Modalities, Research and Personalized Programming

Which Approach Should I Use With My Child Who is Deaf or Hard-of-Hearing?

For hundreds of years, parents of children who are deaf or hard-of-hearing have been faced with two exclusive choices for the education of their children: learning with sign language or learning through the use of spoken language and any residual hearing their child may have (historically called the “oral” approach). Many families have felt torn about which language modality to provide for their child, and some have faced intense pressure to make permanent decisions prematurely.

At the Utah School for the Deaf, things are different.

Here at USD, parents can choose a personalized program using both American Sign Language (ASL) and English, an English-only program using listening and spoken language skills, or they can customize the educational experience for their child with all of the advantages of both programs. Our highly specialized professionals are sensitive to the difficult decisions faced by parents, and in our schools the needs of the child always come first. As the primary stakeholders in their children’s education, parents are encouraged to follow the lead of their children and to be flexible if their needs change over time.

How do we do this? During the regular Individualized Education Plan (IEP) team meetings, our educators evaluate the progress, strengths, and weaknesses of each child with their parents. Using this knowledge the IEP team determines appropriate goals, services, and placement for the child. Parents can send their child to a USDB school (Ogden, Salt Lake, Springville, or St. George) or they can choose to place them within their local school district – with or without the support of USD specialists.

USD then implements the IEP team recommendations for each student. We recognize that each child’s path is individualized and can change over time. If at any time a current placement no longer meets the needs of the child, the parent can request a meeting to discuss other options.

This web page is intended to offer access to facts, research-driven data, and expertise from a variety of professionals in the field of deaf education to assist parents along this journey.

Pictured: Mom Kimberly and infant Pearl share their personal success story.

Please review the following links for more information:

USDB Programs

USDB Statewide Listening and Spoken Language (LSL) Programs
Kenneth Burdett School in Ogden (ASL/English)
Jean Massieu School in Salt Lake City (ASL/English)
Elizabeth Delong School in Springville
Southern Utah School of the Deaf (ASL/English and LSL)

Outside Links

Relevant Research

Recommended First Reads for Parents

Humphries, T., Kushalnagar, P., Mathur, G., Napoli, D. J., Rathmann, C., & Smith, S. (2019). Support for parents of deaf children: Common questions and informed, evidence-based answers. International Journal of Pediatric Otorhinolaryngology, 118, 134–142.
Joint Committee on Infant Hearing. (2013). Supplement to the JCIH 2007 position statement: Principles and guidelines for early intervention after confirmation that a child is deaf or hard of hearing. Pediatrics, 131, e1324–e1349.
NASDSE Guidelines: Optimizing Outcomes for Students Who Are Deaf or Hard of Hearing: Third Edition. (2018).
Suskind, D. (2015) Thirty million words.

Recommendations for Language Planning for Young Children Who are Deaf or Hard of Hearing

Meinzen-Derr, J., Division of Biostatistics and Epidemiology, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center and College of Medicine, University of Cincinnati, 3333 Burnet Ave, MLC 5041, Cincinnati, OH 45229. Kindergarten Readiness in Children who are Deaf and Hard of Hearing Who Received Early Intervention. Pediatrics (2020) 146 (4): e20200557. https://doi.org/10.1542/peds.2020-0557 E-mail: jareen.meinzen-derr@cchmc.org
Hoffmeister, R., Henner, J., Caldwell-Harris, C., & Novogrodsky, R. (January 2022). Deaf Children’s ASL Vocabulary and ASL Syntax Knowledge Supports English Knowledge. The Journal of Deaf Studies and Deaf Education, 27(1), 37–47. https://doi.org/10.1093/deafed/enab032
Moeller, M. P., Carr, G., Seaver, S., Stredler-Brown, A., & Holzinger, D. (2013). Best practices in family-centered early intervention for children who are deaf or hard of hearing: An international consensus statement. Journal of Deaf Studies and Deaf Education, 18(4), 429-445. Retrieved May 17, 2016, from http://jdsde.oxfordjournals.org/content/18/4/429.full
Pontecorvo, E.; Higgins, M.; Mora, J.; Lieberman, A.; Pyers, J.; & Caselli, N. at Boston University and Wellesley College (December 2022). Learning a sign language does not hinder the acquisition of a spoken language https://doi.org/10.1044/2022_JSLHR-22-00505
Secora, K. & Smith, D. (2021). The Benefit of the “And” for Considerations of Language Modality for Deaf and Hard-of-Hearing Children. Perspectives of the ASHA Special Interest Groups, 6(2), p. 397-401. https://doi.org/10.1044/2021_PERSP-20-00267
Stredler-Brown, A. (2010). Communication choices and outcomes during the early years: An assessment and evidence-based approach. In M. Marschark & P. E. Spencer (Eds.), Oxford handbook of deaf studies, language, and education (pp. 292-315). New York: Oxford University Press.
Veyvoda, M., Howerton-Fox, A., Ofori-Sanzo, K., & Embry, K. (2023). Determining the Need for a Signed Language for Deaf or Hard of Hearing Children with Listening Devices. https://language1st.org/cisign

