When Elana Meyers Taylor won gold in the women’s monobob at the 2026 Winter Olympics, she turned to her Deaf son and tearfully signed “Mommy won” in American Sign Language (ASL). The moment went viral for a good reason.1 Taylor, a hearing parent raising 2 Deaf sons, offered a rare public glimpse of what research has long supported: a multilingual, accessible home environment gives Deaf and Hard of Hearing (DHH) children the foundation they need to thrive. That image also brings an important clinical question into focus: how can pediatric providers best support the language development of DHH children?
Resources for providers and families
Early Hearing Detection and Intervention (EHDI): The 1-3-6 benchmarks
The recommended EHDI guidelines establish 3 benchmarks: screening for hearing loss before one month of age, completing a diagnostic audiological evaluation before 3 months of age, and initiating intervention services by 6 months of age.2 These benchmarks exist because timing matters profoundly, yet they are not met or documented for one in four infants in the United States.3 Barriers, including limited access to care and insurance coverage gaps, contribute significantly to this statistic.4
Key clinical takeaway: Ask at every well-child visit whether EHDI benchmarks have been met. If not, help families navigate barriers to timely follow-up.
Early intervention: The earlier, the better
Early Intervention (EI) services are among the most powerful tools for supporting language development in DHH children. When initiated within the first 6 months of life, EI is associated with greater kindergarten readiness and higher language and literacy scores compared to those with later enrollment.5,6 Pediatric providers play a direct role in connecting families to EI referrals without delay.
Sign language: A critical foundation
Many hearing families of DHH children prioritize spoken language as a goal which is entirely valid. However, spoken language outcomes in DHH children remain highly variable and often lag behind those of hearing peers, even with current technological advances.7–11 What the evidence consistently shows is that early sign language exposure, beginning in the first six months of life, is not in conflict with spoken language development; rather, it actively supports it.12,13 DHH children exposed to ASL early demonstrate stronger vocabulary, reading, and writing skills.14–16
A common concern among hearing families is that ASL exposure will only be beneficial if family members are already fluent signers. Research does not support this worry: language benefits are observed even when parents learn sign language alongside their child.12,17 ASL exposure in the home environment, at any parental skill level, is associated with improved ASL proficiency over time.18
For families pursuing cochlear implantation, the evidence is equally clear: DHH children with cochlear implants who had early exposure to sign language show spoken vocabulary, articulation, syntax, and phonological awareness comparable to those of their hearing peers.19,20
Clinical guidance: Regardless of a family’s communication goals, recommend early exposure to sign language beginning in the first six months of life. Frame this as an additive, not an either/or, choice.
Hearing technology: Timing matters
For families who choose hearing augmentation, earlier initiation is consistently associated with better language outcomes:
- Hearing aids provided by 3 months of age are associated with significantly better language outcomes compared to hearing aids initiated at 24 months of age.21
- Cochlear implants provided by 12 months of age (currently FDA-approved for children with bilateral profound sensorineural hearing loss as young as nine months) are associated with age-expected language growth rates, higher receptive language scores, and improved speech perception and production.21–23
Providers can support families by discussing the option of hearing technology early, connecting them with audiology specialists, and clarifying that technology decisions, including the decision not to pursue amplification, belong to the family.
