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Communication is the foundation for language development, and it starts with everyday interactions. Responding to your child and encouraging them to respond to you builds strong connections and supports their growing language skills. For children who are deaf or hard of hearing (DHH), there are many ways to communicate, and each family’s journey may look different. The most important thing is that your child has full access to communication.
Communication can be approached as a single language with or without cues or as a combination of multiple languages. Considering the communication approach(es) that work best for your child requires time and many thoughtful decisions. Keep in mind that no one approach is best for all children and no one language is better than another. All languages (American Sign Language, English, other spoken or signed languages) and communication approaches require a lot of family involvement and a language-rich environment.
Communication is made up of many parts, like building blocks, that work together to help us use and understand language. Everyone uses a mix of these building blocks or modalities in communicating. The different communication approaches you’ll learn about in the next section combine these building blocks in various ways to support each child and family’s unique needs.
The listening and spoken language (LSL) approach uses listening to understand spoken language and uses spoken language to interact and communicate with others.
The cued speech (or cued language) approach uses a system of 8 hand shapes placed in one of four positions near the face to visually present the phonemes of syllables used in spoken English. It makes visual the phonemes or speech sounds that are spoken which cannot be visually distinguished through lipreading.
The bilingual-bimodal approach incorporates the separate use of two languages—one visual and one spoken. Spoken English and English for example, are used in the same environment, with intentional times and roles. The two languages are given equal value and equal representation.
The sign-supported speech approach uses signs to clarify and support the use of spoken language. Signs are used as a visual support for understanding spoken language in loud settings or for understanding new information while primarily relying on listening and spoken language in all other contexts.
The manually coded English or simultaneous communication (sim com) approach uses spoken language and signs at the same time. The system of signs borrows from ASL but are put in English order and therefore not the true language of ASL.
The sign language or visual language approach uses a full sign language to interact and communicate with others.
The following videos put out by the Maine Educational Center for the Deaf can be helpful in exploring communication opportunities.
Communication and Language Opportunities: ELCO Introduction
Listening & Spoken Language - Auditory Verbal: ELCO Overview
Listening & Spoken Language - Auditory Oral: ELCO Overview
Bilingual/Bimodal: ELCO Overview
Manually Coded English: ELCO Overview
American Sign Language: ELCO Overview
The Decision Guide to Communication Choices: For Parents of Children Who are Deaf or Hard of Hearing [PDF] can help guide you through making decisions about communication.
Check out Michigan Hands & Voices Language and Communication [PDF] and Indiana Supports for Language Acquisition [PDF] for even more information on language and communication considerations for your child.
