Journal of Deaf Studies and Deaf Education, 2023, 28, 350–362

https://doi.org/10.1093/deafed/enad026
Advance access publication date 29 July 2023
Empirical Manuscript

Deaf and Hearing American Sign Language–English

Bilinguals: Typical Bilingual Language Development
1,2 1,2,3,
Corina Goodwin and Diane Lillo-Martin *
1 Department of Linguistics, University of Connecticut, Storrs, CT, USA
2 TheConnecticut Institute for the Brain and Cognitive Sciences, University of Connecticut, Storrs, CT, USA
3 Haskins Laboratories, New Haven, CT, USA

*Correspondence should be addressed to Diane Lillo-Martin, 365 Fairfield Way, Unit 1145, Storrs, CT 06269-1145, USA. E-mail: diane.lillo-martin@uconn.edu

Abstract
Some studies have concluded that sign language hinders spoken language development for deaf and hard-of-hearing (DHH) children
even though sign language exposure could protect DHH children from experiencing language deprivation. Furthermore, this research
has rarely considered the bilingualism of children learning a signed and a spoken language. Here we compare spoken English
development in 2–6-year-old deaf and hearing American Sign Language–English bilingual children to each other and to monolingual
English speakers in a comparison database. Age predicted bilinguals’ language scores on all measures, whereas hearing status was
only significant for one measure. Both bilingual groups tended to score below monolinguals. Deaf bilinguals’ scores differed more from
monolinguals, potentially because of later age of and less total exposure to English, and/or to hearing through a cochlear implant.
Overall, these results are consistent with typical early bilingual language development. Research and practice must treat signing-
speaking children as bilinguals and consider the bilingual language development literature.

Introduction other problematic scientific arguments and long-standing biases

This study presents data regarding the spoken English devel- against sign languages, have been used by professionals to dis-
opment of deaf and hearing American Sign Language (ASL)– courage sign language use with DHH children (as discussed in
English bilingual children. People using both a sign language Hall, 2017; Hall et al., 2019; Henner & Robinson, 2023; Humphries
and a spoken language are considered bimodal bilinguals because et al., 2016; Lillo-Martin et al., 2021; Mauldin, 2016). In contrast, if
their two languages primarily occupy two different modalities: we recognize that a child exposed to both a signed and a spoken
auditory/vocal and visual/gestural. We will also use the term language is bilingual, we can learn from the immense literature
“sign–speech” bilinguals in contrast to “speech–speech” bilinguals about speech–speech bilinguals and set realistic expectations for
in this article, with speech–speech referring to bilinguals who language development in two languages.
use two spoken languages. Samples of spontaneous spoken lan- For instance, numerous studies have found that standardized
guage production from both groups of bilinguals were compared tests in a single language underestimate speech–speech bilingual
with each other and with those of hearing, monolingual English- children’s overall language abilities (Castilla-Earls et al., 2020;
speaking children. We discuss the similarities and differences in Thordardottir, 2015). Therefore, when research with DHH children
spoken language development across these three groups and how fails to acknowledge language skills outside of the spoken modal-
the results here should be used to inform language choices for ity, results are inherently biased against children whose language
deaf and hard-of-hearing (DHH) children. knowledge is distributed across a spoken and a signed language
One main argument we make in this paper is that DHH chil- (e.g., see comments by Hall et al., 2019, regarding the study
dren learning both a signed and a spoken language should be by Geers et al., 2017). Furthermore, a singular focus on spoken
considered bilinguals. While this may seem obvious, much of language as the only acceptable manifestation of verbal abilities
the previous literature about these children has not taken their ignores the importance of language, regardless of modality, to a
bilingualism into consideration. Research has typically compared child’s cognitive and social–emotional development (Glickman &
bilingual signing and speaking DHH children to those learning Hall, 2019).
a single (spoken) language, often finding the signing-speaking The remainder of this introduction will set the stage for our
children to be deficient (i.e., that the bilingual DHH children study by discussing the factors that are expected to inf luence
scored below monolingual English-speaking DHH children on the language development of DHH children learning a signed and
standardized tests of spoken English, as in Geers et al., 2017; a spoken language. We will interweave evidence from speech–
but see Fitzpatrick et al., 2016 for a systematic review finding speech bilingualism research with the more limited research on
that there is insufficient high-quality evidence to be conclusive). sign–speech bilinguals specifically, and we will discuss results
The results from these lines of research, in combination with from research with hearing sign–speech bilingual children.

Received: August 23, 2022. Revised: March 15, 2023. Accepted: June 2, 2023
© The Author(s) 2023. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com
 C. Goodwin and D. Lillo-Martin | 351

