Cued Speech - view as single page

Cued Speech

The MG was created by Cate Calder - Cued Speech UK with the support of the Cued Speech UK.

For any interested parties including families and professionals who wish to understand more about the system of Cued Speech and how it gives deaf children (and adults) a way to lip-read with almost 100% accuracy thereby enabling them to develop a fluent mental model of a spoken language; integrate new vocabulary; improve their own pronunciation and be able to develop literacy skills in the same way as hearing peers.   The MG provides the theory and research supporting the development and use of Cued Speech.

 

 

What Is Cued Speech

Description of the system, its history and context as a visual support for speech perception. How to learn to cue and get in touch with relevant organisations.

Description of the system

The name Cued Speech describes a system of 8 handshapes and 4 positions around the face, you cue as you speak.  The combination of these 12 cues and the natural lip patterns of the speaker give a complete visual representation of what is said in real time.  Every sound in every word has a corresponding cue enabling the receiver to see how the words sound.

For deaf children Cued Speech does the job of speech; it is your speech made visible.

It is quick and comparatively easy to learn – the entire system can be shown on one page.

A chart showing the handshapes and positions explains how to put them together to cue words.

How does it work?

Put simply, when sounds look the same on the lips (as they are spoken) an accompanying handshape or position will make each lip-pattern look different.  For example the sounds /p/ /b/ and /m/ sound quite different to hearing people, but they are indistinguishable by watching the lips.  So people who rely on lip-reading alone have no way of distinguishing words such as 'baby' and 'maybe' or 'pay', 'bay' and 'may'.  When you use CS each consonant sound has a different accompanying handshape so each sound now looks quite different.  Vowel sounds with confusing lip-patterns are clarified by positions.

When people speak they join sounds to make words.  Similarly, with Cued Speech the handshapes and positions are joined to clarify a word.

This film gives you a demonstration of how difficult lip reading is because so many lip-patterns are the same for different words and how using  CS overcomes this problem.

How does it look?

This film shows a story narrated by someone who is cueing while children demonstrate the actions and cue key words from the story.

History of Cued Speech

This document outlines how, when and where CS was created and the aims behind it.

Cued Speech in the context of other language support systems

Visual

British Sign Language (BSL)

BSL is a visual language and not a ‘system’, it enables access to the signing Deaf community; it does not have a written form and the grammar of BSL is very different to that of English.  For example in BSL meanings can be added onto a single sign through (for example) direction, duration, facial expression, and body movement.  These additions give a great deal of extra information, for example about what is happening, when, and how the narrator felt – and all in one sign – but this doesn’t tie in at all with either spoken or written English, which may need a whole sentence to convey the same meaning.  In schools deaf children STILL need to be able to understand, read and write that English sentence.

Cued Speech is not a language, it is a lip-reading ‘tool’ that can be used to make any spoken language visible (it has been adapted to over 68 languages and dialects).  Although there are benefits to deaf children using Cued Speech expressively, deaf children and adults do not need to cue themselves but simply receive it.

This document sets out how CS can be used alongside a signed language.  It explores how concepts and vocabulary can be conveyed visually, both by using a signed language, and using Cued Speech to make a spoken language fully visible.

Artificial systems eg Sign Supported English

In an attempt to solve the problem of access to English, some schools use a created system of ‘Manually Coded English’ such as Sign Supported English (SSE) or ‘Signed English’ where some BSL signs are used with additional gestures that were devised to represent some parts of English grammar.  The balance of BSL signs to English varies greatly depending on the speaker's knowledge of the two languages.  A single sign is often differentiated into a number of English words by clearly mouthing the word, so, in order to comprehend SSE well, a person needs good lip-reading (speechreading) skills, as well a pre- existing knowledge of English grammar and vocabulary.  There is also an issue with misrepresenting the meaning of spoken words by only using one sign or gesture with it, for example grammar words like ‘in’ or ‘on’ are often signed as ‘inside’ and ‘on top of’ which is clearly not what is meant in the context of for example ‘in the morning’ or ‘on good behaviour’.  Artificial signing systems may serve older deaf people who already fully understand English and so are able to mentally fill-in the gaps where signs cannot be used and make the cognitive adjustments needed to change the signed meaning to the intended meaning.  However they are not appropriate for use with children who are still in the process of learning language and cannot make the adjustments required to convert the mixed modes into comprehendible language.  SSE is not a language and it does not tie in with the sound-based elements of spoken English.

Cued Speech, while not a language in itself, will give the receiver complete access to the spoken language it is used with – including every aspect of syntax, grammar, tenses and intonation.

This document outlines the challenges faced by children in school with a range of language delay and how CS can meet their needs.

An article that was published in the January 2016 BATOD magazine explains and addresses misunderstandings often made about CS as a system and its use.

