Introduction: Course objectives

Audiology Practice

How the Ear Works

Hearing Loss

Detecting and Diagnosing Hearing Loss in Children

Intervention for Children with Permanent HL


Early Intervention

Communication Choices

Case studies


Credits and Acknowledgements


Last updated: 10-sep-10

Communication Choices

When families enroll in intervention programs and educational programs for children with hearing loss, they will make decisions about the type of communication mode they will use with their child. Below is a full list of communication choices used in the United States, though not all methods are represented in all communities.

American Sign Language (ASL)

American Sign Language (ASL) is a fully developed, autonomous, natural language with distinct grammar, syntax, and art forms. Sign language can perform the same range of functions as a spoken language. "Listeners" use their eyes instead of their ears to process linguistic information. "Speakers" use their hands, arms, eyes, face, head, and body. These movements and shapes function as the "word" and "intonation" of the language. If parents are not deaf, intensive ASL training is necessary in order for the family to become proficient in the language.

Auditory/Oral and Auditory/Verbal

These methods of teaching spoken language stresses the use of amplified residual hearing, speech and oral language development. These methods emphasize teaching the child to use his or her amplified residual hearing and audition from listening devices (like hearing aids or cochlear implants) to the fullest extent possible. A high degree of parent involvement is necessary as parents learn methods to integrate listening and language throughout daily routines.

Total communication

The term Total Communication was first defined as a philosophy which included use of all modes of communica¬tion (i.e. Speech, sign language, auditory training speech, speech reading and finger spelling). Today the term Total Communication is commonly interpreted as Simultaneous Communication (signing while talking). This philosophy led to the formation of manual systems (e.g. Signing Exact English Signed English) that attempt to represent spoken English.

Cued Speech

This system is designed to clarify lip reading by using simple hand movements (cues) around the face to indicate the exact pronunciation of any spoken word. Since many spoken words look exactly alike on the mouth (e.g. pan, man), cues allow the child to see the difference between them. Cued speech can be learned through classes taught by trained teachers or therapists. A significant amount of time must be spent using and practicing cues to become proficient.

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Center on Human Development and Disability, UW LEND, University of Washington,
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