title: Infants and children with hearing loss need early language access.
abstract: Around 96 percent of children with hearing loss are born to parents with intact hearing, who may initially know little about deafness or sign language. Therefore, such parents will need information and support in making decisions about the medical, linguistic, and educational management of their child. Some of these decisions are time-sensitive and irreversible and come at a moment of emotional turmoil and vulnerability (when some parents grieve the loss of a normally hearing child). Clinical research indicates that a deaf child's poor communication skills can be made worse by increased level of parental depression. Given this, the importance of reliable and up-to-date support for parents' decisions is critical to the overall well-being of their child. In raising and educating a child, parents are often offered an exclusive choice between an oral environment (including assistive technology, speech reading, and voicing) and a signing environment. A heated controversy surrounds this choice, and has since at least the late 19th century, beginning with the International Congress on the Education of the Deaf in Milan, held in 1880. While families seek advice from many sources, including, increasingly, the internet, the primary care physician (PCP) is the professional medical figure the family interacts with repeatedly. The present article aims to help family advisors, particularly the PCP and other medical advisors in this regard. We argue that deaf children need to be exposed regularly and frequently to good language models in both visual and auditory modalities from the time hearing loss is detected and continued throughout their education to ensure proper cognitive, psychological, and educational development. Since there is, unfortunately, a dearth of empirical studies on many of the issues families must confront, professional opinions, backed by what studies do exist, are the only option. We here give our strongly held professional opinions and stress the need for improved research studies in these areas.
authors.affiliation: Department of Health Services, University of Washington, Seattle, USA.
authors.forename: Poorna
authors.initials: P
authors.lastname: Kushalnagar
authors.forename: Gaurav
authors.initials: G
authors.lastname: Mathur
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Moreland
authors.forename: Donna Jo
authors.initials: DJ
authors.lastname: Napoli
authors.forename: Wendy
authors.initials: W
authors.lastname: Osterling
authors.forename: Carol
authors.initials: C
authors.lastname: Padden
authors.forename: Christian
authors.initials: C
authors.lastname: Rathmann
mesh_terms: D002648:Child; D003638:Deafness / Q000523:psychology / Q000534:rehabilitation; D003863:Depression / Q000209:etiology; D005194:Family Practice / Q000592:standards; D034381:Hearing Loss / Q000523:psychology* / Q000534:rehabilitation*; D006801:Humans; D007223:Infant; D020407:Internet; D019303:Multilingualism; D010287:Parent-Child Relations; D016487:Parenting / Q000523:psychology; D010290:Parents / Q000523:psychology*; D010821:Physicians, Family; D011320:Primary Health Care / Q000592:standards; D012813:Sign Language; D013997:Time Factors