Aural/Oral

Cued Speech perfectly complements any hearing that a deaf child may be able to use.  Deciding to take an aural/oral approach with a deaf child does not preclude the use of cueing, after all the goal is the same for both – that the child may become a full and fluent user of spoken language.  There are many times when a child may not be able wear their implant or hearing aid (bath/bed time, sports, during illness etc) and many times when they are not in an environment that supports good listening (classrooms/dining rooms, busy streets etc).  With a purely auditory approach, many deaf children may have their access to language seriously impaired at these times.  If Cued Speech is used alongside listening then you have the perfect safety-net, the visual cues will enable uninterrupted access to language at all times.

Whether we have a hearing loss or not we all lip-read to a surprisingly great extent, human brains are hardwired to make use of any visual signals to support what we hear.  Even if a deaf child makes good use of hearing, they will also be lip-reading to support their understanding.  Cued Speech is a lip-reading tool that will not only allow the deaf child to quickly develop an understanding of spoken language visually by enabling them to lip-read with almost 100% accuracy, it will also greatly lessen the exhaustion that often comes with trying to listen/lip-read alone.

Use CS:

1. before a Cochlear Implant to ensure that language development and communication is not delayed.

2. continue after an implant:

  1. to help as your baby or child learns to listen
  2. to give on-going help in situations where listening conditions are poor (when there is background noise etc)
  3. when an implant/hearing aid is not used (in the bath etc).

3. if your child is not making good progress with listening alone.

Read how you can use CS to improve this situation.  This document outlines in simple terms how CS can be used to support language acquisition pre-implant and to support the rehabilitation process post implant

This document explains and quotes research into the use of CS to support CI users.

These research results show how the use of CS enabled deaf children and adults to develop an awareness of the structure of oral language pre-implant which supported their rehabilitation post-late-implant.

This fun, interactive film demonstrates how our brains will choose visual information (from lip-patterns) over auditory information (from the sound of the word) and make us ‘hear’ the word we think we are ‘seeing’.

 

Training in Cued Speech

There are many  training options  offered by the Cued Speech Association - details are available on the website.

Organisations

www.cuedspeech.co.uk

The Cued Speech Association UK

The Forces

Forces Cross

Blackawton

Totnes

Devon   TQ9 7DJ

 

Tel: 01803 712853

Books about CS

Cover - The Cued Speech Resource Book for Parents of Deaf Children

There are a number of information books written and edited by the leading researchers in the Cued Speech community that may help to answer any questions you may have.    

               

The Cued Speech Resource Book for Parents of Deaf Children (December 1992)

Authored by Dr. R. Orin Cornett and Mary Elsie Daisey

 

Cued Speech and Cued Language for Deaf and Hard of Hearing Children (March 2010)

Edited by Carol LaSasso, PhD, Kelly Lamar Crain, PhD, Jacqueline Leybaert, PhD

Why Cue?

The importance of early exposure to language and how cueing can be used to develop listening and lip-reading skills; support social/emotional development and enable full access to education.

Importance of early language acquisition.

All children need to learn language when they are very young because their brains are most sensitive to language when they are babies and toddlers.

Researchers looking at the general population have found that some parents talked to their children very much more than others and that by the time the children were three years old children with chatty parents had vocabulary around twice that of the group which had less input.  This difference in language skills can be seen from infancy and the gap widens with age affecting their literacy and education.

For deaf children learning language can break down at the very first stage: if they can’t hear the speech their parents use, or they hear it indistinctly or intermittently – they don’t (or don’t easily) learn language. 

On the other hand, research shows that: 

  • spoken language clarified by Cued Speech can be understood by young deaf babies 
  • Deaf children brought up with it can: 
  • make better use of their hearing aids or cochlear implants 
  • achieve literacy levels equal to those of hearing children 
  • be fully included in everyday conversations with their hearing family
  • develop language at a pace and level which matches hearing peers. 

 

Download a document which explains what CS is, the issues it helps to overcome, who CS can be used with and how you can learn to cue.

Early exposure to language  is important.  Cueing can give children, with any degree of hearing loss, a way to visually access the language of the home from birth.

An article by Betty Hart and Todd Risley describing research shows that the number of words a typical child is exposed to by the age of 4 will have a lasting impact on their own vocabulary and literacy skills.  Poor readers have been shown to be exposed to 30 million less words than children with high attainment in language and literacy.

Supporting Cochlear Implant Users

Experiencing a cued language early in a child’s development will have long-lasting effects on the child’s ability to learn that language auditorily later, when they receive the cochlear implant.  For all children the first four years of life are vital for language acquisition, it may take many months for a clear diagnosis and approval for implant surgery and then there is a further wait before ‘switch on’.  Every day that a child goes without access to language in those early years will add to the overall language delay that then has to be addressed in the already intense rehabilitation process post surgery.

Children who have been cued to all along will already be acquiring language at the same rate as their hearing peers, they can then map their visual phonemic and language knowledge to the auditory signal given by their implant and so greatly hasten the rehabilitation process.

A strong case can be made for the addition of Cued Speech to the signal delivered by the cochlear implant in order to help deaf children overcome present limitations of cochlear implants. 

Jacqueline Leybaert, PhD Professor of Psychology, Laboratoire Cognition, Langage, et Développement (LCLD), Université Libre de Bruxelles (U.L.B.), Belgium and Carol J. LaSasso, PhD Professor, Department of Hearing, Speech and Language Sciences, Gallaudet University, Washington D.C. 

