Evaluating Communications Options for Your Child

Historically, teachers, doctors and other professionals talked with families about a child’s communications “options.” Today, the word “options” has been replaced with “outcomes” as a reflection of the hearing loss community’s focus on the success of the child.

For children with hearing loss, there are four primary communication outcomes, each tied to an approach to language:

  • Listening and Spoken Language
  • Cued Speech/Language
  • American Sign Language/Bilingual-Bicultural
  • Total Communication Method

Mastering a communication outcome requires hard work and dedication on the part of the child and family. A child’s brain is ready to learn language at an early age, even though he or she will not be able to understand or communicate back right away. Remember that you are laying the foundation for communication proficiency from day one. It is important to stick with one option for long enough to determine that it is the right one for your child and your family.

Total Communication (TC) is a philosophy that includes various types of sign (i.e., ASL, Signing Exact English/S.E.E., and contact languages such as Pidgin Sign English or PSE), finger spelling, speech reading, speaking, and the use of amplification. Simultaneous communication (also referred to as SimCom or SC, and, more recently, manually-coded English; MCE) is TC in which speaking and signing occur at the same time. SC can include contact language (e.g., Pidgin Sign English; PSE and Conceptually-Accurate Signed English; CASE), grammatical forms of English (i.e., Morphemic Sign or MSS; Signing Exact English, S.E.E.) and ungrammatical ASL and English (e.g., Signed English, Sign Supported Speech, Sign Supported English). For more information see https://digitalcommons.usu.edu/jehdi/vol3/iss2/5/.

Reach Us

Alexander Graham Bell Association
for the Deaf and Hard of Hearing

3417 Volta Place NW
Washington, D.C. 20007

Tel: 202-337-5220
TTY: 202-337-5221


Our Mission

Working globally to ensure that people who are deaf and hard of hearing can hear and talk. 

We want all families to be informed and supported, professionals to be appropriately qualified to teach and help children with hearing loss, public policy leaders to effectively address the needs of people with hearing loss, and communities to be empowered to help their neighbors with hearing loss succeed.