TO SIGN OR NOT TO SIGN:
Does signing really benefit the hearing
child?
Does it improve I.Q.?
Strengthen parent bonding?
Increase confidence?
Decrease tantruming?
Helpful when working with children with
special needs?
EARLY INTERVENTION
 In speech-language pathology, Early Intervention (EI) refers to services
that are provided to infants and toddlers (birth to 3 years) who have, or
are at risk for, communication, speech, language, hearing, feeding,
swallowing, and/or emergent literacy problems. (Paul & Roth, 2011)
 Capacity building occurs when the EI providers offer support to strengthen
the caregiver-child relationship, build the caregiver’s confidence and
competence to enhance their child’s learning and accomplish familyidentified outcomes.
 With EI, the focus is placed on building the caregiver’s capacity to promote
their children’s development within the context of their typical routines
and activities. (Fridman, Woods & Salisbury, 2012)
4 GUIDING PRINCIPLES OF EI
 Services are family centered and culturally and linguistically responsive.
 Services are developmentally supportive and promote children’s
participation in their natural environments.
 Services are comprehensive, coordinated, and team based.
 Services are based on the highest quality evidence that is available.
(ASHA 2008a, 2008b, 2008c, 2008d)
SHORT TERM VS. LONG TERM
Short term goal:
•
What can we strive for (and obtain) in the next 3 months that will have a
positive effect on a child’s communication skills?
Child will be able to spontaneously request a desired object/action using a
sign/word 5xs a day for 7 consecutive days.
Long term goal:
•
What would we like to see for this child in 1 year, 5 years, 10 years?
Child will have sufficient speech and language skills to function in daily
routines within their natural environment.
DETERMINATION OF THERAPY TECHNIQUES
 Which modality fits the child and family best?
 Picture exchange-giving a picture in exchange of desired
item/action
 Object exchange-giving an object in exchange for desired
item/action
 Gestures-pointing, nodding, common known gestures in
community
 Sign Language
 Informal: child developed signs/baby signs
 Formal: ASL
DEVELOPMENTAL CONSIDERATIONS
Pre-requisite skills needed for introduction of sign language
 Communicative intent
 Typically developing children become intentional around 6 months of
age
 Examples: deliberate eye contact, use of gestures, persistence in
trying to communicate
 Children must have intentionality to benefit from the use of sign to
support communication development.
Robertson, 2007
DEVELOPMENTAL CONSIDERATIONS
 Symbolic function
 Understanding that one thing can stand for another
 Example: a block can stand in for a car, or food, or telephone
 Language is symbolic in all modes (gestural, oral, and written); the
symbol stands for the real object or concept.
Robertson, 2007
DEVELOPMENTAL CONSIDERATIONS
 Joint attention capabilities
 When a child and their communicative partner are paying attention to
the same thing.
 Example: parent and child can roll a ball back and forth, continuing a
turn taking routine
 Children who are unwilling or unable to participate in joint attention will
most likely not benefit from teaching sign
Robertson, 2007
DEVELOPMENTAL CONSIDERATIONS
 Basic social skills
 Eye contact and a desire and ability to participate with others in a social
setting is critical.
 Children who actively resist communication and eye contact many not
be good candidates for sign language.
 http://www.parents.com/videos/v/78954740/early-signs-of-autism.htm
RELYING ON OUR BASIC SENSES
 Visual cue
 Many early signs are visual representations of item/action (e.g. ball, eat,
drink, bath)
 Child sees the sign of the target word and learns to associate it with
item/action
 Tactile cue
 Hand over hand modeling and learning
 Child begins to sign independently and learns to associate sign with both
spoken word and object
 Auditory cue
 Child hears the target word used over and over with the same sign
 Typically a child’s first verbal word is a sign they know and can use
independently
 Improved parent understanding
 Signs and gestures helped clarify verbal attempts
 Child signing hot, verbalizing ‘ah ah’ –caregiver able to understand that ‘ah
ah’ means hat and can respond appropriately
HOW DOES SIGN ENHANCE VERBAL LANGUAGE?
#1 All children use gestures before they use spoken words
 Language comes in 3 modes:
 gestural, oral, written (in this order!)
 At 7 months old babies are beginning to communicate with gestures
 Waving, blowing kisses, high fives, hugging, pushing, shoving, pointing
 Producing a gesture only requires the control of larger muscle masses, arm,
hands, fingers
 Helpful for children who are not yet able to control small muscle groups
such as oral muscles for speech movements.
Let’s build off of children’s innate gestures to help them
communicate more effectively!
