The Key Role of Early Intervention

For children born deaf or hard of hearing, timely access to language is a critical factor in ensuring healthy brain development. Unfortunately, as highlighted in the 2022 article The Importance of Accessible Language for Development in Deaf and Hard of Hearing Children by Arielle Spellun and her colleagues, many deaf or hard of hearing children experience significant language delays, even with early identification and intervention. The case of Brady, a 5-year-old boy with bilateral hearing loss, demonstrates the crucial need for early, accessible language in all forms—spoken, signed, or a combination of both.

A Familiar Story with Lasting Consequences

Brady's case is not uncommon. Despite being identified with hearing loss early in life and receiving cochlear implants, he continued to show delays in both spoken and sign language development. Like many deaf or hard of hearing children, Brady faced a language plateau, unable to progress beyond using single words in either modality, even with intensive therapy.

The challenges Brady faces are not unique. Research shows that a majority of deaf or hard of hearing children may not reach language milestones appropriate for their age, despite receiving interventions such as cochlear implants. This underscores a critical point raised by the authors: early access to language—whether auditory, visual, or both—is essential to prevent lifelong communication and cognitive deficits.

The Role of Early Intervention Programs

In the United States, Early Hearing Detection and Intervention (EHDI) programs aim to screen newborns for hearing loss by one month of age, confirm diagnosis by three months, and initiate intervention services by six months. These interventions often focus on amplifying auditory input through hearing aids or cochlear implants, but the authors emphasize the importance of also providing immediate access to sign language.

Sign Languages like ASL should not be viewed as a "backup" plan but rather as an integral part of language development. Early exposure to a sign language offers a strong foundation for deaf or hard of hearing children to build communication skills while awaiting auditory interventions. As Brady's case illustrates, delaying visual language exposure can hinder a child’s language and cognitive development, making it difficult for them to catch up later.

Why Accessible Language is Key

As the authors point out, the critical period for language development in children occurs between birth and age five. For deaf or hard of hearing children like Brady, relying solely on auditory input can be risky, as the brain’s language centers are rapidly developing and need consistent stimulation. Without accessible language input—whether spoken or signed—children can suffer from language deprivation, which can affect their cognitive development, academic success, and social integration.

A Multidisciplinary Approach is Essential

To prevent language delays, deaf or hard of hearing children require a team of specialists, including educators, audiologists, speech-language pathologists, developmental pediatricians, and psychologists, to tailor interventions that meet their unique needs. A one-size-fits-all approach does not work when it comes to language development, especially for deaf or hard of hearing children with complex communication needs. For Brady, a combination of sign language and spoken language, paired with cochlear implants, offered the best chance of achieving age-appropriate communication skills.

The Bottom Line

Language is a fundamental human right, and for deaf or hard of hearing children, early and accessible language—whether visual or auditory—should be at the core of every intervention plan. As this case study demonstrates, incorporating both signed and spoken language from the start can significantly improve language outcomes and give children like Brady the tools they need to thrive.

Read the full article.