After diagnosis

Making choices about communication

Source: National Deaf Children's Society

Some parents have said that they felt under a lot of pressure to make choices about communication. It is important to remember that you do not have to make a choice for life. You may want to change your approach as you learn more about your child’s needs and preferences. The right choice is the one that works best for you and your child.

If your child has other disabilities or health problems, check that the communication approach you choose will be fully accessible to them.

The right approach to communication will be the one that works best for you, your family and your child. The three main options are:
  • auditory-oral approaches;
  • sign bilingualism; and
  • total communication.
These approaches are discussed in more detail below.

Some questions that may help you to think about communication choices are as follows.
  • Will the communication approach allow all of your family – including brothers, sisters and the wider family – to communicate with your child?
  • Will the communication approach you are considering be best for your child? Will it allow them to influence their environment, discuss their feelings and concerns, and share imaginative thoughts?
  • Have you been given good information about the full range of communication approaches that are available? Have you talked to a variety of people and heard a variety of views on each option?
  • Will the communication approach help develop your relationships with each other as a family? It should promote enjoyable, meaningful communication among all family members and make your child feel part of your family and know what is going on.
  • Has the information you have received about communication approaches been unbiased?
  • Are you looking at your choice of communication approach in terms of what will be best for your child and family or because someone has promised certain benefits of the approach?
  • Will the approach you use allow your child to communicate with the wider world?
Building blocks of communication
Communication is made up of different things, which we can describe as ‘building blocks’. Everyone uses a combination of different building blocks to make themselves understood. For instance, a conversation between two hearing people can involve speech, tone of voice, gestures and facial expressions. A conversation between two deaf people who use sign language can include sign language, gestures, facial expressions, finger-spelling and lip-reading. The different communication approaches on the following pages use these building blocks in different combinations.

This diagram, provided by the Colorado Home Intervention Programme (CHIP), USA shows the different building blocks of communication and the different ways they can be put together.
Different communication approaches
This section gives more detail about the most common types of communication approaches used with deaf children. All the approaches have advantages and disadvantages –these will vary depending on the needs of your child and your family.
The diagram below shows you some of the communication approaches available, and the building blocks of communication used with them.
Communication approaches
Before choosing an approach to try, it is important to get more information and discuss your thoughts with different professionals and other parents. Remember that some people hold strong views on the best way to communicate with deaf children, so don’t be afraid to ask questions.
Auditory-oral approaches
What are they?
Auditory-oral approaches aim to develop speaking and listening skills in deaf children. They emphasise the use of hearing aids, FM systems and cochlear implants to make the best use of any hearing a deaf child has (their ‘residual hearing’). Most auditory-oral approaches will also use lip-reading to help the child’s understanding.

Auditory-oral approaches do not use sign language or finger-spelling to support the understanding of spoken language.

What are the aims?
The main aim of these types of approach is to allow deaf children to develop speech and communication skills that will allow them to communicate and mix with hearing people.

What are the family’s responsibilities?
You will be expected to practise the approach as part of your everyday life. You will also need to make sure that your child is making best use of their hearing aids, cochlear implant or FM system.

You will normally learn how to use this approach with support from a speech pathologist or teacher of the deaf. This means that you will need to be highly involved with the professionals working with your child. This will allow you to learn the methods and use them at home.

The list below gives more detail about the approaches that are called auditory-oral.

  • The natural aural approach
    The natural aural approach is the most widely used auditory-oral approach. It emphasises the role of the family in helping deaf children to naturally develop spoken language.

    The approach aims to achieve this through the normal experiences of childhood and the child consistently using well-maintained hearing aids or cochlear implants. The results expected by people using this approach are that deaf children will achieve good effective speech.
  • The structured oral approach
    The structured oral approach is used to encourage deaf children to develop speech and language. This involves using their residual hearing and lip-reading with a particular structured teaching system. It often uses written language to help children learn.

  • The maternal reflective approach
    The maternal reflective approach is used with children in education rather than with very young babies.

    It is based on the way that mothers and other significant role models encourage the development of language in children. It is ‘reflective’ because children are encouraged to look back at what was said in a conversation they were involved in. This helps them to understand the structure and rules of the language they are learning. It uses three elements - reading, writing and spoken language.

  • Auditory verbal therapy
    Auditory verbal therapy teaches a child to develop listening skills. This happens through one-to-one therapy and uses the child’s residual hearing with hearing aids, cochlear implants or FM systems. No sign language is used and the child is discouraged from relying on visual cues, such as lip-reading.

  • Lip-reading
    Lip-reading is the ability to read words from the lip patterns of the person speaking. Deaf children will naturally try to lip-read when they are communicating. It is difficult to measure how much of a conversation a deaf person understands just by relying on lip-reading, as lip patterns vary from person to person. It is estimated that about 30% to 40% of speech sounds can be lip-read under the best conditions.

    There are many things that can make lip-reading difficult, for example:
    • beards and moustaches;
    • talking while eating;
    • covering your mouth while talking; and
    • poor lighting.
When children are still building up an understanding of the language they may find it difficult to lip-read words they are not familiar with. It also relies on a speaker having a clear lip pattern. An adult, who has a good understanding of the language being spoken, may understand more.

