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Updated: Oct 12, 2022



The debate continues over cochlear implants (CI). An average of 80% of children born deaf are being implanted with CI (Humphries et al., 2012). Often when their hearing parents are given the news that their newborn child is deaf, they are often devastated. The common practice of health professionals advising, and sometimes insisting, that the family keep the implanted child away from sign language is “an act that leads to the harm of linguistic deprivation” (Humphries et al., 2012).

Audiologists Debra Nussbaum and Kimberly Sanzo are authorities on the topic and have much to share about the benefits of ASL, before, during, and after the implanting of CI. Research affirms that by enhancing the brain with visual language, users outperform nonusers of ASL.

Possible Limits with Cochlear Implants

There can be unforeseen problems experienced with the device itself. CI is a device using batteries that can lose power, causing complete and sudden silence, creating stress and often fear for the child. Some children refuse to wear the device or choose to disconnect it. The device can be lost or damaged. During baths and sleep, the device is removed. Sign Language can offer continued communication at these times.

The benefits of communication with sign language during these interruptions is of great value and comfort. Audiologist Kimberly Sanzo (who I have had the pleasure of interviewing) says that “for every moment that the child’s aid or implant is not working properly, that child loses precious input to the brain” (Sanzo, 2019).

The Importance of Early Language Acquisition

Research has established that language acquisition at an early age, before plasticity locks the language systems in the brain, is critical for the cognitive success of every individual. Language acquisition for hearing children begins in utero, and by the time a deaf child is implanted, they may be several months or over a year old. But as research shows, early language acquisition is vital. During these precious months in utero, before the implant, and during the training period, children are not developing the language systems in their brains.

Therefore, says Debra Nussbaum (audiologist and coordinator of the Cochlear Implant Education Center at the Laurent Clerc National Deaf Education Center at Gallaudet University), “it makes sense that sign should at least be considered as a foundation of early language for a child until the auditory sense has time to develop and the child has opportunities to listen” (Nussbaum, 2008).

Bilingualism and Enhancement of Cognition

Having bilingual skills with both sign language and spoken English is, according to Nussbaum, a “first choice” option for children with CI (Nussbaum, 2008). She discovered that, with appropriate planning and support, CI patients have the opportunity to enhance cognition by using both ASL and spoken English.

Spoken language for hearing people activates the left hemisphere of the language systems in the brain. For users of sign language, the left hemisphere is activated and additionally, the right hemisphere engages in cognitive development. Studies indicate bimodal individuals outperform monolingual and bilingual persons due to cognitive enhancement through visual language acquisition.

Research using the fMRI provides a vivid illustration of how the brain is biologically organizing the spatial images of sign language. Unfortunately, this visual-spatial imaging of the fMRI currently cannot be utilized in individuals implanted with CI, because the implant itself is ferromagnetic (Bortfield, 2018). Since CI is being implanted into 80% of children born deaf, how will we know how this device changes the biological organization of the brain?

Hearing your child and being heard by your child is a wonderful gift. Whether you choose sign language, CI, or both to 'be heard' and staying connected with your child, supersede all else, in my opinion. The brain is a fascinating organ that is able to do more than we can imagine I love learning of its potential and our potential. What new technology will be developed to replace an fMRI?

Thank you to Audiologists Debra Nussbaum, and Kimberly Sanzo for all they do for children and families. To the dedication of Tom Humphries, Poorna Kushalnagar, Gaurav Mathur, Donna Jo Napoli, Carol Padden, Christian Rathmann, Scott R Smith, and Heather Bortfeld for research into understanding how our brain's language systems work.


  • Bortfield (2018) Functional near-infrared spectroscopy as a tool for assessing speech and spoken language processing in pediatric and adult cochlear implant users. Developmental Psychobiology (61) 3

  • Humphries et al. (2012) Language acquisition for deaf children: Reducing the harms of zero tolerance to the use of alternative approaches. Harm Reduction Journal (9) 16

  • Nussbaum (2008) Your child has a cochlear implant: Why include sign language? The Endeavor (Spring 2008)

  • Sanzo (2019) The case for sign language. Language First (February 11, 2019)

Did you enjoy reading this article? You might be interested in Brains are Better with Sign Language where research answers the question, could sign language be beneficial for both hearing children and adults. You may also gain insight with my conversation with Kimberly Sanzo Language First?” and Why ASL is Important for Deaf Children. Learn how Language First was born and discover what Language First has to offer!

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