Hearing is one of the crucial senses through which we perceive our surroundings and navigate our environment. It also helps with maintaining balance, but its most important role is in enabling communication and social interaction. Speech and language develop through hearing, which are essential for establishing communication with others and building interpersonal relationships. However, hearing loss can significantly affect quality of life, whether it is partial or complete. People with hearing loss often struggle with acquiring speech and language, which can negatively affect communication and other daily activities involving social interaction. In children with normal hearing, speech and language development starts at a very early age as they are exposed to sounds and speech from their environment. Children who hear naturally and spontaneously acquire spoken language as their first and native language. In contrast, children with hearing loss face unique challenges. Due to their hearing impairment, they are unable to develop speech and language naturally. Instead, they learn speech and language through rehabilitation methods, relying on whatever hearing remains and the capabilities of their hearing aids.

The greater the hearing loss and the earlier it occurs, the more significant the challenges in speech and language development will be. Hearing loss affects both speech-language development and literacy in deaf and hard of hearing individuals. The impact largely depends on several factors: the degree of hearing loss, when it started, when it was diagnosed, when rehabilitation began, the consistency and intensity of the rehabilitation, the hearing status of the parents, and the support from family and the environment. Children with hearing loss often lag their hearing peers in speech and language development. Some children may not develop intelligible speech or master spoken language by adulthood, leading to difficulties with reading and comprehension. For them, spoken language may feel like a foreign language. They often turn to sign language as their primary mode of communication if they have the opportunity to learn it and interact with others using it. For instance, this is common in deaf families where sign language is the primary language or in educational settings where sign language is used. However, this is not always the case, as some children successfully acquire spoken language and develop reading and writing skills comparable to those of their hearing peers. Several factors influence language acquisition and the choice of language modality. The hearing status of the parents plays a crucial role in determining whether their child with hearing loss will learn spoken or sign language, based on their own first language, social interactions, experiences with education and rehabilitation, and preference for specific rehabilitation methods. Ultimately, the parents’ choice will determine whether the child with hearing loss learns sign language or spoken language.