It’s Time to Rethink “Communication Mode”

The issue

When it comes to raising and educating DHH children, few topics create as much controversy and confusion as “communication mode”. However, surprisingly little research has scrutinized the concept itself.  We examined the ways that communication mode is defined and used in research literature, and discovered several significant problems.

What we know

Our research found no agreement on what “communication mode” means. To some, it refers to how the child communicates; to others, it means how the people around the child communicate. Some view communication modes as unordered categories; others organize them along a scale. (Even researchers who use scales disagree on what the endpoints are, how many in-between points there are, and whether the points represent different systems or different amounts of experience with different languages/systems.) No current approaches can easily represent children whose experience includes more than two languages/systems.

Type: Studies that use communication mode commonly combine languages/systems that are very different, such as putting sign-supported speech (where some important words spoken in phases are signed) with manually-coded English (where signs contain grammatical information). Even worse, ASL is typically included in this same category, despite the fact that it is a different language! This is like treating English and Mandarin as the same because they are both spoken.

Timing: Infancy and toddlerhood are crucial years for language learning, but less than 30% of the studies reported considering this time period when determining a child’s communication mode. In fact, studies frequently don’t mention what time period was used to determine a child’s communication mode, and don’t consider the ways that a child’s previous experience might have been different from their current experience.

Quantity: Communication mode does not capture how much experience a child has had with a given language/system. Suppose Child A’s  experience has consisted of 100% English without signs. Child B’s experience has been 99% English without signs, 1% sign-supported speech. Child C’s has been 100% sign-supported speech. Currently, most studies of communication mode would group Child B and Child C together, even though Child A and Child B have clearly had more similar experiences. 

Language “Exposure” vs. Language “Access”: A child’s ability to learn from the language going on around them depends on their ability to hear or see it, but communication mode typically doesn’t consider how well a DHH child hears or sees. This creates the false impression that children in similar environments can expect similar outcomes. Rather than using communication mode to describe the language that children are *exposed* to, it would be more useful to describe the language input that children are able to *access*.

What we don’t know

To make informed decisions, families of recently-identified DHH children need to know what kind(s) of communication opportunities during infancy and toddlerhood are most likely to help the child master at least one full language by school age. Unfortunately, the problems with communication mode make it impossible for researchers to answer this question, regardless of what the data show.  It is essential that professionals do not give families the impression that all choices have been researched fully; in reality, only a very small number of possibilities have been examined in detail. In short, existing research on “communication mode” simply does not, and cannot, help parents identify how to communicate with their DHH infant or toddler in ways that will maximize their child’s chances of mastering at least one language by school entry.


We propose replacing “communication mode” with a new concept: “language access profile”; Figure 1 shows an example. A language access profile uses percentages to express a child’s cumulative experience with different kinds of communication across infancy and toddlerhood. Including “Limited Access” as a category accounts for the facts that (1) DHH children have diverse sensory abilities, and (2) some (though not all) DHH children experience significant periods with very little access to any type of input. 

This approach creates highly-individualized profiles that can provide helpful insights to families, clinicians, and educators. Meanwhile, researchers and public health programs can use bottom-up classification strategies to reveal naturally-occurring groupings based on children’s complex experiences with language input during infancy and toddlerhood. These data-driven groupings can replace “communication mode” as predictor variables.

Ultimately, we argue that replacing communication mode with language access profiles will help families, clinicians, and educators better understand and support the DHH children of today, while allowing researchers and public health programs to gather the information we need to help future families make better-informed decisions about raising and educating the DHH children of tomorrow.

“Figure 1 shows one DHH child’s Language Access Profile. In this chart, 0% is at the center, with 100% at the outer edge. Over the course of infancy and toddlerhood, this child’s experience consisted of 25% Limited Access, 40% auditory access to spoken English (without signs), 10% ASL, and 25% sign-supported speech.”

Posted on December 18, 2020 by
Matthew L. Hall
Temple University

Sheila Dills
Northwest School for Deaf and Hard of Hearing Children