self-esteem. These methods also maximize the child's ability to socialize with friends, family and community.
Families are the most important factor in the success of any method. The family is the child's first and most important teacher. Methods taught only to a child will isolate the child from the family so include the family and language learning time will increase to 24 hours a day, seven days a week.
You and your child's early intervention team will decide if you want to teach your child to talk, sign, or both talk and sign. Your early intervention team can help guide decisions about your child's learning experiences. These methods are influenced by the culture of your community. They are also influenced by the service providers and the resources in your community.
American Sign Language (ASL) is a fully developed language with distinct grammar, syntax, and art forms. This sign language can perform the same functions as a spoken language.“Listeners” use their eyes instead of their ears to process information. “Speakers” use their hands, arms, eyes, face, head, and body. These movements and shapes function as the “words” and “intonation” of the language. If parents are not deaf, ASL training is necessary in order for the family to become proficient in the language.
ASL is known as the official language of the Deaf Culture. It is recognized by the United States as a distinctly different language from English since it is concept based. ASL grew from a formalization of an extensive home sign system on the island of Martha's Vineyard near Massachusetts. The population of the island was about 40% Deaf. Out of necessity, all the members of the community used sign language to communicate.
In the early 1800's, Laurent Clerc, a Deaf teacher of the Deaf from France visited the island with Thomas Gallaudet. They recognized the richness of the language. By combining the grammatical rules of French Sign Language to the local system, Clerc established ASL as a complete language. Adopted in the US, this language became known as ASL.
The Auditory-Oral approach emphasizes teaching spoken language. Children are taught to use their hearing, lipreading and contextual cues to understand and use spoken language. The goal is to give your child the necessary spoken language skills to be enrolled in the typical public school and to function independently.
This method stresses the consistent use of hearing aids or cochlear implants. It also emphasizes oral language along with naturally occurring, conversational cues such as speech reading. Speech reading uses visual information from the face, body, and environment to help understand spoken words.
The philosophy is that oral language helps the development of reading and writing skills. Good reading and writing skills are critical to all academic areas. Small classrooms are used with daily individual instruction in oral language skills. Teachers provide spoken language instruction in all classroom activities. The Alexander Graham Bell Association and the Oral Deaf Education organization support this option.
The Auditory-Verbal (AV) philosophy supports the option for children with all degrees of hearing loss to develop the ability to listen and to use spoken communication.
This method is based on the normal neurological developmental model. It is based on the belief that the body and brain have been designed to use all five senses equally for learning. Technology is used to enhance and develop the hearing sense to receive information and to learn within the “window of opportunity”. The auditory/verbal method follows a hierarchy of auditory development to teach sound awareness, detection, identification, and discrimination skills.
AV therapists may be early interventionists, teachers of the deaf, audiologists, or speech-language pathologists and are certified by the Auditory/Verbal International organization. This organization requires that the family be present during the therapy sessions.
Bilingualism means being able to use two different languages successfully. Bilingual-Bicultural (BiBi) education for ethnic populations has been recognized in some states since 1969. More recently, it has become recognized as a method for teaching children with hearing loss. It became an important concept in the United States because of a law that was passed in Sweden. In 1981, the Swedish Parliament passed a law stating that people who are deaf need to be bilingual in order to function successfully in the family, school, and society.
BiBi education is based on the principle that children who are deaf are members of the Deaf community and that American Sign Language (ASL) is the language used in Deaf communities. This philosophy recognizes that children who are deaf will need to live and succeed in the world. BiBi education also recognizes and respects the fact that the vast majority of children with hearing loss are from hearing families. Because of these reasons, the BiBi method supports the use of ASL for all instruction. Bi-Bi programs recognize that children with hearing loss come from a culture that values spoken English. English is taught as a second language in school through fingerspelling, reading print, writing, typing, lipreading, speaking, and listening. Children are actively taught to understand and accept the differences between the hearing and Deaf communities.
Some sounds in the English language look alike on the lips. Look in the mirror and say the sounds /p/, /b/, and /m/. Cued speech uses hand gestures to supplement auditory and visual information. Hand movements are made near the speaker's face to help cue the listener about specific speech sounds and to represent the English sounds visually. Family members learn the hand positions to help the child use lipreading skills and to help the child learn the difference between sounds when they look alike.
Cued Speech uses eight hand shapes in four different locations (known as cues) in combination with the natural mouth movements of speech to make all the sounds of spoken language look different. It is known as a sound-based visual communication system. Cued Speech is used to facilitate language development, speech development, reading skills, and communication.
This approach can be used with other approaches. It has been adapted for more than 55 languages and dialects. The use of Cued Speech focuses attention on the mouth, reinforces the sounds in a word or phrase, and integrates motor activity with the use of hearing and vision. More information can be obtained from the Cued Speech Foundation.
Signing Exact English (SEE) is a sign language system that was developed to make everything in the English language visible. It is a literal signed interpretation of English. Since American Sign Language (ASL) is a different language than English, it has different words and different word order. The purpose of SEE was to supplement the vocabulary of ASL so that children could clearly see what was said in English. SEE was developed in the early 1970's.
SEE is based on ASL signs and expanded with words, prefixes, tenses, and endings to give a clear and complete picture of the English language. Learning this sign language system may be easier for English speaking parents because they are familiar with the word order. During the 70's there was a movement to add the use of sign language instruction in public schools to teach children with hearing loss. By 1978, SEE became the most widely used English sign system used in public schools in the United States.
