Carol Flexer

CHOICES: How would you characterize the effect has hearing technology (digital hearing aids, cochlear implants, personal FM systems and so forth) had on language options for families of children with hearing loss during the past 15 years?

CF: We hear with the brain; the ears are just a way in. A primary problem is that hearing loss keeps sound from reaching the brain. If amplification technologies can be used during early childhood to access, stimulate and grow auditory centers, then the secondary negative effects of hearing loss such as language, reading, and academic difficulties can be ameliorated (Joint Committee on Infant Hearing, 2007).

Hearing is powerful! There is substantial evidence that “hearing” (auditory brain development) is the most effective modality for the teaching of spoken language (speech), literacy and other cognitive skills. Child development is positively influenced if “hearing” is emphasized and negatively affected if hearing is minimized.

Therefore, advances in hearing technology and early identification through universal newborn hearing screening have greatly improved the opportunity for children who are deaf or hard of hearing to listen and talk — if that is the desired outcome of the family. Because over 95% of children with hearing loss are born to hearing and speaking families, most of our families will be very interested in a spoken language outcome.

To summarize, current research confirms several facts for families who desire a spoken language outcome for today’s infant or toddler who experiences profound deafness. Families need to know that very early use of hearing aids or insertion of a cochlear implant for severe to profound degrees of hearing loss to access, stimulate, and grow auditory centers of the brain during times of critical neuroplasticity, followed by thoughtful, intense and ongoing auditory skill development activities to take advantage of developmental synchrony and cumulative practice, offer a high probability of reaching their desired outcome of age-appropriate spoken language and literacy skills.

CHOICES: What states or other jurisdictions do an exemplary job of making various language and communication options known to parents of deaf and hard-of-hearing children in an unbiased way? What’s different about those places?

CF: The Alexander Graham Bell Association for the Deaf and Hard of Hearing is a valuable resource for this information.

There are two states that I know of that have made legislative, educational and policy decisions that provide appropriate, unbiased services for infants and young children with hearing loss and their families: North Carolina and Colorado.

  1. North Carolina has a program that receives state and private funding. For more information please see: BEGINNINGS for parents of children who are deaf or hard of hearing. They provide parent support and information from trained professionals through the child's 21st year. The state also has a history of having strong connections to the cadre of professionals who support listening and spoken language. Like all states, they face the challenges of providing services for families who live in rural areas. But, overall, North Carolina does a good job of providing long-term, unbiased family support.
  2. Colorado has a long reputation for being a leader in legislation and practice when it comes to delivering unbiased information and appropriate intervention/educational services. Specifics can be obtained from the Marion Downs Center, or through this link to the Colorado Department of Education.

CHOICES: Which of the following scenarios is more likely to result in a successful outcome for the child within the family? Within the world? Why?

  Primary Language
Four Language Scenarios in the Home
Parent ASL ASL Spoken Spoken
Child ASL Spoken ASL Spoken

CF: Success may be defined as reaching the outcome desired by the family. Typically, the family and child can access each other most companionably if they use the same communication system/language. So, for example, it follows that the family who communicates within the family and community using ASL would have the most access to their child if the child also uses ASL. If, on the other hand, the family uses spoken language to communicate, they will have the most access to their child if the child also communicates using spoken language.

The child will develop best linguistically and social-emotionally if the child uses the same communication system as other members of the family and community.

CHOICES: In your experience, how often do hearing family members (mainly parents and siblings) of fluent signing deaf children become fluent signers themselves? What effect does signing fluency of hearing parents have on the language development of their signing children?

CF: Studies have shown that about 96% of hearing parents rarely learn to sign beyond a baby sign or preschool level. Becoming proficient in ASL requires a great deal of instruction and practice — much more practice than many hearing parents are able to offer.

Unfortunately, many hearing parents reduce their spoken language complexity (both quantity and quality) to accommodate their limited sign language proficiency. So instead of signs adding to the child's language development, limited use and proficiency of signs can reduce the child's access to both spoken language and the complexity of a sign language system.

Moreover, typically, only one person in a hearing household takes on the task of learning ASL — the mother. So, the child can communicate with only one person and has no access to "over-seeing" conversations of others in the environment — if others are speaking and not using ASL.