ASL is a visually perceived language that uses the hands, body, and facial expressions to communicate the same kinds of words and thoughts as spoken languages.  It is a formally recognized language used by the Deaf Community.  ASL is a fully accessible language to children who are Deaf or Hard of Hearing regardless of their hearing levels and can be a building block to spoken language development.

These methods focus on maximizing the use of residual hearing and hearing technology in order to learn the spoken language of the family. The child is encouraged to use listening to understand spoken language in their environment in order to communicate. Auditory skill development is built into the child’s daily life, as are speech and language goals. There are two approaches:

The Auditory Oral (AO) approach encourages the use of visuals as a supplement to listening, such as gestures and sign support. 

The Auditory Verbal (AV) approach emphasizes listening, without visual support.  Supplementary visual support may be added as needed.

These methods focus on maximizing the use of residual hearing and hearing technology in order to learn the spoken language of the family. The child is encouraged to use listening to understand spoken language in their environment in order to communicate. Auditory skill development is built into the child’s daily life, as are speech and language goals. There are two approaches:

The Auditory Oral (AO) approach encourages the use of visuals as a supplement to listening, such as gestures and sign support. 

The Auditory Verbal (AV) approach emphasizes listening, without visual support.  Supplementary visual support may be added as needed.

The Bilingual Bimodal approach supports the acquisition of both American Sign Language (ASL) and spoken language.  “Bilingual” refers to the fluent use of both languages.  This approach includes early access to visual language, while providing the use of hearing technology for access to spoken language. The languages are kept separate, and not used simultaneously. The family prioritizes learning and using both ASL and spoken language throughout their day to day activities.

Cued speech is a visual system of eight hand shapes used in one of four positions around the face (called cues) that a speaker uses to clarify speech sounds and words that look alike or are not visible on the lips.  Cued speech provides complete visual access to the sounds of spoken language, regardless of hearing levels, and is an effective tool for literacy development.

Manually Coded English Systems were developed to provide visual access to spoken English. Many families utilize Sign Supported Speech, which involves the addition of signs to support understanding of spoken language. Unlike

ASL, manually coded systems use signs in English word order and may add certain signs to show the grammar of English.

For some children using one communication approach is sufficient. For others, a combination of approaches is beneficial. Your child's providers will work with you to help you decide when more than one approach may be needed.