This document outlines in simple terms how CS can be used to support language acquisition pre-implant and to support the rehabilitation process post implant.

This document explains and quotes research into the use of CS to support CI users.

These research results  show how the use of CS enabled deaf children and adults to develop an awareness of the structure of oral language pre-implant which supported their rehabilitation post-late-implant.

Power point presentation slides by Jane Smith – a communication specialist - outlining the benefits and challenges of using cochlear implants and how CS can be used by parents to safeguard language development before implantation and when listening is not possible.

Improving lip-reading (speechreading) skills

Lip-reading spoken English is notoriously difficult as we have identical lip-patterns for at least 8 pairs of phonemes and a further 6 phonemes have no discernable lip-pattern at all, this means that at best only about 33% of our spoken words are ‘lip-readable’.  Of course you can only lip-read a language you already have fluent understanding of – if you can’t think in the language you are trying to lip-read then you cannot match lip-patterns to an existing word bank in your memory.

This means that relying on lip-reading alone is not going to give a deaf child a means to learn language in the first place. However, adding Cued Speech to aid lip-reading will change all that.

Cued Speech is a visual version of English

Research shows that with CS, 96% of English can be lip-read accurately. With CS, deaf babies and children can see the whole of the English language as clearly as hearing people hear it. 

This study investigated the possible effects of English CS on the speech perception, phonological awareness, and literacy skills of a 9-year-old boy, who had been exposed to English CS from the age of 1 year.

An added benefit of being cued to is that it is unconsciously training the deaf child to develop exceptionally good lip-reading skills that they can then use to understand people who are not cueing.  Most families find that they need to cue less and less as their deaf child grows older because the child has become such a skilled lip-reader they simply don’t need it as much.  This ability to lip-read well is a skill that continues to serves them for life.

CS improves the speechreading capabilities of profoundly deaf students.

  • Clarke, B. & Ling, D. (1976) "The Effects of Using Cued Speech: A Follow-up Study" The Volta Review, 78, 23-24.

CS instruction improved the speechreading ability of hearing subjects.

  • Chilson, R. F. (1979) "Effects of Cued Speech on Lipreading Ability." Master's thesis, University of Rhode Island.
  • Neef, N. & Iwata, B. (1985) "The Development of Generative Lipreading Skills in Deaf Persons Using Cued Speech."
    In Analysis and Intervention in Developmental Disabilities, Vol. 5, pp. 289-305.

CS significantly improved speechreading abilities of prelingually deaf persons. This study analysed the process.

  • Kaplan, H. (1974) "The effects of Cued Speech on the speechreadingability of the deaf."

Literacy and accessing the language of education.

Literacy

Hearing children acquire their understanding of language through listening to the speech of others – which is made up of sounds. 

Deaf children brought up with CS acquire their understanding of language through watching the cued speech of others – which is made up of the sound-based cues. 

Deaf children brought up with CS and hearing children can both bring the same skills to learning to read.

'It is not surprising therefore that research shows that children brought up with Cued Speech have reading levels which equal that of hearing children and that they learn to read using the same phonetic techniques.'

There are two things that are very important – probably essential - when learning to read. 

  • An understanding of the language you are trying to read 
  • An understanding of the sounds that make up that language and a knowledge of how the sounds tie in with letters – which is known as phonics

This is a prescription for Cued Speech.

Deaf children who are taught to read through BSL must move between two different languages with very different grammar; a much more difficult task.  Connie Mayer and Gordon Wells describe how very hard it is for deaf children to become fully literate through sign language in their paper ‘Can the Linguistic Interdependence Theory Support A Bilingual-Bicultural Model of Literacy Education for Deaf Students?’.  They write: ‘... proponents of bilingual-bicultural models of literacy education for deaf students claim that, if ASL is well established as the language 1 (LI), then literacy in English, language 2 (L2), can be achieved by means of reading and writing without exposure to English through either speech or English-based sign.  In our opinion, this claim is based on a false analogy....’ 

This document outlines the skills needed for good literacy and how CS can enable those skills to be developed in deaf children, supporting research is quoted.

This newsletter article describes some of the results of using CS in a specialist school for the deaf with signing students. 

This document explains what CS is, the skills required for literacy and the synthetic phonics resources from THRASS (Teaching Handwriting Reading and Spelling Skills) which has CS fully integrated into its English Phonics Chart and software program The Phoneme Machine.

Transliterators

To ‘transliterate’ means to represent a language – eg English, in a different ‘mode’ eg visually, through cueing it, rather than orally through speaking it.  This is different from ‘interpreting’ which is representing a first language in a second separate language.

Cued Speech Transliterators (CST) are people with a high level of fluency in Cued Speech who are trained to give equal access to English (or another spoken language) for a deaf child or adult.  They will silently repeat, with cues, the spoken message of the people around the deaf person.  Their role is to make sure that all the auditory information (including environmental sounds such as phones ringing) that a hearing person would be receiving, is made visually accessible to the deaf person through Cued Speech.