The Brain and Importance of Language Acquisition

Bavelier, D., Newport, E., & Supalla, T. (2003). Children need natural languages, signed or spoken. The Dana Foundation. Retrieved May 5, 2016, from http://www.dana.org/Cerebrum/Default.aspx?id=39306
Emmorey, K. (2002). Language, cognition, and the brain: Insights from sign language research. Mahweh, NJ: Lawrence Erlbaum Associates.
Hall, M. L., Eigsti, I.-M., Bortfeld, H., & Lillo-Martin, D. (2018). Executive function in deaf children: auditory access and language access. Journal of Speech, Language & Hearing Research, 61(8), 1970–1988.
Harris, M. (2010). Early communication in sign and speech. In M. Marschark & P. E. Spencer (Eds.), Oxford handbook of deaf studies, language, and education (pp. 316-330). New York: Oxford University Press.
Humphries, T., Kushalnagar, P., Mathur, G., & Smith, S. R. (2016). Avoiding linguistic neglect of deaf children. Social Service Review, (4), 589.
Humphries, T., Kushalnagar, P., Mathur, G., Napoli, D. J., Padden, C., Rathmann, C., & Smith, S. R. (n.d.). Language acquisition for deaf children: Reducing the harms of zero tolerance to the use of alternative approaches. Harm Reduction Journal, 9.
Humphries, T., Kushalnagar, P., Mathur, G., Napoli, D. J., Padden, C., Pollard, R., et al. (2014). Medical Science Educator, 24(4), 409-419. Retrieved May 4, 2016, from http://www.swarthmore.edu/SocSci/dnapoli1/lingarticles/What%20Medical%20Education%20Can%20Do.pdf
Kovelman, I., Shalinsky, M. H., White, K. S., Schmitt, S. N., Berens, M.S., Paymer, N., et al. (2009). Dual language use in sign-speech bimodal bilinguals: fNIRS brain-imaging evidence. Brain & Language, 109, 112-123.
Kushalnagar P., Mathur G., Moreland C. J., Napoli D. J., Osterling, W., Padden C., et al. (2010). Infants and children with hearing loss need early language access. Journal of Clinical Ethics, 21, 143–154.
Mayberry, R. I., Lock, E., & Kazmi, H. (2002). Linguistic ability and early language exposure. Nature, 417(6884), 38.
Mellon, N., Niparko, J. K., Rathmann, C., Mathur, G., Humphries, T., Napoli, D. J., et al. (2015). Should all deaf children learn sign language? Pediatrics, 136(1), 170-176. Retrieved May 4, 2016, from http://deafchildren.org/wp-content/uploads/2015/06/ASDC-Pediatrics-2015-Mellon-peds-2014-1632-Should-All-Deaf-Children-Learn-Sign-Language.pdf
Petitto, L. A., Katerelos, M., Levy, B. G., Gauna, K., Tetreault, K., & Ferraro, V. (2001). Bilingual signed and spoken language acquisition from birth: Implications for the mechanisms underlying early bilingual language acquisition. Journal of Child Language, 28, 453-496.
Petitto, L. A. (2009). New discoveries from the bilingual brain and mind across the lifespan: Implications for education. International Journal of Mind, Brain, and Education, 3(4), 185-197.
Swanwick, R. (2016). Deaf children’s bimodal bilingualism and education. Language Teaching, 49, 1-34.
Van Staden, A., Badenhorst, G., & Ridge, E. (2009). The benefits of sign language for deaf learners with language challenges. Per Linguam : A Journal of Language Learning, 25, (1), p. 44-60.

The Brain is Not Biased to Language Modality

Bavelier, D., Newport, E., & Supalla, T. (2003). Children need natural languages, signed or spoken. The Dana Foundation. Retrieved May 17, 2016, from http://www.dana.org/Cerebrum/Default.aspx?id=39306
Kovelman, I., Shalinsky, M. H., White, K. S., Schmitt, S. N., Berens, M. S., Paymer, N., et al. (2009). Dual language use in sign-speech bimodal bilinguals: fNIRS brain-imaging evidence. Brain & Language, 109, 112-123.
Krentz, U., & Corina, D. (2008). Preference for language in early infancy: The human language bias is not speech specific. Developmental Science, 11(1), 1-9. doi: 10.1111/j.1467-7687.2007.00652.x
Petitto, L. A., & Kovelman, I. (2003). The bilingual paradox: How signing-speaking bilingual children help us resolve bilingual issues and teach us about the brain’s mechanisms underlying all language acquisition. Learning Languages, 8, 5-18.
Walker, E. A., & Tomblin, J. B. (2014). The influence of communication mode on language development in children with cochlear implants. In M. M. Marschark, G. Tang, & H. Knoors, Bilingualism and bilingual deaf education (pp.134-149). New York: Oxford University Press.

