There is no single approach that works for every Deaf child. Families choose from several paths (sign-based, speech-based, or some combination) and many families adjust course as they learn what their child needs. Some approaches work well together. All of them can change over time.

What the research is clear about: a child needs full, consistent access to language from as early as possible. The approach that achieves that for your child is the right one for your family. The approach that leaves gaps warrants a closer look, whatever the reason.

This page introduces the five main approaches. Each links to a fuller page covering what it looks like day to day, what it asks of your family and school, what the evidence actually says, and what questions to ask.

One note before you continue: these approaches are not always mutually exclusive. Some families use elements of more than one, and needs change over time. Your child's hearing history, language development, and what is available in your community all matter. What is available locally is not something families should accept as a given.

ASL is a complete, natural language with its own grammar and structure, separate from English. In a bilingual approach, a child learns ASL and English as two distinct languages. This is the only approach that provides full visual language access from birth, independent of hearing technology.

Full page: ASL / English bimodal bilingual

LSL focuses on developing speech and listening through consistent use of hearing aids or cochlear implants, combined with auditory therapy. The goal is spoken language as the child's primary communication. Signing is typically not part of the approach. Outcomes vary significantly depending on factors that are worth understanding before committing.

Full page: Listening and spoken language (LSL)

Total Communication is a philosophy, not a single defined method. It combines signing, speech, lipreading, and amplification, often simultaneously. Implementations differ widely, and the "Total Communication" label is sometimes applied to programs with very different levels of actual signing.

Full page: Total Communication

Cued Speech uses handshapes near the face to make the sounds of spoken English visible. It is a support system for lipreading, not a language. Research supports its use for developing phonological awareness and English literacy for some children.

Full page: Cued Speech

Manually Coded English, including Signed Exact English (SEE), uses signs to represent English words and grammar in English word order. It is a visual code for English, not a separate language. It is used in some school settings to make English visible.

Full page: Manually Coded English / SEE

These questions are worth asking about any approach, before you start and along the way.

Does this approach give my child access to a complete, grammatically consistent language? Not a code, not a supplement: a full language.

Is there a monitoring plan? What markers will tell us whether this is working? What happens if progress stalls?

Who is recommending this approach, and do they have a financial interest in your family choosing it? Does the information you’re receiving come from peer-reviewed research or from a program’s marketing?

Does your child have access to fluent users of this approach, including Deaf adults and peers who grew up using it?

Can this approach adapt as your child grows? Can you shift or add to it if you need to?

There is no shame in changing course. Many families do. Catching a mismatch early matters far more than staying with a first decision made with good intentions.

• Language access: what it means for Deaf children
• Can my child learn both ASL and spoken language?
• Language testing: what it covers and why it matters
• Marketing vs. Evidence: How to Judge Advice About Your Deaf Child
• Is Your Child Falling Behind? Early Warning Signs with Hearing Aids or Cochlear Implants
• Research Hub

This page provides general information, not legal or medical advice. Verify your state’s specific rules and programs, and consult a qualified professional for guidance specific to your child.