This can be done verbatim and at a speed to match the speaker’s style and pace or it can be adapted to match the receptive skills of the deaf person as appropriate, for example, some may require a slower delivery or only certain words clarified visually.

Educational professionals, such as learning support assistants, can often add transliterating skills to their role. The role of Transliterator has a formal training and qualification process in countries such as America, France and Switzerland, this is currently still in development in the UK.

The Transliterator should comply with a professional code of practise in the same way that other communication professionals do such as spoken or sign language interpreters.

Full access to English is vital for young deaf children learning language, and Cued Speech will give that access in nurseries, pre-schools and schools – including to the nonsense words and rhymes of stories and songs loved by very young children.

Using a CST can be equally important at the other end of the learning spectrum as shown by an assignment to support a student at a university open day in a physics department.  The CST could represent the physics jargon and concepts (without understanding them herself) without difficulty, and could support the student as the group walked around the university site.  The student had full access at all times.  No other support could have provided this.

This document explains the skills and role of professional Cued Speech Transliterators.

Anne Worsfold, Executive Director, Cued Speech Association UK describes some of the many advantages to accessing education through a Cued Speech Transliterator in an article published in the BATOD Magazine January 2006.
A father talks about using cueing at home and how his daughter has benefited from cueing support at school in France and the experience of trying to get the same support in England.

Mental Health and social inclusion.

It is estimated that, in Great Britain, one in ten children and young people aged 5-16 have a mental disorder that is associated with ‘considerable distress and substantial interference with personal functions’, such as family and social relationships, their capacity to cope with day to day stresses and life challenges and their learning.

Research has found that deaf children are four times more likely to experience mental health concerns.

Language and communication delay will limit deaf children’s social skills and interpersonal skills with obvious implications for their emotional well-being.

NDCS believes that deaf children experience a higher risk of psychological, behavioural and emotional problems.  However, deafness in itself is not a risk factor for increased mental health difficulties…The most common factors are the lack of access to language and communication, reduced opportunities for fluent two-way interaction, limited access to incidental learning, a partial understanding of what is happening around them and difficulties in forming and maintaining relationships with others; including within their family.

Good language and effective communication skills are fundamental skills for life, and acquiring them is time-limited - children are 'hard-wired' to learn language as toddlers.  Without language, communication can break down.  With Cued Speech all the simple things you say to a two year old (eg ‘if you put your coat on we can go to the park’) can help them make sense of the word.

The advice of the Cued Speech Association UK - based on years of experience with parents and professionals - is: 

‘Don’t delay in giving full access to English, don’t wait to see if they are going to they fail, and don’t wait (for more than a few months) because they ‘will use their implant soon’.

‘Don’t believe anyone if they tell you that delayed language is OK for a deaf child – it may be common, but it’s entirely avoidable and should never happen.  Use CS now and if they thrive, if they have entirely age-appropriate language and can understand you all the time without speech-reading – use it less.  In time, maybe they will only need it occasionally, and you will have avoided becoming one of the parents who tell us they wish they’d used CS earlier.'

‘When parents of deaf babies learn to cue and use it as they talk naturally with their child they, like hearing children, can learn full language easily and naturally.'

‘With Cued Speech deaf children can join in with the rest of the family and with unambiguous communication, parents can be effective parents.  With an understanding of English deaf children can more easily speech read and communicate in English with people who don’t cue.’

Ruth Campbell, Ph.D. (Professor Emeritus, Department of Cognitive, Perceptual and Brain Sciences, Division of Psychology and Language Sciences, University College London

Who Uses Cued Speech?

Hear from families, deaf users, teachers and therapists.

Also learn how cueing can be used bilingually with signed and/or other spoken languages.

Hearing families with a deaf child

90-96% of deaf babies are born into hearing families, these families need and deserve a way to enable their deaf child to access the language of the home as soon as possible.

If a deaf child cannot hear all the sounds of speech, it does not make sense to communicate using the hearing route alone.  Signing can provide a means of communication but most hearing parents of deaf babies cannot use sign language which is of good quality – because they have not yet learnt it – and signing will never give direct access to complete spoken English.

The use of CS in the home from an early age will give access to language in good quantity, quality and variety.  The addition of aural/oral methods to encourage the maximum use of residual hearing will give the best environment for spoken language to flourish.  With CS hearing parents can cue rhymes, stories, nonsense words, animal noises - anything you say can be cued.  All spoken language and its culture is available in an easily accessible form. 

 A parent explains her journey with her profoundly deaf son diagnosed at 8 days old. She describes how CS enabled her to give him access to fluent language and a phonological awareness that enabled him to learn to read at just 3 years old.

Parents of a profoundly deaf child describe how their family was able to give their deaf daughter full access to both English and French by cueing each language. Their daughter developed age appropriate language and literacy in both languages.

Film of the same family discussing their cueing journey.

Deaf families with a deaf child

Within a sign language using Deaf family, visual access may still be possible to both the sign language of the home and the spoken language of the country.  Often hearing family members such as grandparents, will cue for their deaf grandchildren but if the deaf parents themselves were raised with CS then they may also decide to use it expressively with their own children.

