Conclusions & Recommendations
Dr Berlin’s recommendations & conclusions:
Because the outcome with AN/AD children is not nearly as predictable as with simple outer hair cell hearing loss, we urge families with children who have this diagnosis to first learn and institute Cued Speech around the child so that language comprehension can be assured. Baby signs do NOT conflict with cues and can be used to communicate along with speech so that the baby can have an additional method of expression back to the parents. Then the family is prepared for any number of outcomes.
If the child acts deaf and remains delayed in spoken language, Cued Speech and signs will help assure language acquisition. At that point the family has many options, including, at one extreme, adopting Deaf Culture and Signs for their family, or at the other end of the continuum opting for a cochlear implant and spoken language. Either way the use of cues will have facilitated language acquisition and done no harm.
‘If the child shows few if any signs of auditory problems, the Cued Speech will help in noisy situations but can be phased out if and when it is no longer needed.
‘If and when the child is implanted, Cued Speech will help disambiguate the new sounds and phonemes the child will learn with the implant, and can be retained as a tool for difficult listening situations or when the implant is off.
‘American Sign Language is NOT spoken English on the hands but has a spatial and visual syntax and grammar of its own. If the family opts to do nothing invasive other than use visual language, combining ASL with cues will allow the child to join Deaf Culture, while still having an additional language acquisition tool that supports literacy and English (or any other desired language) word order and usage. Thus the child can have the joys and benefits of belonging to the Deaf world, but have a tool that will make it unnecessary to learn English as a second language.
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