We will end the introduction with our research questions and typical hearing), and amount of input (which can be exacerbated
predictions. by factors such as implant failure, periods of nonuse, etc.). Fur-
Before we begin, we would also like to note that the current thermore, parental attitude toward deafness and sign languages
study focuses on children learning a natural sign language, ASL, is another factor that can affect the amount of exposure to each
and spoken English. However, there are additional ways in which language that DHH children receive (Clark et al., 2013).
DHH children can be considered bilingual. For example, some Broader societal attitudes toward bilingualism have also been
use a sign language and only the written form of a spoken found to affect patterns of linguistic development (Smithson et al.,
language, and they are clearly also bilingual. Some may use 2014). In the United States, the language use of speech–speech
multiple different sign languages or multiple different spoken bilinguals has historically been characterized as “deficient” for the
languages. Furthermore, children exposed to a sign system (e.g., ways in which it differs from monolinguals, and systematic efforts
Signing Exact English) and a spoken language potentially could be have been made to assimilate children to a monolingual Standard
considered bilinguals as well. This is because these children must American English ideal (Flores & Rosa, 2015). Children, especially
learn two phonetic inventories, two vocabularies, potentially two those from first nations groups and immigrant groups, have been
grammars, as well as the pragmatics concerning which contexts physically and emotionally punished for using a language other
map onto the use of each communication modality. Since sign than English in the classroom and have sometimes been relegated
systems are not natural languages, there will be some differences to special education based on IQ tests administered in English, a
in language development based on the type of sign system a child language they may not yet have been f luent in (e.g., Hurstfield,
is learning (Scott & Henner, 2020; Supalla, 1991). Nevertheless, the 1975; Newland, 2022). Because of this subtractive approach to
linguistic experiences of children learning a sign system along bilingualism, children’s development in the majority language (in
with a spoken language are comparable in many ways to those this case, English) often comes at the expense of the minority, or
of bilinguals. home language (Ebert, 2020).
Recent research is shifting from this deficit-based framework
Factors that Influence Bilingual Language toward one that values the linguistic skills of bilinguals (Flores
Development & Rosa, 2015). This modern approach also acknowledges that
Research with speech–speech bilinguals has found many input bilingualism is not double monolingualism, as famously stressed
factors to be relevant to the pace of development in each lan- by Grosjean (1989) and echoed by many others; a bilingual’s
guage. For example, earlier ages of language exposure generally languages interact in complex ways. Thus, their language use may
lead to higher proficiency in a given language (Unsworth, 2013). not look like that of a monolingual in either of their languages.
The manner in which the language input is divided is also impor- Yet despite this shift in framing, the subtractive approach to
tant, with some researchers finding that children must receive bilingualism remains predominant in our society, especially for
a certain percentage of their input in a language to score com- racialized and disabled children (Henner & Robinson, 2023).
parably to monolinguals (Thordardottir, 2019). Similarly, we must DHH children have faced similar discrimination in American
also consider the cumulative amount of exposure a child has to educational systems. Learning spoken English has long been val-
each language, with more exposure leading to higher proficiency ued above all other types of education, such as reading, math,
(Bedore et al., 2016). The number of people who use each language science, and social studies (Booth, 2021, pp. 53–56). DHH students
with a child can also be important, especially for the minority have experienced physical punishment and shaming for use of
(home) language (Unsworth, 2016). sign language in the classroom (Baynton, 1996). Sign languages
It can be presumed that input factors such as these are also are often viewed as animalistic and judgments of a DHH person’s
highly relevant to sign–speech bilinguals. For example, only a very intelligence and worth are frequently based on their ability to
small proportion of DHH children are born into families in which emulate a hearing ideal of spoken language (Henner & Robin-
a natural sign language is already used; according to Mitchell & son, 2023; Holcomb & Lawyer, 2020). The American subtractive
Karchmer (2004), this percentage is not more than 5%. For other approach to bilingualism more broadly, as well as the low status
children, timing of initial sign language exposure, as well as quan- of sign languages specifically, has led to many DHH children
tity and quality of input can vary greatly. Some hearing parents being denied sign language entirely, despite proclamations from
opt to learn to sign, but it takes time before they are able to provide the United Nations and the World Federation of the Deaf reaf-
f luent sign input; meanwhile, the number of other signers the firming the right to sign language for all DHH children (United
child might be exposed to (e.g., DHH mentors, early intervention Nations, 2006; World Federation of the Deaf, n.d.). This subtractive
providers, community members) will vary greatly. Many parents approach to bilingualism means that DHH children are at risk
do not learn to sign (Gallaudet Research Institute, 2011), and their of losing f luency in their sign language as they become more
DHH children’s first exposure to their sign language might occur proficient in a spoken language. It also means that their spoken
at entry to school or often much later, when the child moves from language skills may look more monolingual-like if they become
a program providing spoken language exclusively, to one that uses dominant in spoken language.
a bilingual approach including sign language. While American cultural and educational practices have been
Sign–speech bilinguals also show variation in the age and harmful to hearing children who use a language other than
quantity of exposure to their spoken language. Many DHH chil- English at home, the stakes are even higher for DHH children.
dren receive cochlear implants to improve their access to sound, Because it is still difficult to predict which children will suc-
but the age of implantation varies from as young as 9 months ceed with spoken language using modern hearing technology,
(per 2020 FDA guidelines) to several years (Teagle et al., 2019). withholding sign language denies some DHH children a strong
Following implantation, these children need aural rehabilitation foundation in any language at all (Hall et al., 2019). This language
services, which also contribute to the variation in input provided. deprivation can lead to widespread deleterious consequences,
Even for DHH children who have sufficient access to spoken such as emotional dysregulation and executive dysfunction (e.g.,
language, it is different from that of children born with typical Gulati, 2019). The singular focus on speech for DHH children
hearing—in age of onset, quality of sound (which is different from also ignores additional benefits of sign language use, such as
352 | Journal of Deaf Studies and Deaf Education, 2023, Vol. 28, No. 4

