[One of 50 articles written and published for Demand Media in 2013]

The importance of early intervention for deaf children is universally accepted, but controversy persists over which forms of intervention are best for the child. The deaf community strongly emphasizes a linguistic approach, giving priority to early exposure to language. The medical model emphasizes an auditory approach that prioritizes the ability to speak and hear. Most researchers agree that language acquisition occurs early. Children who do not reach common linguistic milestones as toddlers lag their peers in language skills. If the delay is severe, the lag can become permanent. Early intervention is focused on preventing this stunted communication growth. The debate centers around the benefits and drawbacks of linguistic and auditory approaches.

Linguistic Intervention
The advantage of the linguistic approach is that American Sign Language is a complete, natural language fully on par with spoken languages. Exposure to ASL introduces the child to language immediately, creating a foundation for the later addition of other languages. With family engagement and daily face-to-face communication, ASL is a first step toward full literacy. With the language base secured, it becomes possible to learn the grammar, vocabulary and idiosyncrasies of other languages, particularly English.

Bilingualism
The common fear is that learning ASL will inhibit the understanding of English. But the opposite is true — ASL enhances English learning. Bilingualism has demonstrated benefits in communication as well as brain development and the ability to monitor the environment. The grammar of ASL is expressed in three dimensions, a useful mode of expression not available in English. Rather than generate confusion, knowledge of multiple grammars enhances mental agility.

Auditory Intervention
Auditory early intervention relies on technology to deliver sound perception and intensive training to detect patterns through speech reading. This typically means hearing aids for mild to severe hearing impairment or cochlear implants for profoundly deaf children. The U.S. Federal Drug Administration permits implants as early as 12 months as of 2013. The advantage of the auditory approach is the network effect. Most people rely on speech and hearing to communicate. Children with the capacity to participate in this network have broader access to the resources of the network and the people in it.

Combined Strengths
Parents of a newborn deaf child are faced with the task of sorting out which early intervention strategy they feel is best. If they are hearing, as 90 percent of parents with deaf children are, the prospect of learning ASL can be daunting. Implants require invasive surgery in the skull with variable results, depending on age of implantation, condition of the auditory nerve, degree of recipient’s familiarity with sound and speech, post-operational mapping process and several other factors. Speech reading is most effective for children with mild to moderate levels of hearing impairment.

If the decision is made to go forward with hearing aids or an implant, a hybrid approach that includes ASL exposure may confer the greatest advantage. Current auditory technology is not equivalent to full hearing. Broadly, the effect has been to deliver the equivalent of being hard-of-hearing, leaving critical gaps in comprehension when relying on speech reading and hearing alone. ASL can help fill these gaps, especially during early development when language access is crucial.