Speech, Sign, or Both? Factors Influencing Caregivers’ Communication Method Decision Making for Deaf/Hard of Hearing Children

Purpose: Caregivers of deaf/hard of hearing infants are faced with challenging decisions regarding their child’s communication method. The purpose of the current research note is to characterize the advice that caregivers receive and value as well as the factors that influence caregivers’ decision making. Method: The current study enrolled 105 caregiver–child dyads, including chil-dren between 12 and 18 months of age with bilateral, congenital hearing loss. All children were exposed to spoken language, and 63.81% of children were also exposed to sign language. Caregivers completed the “Making Decisions About Sign, Speech, and Multilingualism Survey” (Crowe et al., 2014). Results: Caregivers most frequently received advice to use both speech and sign and highly valued advice from speech-language pathologists. When con-sidering the use of speech, the factors that caregivers most frequently rated as very important were “My child’s future academic success” (96.19%), “My child’s future literary success” (95.24%), and “My child’s future access to higher edu-cation” (95.19%). When considering the use of sign, the factors that caregivers most frequently rated as very important were “My child’s ability to form friend-ships and future relationships” (82.52%), “My child’s future literary success” (81.37%), and “My child’s future academic success” (81.37%). Conclusions: Results of the current study suggest that throughout the decision-making process, caregivers’ highest priority is understanding how their decisions will influence their child’s future access to opportunities and relationships. Pro-viders may consider discussing these factors early in the decision-making pro-cess to support caregivers’ ability to make an informed choice regarding their child’s communication method. This study was funded by the National Institute on Deafness and Other Communication Disorders Grant R01DC016877, awarded to Principal Investigator: Megan Roberts. The authors wish to thank the families who par-ticipated and research team members who made this study possible.