Author ORCID Identifier

Date Available


Year of Publication


Degree Name

Doctor of Philosophy (PhD)

Document Type

Doctoral Dissertation


Health Sciences


Rehabilitation Sciences

First Advisor

Anne D. Olson, PhD, CCC/A

Second Advisor

Esther E. Dupont-Versteegden, PhD


According to the American Speech-Language-Hearing Association (ASHA), speech-language pathologists (SLPs) are referred to as the experts of communication (ASHA, n.d.) utilizing their specialized training, extensive education, and clinical expertise to work with individuals across the lifespan with a variety of different speech and language delays, disorders, and deficits. However, when working with deaf or hard of hearing (DHH) children, there is often precedent given to speech and listening (M. L. Hall et al., 2019). For example, ASHA only recently updated their DHH portal to include American Sign Language (ASL), though they still list it on some webpages as an Augmentative Alternative Communication system (AAC), illustrating that they do not view signed languages as equal to oral languages. Historically, signed and oral languages have been pitted against each other, creating a false dichotomy and perpetuating the fallacious belief that visual language is inferior or less effective than oral language. This dissertation aims to debunk the myth that exposing DHH children to ASL has a negative impact on the child’s cognitive, academic, speech, and language development. This dissertation consists of three components. The first is a retrospective chart review, as described in Chapter 2, which examines the relationship between early exposure to a visual language, such as ASL, and vocabulary development in children enrolled at a residential school for the deaf. Results from this study influenced the theoretical model, The Fundamental Framework of Deaf and Hard of Hearing Children, outlined in Chapter 3. Its creation, stemming from a modification of Rosenbaum and Gorter’s (2012) “‘F- words’ in Childhood Disability,” is grounded in the World Health Organization’s (WHO) International Classification of Functioning, Disability and Health (ICF) model and aims to facilitate meaningful collaboration between professionals, families, and most importantly the DHH child when making language decisions. Finally, in Chapter 4, a description of a qualitative study is provided, which consists of interviews with parents and caregivers of DHH children to identify what factors influence their views, beliefs, and ultimate decision making in relation to language use and communication for their child(ren). (i.e., ASL, spoken English, or a combination of both languages). The overarching purpose of this dissertation is to provide SLPs and other professionals with information about the benefits of early exposure to a fully accessible language, such as ASL, on the overall development and function of DHH children. The author aims to provide support to professionals who work with this population and explore ways in which SLPs can aid in the acquisition of language for DHH children as experts in the areas of language and functional communication. If SLPs are to be considered communication experts, the field must consider emerging and current evidence in support of a multimodal and bilingual approach for DHH children specifically.

Digital Object Identifier (DOI)

Funding Information

One study of this three part dissertation was supported by the UK University Professor in Health Sciences Endowment in 2020.

Available for download on Thursday, June 25, 2026