Table 1.

Recommendations for Actions that will Help to Advance Justice in Early Intervention Practices.

Recommendation: At all steps along the way, deaf adults should contribute to the information that hearing parents receive.

Justification:

• The lived experiences of deaf adults play a vital role in improving the quality of early interventions provided to hearing families with DHH children (Gale, 2020; Gale et al., 2019).

• Families who received bilingual-bicultural programming services from deaf mentors show greater language gains compared with families who did not participate (Watkins et al., 1998).

• Hearing parents report that encounters with deaf adults helped them feel more confident in raising deaf children (Hintermair, 2000), and improved their DHH child’s quality of life (Petersen et al., 2018).

• Principle 8 for Collaborative Teamwork from the FCEI International organization recommends including deaf adults as members of early intervention teams (Moeller et al., 2013): “D/HH adults can serve as role models, consultants, and/or mentors to families, offering information and resources and demonstrate enriching language experiences.”

Recommendation: Providers should offer deaf children and their families accurate and balanced information about communication opportunities including the early bimodal bilingual approach.

Justification:

• Informed choice is about offering parents unbiased and balanced information regarding choices for their deaf children.  • Parents internalize opinions from their professionals (Decker et al., 2012).

• The Joint Committee on Infant Hearing (JCIH) recommends, “Develop a mechanism that ensures family access to all available resources and information that is accurate, well-balanced, comprehensive, and conveyed in an unbiased manner,” and “Establish and implement professional development programs that include training in dissemination of information without bias” (The Joint Committee on Infant Hearing et al., 2013).

• FCEI Principle 3, Informed Choice and Decision Making, recommends “adopt[ing] open and flexible policies that effectively endorse a range of communication possibilities,” and “shar[ing] information and experiences from a variety of sources that are comprehensive, meaningful, relevant, and unbiased to enable informed decision making” (Moeller et al., 2013).

• When bilingualism is presented as a healthy default option (Murray et al., 2019; Wilkinson & Morford, 2020), DHH children can have access to linguistic input as early as possible so that they need not rely exclusively on the eventual development of spoken language.

Recommendation: Medical and early intervention professionals must be trained on the social-cultural perspectives of the deaf community, and the factors that affect language development in DHH children.

Justification:

• Medical professionals need to receive language development training so they can properly advise parents about language and education opportunities, explain why using assistive devices and sign language are not an either/or decision, and discuss consequences of waiting to use sign language as a back-up if the child does not perform well with their assistive device (Hecht, 2020; Humphries et al., 2014; Spellun & Kushalnagar, 2018).

• This training should include content concerning language acquisition, Deaf culture and the benefits of visual languages, as well as regular opportunities to interact with deaf signers. These topics should be included when focusing on the goal to train health professionals and service providers in key aspects of the Early Hearing Detection and Intervention (EHDI) Program from Health Resources and Services Administration (HRSA), which is part of the U.S. Department of Health and Human Services Maternal and Child Health Bureau Division of Services or Children with Special Needs.

Recommendation: Additional research focusing on language development in DHH children should be conducted

Justification:

• Studies that examine development of both sign and speech in children whose parents are also learning a natural sign language would increase our understanding of ways to improve early access to language.

• Studying the parents as M2L2 learners may also help to improve instruction for such learners.

Such research is an important strategy to spotlight the benefits of visual languages leading to equitable education for deaf children.