Language and Communication Development
Language and Communication Development
This domain tests how DHH children acquire language and communication, including the interplay of audition, vision, and early experience, and how teams select and monitor communication modes.
Core rules and concepts
- Early accessible language is foundational. The critical period for first-language acquisition is early childhood; inconsistent or delayed access is associated with language deprivation, which can affect literacy, cognition, and social development.
- Communication approaches include ASL, spoken English with auditory access, total communication, cued speech, and auditory-verbal practice. Bilingual-bicultural programs treat ASL and English as two languages, not as a sign support for English.
- Auditory skill development follows detection, discrimination, identification, and comprehension. A child's "hearing age" begins at consistent device use, not birth.
- Amplification and cochlear implants do not guarantee typical access; background noise, distance, and reverberation matter. FM/DM systems improve the signal-to-noise ratio.
- Assessment should include language samples in the child's natural mode, ASL proficiency measures when relevant, and family-reported communication, not only English standardized tests.
Worked example
A child received a cochlear implant at 18 months and has 40 spoken words at age 3. The family asks whether adding ASL will delay speech. The team should explain that visual language does not replace spoken language and can reduce the risk of language deprivation while spoken skills are monitored. The plan should include both consistent device use and ASL exposure, with progress data in both modalities.
Traps that cost marks
- Treating ASL as a last resort or as "gestures."
- Equating a cochlear implant with normal hearing.
- Using an English-only test to conclude a child has low language ability.
- Ignoring family choice and cultural context.