development of self-acceptance and a deaf identity (Gale, 2021; between the deaf and hearing native signers. However, other
Mayer & Leigh, 2010, p. 176). studies examining specific areas of ASL development in sign–
speech bilingual children have found differences in comparison
Sign–Speech Bilingual Language Development to monolinguals, which can be attributed to the participants’
in DHH Children bilingualism (Chen Pichler et al., 2018). For example, Palmer (2015)
Many studies of language development in DHH children have found that very young ASL–English bilinguals did not make use
included a heterogenous group of participants in terms of their of the full range of word-order changing operations in ASL as a
background knowledge of a natural sign language. Most partic- comparison group of deaf signers did. Similarly, Reynolds (2018)
ipants would have been first exposed to ASL (or another sign observed differences in the use of reference tracking devices in
language or sign system) in primary school or perhaps preschool, the narratives expressed in ASL by ASL–English bilinguals (deaf
with varying degrees of quantity and quality of input. It is clear cochlear implant users and hearing native signers) compared with
that the earlier a child is exposed to f luent signed input, the ASL-dominant deaf signers. These studies reinforce the conclu-
more likely they will have better outcomes in their sign language sion that bilingual children are not just like monolingual children
(Henner et al., 2016, 2019; Hrastinski & Wilbur, 2016). Given the in either of their languages—even the one that they began to
variability introduced by input variation, we will focus here on acquire first and use at home.
children who have had access to sign language input from birth. It
is important for future research to develop better understanding Sign–Speech Bilingual Language Development
of early language development in DHH children with later and in Hearing Children
more variable input (see, e.g., Berger et al., 2023; Caselli et al., 2021; While research examining the development of spoken language
Pontecorvo et al., 2023). by signing DHH children often overlooks the fact that they are
A few studies have specifically examined language develop- bilingual, a related problem can be found in studies of language
ment in DHH children who experienced f luent sign language development in hearing children whose deaf parents use a sign
input from birth, and who also accessed spoken language through language with them at home. In particular, some studies raised
cochlear implants. Hassanzadeh (2012) examined speech percep- concerns that although these children have typical hearing, they
tion, speech production, and language development in spoken would have difficulties with speech if the model of spoken lan-
Persian for seven cochlear-implanted deaf children of deaf, sign- guage they received at home was from a deaf caregiver. This
ing parents, compared with data from deaf children with hearing viewpoint continues to be seen in practice, as many families and
parents. Hassanzadeh found that the children with early sign speech–language pathologists continue to express concern about
language exposure outperformed the children of hearing parents, possible negative inf luences of the use of a natural sign language
and recommended that deaf children be encouraged to sign before for hearing children, and they are over-referred for spoken lan-
implantation. Similarly, Davidson et al. (2014) looked at several guage treatment (Chen Pichler et al., 2014).
measures of spoken English development in five deaf, cochlear- In contrast, many studies have found that hearing sign–speech
implanted children exposed to ASL from birth, and compared bilingual children’s spoken language development is not delayed
their results with those of 20 hearing children who also had or harmed by their exposure to a sign language (for overviews,
been exposed to ASL from birth. They found that the two groups see Lillo-Martin et al., 2022; Quadros et al., 2016). Research has
performed very similarly, and furthermore, that they scored at investigated the language development of sign–speech bilingual
age-appropriate levels for monolinguals on standardized tests for children for the insights that such studies can provide on the
which such comparisons were possible. nature of bilingualism. For example, Petitto et al. (2001) observed
Goodwin & Lillo-Martin (2019) examined additional data from three hearing children of deaf parents, who were learning both
the five deaf, sign–speech bilingual children in Davidson’s study, spoken French and the sign language used in Montreal, Langue
in comparison with seven hearing sign–speech bilinguals, focus- des signes québécoise. They found that the children’s early lan-
ing specifically on the development of English grammatical mor- guage milestones were equivalent in the two languages. Impor-
phemes. They also observed no statistically significant difference tantly, studies of sign–speech bilingual development in hearing
in accuracy between the two groups. They did find that the deaf children have consistently observed typical bilingualism effects
children seemed to make more errors than the hearing children (Lillo-Martin et al., 2016).
on the use of regular plurals, which might be attributed to the Before introducing the details of the current study, we provide
lower acoustic salience of this grammatical morpheme in English. some background on bilingual language sample analysis (LSA), as
While the studies summarized here have found high levels of this is the approach we take.
performance in the spoken language of sign–speech bilinguals,
it is important to point out that age-equivalency with monolin- Bilingual Language Sample Analysis
guals should not be the general expectation for either DHH or LSA involves the collection and analysis of language samples
hearing bilinguals. As we have already noted, bilinguals typically in order to measure aspects of a child’s productive ability in a
progress along a different time scale compared with monolinguals naturalistic environment. It is often seen as an integral part of
in both of their languages and their languages may inf luence language assessment for bilingual children (Castilla-Earls et al.,
one another. Furthermore, for DHH children accessing spoken 2020; Ebert, 2020). LSA has advantages over standardized quanti-
language through hearing technology, factors such as the timing tative approaches to language assessment for bilingual children,
and quality of input accessed using hearing technology, and the although the latter are still frequently used (Caesar & Kohler,
relative amount of input in each language, can be expected to 2007). Furthermore, LSA is not immune from the vulnerabilities
have an effect. This can lead to hearing sign–speech bilinguals when using comparisons between bilinguals and monolinguals, a
showing scores that are closer to those of monolinguals than DHH point we will return to in the Discussion. Some of the benefits of
bilinguals do. LSA are that it can be considered ecologically valid and is appro-
The study by Davidson et al. (2014) included one test of ASL priate for use with the youngest of children. Additionally, LSA
development, which also indicated overall parallel performance can simultaneously provide information about multiple linguistic
 C. Goodwin and D. Lillo-Martin | 353

