- Who, who, here, here, here.

- [Pamela] Parents of young children gather at Rhode Island School for the Deaf.

- What are we doing next?

- Good job, good job.

- [Pamela] To learn American Sign Language or ASL together.

- A group hug is what this mouse needed.

- [Pamela] David Melowney is their teacher being interpreted aloud.

- This is the sign for I love you.

You'll see this a lot in American Sign language.

- [Pamela] They are starting early to make sure their deaf and heart of hearing children don't fall behind.

Nancy Maguire Heath has been director at Rhode Island School for the Deaf for the last 11 years.

- We frequently, especially the last few years, have had number of students referred to us who have no language or have little language.

They may have 50 to 100 spoken words when they should have thousands by that age.

- [Pamela] Most arrive never having learned any sign language.

And Maguire Heath is entrusted with helping them catch up after years of missing out on opportunities to learn.

- You and I, because we are hearing, we learn from our environment all the time.

We learn from mom on the telephone talking to the plumber.

A deaf child may not get any of that.

They're not getting that incidental learning that our brain grows from.

- [Pamela] That brain growth is the focus of extensive research by Dr. Wyatte Hall, assistant professor of Public Health Sciences at the University of Rochester Medical Center.

He says when it comes to language exposure, there's a ticking clock.

- [Wyatte] We've seen a lot of research that there appears to be a critical period or a sensitive period depending on who you talk with.

That period is a time where we are born biologically ready to acquire language.

- [Pamela] Studies estimate the window lasts from birth to ages three to five.

If children can't easily hear people talking or see people signing, they run the risk of developing what's known as language deprivation.

- Their thinking becomes locked in the concrete.

They can keep learning, but they don't do well in the abstract and they can't keep up.

(child howling) - Oh, you're a wolf now?

- No, I'm a werewolf.

- Oh, you're a werewolf?

- [Pamela] Emma White, a social worker in Rhode Island, is dedicated to ensuring her five-year-old son Luca is immersed in language.

- One, two, three, four, five, six.

- Okay, you gotta find a green square.

The first one?

- The first time.

- The first time.

- [Pamela] White found out Luca was profoundly deaf in both ears when he was just three weeks old.

- I'm just thinking like, is he ever going to be able to hear, will he ever be able to talk?

Am I gonna be able to communicate with him?

What did you make at grandma's today?

- Snow man.

- How many?

- Two.

- Two?

- [Pamela] Parents of deaf and hard of hearing children are usually given two main options.

- Should we be signing to him?

Should we be focusing on spoken language?

The advice that I was getting was at times conflicting of what I should do.

- That's the parents.

- Good job.

- [Pamela] The family started off by learning sign language and then at a year old, Luca received a cochlear implant.

Unlike a hearing aid, which amplifies sound, a cochlear implant is surgically connected to the hearing nerve in the brain.

The vast majority of infants born in the US today get the procedure.

What was it like the first time that you realized he could hear your voice?

- I remember it was the S sound, and he, I don't think had ever really been able to hear that with his hearing aids.

So when he heard that, he was just like looking around, and I was like, okay, it worked.

Now the work is really gonna start.

- [Pamela] And start it did.

- What color did you get?

- Purple.

- Purple?

- [Pamela] Appointments to calibrate the sounds Luca hears, speech therapy, and advocating for accessibility at school.

But for many families at her school, Maguire Heath says the money and time needed for these programs is out of their reach.

- The cochlear implant can be a very successful tool if the child can learn from it.

What's being left out is that it's not a magic bullet.

It becomes a class issue, a socioeconomic class issue.

I see many children who are implanted and parents are very excited about doing that, but they are parents who don't have the means or the ability, even if they have the desire to do the work, to get maximum benefit from that tool.

- Mouse sliding down the hill.

- These days, many deaf adults use a combination of sign language and hearing technology, but in our conversation with Dr. Hall, he notes that cochlear implants and ASL are often pitted against one another.

- [Wyatte] Some people think if you learn ASL first, it would somehow harm cochlear implant outcomes.

We actually have some research suggesting that signing children can do better with their cochlear implants and have better speaking abilities than non-signing children who are implanted.

- Does that message seem to be getting out though?

- [Wyatte] Well, no.

There is a very powerful, a very strong structure and system, both medical and education in our country that strongly support using spoken language only approaches.

So the best numbers that we have is roughly less than 10% of deaf children in America are getting early access to sign language.

