Early Intervention Protocols: Proposing a Default Bimodal Bilingual Approach for Deaf Children

Abstract

Despite advances in hearing technology, a growing body of research, as well as early intervention protocols, deaf children largely fail to meet age-based language milestones. This gap in language acquisition points to the inconsistencies that exist between research and practice. Current research suggests that bimodal bilingual early interventions at deaf identification provide children language foundations that can lead to more effective outcomes. Recommendations that support implementing bimodal bilingualism at deaf identification include early intervention protocols, language foundations, and the development of appropriate bimodal bilingual environments. All recommendations serve as multifaceted tools in a deaf child's repertoire as language and modality preferences develop and solidify. This versatile approach allows for children to determine their own language and communication preferences. Keywords Language acquisition • Deaf children • Early intervention • Bimodal bilingual • American Sign Language/ASL Significance Statement Professionals working in the field of Deaf 1 education 2 remain stymied by persistent delays in language acquisition persisting across decades despite advances in assistive hearing technology, newborn screenings, early intervention services, research, and knowledge. It would seem that current systematic practices are not adequately addressing persistent language delay issues in the Deaf education field. Therefore, bimodal bilingual interventions are recommended.

Language not auditory experience is related to parent‐reported executive functioning in preschool‐aged deaf and hard‐of‐hearing children

“…Overall, our findings strongly indicate that we must ensure that deaf children have access to language , not just speech (Hall et al, 2019 ). In many cases, the best way to ensure this would be to take a bilingual approach that includes both a signed and spoken language (e.g., Clark et al, 2020 ). Although much research has found that earlier interventions with cochlear implants or hearing aids lead to better spoken language outcomes, age‐appropriate language development does not occur for many DHH children, even using modern hearing technologies (see, e.g., the range of spoken‐language outcomes reported for children with cochlear implants in Dettman et al, 2016 ).…”

“…Hearing parents are typically guided toward medical technology and spoken language-only interventions (Mauldin, 2016, pp. 158, 161), with bimodal-bilingual approaches including sign language a rarity (Clark et al, 2020).Research indicates that the challenges surrounding language access for DHH children have consequences for cognitive domains outside of language, such as executive functioning (EF). EF refers to behaviors that allow an individual to overcome more automatic or established responses to achieve a goal (e.g., Garon et al, 2008).…”

“…Hearing parents are typically guided toward medical technology and spoken language‐only interventions (Mauldin, 2016 , pp. 158, 161), with bimodal‐bilingual approaches including sign language a rarity (Clark et al, 2020 ).…”

Being Deaf in Mainstream Schools: The Effect of a Hearing Loss in Children’s Playground Behaviors

“…Third, all the DHH children in our study used spoken language as their primary mode of communication. However, this is not true for all DHH children mainly because spoken language is not accessible to them (e.g., they have irreversible deafness; they do not have criteria to benefit from hearing devices) or because they rely on a more visual—or bilingual—modes of communication (e.g., sign supported language) [ 54 ]. DHH children who do not use spoken language might have a different social experience—and engagement—than the DHH children included in our study.…”

The Benefit of the “And” for Considerations of Language Modality for Deaf and Hard-of-Hearing Children

“…Furthermore, studies of language modality have indicated that, neurologically, the brain seeks patterns in language, whether auditory or visual (Petitto et al, 2000). Researchers and practitioners are calling for bimodal bilingualism to be the standard approach for early intervention with DHH children (Clark et al, 2020). Based on the abovementioned evidence, a bilingual approach for communication is not contraindicated for children, including DHH children.…”