levels (e.g., phonology, vocabulary, morphology, and syntax) and dataset on these two populations presented to date. We focus on
can be conducted in both of a bilingual’s languages. three main research questions:
Here we discuss basic outcomes from research using the same
(1) Do deaf and hearing ASL–English bilinguals show increasing
three language measures that we will present below for the ASL–
scores on English vocabulary diversity, syntactic complexity,
English bilinguals in our current study. The first measure, vocab-
and syntactic diversity from ages 2 to 6 years?
ulary diversity (VocD), is a measure of the diversity of vocabulary
(2) Do deaf and hearing ASL–English bilinguals have similar
items used that was developed to be less dependent on sample
scores on English vocabulary diversity, syntactic complexity,
size than alternative measures, such as number of different words
and syntactic diversity from ages 2 to 6 years?
and type-token ratio. VocD has been found to increase develop-
(3) How do both groups of bilinguals’ scores on the three lan-
mentally from ages 18 to 60 months (Durán et al., 2004). The sec-
guage measures compare to a database of hearing, monolin-
ond measure, Mean Length of Utterance in Morphemes (MLUm), is
gual English-speaking children?
a measure of syntactic complexity based on the average number
of morphemes per utterance across a language sample. MLUm For research questions 1 and 2, we use a linear mixed-effects
has been widely used across theoretical and clinical studies of model to explore possible contributions of age and group to scores.
language development and has been found to be sensitive to We expect that age will significantly predict language scores, with
differences because of Specific Language Impairment/Develop- increasing age associated with higher scores as all participants
mental Language Disorder until around age seven (Rice et al., experienced additional cumulative exposure to spoken English
2010). The last measure, the Index of Productive Syntax (IPSyn), with their increasing age. We also expect possible significant
is a checklist of 59 English grammatical constructions; children differences for hearing status. This is because the deaf children
can score 0, 1, or 2 points for each item, depending on how many (1) began learning spoken English at a later age than the hearing
times the structure occurs in the sample (Altenberg et al., 2018). children because of the inaccessibility of spoken language prior to
IPSyn can be used to understand a child’s developing syntactic cochlear implantation, (2) experienced degraded auditory input
diversity. For typically developing monolingual children, IPSyn through their cochlear implants, which cannot perfectly replicate
scores have been shown to plateau early in development, making natural hearing, and (3) likely experienced some disruption in
this measure most appropriate for use in monolingual children up access to spoken language through periods of disuse of their
to age 4 years. cochlear implants.
Research using LSA has generally found that speech–speech For research question 3, we analyze Z-scores using the CHILDES
bilinguals tend to score below monolinguals on these three lan- KidEval monolingual database as the reference distribution of
guage measures, although the difference is not always statistically scores. We predict that both groups of bilinguals will tend to score
significant (Blom, 2010; Otarola-Seravalli, 2021; Paradis & Gene- lower than monolinguals on all language measures (i.e., have
see, 1996). Input factors are important, with some studies showing negative Z-scores). This is expected because previous research has
that balanced bilinguals, or those with relatively equal amounts demonstrated numerous ways in which bilingual language devel-
of exposure to each language, do not differ from monolinguals in opment differs from that of monolinguals, typically manifesting
either of their languages (Thordardottir, 2015). On the other hand, as lower scores on English language measures. Furthermore, we
results differ for children who receive disparate amounts of input predict that the deaf bilinguals might differ more from the mono-
in each language and who thus become dominant in the language linguals because they likely have experienced a later onset of
that they have greater exposure to. These children tend to look access to spoken language, as well as less overall English input,
like monolinguals in their dominant language and to score below which may also have differed in perceptual quality from the hear-
monolinguals in their nondominant language. ing group. However, when the deaf bilinguals are compared with
Generally, research on spoken language development using LSA hearing children at a similar hearing age, we expect differences in
with DHH children who use cochlear implants has found that they scores to be reduced.
tend to score lower than hearing monolinguals on the number of
different words produced (results not available for VocD specifi-
cally), MLUm and IPSyn (Geers, 2004; Tomblin et al., 1999; Yang
Method
et al., 2021). Some (but not all) research has found that when Participants
children with cochlear implants were matched to hearing peers All data were collected and managed in compliance with Uni-
based on the time since they received their implant (so-called versity IRB guidelines. We present data from two groups of ASL–
“hearing age”), rather than based on their chronological age, there English bilingual children between the ages of 20 and 71 months:
were no longer any differences between DHH and hearing children six hearing children and six deaf children who used CIs. None
(Flipsen & Kangas, 2014; Tavakoli et al., 2015). Additionally, while of the participants were diagnosed with an additional disability.
some research has found that use of a signed system did not Both groups of bilinguals were drawn from a longitudinal corpus
inf luence IPSyn scores specifically (Geers, 2004), other research of ASL–English bilingual children collected over a period of years
has found that early exposure to a natural sign language may be as part of a larger project on the development of ASL–English
beneficial (Davidson et al., 2014). bilingualism, for which participants were recruited from the deaf
community (Chen Pichler et al., 2016; Quadros et al., 2014).
All participating children had at least one Deaf parent and
The Current Study were exposed to ASL from birth. The hearing children were also
In this study, we analyze vocabulary diversity using VocD, sen- exposed to English from birth by hearing family and community
tence complexity using Mean Length of Utterance in morphemes members, but spoken language was not accessible to the deaf
(MLUm), and sentence diversity using the Index of Productive children until after they received their cochlear implants. All deaf
Syntax (IPSyn) in the longitudinal spontaneous spoken language children received regular English speech and language therapy
produced by deaf and hearing ASL–English bilinguals between the as recommended by their interventionists. Table 1 provides
ages of 2 and 6 years. The current study includes the largest such basic demographic information for all participants, and Table 2
354 | Journal of Deaf Studies and Deaf Education, 2023, Vol. 28, No. 4

Table 1. Participant information

Hearing Pseudonym Sex Maternal Number of deaf/hearing Language use at homeb Language use at Other deaf family
status educationa parents (%ASL/%English/%Mix) school/daycareb membersc
(%ASL/%English/%Mix)

Deaf D1 M 16+ 2(mother, father)/0 50/0/50 0/100/0 2 siblings

D2 M 16+ 2(mother, father)/0 50/0/50 0/50/50 1 sibling, grandparents
D3 F 16+ 2(mother, father)/0 75/5/20 0/100/0 None
D4 F 16+ 2(mother, father)/0 50/0/50 0/100/0 2 siblings
D5d M 16+ 2(mother, father)/0 50/0/50 0/100/0 2 siblings
D6 M 16+ 2(mother, father)/0 50/0/50 0/100/0 1 sibling, grandparents

Hearing H1d M 16+ 2(mother, father)/0 50/30/20 0/100/0 1 sibling, 1 grandparent

H2 F 16 1(father)/1(mother- Unknown Unknown Grandparents, aunt,
CODAe ) uncle, cousins
H3 M 16+ 1(mother)/1(father) 40/20/40 0/100/0 Grandparents
H4d M 16+ 1(mother)/1(father) 50/20/30 60/0/40 None
H5 M 16+ 2(mother, father)/0 80/10/10 0/100/0 None
H6 M 16+ 1(mother)/1(father) 75/15/10 0/100/0 None

Notes. a Maternal education is measured in years, with “16” indicating an undergraduate degree. b Parents were asked to report the proportion that American
Sign Language (ASL), English, or a mix of ASL and English was used with their child at home and at school and/or daycare. c Family member(s) that the
children had regular contact with. d Attended an ASL/English bilingual daycare or preschool before moving to an all-English program. e Mother’s parents are
deaf ASL signers.