As the development of Cued Speech reached its 50th Anniversary, some deaf people who grew up with CS are using in it with their own children.

"My kids are deaf," Consacro said. "They have the miracle of the technology of cochlear implants, [and] they have the language from their dad and I cueing - it just works."

This article from the Washington Post  is about a deaf couple who, having been raised with CS, now use it with their own deaf twins.

Film showing how a baby from birth responds to the cued language of her deaf parents.

Children with different levels of hearing loss

If a child has a mild hearing loss CS may simply be used to support their understanding of individual phonemes for literacy learning or for things like word endings that they may be missing.   CS can also be used to help them to correct any pronunciation errors and to help them develop lip-reading skills.

If a child has any other degree of hearing loss including profound with no audition at all – CS can be used in all the ways given above and for complete access to spoken language through vision which perfectly complements any hearing they may also be able to use. 

'You don’t need to have ANY hearing to benefit from CS (see chapter 3 in Cued Speech and Cued Language for Deaf and Hard of Hearing Children) 5.  CS fully supports any listening the child can do.  CS is of real benefit both before implantation - ‘experiencing a cued language early in a child’s development will have lasting effects on the child’s ability to learn that language auditorily later, when they receive the cochlear implant’ …and after implantation - ‘comprehension does not develop exclusively by the auditory channel but necessitates audiovisual integration.'  (Leybaert, J. & LaSasso, C.J. 2010) 6

CS is particularly recommended for children with Auditory Neuropathy/Dys-synchrony*

One of the leading authorities on AN/AD is Charles Berlin Ph.D., who is Professor of Hearing Science and Clinical Professor of Otolaryngology Head and Neck Surgery, LSU Health Services Center and also retired Director of the Kresge Hearing Research Laboratory, New Orleans.  He has managed over 300 cases of the disorder.

“The family must understand and appreciate the many differences between speech and language.

Our primary job is to teach children LANGUAGE by stimulating their brains with meaningful words, sounds, symbols and associations.  Normal-hearing children learn language as a result of auditory stimulation, by eavesdropping, imitating, playing verbal games, singing songs, etc.  Children with hearing disorders cannot learn language as easily by eavesdropping like their normal-hearing peers.  They have to learn by eavesdropping VISUALLY.  Thus, language can be learned and appreciated WITHOUT hearing speech clearly and without expecting speech to be produced.  That is to say, abstract concepts and their representation can be signed, or Cued (eg put the book ON…under…along side of…the table; play nicely; show me a picture of ….; where is…; what day is today?; etc) but until the child has grasped the nature of these abstractions, speech will not necessarily follow.  Signs generally carry NO representation of the sounds of the language.  Thus the signs for BABY and the sign for BOY have no /b/ sound coded in them.  Those words, when properly Cued, will always have a representation of a /b/ sound in them.

Using Cued Speech, families can also raise multilingual children who might understand Spanish, English and Dutch for example.  I know of families where the children use three modes of communication, spoken English, ASL and Cued English."

To see the full article by Dr Berlin, click here

An article that was published in the January 2016 BATOD Magazine explains and addresses misunderstandings often made about CS as a system and its use.

 

 

Professionals: Educators and Speech and Language Therapists

Educators 

Cued Speech can be used to fully support the deaf child’s access to language, the curriculum and all of school life from nursery through to university. Teachers themselves can use it – it is particularly helpful to support phonics learning for all children. Many hearing children benefit from having the consistent visual element that the cues add to a spoken message, particularly children for whom English is a second language or who themselves have any kind of auditory processing issue or language delay/disorder. Often it is the Teaching Assistants who learn to cue for a particular child, this may begin at a basic level but as the benefits become this may expand into a Transliterator role (see Literacy and accessing the language of education.).

Film  of a mainstream teacher explaining how she has used CS to help her whole class with phonics learning.

A short film  by a Teacher of the Deaf who uses CS to support literacy skills for school age children.

An Open letter to Teachers of the Deaf, by Cate Calder, explains what CS is and why it is so important for supporting deaf children to acquire a fluent mental model of the home language.

Document explaining the skills and role of professional Cued Speech Transliterators.

Document outlining the challenges faced by children in school with a range of language delay and how CS can meet their needs.

This is a newsletter article describing some of the results of using CS in a specialist school for the deaf with signing students. 

Speech and Language Therapists

Although CS was not devised to improve speech production in deaf children it almost always does and many Speech and Language Therapists find adding cueing to their skill set is of real benefit.  One of the main advantages - beyond enabling deaf children to perceive all the speech sounds and so develop a (visual) phonetic awareness – is that it helps deaf children to use clear and appropriate lip-patterns themselves.  It is also an invaluable tool in helping deaf children to perceive and use appropriate word endings such as plural and past tenses and develop a natural speech pattern with intonation. 

Speech and Language Therapist (SALT) Anne Clarke explains the use of CS at Thornfield House School for children with language impairments in Belfast.  SALTS, teachers and classroom assistants use CS daily with specific children to develop their phonological awareness, sequencing of sounds, blending and segmenting as well as speech production.

