Raising a Deaf Child: Communication and Language Choices

The issue


If parents are told that their child is deaf, most of them find themselves on a rollercoaster of experiences, emotions and decisions. Ninety-five percent of these parents are hearing, without any knowledge of deafness, but they need information quickly because important decisions about communication and language input have to be made right away. Fluent, rich communication in an accessible language within the first two years of life is crucial for an optimal course of language development.

Choices to be made include whether parent-child (and later teacher-student) communication will be in speech only, speech supported by signs, or in sign language. Part of this choice also relates to language. Should their child be raised with one language, a spoken language? Does access to speech need to be increased through digital hearing aids or early cochlear implantation? Or should their child be educated in both spoken and sign language, bilingually, recognizing that parents will be raising their child partly in a language they still have to learn themselves?

The core issue is access to versus availability of language: Is spoken language accessible to the deaf child and/or is sign language available from very early on?

What we know

If fluent communication in an accessible language, regardless of the modality, is not established within the first two years of life, children will have problems processing, comprehending, and producing complex grammar throughout life. The language proficiency of deaf children varies considerably more than that of hearing peers.

Even relatively mild hearing losses endanger spoken language acquisition. Approximately one third of children with mild to moderate hearing losses will develop serious language problems due to inconsistent access because of improper fitting of hearing aids, inconsistent use, or noisy listening environments. Spoken language development in profoundly deaf children is very much enhanced by universal newborn hearing screening and subsequent early cochlear implantation, but not all children profit equally.

Raising and educating a hearing child bilingually has distinct cognitive advantages, provided there is qualitatively good input of both languages. Signing does not hamper the development of spoken language and may even enhance it, provided there is early and qualitatively good input of spoken language. Deaf children similarly may acquire a sign language and reach milestones just as in spoken language acquisition as long as there is early and rich input.

Finally, the information many parents of young deaf children receive from professionals often is unbalanced and not evidence based. A medical viewpoint tends to prevail. In real life, however, sooner or later most deaf children will use both spoken and sign language to some extent, regardless of how they were brought up.

What we don’t know

Children with mild to moderate hearing losses are sometimes called “forgotten children,” because research into their (language) development is largely lacking. Furthermore, spoken language development after cochlear implantation varies widely, for reasons still unclear. The conditions under which sign support of spoken language will enhance or inhibit processing, comprehension, and production of speech also remain unclear.

With respect to bilingual deaf education, although the theoretical foundations are rather strong, empirical evidence concerning efficacy and effectiveness is rather weak. In addition, it is not certain that bimodal (signed in spoken) bilingualism will lead to the same cognitive advantages as unimodal (spoken only) bilingualism. Lastly, we do not know the success rate of hearing parents and teachers being able to create rich bilingual sign and spoken language environments for deaf children; but it is not easy.


Educational policy should be flexible, leaving room for the use of spoken, sign-supported and sign language at whatever point(s) in the development of a deaf child this is thought necessary. Counselling of parents should take place within the context of the families’ wishes, possibilities, and limitations. It needs to be balanced and evidence-based, explaining risks and chances. Contacts with deaf people, the Deaf community, their Deaf culture, and their sign language should be encouraged. Most importantly, careful monitoring of the development of a deaf child should be an integral part of provision. If there is the wish or need to use sign language or sign support, parents need to be instructed thoroughly and deaf sign language users should support the whole family.

Posted on December 11, 2013 by
Harry Knoors, Royal Dutch Kentalis and Radboud University Nijmegen, The Netherlands

Further reading