Maximum use of residual hearing and speechreading is encouraged since the SEE signs match all of the parts of spoken English. SEE encourages the incorporation of ASL features to show intonation visually. This option is supported by the S.E.E. Center.
Simultaneous Communication occurs when a person uses sign language and spoken English at the same time. The words that are signed and the words that are spoken occur simultaneously. This method has been used to teach language to children who have Autism or Down's Syndrome as well as to facilitate the language development of normal hearing babies.
If this method is chosen, it is important to consistently sign when you speak to your child. Sign language courses are routinely offered through the community, local colleges, adult education, etc.
Total Communication includes the use of all modes of communication at the same time (i.e. speech, Signing Exact English, auditory training speech, speech reading, lip reading, and finger spelling). The child is provided information in both auditory and visual formats. This allows the child to use the information that best suits their needs.
The purpose of Total Communication was to provide a child with access to a visual language base and at the same time encourage development and use of spoken language. Some people were concerned that children were not able to develop a solid language base in either American Sign Language (ASL) or English (signed or spoken). Today, the term Total Communication is commonly confused with Simultaneous Communication (signing while talking).
There are over 117 different sign languages around the world. Within each country, there can be different dialects of a sign language just like there is with spoken English. Exploring sign language systems can be very confusing because of the number of different systems and because of the variety of terminology.
For instance, there are a number of other systems of sign language that have been developed for use with spoken English. Collectively, these systems may be referred to as Manually Coded English (MCE), Sign Supported Speech (SSS), Sign Supported Systems (SSS) or Sign Supported English (SSE). These terms are not languages or methods - they simply refer to systems that use both signs and speech for communication.
Many public school systems use Conceptually Accurate Signed English (CASE) for instruction. The important thing to remember about CASE is that the term refers to sign language systems that use ASL signs, chosen on the basis of the ASL meaning. Signs are not chosen on the basis of its sound or meaning in English.
| FREQUENTLY ASKED QUESTIONS |
Why is it important to start working with my baby now rather than waiting until he or she is older?
Language is an important part of the interaction between parent and child. Introduction to language starts at birth. A baby sees his or her mother smile just before he or she falls asleep and, by the age of 2 to 4 weeks, the baby is smiling back. A baby feels his or her father's soft touch during bath time and wiggles in delight. As the baby grows and develops, he or she becomes more and more skillful at communication and language. This early groundwork of language helps with the ability to read and write, social skills development, and later growth in school. The gift of language will open doors for you and your child and will help him or her build communication skills that will last a lifetime.
What are the differences between communication, language, speech, and signing?
- Communication is sharing ideas. These ideas can be shared using language. The language can be spoken language or sign language.
- Language uses symbols such as words and grammar rules. These symbols can be in sign language or in spoken language.
- Spoken language uses the voice and mouth to express language. There are many spoken languages. Some examples are English, French, and Spanish.
- Sign language uses the hands, face, and body to express language. There are many sign languages. Some examples are American Sign Language (ASL), Italian Sign Language, and French Sign Language.
How will my baby learn language?
Babies learn language early by experiencing the world around them with all their senses. Babies use both their eyes and ears to understand what someone is trying to communicate. Some babies will learn to rely more on one sense. Some babies will rely mostly on their hearing with hearing aids or a cochlear implant. Other babies will rely more on their eyes. The method that is used to teach your baby to communicate influences the way that your baby learns to use his or her senses.
What method should I use to teach my baby to communicate?
Babies have a ‘critical period’ for learning speech and language. They learn speech and language best in early childhood. It is more difficult to learn speech and language later in life. This is true for both signed languages like ASL, and spoken languages such as English. You and your child's early intervention team will decide if you want to teach your child to talk, sign, or both talk and sign. Your early intervention team can help guide decisions about your child's learning experiences. These methods are influenced by the culture of your community and by the service providers and resources in your community.
What kind of approaches are there to help my baby develop language?
There are many methods used to teach babies with hearing loss to communicate. These educational programs take a different approach to communication. Some of the most common methods include:
- American Sign Language (ASL)
- Auditory-Oral
- Auditory-Verbal
- Bilingual-Bicultural (BiBi)
- Cued Speech
- Simultaneous Communication
- Signing Exact English
- Total Communication
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Information on this web site was obtained from the Infant Hearing Guide developed in a cooperative project between the University of Arkansas for Medical Science, Arkansas Children's Hospital and the University of Arkansas RRTC and we would like to acknowledge their work. THIS INFORMATION DOES NOT PROVIDE MEDICAL ADVICE. All content, including text, graphics, images and information are for general informational purposes only. You are encouraged to talk with your doctor or other health care professional with regard to information contained on this web site. After reading this information, you are encouraged to review the information carefully with your doctor or other healthcare provider. The Content is not intended to be a substitute for professional medical advice, diagnosis or treatment. NEVER DISREGARD PROFESSIONAL MEDICAL ADVICE, OR DELAY IN SEEKING IT, BECAUSE OF SOMETHING YOU HAVE READ ON THIS web site. |
Quick Links
Minnesota Early Learning Services
2011 Early Hearing Detection and Intervention (EHDI) Summit: Building Connections!
If your child swallows a hearing aid battery call the Minnesota Poison Control System
If you have questions or comments about this page, please contact Children and Youth with Special Health Needs at health.cyshn@state.mn.us