Natural, Interactive Language is Important for Shaping Brain Architecture and Pragmatic Language

Baker, S. (2011). Advantages of early visual language (Research Brief No. 2). Washington, DC: Visual Language and Visual Learning Science of Learning Center. Retrieved on May 17, 2016, from http://vl2.gallaudet.edu/research/research-briefs/english/advantages-early-visual-language/
Center on the Developing Child. (2016). Serve and return interaction shapes brain circuitry [Video]. Cambridge, MA: Harvard University. Retrieved on May 17, 2016, from http://developingchild.harvard.edu/resources/serve-return-interaction-shapes-brain-circuitry/
Hall, M.L., Hall, W.C., & Caselli N.K. (2019). Deaf children need language, not (just) speech. First Language, Sage Publications, 39(4), 367–395. doi: 10.1177/0142723719834102
Thagard, E. K., Hilsmier, A. S., & Easterbrooks, S. R. (2011). Pragmatic language in deaf and hard of hearing students: correlation with success in general education. American Annals Of The Deaf, 155(5), 526–534.
Yoshinaga-Itano, C. (2015). The missing link in language learning of children who are deaf or hard of hearing: pragmatics. Cochlear Implants International, 16 Suppl 1, S53–S54.

Cochlear Implants and Signed and Spoken Language Development

Davidson, K., Lillo-Martin, D., and Chen Pichler, D. (2013). Spoken English language development among native signing children with cochlear implants. Journal of Deaf Studies and Deaf Education,19(2), 238-250.
Giezen, M., Baker, A., & Escudero, P. (2014). Relationships between spoken word and sign processing in children with cochlear implants. Journal of Deaf Studies and Deaf Education,19(1), 107-125.
Mitchiner, J., Nussbaum, B. D., & Scott, S. (2012). The implications of bimodal bilingual approaches for children with cochlear implants (Research Brief No. 6). Washington, DC: Visual Language and Visual Learning Science of Learning Center. Retrieved May 4, 2016, from http://vl2.gallaudet.edu/research/research-briefs/english/children-cochlear-implants/
Yoshinaga-Itano, C. (2006). Early identification, communication modality, and the development of speech and spoken language skills: Patterns and considerations. In P. Spencer & M. Marschark (Eds.), Advances in the spoken language development of deaf and hard-of-hearing children (pp. 298-327). New York: Oxford University Press.

Make the Best Use of Hearing Technology and Spoken Language

Blamey, P. J. (2003). Development of spoken language by deaf children. In M. Marschark & P.E. Spencer (Eds.), Oxford handbook of deaf studies, language, and education (pp. 232-246). New York: Oxford University Press
Dettman, S. J., et al. (2016). Long-term Communication Outcomes for Children Receiving Cochlear Implants Younger Than 12 Months: A Multicenter Study. Otology & Neurotology, 82-95.
Geers, A. E. (2006). Spoken language in children with cochlear implants. In P. E. Spencer & M. Marschark (Eds.), Advances in the spoken language of deaf and hard-of-hearing children (pp. 244-270). New York: Oxford University Press.
Hearing First: Mission Probable. (2019). Age-Appropriate Listening and Spoken Language Abilities for Children with Hearing Loss.
Hearing First. (2019). Start with the Brain and Connect the Dots.
Kral, A., & Sharma, A. (2012). Developmental neuroplasticity after cochlear implantation. Trends in Neuroscience, 35(2), 111–122.
Kristina Tachtsis & Shani Dettman (2018) Relationships between caregiver decisions about communication approach and language outcomes for children using cochlear implants, Deafness & Education International, 20:3-4, 182-204.
Pisoni, D. B., Conway, C. M., Kronenberger, D. L., Horn, J. K., & Hennings, S. C. (2008). Efficacy and effectiveness of cochlear implants in deaf children. In M. Marschark & P. C. Hauser (Eds.), Deaf cognition: Foundations and outcomes(pp. 52-101). New York: Oxford University Press.
Sharma, A., Nash, A. A., & Dorman, M. (2009). Cortical development, plasticity and re-organization in children with cochlear implants. Journal of Communication Disorders, 42(4), 272–279.
Smith, J., and Wolfe J. (2017). Lessons from OCHL. The Hearing Journal, December, 12-16.
Spencer, L. J., & Tomblin, B. (2006). In P. E. Spencer & M. Marschark (Eds.), Advances in the spoken language of deaf and hard-of-hearing children (pp. 166-192). New York: Oxford University Press.