Cochlear Implant Education Center Frequently Asked Questions

Question 1: What is your opinion about using sign language for students with cochlear implants?

Based on evidence and personal observations and experiences, we believe that sign language can have an integral role for children with cochlear implants. There is lack of support in literature demonstrating that visual language inhibits long-range spoken language outcomes. The evidence suggests:

  • The brain has the capacity to acquire both a visual and spoken language without detriment to the development of either language through either modality; and  

  • Development of early visual linguistic competence can effectively be used to map onto, link to, and facilitate spoken language development.  

While use of signed language can play an important role for children with cochlear implants, it is important to recognize that for spoken language to develop, it must be used and valued in the child's life. Dedicated opportunities to facilitate development and use of auditory, speech, and spoken language must be an integral part of a student's daily communication interactions and learning in signing environments.  


Archbold, S., & O'Donoghue, G.M. (2009). Education and childhood deafness: changing choices and new challenges. In: Niparko, J.K., (ed.) Cochlear Implants: Principles and Practice, 2nd ed. Baltimore, MD: Lippincott Williams & Wilkins: 313-345  

Jiménez, M.S., Pino, M.J., & Herruzo, J. (2009). A comparative study of speech development between deaf children with cochlear implants who have been educated with spoken or spoken and sign language. International Journal of Pediatric Otorhinolaryngology. 73:109-114

Kovelman, I., Shalinsky, M.H., White, K.S., & et al. (2009). Dual language use in sign-speech bimodal bilinguals: fNIRS brain-imaging evidence. Brain and Language. 109:112-123

Marschark, M., & Hauser, P. (2012). How deaf children learn; What parents and teachers need to know. New York, NY: Oxford University Press.            

Marschark, M., Schick, B., & Spencer, P.E. (2006). Understanding sign language development of deaf children. In: Schick, B., Marschark, M., & Spencer, P.E. (eds). Advances in the sign language development of deaf children. New York, NY: Oxford University Press. 3-19  

Mitchiner, J., Nussbaum, D.B., & Scott, S. (2012, June). The Implications of Bimodal Bilingual Approaches for Children with Cochlear Implants (Research Brief No. 6). Washington, DC: Visual Language and Visual Learning Science of Learning Center. Available at:

Petitto, L.A., Katerelos, M., Levy, B.G., Gauna, K., Tétreault, K., & Ferraro, V. (2001). Bilingual signed and spoken language acquisition from birth: Implications for the mechanisms underlying early bilingual language acquisition. Journal of Child Language. 28: 453-496  

Petitto, L.A., & Kovelman, I. (2003). The bilingual paradox: how signing-speaking bilingual children help us resolve bilingual issues and teach us about the brain mechanisms underlying all language acquisition. Learning Languages. 8: 5-18  

Seal, B.C., Nussbaum, D.B., Belzner, K.A., Scott, S., & Waddy-Smith, B. (2011). Consonant and sign phoneme acquisition in signing children following cochlear implantation. Cochlear Implants International. 12: 34-43  

Tait, M., Lutman, M.E., Robinson, K. (2000). Preimplant measures of preverbal communicative behavior as predictors of cochlear implant outcomes in children. Ear and Hearing. 21: 18-24  

Yoshinaga-Itano C. (2006). Early identification, communication modality, and the development of speech and spoken language skills: Patterns and considerations. In: Marschark, M., Spencer, E. (eds). Advances in the spoken language development of deaf and hard-of-hearing children. New York, NY: Oxford University Press US, 298-327    

Question 2: What supports are provided for students with cochlear implants at the Clerc Center?

Students with cochlear implants are integrated into the American Sign Language (ASL)/English bilingual educational programs within the Clerc Center's demonstration schools: Kendall Demonstration Elementary School (KDES) and the Model Secondary School for the Deaf (MSSD). The Clerc Center incorporates an assessment driven individualized language planning process to guide development and use of both ASL and spoken English for each student, including students who use cochlear implants.

On-site audiologic evaluation, daily cochlear implant (CI) technology checks, and CI troubleshooting and replacement parts, as well as a variety of assistive listening technologies are available within the demonstration schools to support students with cochlear implants. Support services to facilitate listening and spoken language development are provided based on individual student needs, and built into each student's IFSP/IEP. At KDES, spoken language resource specialists are available to provide spoken language supports for learning as needed throughout the educational program. A support group for students with cochlear implants is available at MSSD. 

Question 3: My child has a cochlear implant and uses sign language. Can you recommend the best educational program for my child?

We do not recommend specific programs to families, but rather encourage families to examine a child's individual needs and circumstances. There are varied profiles and outcomes for children with cochlear implants, just as with all children who are deaf. This range should be reflected in the diversity of educational program and service options. Factors related to the child's history, age, language functioning, communication mode, social/emotional development, family, and cultural environment would influence program choices, recommended supports, and expectations. An appropriate program should take into considerations all factors influencing a child's overall linguistic, cognitive, and social emotional development, not only listening but also with spoken language. For further information about planning an appropriate educational program for a student with a cochlear implant see: Students with Cochlear Implants: Guidelines for Educational Program Planning.   

Compiled by:
Debra Nussbaum, Manager
Projects-Language Development and Communication Support
Last revised September 15, 2014

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