Bilingualism – Spoken Languages

The system of Cued Speech has been adapted for at least 68 languages and dialects and more are being developed all the time.  This means that it is highly likely that families and professionals will be able to represent as many spoken languages as they wish for the deaf children in their lives.  There are as many ways to model more than one language for children as there are families doing so.  One tried and tested method is for someone to use different hands for the different languages eg cue English with the right hand and French with the left.  Deaf children receiving languages in this way are no different to hearing children hearing the different languages and will easily adapt.  All children in bilingual situations will naturally ‘code switch’ expressively for a while and use a mixture of words from each language before they refine their skills to one language at a time.

'Using Cued Speech, families can also raise multilingual children who might understand Spanish, English and Dutch for example.  I know of families where the children use three modes of communication, spoken English, ASL, and Cued English.’ Charles Berlin Ph.D., who is Professor of Hearing Science and Clinical Professor of Otolaryngology Head and Neck Surgery, LSU Health Services Center

Parents of a profoundly deaf child describe how their family was able to give their deaf daughter full access to both English and French by cueing each language. Their daughter developed age appropriate language and literacy in both languages.

Film of the same family discussing their cueing journey.

CS has been adapted to many different languages and dialects around the world and more are being developed all the time, and this link lists many of them.

Bilingualism – Signed and Spoken Languages

Within a sign language using Deaf family, visual access may still be possible to both the sign language of the home and the spoken language of the country.  Often hearing family members such as grandparents, will cue for their deaf grandchildren but if the deaf parents themselves were raised with CS then they may also decide to use it expressively with their own children.

British Sign Language is a 100% visible language.  Cued Speech makes the language of English 100% visible. 

 ‘Complete Bilingualism’ for deaf children means:

  • fluency in English in all its richness when access is given visually through Cued Speech by competent users of English.
  • fluency in BSL in all its richness when access is given visually by competent users.

This document sets out how CS can be used alongside a signed language.  It explores how concepts and vocabulary can be conveyed visually, both by using a signed language, and using Cued Speech to make a spoken language fully visible.

Document written by a parent of a profoundly deaf boy who was able to understand the spoken language of the home through cueing and use BSL as his expressive language.  Additional notes are included from their advisory teacher.

Use with Deafened Adults

Cued Speech can be of real benefit to adults with a hearing loss by giving full access to spoken language, helping them process new vocabulary accurately and keep their own pronunciation skills honed.

The situation for deaf adults falls broadly into three categories:

  1. Deaf adults who are already fluent in English - and Cued Speech - because they have had access through Cued Speech from an early age
  2. Deafened adults who are already fluent in English because they have previously had normal hearing
  3. Deaf adults who may be signers and wish to learn English as a second language.

1. Deaf Adults who have had access to English through Cued Speech may continue to use it:

  • to access any social or work situation as required.
  • to clarify new words.
  • to help themselves improve their own lip-patterns/pronunciation.
  • to support lip-reading in ‘difficult’ situations e.g. over a wide distance, with someone who has unclear lip-patterns, in new situations.
  • as a transliteration service.

2. Deafened adults who are already fluent in English because they have previously had normal hearing:

  • will need to train with someone with whom they regularly communicate.  They need to be able to ‘receive’ a cued message and do not need to learn to cue themselves, although many find it helpful to do so as a way to deepen their understanding of the system.

The English language is notoriously difficult to lip-read as about 70% of the lip-patterns are so similar they cannot be differentiated.  It does take time to learn to ‘cue read’, but it is worth the effort because with the cues added it may become possible to lip-read with almost 100% accuracy, which is a huge advantage for deafened people functioning ‘in the hearing world’.

  • By learning to lip-read somebody who is cueing, the ability to lip-read others who are not cueing is also increased.
  • They may make use of a transliteration service.
  • They may relieve the stress of lip-reading as this takes an enormous amount of energy and concentration, watching someone cueing is far less tiring.
  • It will be possible to learn/see the correct pronunciation of new vocabulary.
  • You can use Cued Speech like a therapy tool to maintain and improve clear speech patterns.

3. Deaf adults who wish to learn English as a second language:

  • One of the arguments for using sign language is that it is ‘natural’ because it is visual and does not require the receiver to hear anything to understand it.  It is also possible for deaf people to receive spoken language in this perfectly ‘natural’ way by seeing it cued.  Cued Speech is an entirely visual mode and also does not require the receiver to hear anything to understand it.
  • Cued Speech may also support the understanding of written English as each sound within each word is visually represented.  These individual sounds can then be separately emphasised and linked to the appropriate spelling choices.  In this way the Deaf person can develop a phonological awareness and then draw on the same skills that hearing people use when they read or write English.  (Hearing people recall how words ‘sound’ when they read and write - they turn those sounds into letters when they write and turn letters into sounds when they read.  With Cued Speech, Deaf people can learn to use those same techniques.)

Case Studies

How has cueing been used by hearing families with a deaf child, deaf families and professionals.