Your child will need a good understanding of the English language to get the most out of lip-reading. This means that they will need to know about grammar and how sentences are constructed. Your child will also need to know what the conversation is about.

For example, explaining a trip to the dentist will help your child to follow the lip patterns used there more accurately. So explain that the dentist will say ‘say ahh’…’open wide’… ‘does this hurt?’… ‘you will need some fillings’.

Lip-reading can be used with other communication approaches such as finger-spelling and gestures. Your child will also watch the facial expression and body language of the speaker to get more clues. The combination of these things makes it possible to understand most of the conversation.
Sign bilingualism
What is it?
Sign bilingualism uses sign language as the child’s first language. The spoken language of the family is learned as a second language. This can be taught through speech, writing or a sign-support system.

Baby signingIn Australia, the two languages used are usually Australian Sign Language (Auslan) and English. If the family uses another language, such as Arabic or Vietnamese, the child may learn that as the second language, with or without English.

Australian Sign Language (Auslan) is the natural language of Australiam deaf people. It is estimated that around 6,000 people use Auslan as their first or preferred language.

Auslan is a visual language that uses handshapes, facial expressions, gestures and body language to communicate. It has a structure and grammar different from that of written and spoken English. It is an independent and complete language with a unique vocabulary. Like other languages, it has developed over time and has also developed regional dialects.

Australian Sign Language (Auslan) is recognised in the Australian Government Language Policy as a community language.

What are the aims?
The aim of using sign bilingualism is to allow the child to communicate in a way that doesn’t depend on their hearing. Auslan is a totally visual language and so being deaf does not affect a child’s ability to learn the language. When a child has become confident in Auslan, they can use this as a way to learn English. Auslan will also give them access to other deaf people in the community.

What are the family’s responsibilities?
Your child must have access to adults (deaf or hearing) who are fluent in Auslan so they can develop this as their first language. If you use sign bilingualism, you will need to become fluent in Auslan to communicate fully with your child. It is also useful for your child to be around other deaf adults and children who use Auslan.

If most of your family members can hear, or are deaf but do not use Auslan, they will need Auslan training and education.
Total communication
What is it?
Total communication is based on using a combination of methods at the same time to communicate with a deaf child. The idea is to communicate and teach vocabulary and language in any way that works.

The child and their family are encouraged to use:
  • a sign language system based on the English language, such as Signed English;
  • finger-spelling;
  • natural gestures;
  • lip-reading;
  • body language;
  • speech; and
  • hearing aids, cochlear implants and FM systems.
They may also use other methods of communication within this approach. More details are given later in this section.

What are the aims?
The aim of total communication is to provide an easy method of communication between the deaf child and their family, friends and others that they are in contact with. The child is encouraged to use speech and sign language at the same time and use all other clues to help them communicate effectively.

What are the family responsibilities?
The sign system you choose should be learnt by at least one member of the family. It is better if all the family learn the system. This will allow your child to communicate fully with you and develop their language skills.

Learning the sign system and the vocabulary is a long-term, ongoing process. As your child’s sign language skills develop and become more complex, your family’s skills will need to keep pace to provide a stimulating language-learning environment for your child. You will also have to encourage your child to consistently use hearing aids, cochlear implants or FM system.

You must consistently sign while you speak to your child. Sign language courses are usually offered through the deaf societies or TAFE system. Many books and videos are also widely available. Auslan Signbank is an interactive dictionary of Auslan and available on the Internet. To become fluent, signing must be used consistently and become a routine part of communication with your child.

Finger-spelling
Finger-spelling supports sign language. It uses the hands to spell out English words. Each letter of the alphabet is indicated by using the fingers and palm of the hand. It is used for spelling names, places and for words that don’t have an established Auslan sign.
Other common communication methods and sign systems used
Sign Supported English
Sign Supported English (SSE) uses signs taken from Auslan. Signs are used in the same order as English words, but not every word that is spoken would be signed. Many hearing parents find this an easier way to become familiar with sign language as it means that you can use signs with your own language. As it uses the same signs as Auslan, it can be helpful to both you and your child if you want to develop Auslan skills at a later stage. SSE is not a language in its own right.

Signed English
Signed English (SE) uses signs to represent English exactly by using a sign for every spoken word. It uses Auslan signs, finger-spelling, and specifically developed signs to represent important grammatical information.
Signed English is not a language like Auslan, but it has been designed as a teaching tool to be used at the same time as spoken English. Its aim is to develop reading and writing skills.

Cued Speech
Cued Speech is a simple sound-based system that uses eight hand shapes in four different positions (cues), together with natural mouth movement of speech. Some words which sound different to hearing people can look very similar when they are lip-read by deaf people (for example, ‘pat’ and ‘bat’). Cued Speech is visual and the cues are placed near the mouth. This helps to make every sound and word clear to a deaf child. It can be used together with sign language or to complement speech. Cued speech is rarely used in Australia.
Information supplied by The National Deaf Children's Society
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Reproduced with permission.
Date reviewed: 22.11.2008

Disclaimer: This website is for general information only and is not intended as a substitute for independent professional advice.

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