Role of speech therapy and sign language prior to cochlear implantation.

The speech therapist should assess and develop the communication skills of the deaf child prior and after a cochlear implantation. The goals are first the acquisition of a useful communication system by the deaf child (for avoiding a cognitive stimulation lack) and parallely the acquisition of good oral language competencies. The different modes of communication useable in the profoundly deaf education are presented. Exclusive sign language use is not indicated in implanted children. It is well demonstrated that an exclusive oral communication is associated with an insufficient knowledge of the oral language. The total communication (combination of listening, speech reading, signing with or without finger spelling) is a defective communication mode with a bad representation of the morpho-syntactic and the phonologic aspects of the oral language. The best choice seems to be the simultaneously use of a spoken language and a manually coding of their phonological structures. The limits of this alternative are discussed.