Lots of video examples.

The Family’s Perspective

A fascinating and  in depth description of a family’s journey with cueing and the reasons they chose to use it alongside signing for their profoundly deaf son.

Access to communication in English – article by a parent of a bilingual deaf child.

A parent gives  a brief description of using cueing with both of her profoundly deaf sons.

The Cued Speech website shows a range of videos captured of parents discussing their experiences with CS.

The Professional’s Perspective

A Teacher of the Deaf describes how a deaf girl she works with was able to accelerate her literacy learning when she and two teaching assistants learned to cue for her.

An article by Charlotte Lynch,  a ToD, explains how one implanted little girl has benefited from CS.

Cued Speech at Manchester schools -– Tina Kirwin and Alison Patton (BATOD Magazine 2008) write about a workshop describing how the Manchester Service uses cued speech with the children that they work with.

Cued Speech and BSL at ERADE Lee Fullwood and Cate Calder describe the use of Cued Speech and BSL at ERADE (Exeter Royal Academy for Deaf Education) (BATOD May Magazine 2014)

Listen and watch about Cued Speech

A mainstream primary school teacher talks about successfully using cueing with her whole class to support their phonics learning.

Film of the mum of a deaf child and the classroom assistant that works with her explain how recently learning to cue has helped them to support that child’s speech production, give her access to English vocabulary and enabled reading skills to develop.

A 5 year old deaf boy demonstrating his reading skills with cueing (after only 7 months exposure!) while his TA describes how she uses it to give him access to English and literacy lessons at school.

Wendy (a year on from the previous film) describes a mainstream phonic programme that she is able to give Alfie full access to through cueing.

The manager of the peripatetic Teacher of the Deaf Service in Devon explains how his team are trained in Cued Speech to support literacy skills for deaf children in mainstream schools and how they have developed the role of Deaf Inclusion Workers in the county to provide bilingual access through signing and cueing for deaf children.

A Deaf Inclusion Worker working with an 11 year old in a mainstream school using both BSL and CS. After only one year the boy has gone from being pre-literate to having a reading age of 5.5yrs.

The same Deaf Inclusion Worker explains how she used cueing to give three BSL using deaf boys access English; and in particular technical maths vocabulary.

A teacher explains how she learned to cue and found ways to use it in her work with mainstreamed deaf children.

Two professional cuers from France talk about their work with the French version of Cued Speech.

 

 

Deaf People’s Perspective

A deaf man describes how his understanding of English and educational experience was greatly enhanced once his parents started to use CS with him from 5th grade onward.

 

Experiences & Perceptions of Cueing Deaf Adults in the US, 2010, Crain & LaSasso. Cued Speech and Cued Language for Deaf and Hard of Hearing Children, Plural Publishing, 2010.

Film -  a Deaf BLS user talks  about how learning to cue is helping her with the English language.

CueTube

Lots of short films of parents and professionals talking about how they use Cued Speech, including examples of Cued Speech in action. 

An American website – lots of films showing  how different families, professionals and deaf people themselves use cueing in their lives.

Evidence

Research and evidence into using cueing to support language acquisition, listening and lip-reading skills and age-appropriate literacy levels for deaf children.

Early Language Acquisition

Dr Ruth Campbell, Ph.D Foreword, ‘Cued Speech and Cued Language for Deaf and Hard of Hearing Children’ Plural Publishing 2010 

Berlin, C. I., et. al. ‘Multi-site diagnosis and management of 260 patients with [ANAD]’, International Journal of Audiology, 2010; 49; 30- 43 

Nicholls, G. H., & Ling, D. (1982). Cued Speech and the reception of spoken language. 

Journal of Speech and Hearing Research, 25, 262 -269 

Santana, R. (1999). ‘Papel de La Palabra Complementada en el desarrollo y uso de las representaciones fonológicas en el sordo’ [Cued speech role on the development and use of deaf’s (sic) phonological representations]. University of Las Palmas de Gran Canaria. 

LaSasso, C., Crain, K. L., and Leybaert, J. (2010) ‘Cued Speech and Cued Language for Deaf and Hard of Hearing Children’, Plural Publishing

more information 

Cochlear Implant Users

Cued Speech and Cochlear Implants: Powerful Partners - Smith, J., (2006) full text 

 

Cued Speech and the Reception of Spoken Language - Nicholls, G. H., Ling Mcgill, D., (1982)  abstract 

 

Cued Speech for Enhancing Speech Perception and First Language Development of Children with Cochlear Implants - Leybaert, J., LaSasso, C. J., (2010)  abstract 

 

Cued Speech in the stimulation of communication: an advantage in cochlear implantation - Descourtieux, C., Groh, V., Rusterholtz, A., Simoulin, I., Busquet, D., (1999)  abstract 

 

Effects of English Cued Speech on Speech Processing and Literacy: A single case study - Bladel, J., Rees, R., (1989) abstract 

 

From 1-word to 2-words with cochlear implant and cued speech: A case study - Moreno-Torres, I., Torres, S., (2008)  abstract 

 