Table 2. Audiological characteristics for deaf participants

Pseudonym Age at first implant activation (months) Age at second implant activation (months) Pre-aided hearing level

D1 13 23 Severe to profound
D2 19 19 Profound
D3 18 42 Profound
D4 12 12 Profound
D5 16 42 Severe to profound
D6 12 17 Profound

provides audiological information for the deaf participants. For all During these sessions, the child and interlocutor engaged in
the deaf participants, parental reports indicate that the children age-appropriate play with toys and/or books. Interlocutors were
were deaf at birth. trained to encourage the child to lead the discussion. Naturally,
All children used ASL in the home; some children also attended the amount of language produced by children varied greatly
bilingual ASL–English (pre-)school programs for a period of time. across sessions.
While we do not include any measure of language dominance Participants were invited to engage in weekly data collection
here, it is likely that many of the children may have had rela- sessions over a period of ∼2 years. Because of the significant
tively balanced language skills or been ASL-dominant early in imposition of such a study, participating families sometimes could
the observation period. This is when they were toddlers and not meet the expected schedule, but continued in the study as
likely spent more time in the ASL-rich home context. As the much as availability permitted. A few of the families agreed to
children entered preschool or kindergarten, their exposure to remain in the study for roughly an additional year. The small size
English likely increased, possibly leading to English dominance, of the population from which the native signing children with CIs
especially for those children attending a monolingual English is drawn also means that some participants were only recruited
school. Three of the hearing participants and three of the deaf at a later age. This necessary f lexibility in data collection resulted
participants took part in a separate study that assessed their in differential age ranges and frequency of samples available
overall ASL and English skills when they were 5–1/2–6 years for the present study. In general, the project aimed to collect
old (Davidson et al., 2014), using the ASL-Receptive Skills Test data in sessions which alternated between ASL as the target
(ASL-RST; Enns & Herman, 2011) and the Preschool Language language, with deaf and f luent hearing signers as interlocutors,
Scales, Fourth Edition (PLS-4; Zimmerman et al., 2002). On the and English as the target language, with hearing English-speakers
PLS, five of the six participants scored within 1 standard deviation as interlocutors.
of the mean on both subscales (Expressive Communication and For the current analysis, all available English-target sessions
Auditory Comprehension); the sixth child, a deaf participant, had up to one per month for each child within the age range 20–
a standard score of 75 on the Auditory Comprehension portion of 71 months were included, resulting in a total of 189 sessions.
the test. On the ASL-RST, all participants scored at or above the While ASL-target sessions were also collected as part of the larger
mean standard score (of 100) with the exception of one hearing project on ASL–English bilingualism, none of these sessions were
child, whose standard score was 97. Unfortunately, we do not have analyzed here. Similarly, while many children used some ASL in
scores on such assessments for the other six participants. English-target sessions, no ASL utterances or signs were included
in the analyses discussed below. The different numbers of ses-
Procedure sions that were available for each participant across different age
All children were recorded while interacting with researchers ranges are shown in Table 3 below (see Supplementary Figure 1
or family members during spontaneous play sessions of ∼1 hr. for distribution of observations).
 C. Goodwin and D. Lillo-Martin | 355

Table 3. Number and age range of observations per child Table 4. Linear mixed effects models results

Hearing status Pseudonym Age range Number of Predictors Estimates CI p

(months) observations
VocD
Deaf D1 34–71 25 (Intercept) 19.28 9.43 to 29.14 <.001∗∗∗
D2 66–70 4 Age mths .40 .19 to .61 <.001∗∗∗
D3 63–71 5 Group [hearing] 5.37 −7.51 to 18.26 .414
D4 23–34 11 Age × Group .04 −.26 to .34 .808
D5 54–71 11 MLUm
D6 28–56 18 (Intercept) 1.13 −.17 to 2.44 .088
Total 74 Age mths .04 .02 to .06 .001∗∗
Group [hearing] −.65 −2.30 to 1.00 .442
Hearing H1 24–67 24
Age × Group .02 −.01 to .06 .121
H2 27–64 22
H3 24–40 12 IPSyn
H4 36–71 20 (Intercept) 22.00 13.99 to 30.02 <.001∗∗∗
H5 23–60 25 Age mths .36 .22 to .51 <.001∗∗∗
H6 22–41 12 Group [hearing] −17.38 −27.13 to −7.63 <.001∗∗∗
Total 115 Age × Group .46 .27 to .65 <.001∗∗∗

Note. MLUm, Mean Length of Utterance in Morphemes; VocD, vocabulary

diversity; IPSyn, Index of Productive Syntax, ∗ p < .05. ∗∗ p < .01 ∗∗∗ p < .001.

