Sign Language and Augmentative and Alternative Communication in Early Intervention

Written by Amanda Franklin

Use of Baby Signing

Baby sign language is a strategy that has become particularly popular within recent years as hearing parents have used sign to communicate with their hearing children who have yet to learn to speak. There is plenty of discussion within the educational world that begs the question of whether or not baby sign is beneficial or harmful for typically developing hearing infants. There are three positions that people generally fall into in these beliefs; those who advocate for the benefits in linguistic and cognitive development, those who advocate for the purpose of early bilingual language learning, and those who believe it competes for attention with spoken language and that it delays spoken language acquisition (Seal & DePaolis, 2014). The impact of sign language intervention on development and interaction with others will be explored throughout this article.

A review done by Fitzpatrick, Thibert, Grandpierre, and Johnston in 2014 focused on outcomes with interest in receptive and expressive, or understanding and expressing, language. The study focused on communication in typically developing hearing infants. “Three studies suggest that using baby sign language does not interfere with parent-child interaction and may, in fact, contribute to positive interactions” (Fitzpatrick, Thibert, Grandpierre, & Johnston, 2014). Overall, the research shows that there is not a strong compilation of evidence that would support the benefits in language acquisition for typically developing children, but allows for certain interactions that are not possible until later in development. For typically developing children, there is a short window in which sign language can enhance early communication, but there has been no evidence that would support the notion of lasting benefits in spoken language or cognitive development. Overall, the authors concluded that while there is no evidence that supports long-lasting benefits for typically developing children, there is also no evidence that shows adverse effects to typical language development or parent-child interaction. There is no reason to advocate for or discourage the use of symbolic gestures or sign language in early communication with young, typically developing children (Fitzpatrick et al., 2014). The research and studies simply do not provide statistically significant evidence that can support or disprove that the use of signing helps or harms linguistic development.

Expression of Vocabulary Acquisition in Children with Intellectual Disabilities

In Seal and DePaolis’ study (2014), they focus on the relationship between vocal, as in verbal, and manual, as in using of the hands or gestural, activity. Their study shows a clear link between both verbal and nonverbal means of expressive communication. The study also places emphasis on the parent and whether they emphasize only a certain number of signs, which can restrict, or limit, a child’s manual-vocal development trajectory. This is important, as the study shows that parents who use American Sign Language, British Sign Language, or another sign language better support manual-vocal activity which leads to increased manual-vocal activity in interactions and more meaningful gestures, signs, and first words. The results of this study conclude that there are no language based deficits derived from the use of baby sign. They also fail to support the concerns of those who warn against the use of baby sign due to the belief that it interferes with the learning of spoken language (Seal & DePaolis, 2014). Baby signing is not shown to advance or delay spoken language acquisition in infants.

In typically developing children, it is clear that there is no evidence that supports the use of baby signing for the purpose of long-term benefits. However, when the child is atypical, we see different results. For children with intellectual disabilities, language acquisition can be limited or delayed. Vandereet and others in 2011 attempted to identify factors that contributed to the development of language in children with intellectual disabilities. Specifically, their aim was to “explore whether point of view, sign, child, and social environmental characteristics, as factors, are sufficient to explain the degree to which children with ID depend on manual signs during the longitudinal process of their expressive vocabulary acquisition” (Vandereet, Maes, Lembrechts, & Zink, 2011). Factors related to vocabulary acquisition include child characteristics, cognitive skills, communication skills, initial vocabulary comprehension, social-environmental characteristics, and home environment. The conclusion of the study shows that exposure to manual signs does not guarantee that the child will use them or develop adequate symbolic skills. Linguistic, cognitive, and communicative factors that are fundamental to the development of speech are also notably fundamental in the development of manual sign use (Vandereet et al., 2011).

Social-environmental factors have a vital role in language acquisition within the studies. Making sure that parents are able to support the use of signing in the home was an emphasized point in Vandereet and others’ study. It is also an important factor in “Predicting Language Outcomes for Children Learning Augmentative and Alternative Communication: Child and Environmental Factors” (2013), as their findings showed that in children with a speech delay, without intervention, the children will typically receive less language input from parents and peers. Increasing input at home and stressed importance of an enriched home language environment can positively affect growth of vocabulary. The findings of the study “support the importance of enriching social communication input across home and school environments during this sensitive period of symbolic word learning, as well as assessments of and interventions aimed at improving comprehension, play, visual discrimination, and communication complexity” (Brady, Thiemann-Bourque, Fleming, & Matthews, 2013). This factor was one of a few that was found to significantly be able to predict word production in early intervention.

Use of Sign Language and Augmentative and Alternative Communication

The use of sign language and augmentative and alternative communication(AAC) in hearing children with the presence of disorders such as Autism Spectrum Disorder and Down Syndrome has become commonplace as over 50,000 children between the ages of 4 and 6 years are learning to communicate with forms of AAC (Brady et al., 2013). Augmentative and alternative communication includes any form of communication other than oral speech that is used to express ideas, needs, or wants. For children with intellectual disabilities, this allows them to communicate in ways other than communicating verbally. In Toth’s study in 2009, it was affirmed that children seek to communicate, regardless of ability. Given the chance and education to use a different form or method of communication, via a visual or gestural language, such as American Sign Language, or a text or symbol to speech method, children respond. The will to communicate shows through physical, developmental, and cognitive impairment (Toth, 2009). Children exposed to sign language can have very different results. In Toth’s study, the results were shown in narrative form to give better context of results. In multiple cases, correlated with small developments in vocalization, modification of maladaptive behavior, and improved communication with others.

In Toth’s study (2009), the narrative results of the Bridge of Signs program show many improvements to the lives of the children involved as one of the children in the study who was nonverbal with autism had reduced some frustration and gave the family hope for the possibility of their son developing language. This was not the only case in the study where a participant in the program responded to a caregiver’s attempt to interact by pausing maladaptive behavior to make eye contact and view the signs. At a minimum, the children in the program who had severe difficulties came away from the program with the ability to anticipate a transition from one activity to another, a greeting, and a nutrition or bathroom break. Some others who were a part of the study developed their spoken language as well as their signing.



Brady, N. C., Thiemann-Bourque, K., Fleming, K., & Matthews, K. (2013). Predicting language outcomes for children learning augmentative and alternative communication: child and environmental factors. Journal of Speech, Language, and Hearing Research, 56(5), 1595-1612 .

Fitzpatrick, E. M., Thibert, J., Grandpierre, V., & Johnston, J. C. (2014). How handy are baby signs? a systematic review of the impact of gestural communication on typically developing, hearing infants under the age of 36 months. First Language, 34(6), 486-509.

Seal, B. C., & DePaolis, R. A. (2014). Manual activity and onset of first words in babies exposed and not exposed to baby signing. Sign Language Studies, 14(4), 444-465.

Toth, A. (2009). Bridge of signs: can sign language empower non-deaf children to triumph over their communication disabilities? American Annals of the Deaf, 154(2), 85-95.

Vandereet, J., Maes, B., Lembrechts, D., & Zink, I. (2011). Expressive vocabulary acquisition in children with intellectual disability: speech or manual signs? Journal of Intellectual & Developmental Disability, 36(2), 91-104.


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