Robertson, 2007
#2 GESTURES AND SIGNS HELP ESTABLISH CRITICAL
SOCIAL SKILLS NEEDED FOR COMMUNICATION
 Early signs and gestures help children connect with their environment
and develop important relationships and social skills
 When a child raises their hands to be held, adult responds by picking
them up; child learns that they can control their environment through
communication
 As a child learns that their communication attempts get results they
are more likely to continue to attempt to communicate
 Need face to face interactions for sign language to be successful
 Able to understand response contingency needed for conversational
skills later on
 Alternatively, if a child does not develop a functional communication
system early on they are less likely to initiate communication attempts
later
Robertson,
2007
#3 GESTURES AND SIGNS HELP ESTABLISH CRITICAL
COGNITIVE SKILLS FOR COMMUNICATION
 Imitation skills:
 Cognitive foundational skill needed for language learning
 Signs are easier to imitate than words
 Able to help a child by doing hand over hand signing, impossible to do with
oral movements
 Child is able to compare their movement to adults movement, leads to
child comparing their word approximation to adult model
 Symbolic function:
 The ability to understand that one thing can stand for another; gestures
can stand for a word
 Another cognitive foundational skill needed for language learning (oral
and written)
Robertson, 2007
#4 CHILDREN’S BRAINS PROCESS GESTURES AND
SIGNS MORE EFFICIENTLY THAN WORDS.
 Information processing theory: short term memory vs. long term
memory
 Children who are language delayed have a reduced capacity and
function of short term memory
 Unable to retain a spoken work long enough to process it and relate it
to a given concept
 Showing a child a concrete sign allows the child to see it long enough
to process it and move it to their long term memory
 Mirror neurons: a neuron that fires when a person acts, and also when
the person observes the same action performed by another.
 Mirror neurons are thought to be in the pre-frontal cortex and inferior
parietal cortex and are important for language development
 The more we encourage the growth of mirror neurons in gestures and
signs the more we encourage overall language development
Robertson, 2007
 Sign stimulates the visual and auditory neural pathways in the cerebral
cortex of the brain
 Visual cortex matures faster than the auditory cortex
 Spoken language uses only auditory pathway
 Sign stimulates both hemispheres, oral stimulates only the left
hemisphere
 90% of brain growth is in the first 3 years of life!
Robertson, 2007
STUDIES SHOW USING SIGN IS BENEFICIAL FOR
LANGUAGE DEVELOPMENT
 Goodwyn et al. (2000)
 103 children at 11 months old
 32 sign training with verbal training, 32 verbal training only, compared
to 39 control group children
 testing periods at regular intervals up to 36 months old
 signing training children showed statistically significant higher receptive
and expressive language scores than verbal and control groups
 Verbal training children did not show higher language scores than
control group at any interval
 ‘the results…strongly support the hypothesis that symbolic gesturing
facilitates the early stages of verbal language development.
 Instead of interfering with language development, use of signs and
gestures appear to accelerate language growth.
 Children who learned signs showed an increase in IQ of 8-13 points
compared to control groups who were not taught signs
 8-13 point increase in IQ still evident at 8 years old
SIGN LANGUAGE IMPACT ON DAILY ROUTINES
 Hand over hand signing encourages parent/caregiver bonding and
developing early social skills
 Building imitation skills (play, gross motor, fine motor)
 Controlling environment – increase child confidence, decrease tantruming
 Makes communication easier and interactions more positive
 Able to request actions without crying (more, out)
 Able to request specific food items for clarification (goldfish, crackers,
cheerios)
 Helped books, movies, TV shows become interactive with animal signs
(monkey, zebra, bear)
 Descriptive signs helped share emotions and insights (hot, happy,
afraid)
DEVELOPMENTALLY APPROPRIATE SIGNS
ERRORS AND MISUSES
 Only as accurate as the model who demonstrates
 YouTube videos, flash cards, ASL books are hard to imitate with out a
competent model
 Signing face to face may lead to mirror imitations instead of a child
using their dominant hand for signing
 Signs that are developmentally easier can be misused or overused
 ‘more’
 becomes a catch all and children can get stuck using it for all items
and actions
 better to teach ‘again’ for action words instead of always using ‘more’
 contextual difference between ‘one more bite’ and ‘more cereal’
 ‘all done’
 often used for ‘all gone’
 contextual difference between ‘all done’ and ‘all gone’
Seal,
2010
TO SIGN OR NOT TO SIGN:






Does signing really benefit the hearing child?
Does it improve I.Q.?
Strengthen parent bonding?
Increase confidence?
Decrease tantruming?
Helpful when working with children with special needs?
Language that is paired with gesture has the potential to
facilitate language development that is faster, more
organized and more durable.
REFERENCES
American Speech-Language-Hearing Association (2008b). Roles and responsibilities
of speech-language pathologists in early intervention [Guidelines].
Friedman, M., Woods, J., & Shelden, M. L. (2012). Caregiver Coaching Strategies for
Early Intervention Moveing Toward Operational Definitions. Infants & Young
Children, 25(1), 62-82.
Goodwyn, S., Acredolo, L., & Shawd, B. (2000). Impact of symbolic gesturing on early
language development. Journal of Nonverbal Behavior, 24, 81-103.
Paul, D., & Roth, F. (2011). Guiding Principles and Clinical Applications for SpeechLanguage Pathology Practice in Early Intervention. Language, Speech and
Hearing Services in Schools, 42, 320-330.
-Robertson, S. (2007). Using Sign to Facilitate Oral Language: Building a Case with
Parents.
Seal, B. (2010, November 02). About Baby Signing. The ASHA Leader.