My child is deaf or hard-of-hearing. Now what?

Finding the Best Communication Method for Your Child and Family

Families have multiple communication opportunities to consider when their child is diagnosed as deaf, hard-of-hearing, or has a hearing difference.

At Spokane HOPE, we respect each family’s right to choose the communication method (or methods) that best fits their child and family.

Common communication methods for children who are deaf or hard-of-hearing:

American Sign Language (ASL) uses visual cues, like hand movements and facial expressions, to communicate.
Listening and Spoken Language (LSL) relies on hearing sounds, often with the help of technology, to understand language. Auditory Verbal Therapy (AVT) is another term for the same method.
Cued Speech: A system that combines hand shapes with lip reading to help with understanding speech.
Lip Reading: Understanding speech by watching a speaker’s lip and mouth movements.
Augmentative and Alternative Communication (AAC): Includes tools like picture boards, communication books, and speech-generating devices to assist individuals with their language development.
Total Communication: A blended approach incorporating multiple methods to support language development.

What Communication Methods Does Spokane HOPE Specialize In?

Spokane HOPE’s preschool program helps deaf children learn to listen and speak using technology through Listening and Spoken Language and Auditory Verbal Therapy. Our Birth-to-3 program supports early language development with both American Sign Language and Listening and Spoken Language.

For families and caregivers who choose to focus on teaching their child to listen and speak, Spokane HOPE is the only center in Eastern Washington dedicated to providing specialized LSL education and support for children who can benefit from these services.

Our expert team includes certified Teachers of the Deaf, Speech-Language Pathologists, and LSL Specialists, all holding master’s degrees in deaf education and/or Speech and Hearing Sciences. These specialists help deaf children become confident communicators, empowering them to thrive in the hearing world.

How is LSL different from ASL?

Listening and Spoken Language relies on hearing sounds to understand language, while American Sign Language uses visual cues, like hand movements and facial expressions, to communicate.

What is American Sign Language (ASL)?

American Sign Language is a complete, natural language that has the same linguistic properties as spoken languages, with grammar that differs from English. ASL is expressed by movements of the hands and face. It is the primary language of many North Americans who are deaf and hard of hearing and is used by some hearing people as well (National Institute of Health).

What is Listening and Spoken Language (LSL)?

Listening and Spoken Language (LSL) is a research-based approach that helps individuals who are deaf or hard of hearing develop speech and listening skills using hearing technology like hearing aids, cochlear implants, and bone-anchored hearing aids (BAHAs). By maximizing auditory input, LSL strengthens the brain’s ability to process sound and build language.

Some individuals may use both LSL and ASL depending on their communication needs and preferred mode of expression. It’s entirely each individual’s right to choose what’s right for them.

Why is a specialized school for the deaf, like Spokane HOPE, the best choice for my child?

When children receive hearing technology, such as a cochlear implant, they must learn how to interpret and process the sounds they hear to develop effective listening and verbal skills.

This is where our specialized team of professionals comes in.

Early identification of hearing loss, combined with timely access to hearing technology and dedicated LSL support, is crucial for a child’s long-term language development.

Research shows that the brain’s most crucial period for auditory and language development is from birth to age five, making early intervention essential for building strong communication skills and ensuring academic success (National Institute of Health).

At Spokane HOPE, we are committed to helping children reach their full potential through expert guidance, innovative technology, and a nurturing learning environment.

Additional Resources & Research on the LSL Approach

Since Spokane HOPE specializes in the LSL approach, we have collected additional resources and research to help inform you about this specialized communication modality.

Please note: This is not a comprehensive list of resources covering all communication modality options, so we encourage you to do your own research.

Research Studies on LSL Outcomes

A study by Chu et al. (2016) found that children with hearing loss who exclusively used Listening and Spoken Language (LSL) developed language abilities comparable to their peers with typical hearing. This applied to both their receptive language and overall language skills.

A study by Dettman et al. (2013) found that children in auditory-verbal programs achieved the best language outcomes compared to those in other programs. They demonstrated significantly stronger language skills and word recognition than children in Total Communication programs. These findings support the idea that prioritizing auditory access to language is the most effective approach for developing listening and spoken language skills in children with hearing loss.

Geers (2017) and others have demonstrated that children who use spoken language have better language and literacy skills than children who use ASL.

Once a child develops a strong foundation in one spoken language, they can more easily learn additional languages, including ASL. With a solid spoken language base, they have the flexibility to navigate both the deaf and hearing worlds if they choose. However, the ability to speak is only possible if auditory brain pathways are developed within the critical early years. While signing can be learned at any age, spoken language must be established early to remain an option later in life (Madell, 2016).

Early Intervention Studies

Auditory Verbal Therapy (AVT) can lead to significant positive outcomes, with studies showing that around 80% of children who undergo AVT for at least two years achieve age-appropriate language skills, with some reports indicating even higher success rates for children without additional needs reaching near 97% competency in spoken language development; this includes the ability to attend mainstream schools and perform at similar levels to hearing peers in academics like reading and math (Noel et al., 2023).

The LOCHI study found that early fitting of hearing aids or cochlear implants, and focusing on LSL, resulted in better speech, language, and functional outcomes. Improved speech perception was associated with stronger language skills and higher cognitive abilities, while better psychosocial development was linked to enhanced language and functional performance. (Ching, et al., 2013).

Research by Sharma and others has shown that there is a critical window for developing auditory neural pathways and preventing auditory deprivation. If children do not develop these pathways and learn to listen within the first few years of life, reduced neural plasticity limits their ability to do so later. This underscores the importance of early auditory access for optimal brain development (2011).

More than 80% of children that are hard of hearing successfully integrate into mainstream public schools using spoken language. While children who use ASL can also attend mainstream schools with an interpreter, relying on interpretation for social interactions may create challenges in building peer relationships (Madell, 2016).

Relevant LSL Statistics

Of the 48 million people in the United States who are deaf and hard of hearing less than 500,000 — or about 1% — use sign language. Of those people who are deaf/Deaf or are hard of hearing, approximately 97.2% to 99% use oral communication (Lacke, 2020).That means that less than 1% of the population understands ASL. Listening and spoken language offers the opportunity to live life without limits and participate in a “hearing world.”

95% of children diagnosed with hearing loss are born to hearing parents who do not know sign language (NIH).

More than 80% of children that are hard of hearing successfully integrate into mainstream public schools using spoken language. While children who use ASL can also attend mainstream schools with an interpreter, relying on interpretation for social interactions may create challenges in building peer relationships (Madell, 2016).

Need Help Deciding if LSL is the Right Communication Modality for Your Child?

If you are researching which communication method works best for your child and family, we’re here to help in any way we can.

Our program focuses on teaching deaf or hard-of-hearing children to listen and speak using hearing technology. Many families, both in the program and those who have graduated, would be happy to share their personal experiences with you.

To talk to one of our educators or families, please fill out the contact form below.