Our most special children are those who have one or more additional disabilities with their hearing loss.

Cued Speech has unique attributes for addressing several needs simultaneously. The following chart delineates some needs and explains how your use of Cued Speech will help you meet those needs.

Your Child's Needs	When you use Cued Speech
To relate to other people To focus on faces for interpersonal interaction	…The movements and changing of Cued Speech handshapes near your mouth will bring your child’s attention to your face. Beginning with individual sounds and short words, your child will learn that the expressiveness of your face, your mouth movements and your hand cues are integrated and meaningful. With Cued Speech, you are providing a model for your child’s interaction and communication with you and others.
To pay attention to and discriminate between speech sounds (phonemes). This skill is critical to learning to articulate and to developing the base for learning to read.	…Your child simultaneously will hear a sound (phoneme) AND see its production AND see the cue that distinguishes it from similar sounds. z
To receive speech without sound Some children are hypersensitive to sound or have no access to sound.	…Your mouth and cueing hand work together like the coordinates on a map to make every sound look different, just as others hear them as different. Thus, you are making pronunciation and spoken language visually clear to your child.
To learn to articulate speech sounds (phonemes) Continued at bottom of page...	…The placement and movements of your lips, teeth and tongue are focused on with Cued Speech. You are providing a model of speaking for your child to imitate.
To sequence sounds for speech and language use	Receptive: …Your child will see the sequence of sounds as well as hear it. Expressive: …When your child copies the sequence by cueing-and-saying it himself, a motoric pattern in his hand reinforces what is being said, building a neurological pattern in his brain. This is the base for language.
To receive speech sounds (phonemes) with expanded duration, so your child’s brain has time to process, recognize and understand the sounds This is important for some children in developing auditory processing of language.	…Your child will see and hear sounds you produce, for any length of time that you say them. For example, you might cue-and-say a long “ahhhhhhhh” or “mooooooo”. As your child’s auditory processing abilities improve, you will be able to cue-and-say these words as “ahhh” and “mooo”, and finally “ah” and “moo”.
To learn phonics	…When your child is old enough to learn which written letters represent which spoken phonemes, his base of language you provided through Cued Speech will facilitate and often accelerate this learning of phonics.

Let’s consider some of the specific suggestions for using Cued Speech with specific disabilities:

DISABILITY	HOW YOU WILL USE CUED SPEECH
Deaf-Blind	Each child is an individual, with hearing and vision on separate continuums. Your manner of using Cued Speech will vary with the perceptual capabilities of your child. If your child has some vision, you need to be sure you are at the best distance for your child to see your mouth and cues. You may need to be very close to your child’s face. Your child may need to place one hand on your face (Tadoma) and the other on your cueing hand. Research shows that Cued Speech is the most effective supplement to Tadoma for perceiving vowels and consonants, providing the child with nearly-perfect discrimination of consonant-vowel pairs.1 If your child has more vision, you may need only to be sure you are at the best distance for the child to see you. If your child flicks his fingers in front of his eyes for stimulation, Cued Speech provides a meaningful alternative activity for his fingers.
Apraxia, dyspraxia, aphasia	These and other conditions interrupt your child’s neurological control of the muscles producing speech. Cue and speak slowly to your child, giving him time to process this information. When possible, add an object or action related to what you are saying; e.g., show a hat when you are talking about a hat. When you cue and speak slowly to your child, his or her attention is drawn to the appropriate speech movements differentiated by the cues. Your next strategy is to encourage your child to initiate both the speech production and the cues--starting with individual sounds and expressions such as oh! ah! Mom! oo! boo! ba! When your child copies, learns, and uses the cues, the motor movements of the hand act as a trigger for the muscles of the face, reminding and releasing them to perform.
Unable to use hands	Your child may be physically unable to cue near his face and only make some of the handshapes at a lower location. Your child may not be able to cue with his hands at all. Your use of cueing will give your child the benefit of developing the spoken language base for reading and full inclusion at home and school. For his expressive communication, the Nu-Vue-Cue grid is a simple tool. Depending on your child’s capabilities, he can point with his head, foot, or eyegaze for the full range of spoken communication at minimal cost.
Hypersensitive to sound	Present cueing activities and cued conversation with natural mouth movements, but without voice. Later, you may be able to add soft voice to your interactions.
Down Syndrome; developmentally delayed	Take advantage of your child’s ability to watch and imitate. Introduce just one or two sounds to use for fun and for meaning, such as /mah/ for mom and /mi/ for milk. Select words based on your child’s interests and sounds he creates on his own. Add new sounds in another day or week. You will need to do many repetitions over time, encouraging your child to imitate your speech and cues. Make it fun, in the bathtub, on the swing, with music, and using all his senses and his body.