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Language vs Speech

Dr Berlin writes that it is very important to distinguish between speech and language:

The family must understand and appreciate the many differences between speech and language.

'Our primary job is to teach children LANGUAGE by stimulating their brains with meaningful words, sounds, symbols and associations. Normal-hearing children learn language as a result of auditory stimulation, by eavesdropping, imitating, playing verbal games, singing songs, etc. Children with hearing disorders cannot learn language as easily by eavesdropping like their normal-hearing peers. They have to learn by eavesdropping VISUALLY.  Thus, language can be learned and appreciated WITHOUT hearing speech clearly and without expecting speech to be produced.  That is to say, abstract concepts and their representation can be signed, or Cued (eg put the book ON…under…along side of…the table; play nicely; show me a picture of ….; where is…; what day is today?; etc.) but until the child has grasped the nature of these abstractions, speech will not necessarily follow.  Signs generally carry NO representation of the sounds of the language.  Thus the signs for BABY and the sign for BOY have no /b/ sound coded in them.  Those words, when properly Cued, will always have a representation of a /b/ sound in them. 

'Using Cued Speech, families can also raise multilingual children who might understand Spanish, English and Dutch for example.  I know of families where the children use three modes of communication, spoken English, ASL, and Cued English.

'The main point here is that if parents want speaking children, they first have to teach language comprehension and that is most easily accomplished by eavesdropping and imitating.

Successful interventions

For all AN/AD children, whether they outgrow the disorder or not, lip-reading and facial cue reading will nurture language growth, while hearing aids and COVERING the mouth has not in the past been very successful.  Hence the unique value of Cued Speech as a tool to allow the child to eavesdrop on the spoken language of the home regardless of whether invasive interventions are used.  Its major advantages are that the family does NOT have to learn a new sign for each concept or word, and the grammar, syntax and vocabulary match whatever the family uses for speech.  Thus CS is ideally suited for bi-lingual families because Cued Speech can be used as a tool to teach virtually ANY language.

Cued Speech complements baby signs, signing and speaking and cochlear implants ideally, and we have seen the fastest language growth and quickest transition to spoken language and literacy from children who have been implanted by one year of age and/or were exposed to CS and then had implants after age 2.  CS remains a lifelong tool, useful when implants fail or when the implants are off during bathing, swimming, or for adults where ambiguity of spoken messages cannot be resolved by hearing alone, etc.

Dr Berlin writes: 

The most common causes shown in our data base of 300 patients are:

  • Genetic absence or compromise of inner hair cells secondary to otoferlin or other mutations (like Mohr-Tranebjaerg) affecting the senses.  These sometimes spread to outer hair cells and obliterate otoacoustic emissions, complicating the diagnosis. Some of the rare forms bring with them late onset blindness and ataxia making visual forms of language support more complicated.
  • Genetic diseases of the peripheral nerves (eg Charcot Marie Tooth Disease, etc.)
  • Mitochondrial disorders which affect vision, motor function as well as hearing.
  • Absence or compromise of inner hair cells secondary to anoxic or hypoxic episodes.
  • Hyperbilirubinemia requiring transfusion, with or without concurrent kernicterus.

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