We outline a number of fundamental issues in how sign language exposure and proficiency were operationalized and reported by Geers et al. Most importantly, the authors did not distinguish between those exposed to ASL versus English signing systems (eg, signing exact English, sign-supported English, baby sign) when classifying children. This is a fatal flaw because, in contrast to artificial English signing systems, natural sign languages such as ASL are legitimate languages (as long-affirmed by the Linguistic Society of America1), with all the cognitive benefits a natural language provides. The study is recklessly misleading because of this inappropriate conflation, especially given that the authors’ conclusions contribute to long-standing bias, resistance, and misperceptions against natural sign languages in clinical recommendations for deaf children.
Among other issues, there is not enough information provided about participants’ sign language proficiency and exposure. At minimum, it is critical to know the number of children exposed to only ASL (as opposed to artificial signing systems), the age of first exposure to ASL, the number of ASL language models, and the ASL proficiency of parents and children. Effects of “sign language exposure” may have been carried by participants who used an artificial signing system, received late exposure relative to the critical period of language acquisition, had only 1 ASL model, and families with limited to no ASL proficiency. The little information provided about sign language exposure was not collected by using direct measurement; rather, it appears to have been measured by using an unvalidated parental report questionnaire. The criterion for positive indication of sign language exposure was, in our view, low (>10% of the time), and there was no rationale offered for why 10% is minimally sufficient. It is possible that the sample in this study represents a straw man hypothesis; no one would argue that such language conditions are sufficient for a child to thrive.
ASL is typically used within a bilingual approach encouraging both natural sign language and spoken and written English acquisition,2 and it should be evaluated as such. Because those children are emerging bilinguals, their combined proficiency in both ASL and English must be considered to draw any conclusions about ASL-based intervention efficacy. In addition, because bilingual and monolingual language acquisition differs, bilingual-signing children’s appropriate comparison group is other bilingual children, and they should not be compared with monolingual norms.
Although this study was designed for the authors to look narrowly at English-based outcomes, the authors overinterpret the results as evidence against the assertion3 that a natural sign language can be beneficial for deaf children. Although English proficiency is certainly 1 route to success, it is not a necessary condition for it. The results of this study have no bearing on whether exposure to a natural sign language has any effect on the holistic well-being and health-related outcomes of deaf children, but they are dangerously framed and misinterpreted as such.
CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.
- Perlmutter D
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- Niparko JK, et al
- Copyright © 2017 by the American Academy of Pediatrics