Auditory System Hearing Testing Impairments Deaf Communication

For many years, both the Deaf community and the hearing community have engaged in debate about the relative benefits of manual vs. oral communication. These two types of communication for deaf and hard of hearing individuals have relative benefits and downsides; points of concern include Deaf cultural identity and assimilation and communication with the hearing community.

Manual Communication

The term “manual communication” refers to communicating through movements of the hands, rather than through spoken words. Supporters of manual communication are often members of Deaf culture, who believe that deafness is a part of a cultural identity, and that sign language is the natural language of the deaf. The best-known forms of manual communication are signed languages, such as American Sign Language (or ASL). Signs derive their meaning from:

  • Facial gestures and body language
  • Hand movement
  • Hand placement
  • Hand shape.

These languages have their own grammar, and are distinctly separate from their spoken counterparts. Signed Exact English is a less common form of manual communication, which is based on English grammar and word order, translated directly into signs.

Cued speech is a form of communication that has both manual and oral elements. Cued speech users use oral language; however, not all spoken words can be understood solely by looking at the speaker’s mouth. For example, when the words “bat,” “pat,” and “mat” are mouthed silently, they cannot be differentiated; listeners rely on auditory information to make a distinction. Cued speech assigns a different manual cue to sounds that look the same on the lips in order to facilitate spoken language use. Cued speech can be helpful because individuals who have been deaf or profoundly hard of hearing for long periods of time can have somewhat distorted speech, because their auditory feedback loop (ability to listen to and monitor their own speech) is not intact.

Oral Communication

“Oralists,” or supporters of oral communication for the deaf community, argue that the hearing community’s communication with deaf and profoundly hard of hearing individuals is hampered by the use of manual communication systems. That is, members of the hearing community who do not understand sign language must rely on a third party interpreter to communicate with users of ASL. They advocate use of oral communication (speech) for deaf and hard of hearing individuals so that they may assimilate into the hearing community and communicate easily with hearing individuals. The oralist approach advocates early and intensive training in speechreading and speech production for individuals who are hard of hearing or deaf. Communication with hearing peers is facilitated through this training.

The oral vs. manual approach discussion has been controversial for centuries. Historically, manualists and oralists have often been unable to find common ground. If you or a loved one has to make this difficult decision, it is important to weigh both sides of the issue, and choose the method that is best for your lifestyle and personal values.


Baker, K. (2008). Oral communication versus american sign language. Retrieved February 7, 2010, from Drury University Web site: