Oral communication (communication by mouth) combines helping a child use any hearing she has as much as possible, with lip reading, and with learning to speak. In many countries, schools for children with hearing loss teach only oral communication. Unfortunately, oral communication usually only works well for children who can hear the differences between many words, or for children whose hearing loss began after they learned to speak.
Total Communication
Total Communication is an approach that encourages a child to learn and use all the different methods that work well for that child in her particular community, especially if there are not sign language speakers who can help a child develop a complete language. This might include any (or all) of these:
the child’s own gestures
sign language
drawing, reading, and writing
finger spelling
whatever hearing the child has, to develop lip reading and speech
IMPORTANT! “Total Communication” as we use the term, does not mean that all the above methods are used for every child. It means that we try all the methods that might work for a child. Then we work with whatever methods will help the child communicate as easily, quickly, and fully as possible with her family and community. It is an approach for where there is no local sign language and is adaptable to individual and local needs.
WARNING: Beware of programs that teach only oral communication
In many countries, schools for people with hearing loss still try to make all children learn only ‘oral communication’ (lip reading and spoken words). The results are often disappointing, or even harmful, especially for the child with complete hearing loss since birth. Lip reading at best gives a lot of problems. A skilled lip reader can only understand about 40 to 50 percent of English words, and has to guess at the rest. (For example, “Mama” and “Papa” look exactly the same on the lips.) Even if the child does learn to lip read and speak some, often his words are unclear. As a result, when he grows older, often he prefers not to speak.
The biggest problem with teaching only oral communication is that it slows down a child’s language development at the age when children learn language fastest (age 1 to 7 years). A child with hearing loss usually learns to lip read and speak only 5 or 10 words by age 5 or 6. By that age, the same child can easily learn over 2,000 signs—as many words as a hearing child speaks.
Studies have shown that children with hearing loss who learn to use gestures and signs can communicate easier, earlier, and more fully than those who are taught only oral communication. Learning sign language and other forms of communication first actually makes it easier for a child to learn to speak and read lips.
For all these reasons, more and more experts and organizations of people with hearing loss recommend teaching most children with hearing loss a combination of communication methods, including some form of sign language.
Total Communication is not new. In villages in many parts of the world, people with and without hearing loss find imaginative and effective ways to talk with each other. They figure out a system of hand signs, objects, face movements, pictures, and certain sounds or words. As a result, people with hearing loss often manage fairly well in the community. They can communicate and understand a lot.
We know families from villages like these who took their child with hearing loss to speech therapists in the city. Often the parents and child had already begun to communicate with each other by using the local signs and inventing more of their own. The child was happy and learning fairly well. But the therapists told the parents that they were wrong. They told them that they must not let the child use signs, because if he got used to signs he would never learn to speak. They said the child should be put in a “special education program” and taught “oral communication.” But since the only programs of this kind are in the cities (and often have a 3-year waiting list) the parents took their child back to the village. Trying to follow the therapist’s orders, they tried not to use signs with their child, and punished him when he used them or took off his uncomfortable hearing aids. As a result, both the parents and child felt frustrated, guilty, angry, and hurt. The child’s learning and social development were held back. His chances of learning to speak became less than they were when everyone happily used the village system.
Fortunately, most of these families in time realized that they simply could not manage without using signs, and gradually went back to accepting Total Communication.
In the richer countries more and more special educators and speech therapists are beginning to favor Total Communication. They have changed to this approach partly because people with hearing loss have organized and demanded it. People with disabilities in poor countries, including people with hearing loss and their families, also need to organize. They need to help professionals listen to them, and to respond to their needs in more realistic ways.
