Using Sign Language and Voice for Total Communication

What can parents do when they are not sure whether to use only the oral method or only sign language with their deaf child? They can use total communication and get the benefits of both.

Woman signing
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What Is Total Communication?

Total communication is using any means of communication — sign language, voice, lipreading, fingerspelling, amplification, writing, gesture, visual imagery (pictures). The sign language used in total communication is more closely related to English. The philosophy of total communication is that the method should be fitted to the child, instead of the other way around. Another commonly used term for total communication is ​simultaneous communication, known as sim-com.

Total communication acknowledges that the means of communication may need to be adjusted based on the situation. Sometimes signing is the right method to use, while at other times, it may be speech. In other situations, writing may be the best method to use.

Although some schools/programs for the deaf use ASL and English, the majority of educational programs for the deaf use total communication. (The program my own children attended uses total communication.) The idea is that using total communication will create the "least restrictive" learning environment for the deaf child, who is free to develop communication preferences (although the child will be encouraged to use both speech and sign language).


Some parents and educators favor total communication as a catch-all that ensures that a deaf child has access to some means of communication (speaking as needed, or signing as needed).

For example, a deaf child who cannot communicate well orally gets the additional support of sign language, and vice versa. Using total communication can also reduce the pressure on parents to choose one method over another.

A study compared 147 children in either oral and total communication programs who used cochlear implants. The study compared the children's expressive and receptive language, spoken or signed. The results demonstrated that the children improved no matter which program they were in — oral or total communication.​

The results also showed that the total communication students performed better on some measures. Both the oral and total communication students were able to understand when they were spoken to. However, in those children that received their cochlear implants before they were 5 years old, the total communication students could understand better when spoken to than the oral communication students. In addition, the total communication students had better scores on expressive language when they were implanted earlier.


The risks of using total communication in the classroom are that instructors may use them inconsistently. Plus, total communication may not meet the communication needs of all the deaf students in the classroom. This can have an impact on how well the educational information is received by the deaf student.​​

Another possible risk is that total communication may result in less-developed speech skills. This was noted in a study done by researchers in an oral program. Their study compared students in total communication programs with students in oral-only programs. Their study found that the students in the oral programs developed more intelligible speech than the total communication students.

Books on Total Communication

Most books about communicating with and educating deaf and hard-of-hearing children include a chapter on total communication. Books that are solely about total communication appear to be few in number. They include:

  • "Total Communication: Structure and Strategy" by Lionel Evans
  • "Total Communication: The Meaning Behind the Movement to Expand Educational Opportunities for Deaf Children" by Jim Pahz

Why Parents Chose Total Communication

Parents who use this site gave this explanation for why they chose total communication:

"We chose total communication for our two children — they wear hearing aids. Their school used SEE [signing exact english] along with speech, so there was no problem with them getting incomplete exposure to the language. Both children developed English as their first language and both excel in reading.

"We expect that they will take classes in ASL in high school and/or college, but in their early years, we were most interested in making sure that they had a firm foundation in the language they would be working within their professional as well as personal lives for the rest of their lives.

"Learning English as their first language has helped to ensure that they won't be dependent on someone who knows ASL to be around so that they can understand the happenings around them. And we felt that a strong foundation in English would equip them to find fulfilling jobs as adults; we assume that they'll rely on written communication even more than most people, so it made sense to us to make sure that they were as good at English as they would be!"

3 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Schiavetti N, Whitehead RL, Metz DE. The effects of simultaneous communication on production and perception of speech. J Deaf Stud Deaf Educ. 2004;9(3):286-304. doi:10.1093/deafed/enh031

  2. Connor CM, Hieber S, Arts HA, Zwolan TA. Speech, vocabulary, and the education of children using cochlear implants: oral or total communication?J Speech Lang Hear Res. 2000;43(5):1185-1204. doi:10.1044/jslhr.4305.1185

  3. Geers AE, Moog JS. Speech perception and production skills of students with impaired hearing from oral and total communication education settings. J Speech Hear Res. 1992;35(6):1384-93. doi:10.1044/jshr.3506.1384

Additional Reading
  • Hawkins L, Brawner J. Educating Children Who Are Deaf or Hard of Hearing: Total Communication. ERIC Digest #559. August 1997. ED414677. 

  • Jones, TW. Teacher Trainees' Classroom Communication Preferences. Collected Papers presented at the Annual Conference of the Association of College Educators - Deaf and Hard of Hearing (23rd, Santa Fe, NM, March 7-10, 1997)(ED406775)

By Jamie Berke
 Jamie Berke is a deafness and hard of hearing expert.