Little Heroes Pediatric Hearing Clinic

By: Dr. Lindsey Tubaugh

When I was a teenager, I purchased a book about Cued Speech.  I was always interested in learning American Sign Language (ASL) but this book caught my eye at the bookstore and at the time I did not know what Cued Speech was – but was intrigued about learning more. 

At the time, I was not exposed to Deaf culture and knew essentially nothing about different communication options available to those with deafness. And that was true for many years—all I knew was there was something that really interested me about visual languages. 

Fast-forward to college when I was deciding whether to be a special educator or speech pathologist and ended up choosing audiologist, lol.   

At Utah State University I took many ASL (American Sign Language) courses and learned a lot about the Deaf community.  The most important lesson learned, however, was the importance of choice for those who are deaf to choose their mode of communication. 

Naively, prior to my introduction to the Deaf community, I assumed when a baby was born deaf, most would want to be “hearing”. I cringe now to even write that!   

Many might think that all audiologists push spoken language and the use of hearing aids or cochlear implants on every patient.  I have not found that to always be the case.  Yes, there are still those out there that feel “hearing” is the only appropriate route—but that’s the minority now. 

It can be difficult to approach communication choices with parents whose child was diagnosed with profound hearing loss.  

It is important for parents to understand that while choosing visual language is a valid option, they must also understand that if the brain is not stimulated with sound, its ability to process auditory information will deteriorate. 

In other words, if a parent chooses to not fit amplification and then the child decides she wants to use hearing aids and/or cochlear implants at 15 years of age, there is little likelihood she will be able to process any sounds that are sent to the brain.   

Nevertheless, if a parent chooses a visual language for their child and does not want to use amplification, I support them by offering whatever resources are available!  There is no black and white when it comes to preferred communication styles.   

As an audiologist, my job is to facilitate those who choose audibility and spoken language, as well as inform parents of the other communication options so they can connect with the support system that is most fitting. 

Here are a few of the options for communication for those who are deaf or hard-of-hearing: 

1. Cued Speech:   Developed in 1966, Cued speech is a form of visual communication using hand movements combined with the mouth movements of the speaker.  It is not the same thing as sign language.  For more information on Cued Speech visit the National Cued Speech Association.
2. Hearing/Spoken Language:   Early amplification using a hearing aid and/or cochlear implant which may require listening therapy/aural habilitation.  An individual choosing this form of communication will work closely with an audiologist, otolaryngologist, and possibly speech language pathologist.
3. Sign Language (ASL in the US):   American sign language is a complete language (just like any other spoken language) with its own grammar structure.  It utilizes visual gestures such as facial expression and body language in conjunction with hand signs.  For more information check out The National Association of the Deaf.
4. Total Communication:  Total communication is a philosophy which, in short, is a combination of both hearing and visual communication with an additional emphasis on lipreading and speech.  For more specific information visit Hands & Voices.

Regardless of communication style chosen, the most important thing is: EARLY DETECTION 

Why?  Because regardless of whether you choose a visual or spoken language, early and rich access to language is extremely important.  Little baby brains work a lot differently than 40-year-old brains, and the earlier we understand the thresholds of hearing and make a choice of communication method so we can enrich that child’s life with as much communication as possible, the better the outcomes are. 

One last thing if you are a parent deciding what mode of communication is best for your child: 

The best people to talk to is other parents who have been in your situation.  While an audiologist can (and should) give you the communication options you have, they cannot understand what you are feeling unless they are deaf or hard-of-hearing themselves.  Even then, it is a deeply personal choice.  Connecting with parents and other people who are deaf or hard-of-hearing that have chosen the above communication styles will give you the best information and support in whatever you choose.   

Parent advocates are available in Utah through the Parent-Infant-Program (PIP), The Utah Department of Health, and social media groups.   They are often your best help in guiding you through this journey because they have been where you are. 

Remember:  You are the best advocate for your child and whatever you decide, be proud and find support systems for your journey with your child!