All sessions were first transcribed using the ELAN transcription

program (Crasborn & Sloetjes, 2008). The English transcriptions analyzed each measure using the glmmTMB package (Brooks et al.
were produced by undergraduate research assistants who 2017) of R (R Core Team, 2021) running within RStudio (RStudio
were trained to follow the English transcription conventions Team, 2019). We used the performance package (Lüdecke et al.,
that were adopted by the lab, based on the conventions in 2021) to check model assumptions; we checked for normality
the CHILDES/CHAT Manual (MacWhinney, 2000). At any point using residuals and random effects, we checked for linearity, and
when a question arose as to the appropriate annotation, the we checked for homogeneity of variance. None of the model
questionable segment was discussed in the lab until a consensus assumptions were violated. The full model did not converge for
was reached. IPSyn, so we re-ran the model omitting by-participant slopes, and
The ELAN transcripts were then checked by the lab manager this second model converged. The R script used in our analysis is
and converted into CHAT format. The MOR function was then available in the Supplementary Material on OSF.
used to morphologically analyze all words within each transcript, We summarize the statistical results in Table 4, and plot the
and the morphologically analyzed transcripts were checked. This overall distribution of raw scores in Figure 1. Plots of results by
allowed us to use the KidEval utility within the Computerized individual participant are provided with the full data set on OSF.
Language Analysis program (Ratner & MacWhinney, 2016). KidE- As shown in Table 4, age was a significant factor for all three
val automatically calculates various measures of spoken English measures. Group was not a significant factor for MLUm. Group
language development and compares them to a hearing, monolin- was also not a significant factor for VocD, although the mean
gual English-speaking reference database constructed from the score for the hearing group was consistently higher than the mean
overall CHILDES database (https://childes.talkbank.org). KidEval score for the deaf group, and the variance is high. The interaction
compares each individual transcript to children of a similar age between age and group was not significant for either MLUm or
in the reference database, which is split into nine different 6- VocD. For IPSyn, age, group, and the interaction between age and
month age intervals between the ages of 18 and 71 months group were all significant.
(e.g., 18–23 months, 24–29, etc.). KidEval provides the database
group mean and standard deviation for each measure, as well as (3) How do both groups of bilinguals’ scores on the three lan-
information about how much the comparison child’s score differs guage measures compare to a database of hearing, monolin-
from the database mean in terms of standard deviations. We gual English-speaking children?
analyzed vocabulary diversity using the VocD measure, syntactic Z-scores were used to compare bilingual participants’ English
complexity using MLUm, and syntactic diversity using IPSyn. language skills to those of monolinguals. Z-scores indicate how
far an individual score falls from the comparison mean in terms
of the number of standard deviations, where a Z-score of −1
Results indicates that an individual score is 1 standard deviation below
Results are presented as responses to the three research questions the mean, 0 indicates that an individual score is the same as
raised earlier, starting with questions (1) and (2). the mean, and 1 indicates that an individual score is 1 standard
deviation above the mean. The reference means and standard
(1) Do deaf and hearing ASL–English bilinguals show increasing
deviations are drawn from the KidEval reference database.
English vocabulary diversity, syntactic complexity, and syn-
Figure 2 shows the distribution of Z-scores for participants
tactic diversity from ages 2 to 6 years?
on all three language measures by group. Assuming a normal
(2) Do deaf and hearing ASL–English bilinguals have similar
distribution of monolingual scores in the KidEval database, we
scores on English vocabulary diversity, syntactic complexity,
expect about 50% of monolingual scores to fall below the mono-
and syntactic diversity from ages 2 to 6 years?
lingual mean. The majority (74–95%) of Z-scores for both groups
We addressed these questions using linear mixed effects mod- of bilinguals fell below the monolingual mean (i.e., Z < 0) on all
els, with participants as a random effect (including by-participant three language measures, as shown in Table 5. It is important to
intercepts and slopes), and hearing status as a fixed effect. We note again, however, that the data are not cross-sectional; each
356 | Journal of Deaf Studies and Deaf Education, 2023, Vol. 28, No. 4

Figure 1. Spoken English Raw Scores by Age for American Sign Language–English Bilinguals. Note. VocD, vocabulary diversity; MLUm, Mean Length of
Utterance in Morphemes; IPSyn, Index of Productive Syntax. Each child contributes more than one data point to each scatterplot.

Table 5. Distribution of Z-scores by group

Language measure Z<0

Monolingual expected Deaf bimodal bilingual Deaf bimodal bilingual Hearing bimodal bilingual
(chronological age) (hearing age)

VocD 50% 95% 72% 74%

MLUm 50% 84% 60% 86%
IPSyn 50% 84% 58% 83%

Z < −1.5

VocD 6.7% 30% 9% 7%

MLUm 6.7% 16% 1.5% 6%
IPSyn 6.7% 14% 6% 8%

Note. MLUm, Mean Length of Utterance in Morphemes; VocD, vocabulary diversity; IPSyn, Index of Productive Syntax.

bilingual participant contributes different numbers of scores to age. The results of this comparison are also given in Table 5,
each group. under the heading “Deaf bimodal bilingual (hearing age).” Using
In order to get an idea of the magnitude of difference between the hearing age standard, the percent of scores below the mean
the two groups of bilinguals and the monolingual scores in the is similar to or less than the percent for the hearing bimodal
KidEval database, we also looked at the percentage of scores that bilinguals. Looking at the percent of scores over 1.5 standard
fell more than 1.5 standard deviations below the mean (Z < −1.5). deviations below the mean, the deaf bilinguals are again similar to
There is no standard to rely on for potentially clinically significant or less than the corresponding scores for the hearing participants.
scores on language samples of bimodal bilinguals, so we selected
1.5 SD as one of the options that is used for other standardized
measures and one that would be more conservative in identi- Discussion
fying potentially significant delays. Again, assuming a normal We analyzed spoken English data from the largest set of sponta-
distribution for the monolingual database, about 6.7% of scores neous speech samples from deaf and hearing ASL–English bilin-
are expected to fall 1.5 standard deviations below the mean. The gual children to-date. We investigated which factors (age and
hearing bimodal bilinguals had roughly this number of scores on hearing status) predicted English-language outcomes, as well as
the measures VocD and MLUm, and a slightly higher number on how the bilinguals compared with hearing, monolingual English-
IPSyn (see Table 5). However, there were a greater proportion of speaking children.
such scores for the deaf bilinguals on all three language measures. Using a generalized linear mixed effect model, we found that
In view of the fact that the deaf bimodal bilinguals received scores on English-language measures of vocabulary diversity
access to spoken language after CI activation, we determined (VocD), syntactic complexity (MLUm), and syntactic diversity
each child’s “hearing age” for every observation by using their (IPSyn) increased with age. This is unsurprising given that all
activation date rather than their birthdate. We then compared participants had cumulatively more exposure to English as they
the score for each session against the monolingual database for got older. We also found that hearing status (deaf or hearing)
children in the same age band as the deaf participants’ hearing significantly predicted scores on only one out of the three
 C. Goodwin and D. Lillo-Martin | 357

Figure 2. Spoken English Z-scores by Age for American Sign Language–English Bilinguals. Note. VocD, vocabulary diversity; MLUm, Mean Length of
Utterance in Morphemes; IPSyn, Index of Productive Syntax. Each child contributes more than one data point to each scatterplot.