Influence of communication mode on speech intelligibility and syntactic structure of sentences in profoundly hearing-impaired French children implanted between 5 and 9 years of age. - Vieu, A., Mondain, M., Blanchard, K., Sillon, M., Reuillard-Artieres, F., Tobey, E., Uziel, A., Piron, J. P., (1998)  abstract 

 

Reading and Reading-Related Skills in Children Using Cochlear Implants: Prospects for the Influence of Cued Speech Bouton, S., Bertoncini, J., Serniclaes, W., Cole, P., (2011)  abstract 

 

Research into profoundly deaf children’s English language comprehension and expression, Marilyn Peterson, The Cued Speech  Resource Book for Parents of Deaf Children by Dr R Orin Cornett, Ph.D. & Mary Elsie Daisey, M.Ed.

Lip-Reading Skills

The role of lip-reading and Cued Speech in the processing of phonological information in French-educated deaf children. - Alegria, J., Charlier, B., Mattys, S., (1999)  abstract 

 

Use of Internal Speech in Reading by Hearing and Hearing-Impaired Students in Oral, Total Communication, and CS Programs - Wandel, J. E., (1990)  full text 

 

An investigation of speechreading with and without Cued Speech - Gregory, J. (1987).  abstract

 

CS improves the speechreading capabilities of profoundly deaf students.

  • Clarke, B. & Ling, D. (1976) "The Effects of Using Cued Speech: A Follow-up Study" The Volta Review, 78, 23-24.

CS instruction improved the speechreading ability of hearing subjects.

  • Chilson, R. F. (1979) "Effects of Cued Speech on Lipreading Ability." Master's thesis, University of Rhode Island.
  • Neef, N. & Iwata, B. (1985) "The Development of Generative Lipreading Skills in Deaf Persons Using Cued Speech."
    In Analysis and Intervention in Developmental Disabilities, Vol. 5, pp. 289-305.

CS significantly improved speechreading abilities of prelingually deaf persons. This study analysed the process.

  • Kaplan, H. (1974) "The effects of Cued Speech on the speechreadingability of the deaf."
  • Effects of English Cued Speech on Speech Perception, Phonological Awareness and Literacy. Rees R and Bladel J. Journal of Deafness and Education International, vol 14, no 4 2013.  182-200

Literacy

Effects of English Cued Speech on Speech Processing and Literacy: A single case study - Bladel, J., Rees, R., (1989) abstract

Reading and Reading-Related Skills in Children Using Cochlear Implants: Prospects for the Influence of Cued Speech - Bouton, S., Bertoncini, J., Serniclaes, W., Cole, P., (2011) abstract 

An Alternate Route for Preparing Deaf Children for BiBi Programs: The Home Language as LI and Cued Speech for Conveying Traditionally Spoken Languages - LaSasso, C. J., Metzger, M. A., (1998)  abstract 

An examination of Cued Speech as a tool for language, literacy, and bilingualism for children who are deaf or hard of hearing - Reynolds, S. E. (2007)  full text 

In addition, an informal report into the use of Cued Speech at a special school:  Can Late and Limited Exposure to Cued Speech Impact the English Skills of Signing Deaf Pupils? By Laura Gratton  read full text 

Strength of Evidence

Cued Speech was originally devised in 1966 and throughout the years since it has been subject to research by a diverse range of scientists working in disciplines such as linguistics, psycholinguistics, neurolinguistics, cognition, speech science, hearing science, social science and computer science as well as by practitioners working directly in the field of deafness.  We would recommend the publication "Cued Speech and Cued Language for Deaf and Hard of Hearing Children" edited by Carol J. LaSasso, Kelly Lamar Crain and Jaqueline Leybaert which summarises findings by at least 44 contributing researchers across 4 countries.

Transferability

The system of Cued Speech has been adapted to represent the phonemes of at least 63 different languages and dialects across the world with more adaptations being developed all the time. British English uses 8 hand shapes, 4 positions about the face and 4 movements, to date the adaptations for all the cued languages draw from 17 hand shapes, 5 positions and 5 movements. Some examples are French, Spanish, Polish, Slovak, Chinese, Thai Tammasaeng, Urdu, German and the full range of English dialects such as American, Australian, South African, Welsh and Scottish.

 

Editor’s comments

It is estimated that there are 45,000 children in the UK with some degree of permanent hearing loss and over 90% of those children are born into hearing families who are of course using a spoken language in the home.  The human brain as it develops will naturally integrate what it hears of a spoken message with what it sees from the lip-patterns and other facial features, this is natural a process that reaches completion in adolescence. We offer Cued Speech as a system that works in sympathy with this facility of the brain to process speech in a multimodal way, adding the cues to a spoken message simply gives consistent visual clarification to what may or may not be accessible to deaf child through listening.

Areas for further research

Current research in the UK is being done at University College London - Can explicit training in Cued Speech improve phoneme identification? Rachel Rees, Claire Fitzpatrick, Jess Foulkes, Hilary Peterson & Caroline Newton. Please visit www.cuedspeech.co.uk to access more information on international research projects and results.

Online Community

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