- [Pamela] Jesus Flores was not diagnosed as deaf until he was three years old.

His mother, Marta Gomez, spent years trying to figure out why he wasn't communicating.

Doctors told her.

- If you put a cochlear implant, Jesus gonna talk, or you can leave it there and just do a sign language.

Of course, I'm gonna go to the side for he can talk, he can hear because all my family can be like good communication with him.

- [Pamela] Jesus went through three surgeries for his cochlear implants.

He also went to a specialty school in Rhode Island that exclusively focuses on spoken language.

After seven years at the school, Jesus wasn't showing much progress.

- And I'm asking for a second opinion.

And with the second opinion, they did tell us we got that wrong diagnosis.

- It turned out Jesus had an auditory nerve problem that the cochlear implant would never have been able to resolve.

And how did you feel when you heard that?

- Oh my God, my whole entire word is like, everything is I cry, I cry a lot, I cry a lot.

And then when I decide to thinking about something else and we talking about School of the Deaf in that moment.

- So up until that point, had he had much language development?

- No, he tried to say words, but basically, I never know if he can understand, fully understand that.

- So he was living in a pretty silent world for many years.

For children who rely solely on cochlear implants, not hearing enough during their formative years can be detrimental.

- [Wyatte] By the time the critical period is over, it's very difficult to go back and fill in the gaps for their language functioning and for their everyday use of language.

- [Pamela] Jesus didn't start learning ASL until he was 11 years old at Rhode Island School for the deaf.

Social worker Gerlany Mejia has been a support for both Gomez and Jesus.

- So Jesus is the one student who we know he will always support his peers.

If there's something going on, we know Jesus knows what's happening because he's so helpful and so kind and compassionate.

- He's 16.

And where would you say he's in school now?

- Way behind, elementary.

Like way, way, way, way behind.

- So he has to work harder?

- So hard.

- [Pamela] Dr. Hall says that language deprivation shouldn't happen to any child.

- [Wyatte] We already know how to prevent these problems.

You give deaf children sign language.

It's completely preventable.

I've seen problematic framings that options are framed as or, that you have to pick ASL or English, a spoken language.

What I've also seen is it does not have to be that way.

It can be and.

You can have ASL and English, you can give all the options.

- [Pamela] To prevent that language deprivation, more than 20 states across the country have passed laws to monitor deaf children's language development milestones.

Similar bills have been proposed in Rhode Island, but have not passed.

- [Interpreter] Good morning, good morning.

- [Pamela] Another group of hearing parents.

- [Interpreter] If you've made a snowman with your child, you can explain the buttons.

- [Pamela] Meet to learn sign language from David Melowny who is being interpreted aloud.

- [Interpreter] And there's snow.

He sees more snow, he's like, "yes, there's more snow".

And he's excited.

- [Pamela] He signs the picture book "The Snowy Day".

- [Interpreter] So Peter was sleeping all night.

- [Pamela] And teaches key vocabulary to parents.

- [Interpreter] Morning.

And then third, sliding.

He's walking along, he sees a tree.

He looks up and he's poking the tree, poking it again.

- [Pamela] So that they can sign bedtime stories to their children.

- Pete.

Pete, Pete got up.

He woke up?

He wake up.

He woke up?

He woke up?

Yep.

- [Interpreter] My parents were not strong signers at all, but they did sign.

They tried their best and I'm so thankful for them for being willing and able to learn how to communicate with me.

Keep that in the back of your head.

Keep communicating, keep trying to improve, keep working on it.

The fact that you are showing the effort is really great.

- [Pamela] It's a familiar road for Gomez who has been learning sign language for Jesus.

She says he helps her get better.

- Example, we cooking together, and I'm gonna ask Jesus, how I sign this, or how I say this, I try.

- He's teaching you?

- Yes, he's my teacher, and when I do it wrong, he laugh for me too.

- What do you say to him to keep him motivated?

- I just show how much I love him and doesn't matter what happened.

He always got all my support.

- [Pamela] And that's the approach Maguire Heath says all parents should take.

- You're the oil that connects things.

You're the link that connects things for your child.

There's no limit to what they can learn and what they can do, but they need you to help connect it to what's really happening in the world.

Accept your child as he is, she is.

Let them know that and to give them every tool in the book, including American Sign Language, and they will let you know what works for them and what doesn't work for them, and they will appreciate that you were open to all of that.

(gentle music)