language measures, IPSyn, although a larger sample size might preschool/early school age children with large norming samples.
have led to significance for group on VocD as well (see Table 4). One existing test is the ASL-Receptive Skills Test (Enns & Herman,
Potential differences between the results for the deaf and hearing 2011). As mentioned earlier, a subset of the current participants
groups would be consistent with what is understood about how were given the ASL-RST, and performed age-appropriately.
input affects bilingual language development, since the deaf ASL– While LSA is an important tool for assessing the language
English bilinguals were exposed to English later than the hearing development of bilingual children, including bimodal bilinguals,
bilinguals (Unsworth, 2016). They also likely continued to have it has limitations. In addition to the time and expertise that are
less exposure to English after cochlear implantation because of needed to conduct LSA, it cannot capture the full extent of a
periods of processor disuse and differences in sound quality. child’s linguistic abilities. Language samples provide a limited
Turning to the Z-scores analyses, results were consistent with snapshot of a child’s production capabilities, underestimating the
expectations based on previous studies with speech–speech bilin- child’s full knowledge since a child might not happen to produce
guals. When compared with chronological age cohorts of hearing, utterances of which they are capable during the observation
monolingual English speakers, both groups of ASL–English bilin- period. In addition, a language sample study does not assess
guals tended to score below the monolingual mean at higher rates children’s comprehension abilities, which may well supersede
than would be expected for a group of monolinguals, based on a their production.
normal distribution. This is unsurprising given that the bilinguals We do want to stress that the participants in this study had very
received less exposure to spoken English than the monolinguals. good access to both ASL and English, and we recognize that this is
In terms of the magnitude of this difference, the deaf bilinguals not the case for all DHH children. Nevertheless, they also differed
tended to score lower than 1.5 standard deviations below the in factors such as number of deaf/signing family members, birth
mean more than would be expected for monolinguals on all order, educational and/or child care experiences, etc. While such
three language measures. However, when we compared the deaf factors may also affect the timecourse of language development,
children to hearing monolinguals who matched their “hearing given the small size of our sample it is not possible to draw
age” by taking into consideration the age of activation of their any conclusions about how these factors might specifically have
cochlear implants, they patterned closer to the hearing bilinguals. inf luenced the results of this study.
For a full picture of the language skills of the participants, it
would be vital to assess their ASL as well as their English. A similar
approach has been argued for assessing bilingual children with Implications
other language pairs (Castilla-Earls et al., 2020). Unfortunately, it Children acquiring a sign language and a spoken language
is much more challenging and time consuming to do analyses are bilingual, and therefore expectations regarding milestones
such as the ones presented here for ASL, using language sample of development in each language should consider this factor.
analyses. There is no automated system for conducting language With the recognition of their sign language, bilingual deaf
analyses, and no comparison group database against which to children may be progressing in the development of their spoken
measure results. In ongoing work, we are developing and applying language at a different pace compared with monolingual children.
LSA techniques to data that we previously collected with deaf Thus, previous studies that used deaf children’s slower pace
children of deaf parents (Lillo-Martin et al., 2017, 2021). Our of development in spoken language to justify excluding the
preliminary conclusion from this work is that an ASL version use of sign language must be reexamined in light of all that
of IPSyn is more sensitive to language development in children is known about bilingual language development (see also Hall
ages 2–5 years than is application of MLU to sign language data. et al., 2019). Furthermore, the benefits of early bilingualism for
There are also unfortunately few tests of ASL development for DHH children far outweigh the potential risks of severe effects
358 | Journal of Deaf Studies and Deaf Education, 2023, Vol. 28, No. 4

