The July 2015 article, “Ethics Rounds: Should All Deaf Children Learn Sign Language,” concludes that the benefits of learning sign language clearly outweigh the risks and that this approach seems clearly preferable to an approach that focuses solely on oral communication, and all deaf children should learn sign language.
As a professional in the field for >30 years and speaking as the executive director of the Center for Hearing and Communication (CHC) in New York City, I do not believe that there is one way for “all” deaf children to learn language or to be educated. At CHC, we provide a wide range of services to people with all degrees of hearing loss regardless of mode of communication. That said, our habilitation program for children who are deaf or hard of hearing is an auditory-oral program with the goal of having the children attend a mainstream educational program, typically beginning in the preschool years. Although we recognize that this approach may not be the right choice for every child, with the advent of universal newborn hearing screening, technical advances in amplification (including early bilateral cochlear implantation), and access to early intervention, this is a realistic option for more children than ever before.
At CHC, it is no longer unusual for us to begin working with infants as young as 4 weeks of age, immediately providing amplification and beginning a habilitation program with the infant, family, and other caregivers. It would be an extremely rare case where a trial of hearing aids was not medically indicated, and with current amplification technology, some degree of hearing aid benefit is always provided. It is becoming the “norm” for infants to receive a cochlear implant, if not 2 implants, by the age of 7 months. As a result of this early intervention, the children we see are achieving age-appropriate linguistic and cognitive milestones at very young ages.
It is our hope that when pediatricians find themselves in a position to counsel families of newly diagnosed deaf children that they recognize, as we do, that every family and child is unique and every recommendation must be individualized. We also hope that in this ever-changing field, they recognize that the outcomes possible today for deaf children learning spoken language far exceed those that are seen in published research of just a few short years ago. The controversy over whether sign language should be incorporated into a deaf child’s communication system is almost 200 years old. The field of early childhood deafness and the opportunities for management have dramatically changed even within the past 5 years, and how we discuss this controversy must change as well.
Conflict of Interest:
- Copyright © 2015 by the American Academy of Pediatrics