from language deprivation, and a typical bilingual difference in to the later start, lower quantity, and different quality of the
pace as compared with monolinguals should not be considered English input that the deaf children received using their cochlear
problematic. implants as compared with the English input received via typical
This is not to say that all DHH children who are exposed to hearing for the hearing children. Possible differences between
a natural sign language are developing language typically. Many the bilinguals as a group compared with the monolinguals
of these children experience a period of no accessible input, could be attributed to the fact that as bilinguals, they divide
which surely affects their language development, and the possible their time between two languages. This entails that the timing,
effects of lower quantity and quality of their signed input are amount, and quality of input for each language separately are
currently unknown. Nevertheless, understanding the factors that likely to be less than what a monolingual would experience. As
are known to affect bilingual language development will help to noted in the introduction, multiple studies of bilingual children
calibrate expectations regarding the pace of achieving various attest that such differences contribute to differences in the pace
milestones. of acquiring linguistic f luency including vocabulary diversity,
Given the prevalence of periods of language deprivation for syntactic complexity, and syntactic diversity. Additionally, a
DHH children, the magnitude of the consequences of this sit- bilingual’s production of both of their languages may differ
uation cannot be overstated. Early accessible language input is from that of a monolingual because of interaction between the
crucial for the development of multiple cognitive and social– two languages in domains such as phonology and syntax (e.g.,
emotional abilities, including executive function (Goodwin et al., Serratrice, 2013). Hence, the mere exposure to a sign language
2021; Hall et al., 2018), Theory of Mind (Schick et al., 2007), is not clearly a causal factor when looking at differences in the
and numeracy (Carrigan et al., n.d.; Langdon et al., 2020). Many pace of spoken language development between monolingual and
parents are advised to pursue a monolingual spoken language bilingual DHH children.
approach initially, with the reassurance that their DHH child can Given the known and expected differences in the development
learn a sign language later if it turns out to be desirable (Sugar, of a majority language by bilingual children, we believe that over-
2015). However, this approach ignores the serious consequences all group differences between the bilinguals and monolinguals
for children lacking early, accessible language input. Additionally, in our study should not be worrisome. Differences in the pace
the view that sign language can be learned later overlooks the of language development between bilinguals and monolinguals
well-documented critical period for sign language development are not necessarily in themselves indications of language delay
(Mayberry & Kluender, 2018). or deviance; rather, they are indications of bilingualism. Previous
What this discussion makes clear is that monitoring the devel- research with deaf children who had early experience with a
opment of both speech and sign is critically important. We stress natural sign language and attended schools providing instruction
that we do not advocate low expectations for deaf and hear- in ASL (Henner et al., 2019; Hrastinski & Wilbur, 2016) leads us
ing ASL–English bilinguals; rather, we ask that speech–language to expect that these children will show good academic achieve-
pathologists, early interventionists, educators, and other service ment in the community language. Moreover, they will experience
providers draw on the knowledge base that has already been the academic, social, and personal benefits of bilingualism (Hol-
developed based initially on speech–speech bilinguals and apply comb & Lawyer, 2020). We support shifting from a subtractive
this to sign–speech bilinguals. As such, we support the use of approach to bilingualism wherein English development occurs at
methods proven to be effective in evaluating bilinguals, such as the expense of the minority language toward an additive approach
using converging evidence from parent and teacher reports, LSA, to bilingualism in which children are supported in the develop-
and evaluation of learning potential using dynamic assessment ment of both (or all) of their languages and one form of expression
(Castilla-Earls et al., 2020; Chen Pichler et al., 2014; Holcomb & is not seen as superior to another.
Lawyer, 2020; Mann et al., 2014). It is important to remember that the participants in this study
Because we need to assess skills in both of a child’s languages, all had the benefit of early exposure to f luent ASL from their
we also need to support the study of sign language develop- deaf, signing parents. Most DHH children have hearing parents
ment and deaf researchers creating knowledge of sign language who were unfamiliar with deaf culture and natural sign languages
acquisition, in order to have valid and reliable measures of ASL before their child was born. If these children are exposed to a
(Henner et al., 2019; Holcomb & Lawyer, 2020). Toward this end, sign language, they may become sign–speech bilinguals, but the
we encourage cross-disciplinary research collaborations and the input factors we discussed earlier—timing, quantity, and quality
recruitment and support of deaf students in the audiology, speech of accessible linguistic input—will likely inf luence the course
language pathology, linguistics, education, and early intervention of development of both their sign language and their spoken
fields. Furthermore, more resources should be dedicated to assist- language. One recent study (Caselli et al., 2021) observed ASL
ing hearing parents and family members in learning a natural vocabulary development in DHH children of hearing parents. They
sign language, and serious efforts should be made to increase found that children whose exposure to ASL began by the age of
the inclusion of deaf mentors and deaf educators as role models 6 months showed ASL vocabulary sizes and rates of vocabulary
(Cawthon et al., 2016; Clark et al., 2020; Gale, 2021; Hecht, 2020; growth resembling those of DHH children with deaf, signing par-
Wilkinson & Morford, 2020). ents. Children whose exposure began between 6 and 36 months
had somewhat smaller vocabularies, an indication of the effect of
input timing. However, they also made rapid gains.
Conclusion For children acquiring both a sign language and a spoken
We introduced the current study by proposing three research language with more variable input, tracking progress in both
questions. These questions ask about two kinds of comparisons: languages becomes even more important, given the major impact
first, between the deaf and hearing bilingual children; and that is likely to result from extended periods with no, little, or poor-
second, between the bilinguals and monolinguals. Any differences quality accessible input. Data like that presented here can serve as
observed between the deaf and hearing bilingual participants a benchmark for the range of spoken language scores that might
in their development of spoken English could be attributed be expected for bilingual children, using those with full and early
 C. Goodwin and D. Lillo-Martin | 359

access to both languages as the appropriate standard. Educators zero-inflated generalized linear mixed Modeling. The R Journal,
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Research reported in this publication was supported by the
of language exposure does: Insights from deaf children acquiring
National Institute on Deafness and Other Communication
signed and spoken language. https://languagecreationlab.uconn.
Disorders of the National Institutes of Health (award numbers
edu/wp-content/uploads/sites/644/2022/07/Carrigan_Coppola_
R01DC009263, R01DC016901). The content is solely the respon-
Shusterman_in_prep.pdf.
sibility of the authors and does not necessarily represent the
Caselli, N., Pyers, J., & Lieberman, A. M. (2021). Deaf children of
official views of the National Institutes of Health. Support was
hearing parents have age-level vocabulary growth when exposed
also provided by awards from the Gallaudet Research Institute to
to American Sign Language by 6 months of age. The Journal of Pedi-
Deborah Chen Pichler.
atrics, 232, 229–236. https://doi.org/10.1016/j.jpeds.2021.01.029.
Castilla-Earls, A., Bedore, L., Rojas, R., Fabiano-Smith, L., Pruitt-
Lord, S., Restrepo, M. A., & Peña, E. (2020). Beyond scores:
Acknowledgments
Using converging evidence to determine speech and language
We express our sincere appreciation to the children and their services eligibility for dual language learners. American Jour-
families who participated in this study. Your patience and persis- nal of Speech-Language Pathology, 29(3), 1116–1132. https://doi.
tence are what makes this research possible. We also acknowl- org/10.1044/2020_AJSLP-19-00179.
edge the participation of many others in the project “Develop- Cawthon, S. W., Johnson, P. M., Garberoglio, C. L., & Schoffstall, S.
ment of Bimodal Bilingualism” (https://slla.lab.uconn.edu/bibibi/) J. (2016). Role models as facilitators of social capital for deaf
of which this work is a part. In particular, we thank principal col- individuals: A research synthesis. American Annals of the Deaf ,
laborators Deborah Chen Pichler and Ronice Müller de Quadros; 161(2), 115–127. https://doi.org/10.1353/aad.2016.0021.
research assistants who collected and transcribed the data; and Chen Pichler, D., Hochgesang, J. A., Lillo-Martin, D., Quadros, R. M., &
lab managers Lee Prunier and Janina Piotroski. Finally, we thank Reynolds, W. (2016). Best practices for building a bimodal/bilin-
the participants in the UConn Sign Language Research and Dis- gual child language corpus. Sign Language Studies, 16(3), 361–388.
cussion Group (SLRDG) for important feedback, as well as JDSDE https://doi.org/10.1353/sls.2016.0007.
reviewers. Chen Pichler, D., Lee, J., & Lillo-Martin, D. (2014). Language
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