Wyatte Hall, University of Rochester Medical Center

Hearing parents of deaf newborns use Wyatte Hall's research at the University of Rochester Medical Center to challenge speech-only medical advice and advocate for early ASL exposure during the critical language development window before age three.

ENABLE Model location

• Builder-side Interventions → Create Accessible Content
• Builder-side Interventions → Set Requirements that Include Accessibility

What it is

Wyatte Hall is an assistant professor of public health sciences at the University of Rochester Medical Center (URMC) and director of the Visual Language Access and Acquisition Lab. Hall, who is deaf, holds a PhD in clinical psychology from Gallaudet University and joint appointments across URMC's departments of pediatrics, obstetrics and gynecology, and the cancer center.¹

Hall's research documents language deprivation as a public health crisis in deaf and hard of hearing communities. Approximately 90-95% of deaf children are born to hearing parents who do not know ASL.² For decades, pediatricians, audiologists, and otolaryngologists advised those parents to avoid sign language, claiming it would interfere with spoken language development or cochlear implant outcomes. Hall's longitudinal research directly tests that claim and finds no evidence to support it. The research produces builder-side content that hearing families draw on when seeking ASL instruction or pushing back on speech-only clinical recommendations.

A 2025 study co-authored by Hall followed deaf children of hearing parents who received early ASL exposure before age three. Those children achieved age-appropriate vocabulary and academic outcomes comparable to deaf children of deaf parents, who receive native language access from birth.³ An earlier foundational paper, "Deaf children need language, not (just) speech," synthesized evidence that early bilingual ASL-English exposure supports rather than undermines spoken English acquisition.⁴ Hall has also defined and documented "language deprivation syndrome," a cluster of cognitive, mental health, and developmental harms that follow when deaf children receive neither accessible sign language nor sufficient auditory input during the critical 0-5 year window.⁵

In February 2023, Hall joined a Congressional briefing at the U.S. Capitol to present this evidence directly to legislators and advocate for language access policy for deaf children.⁶ In May 2024, the National Institute on Deafness and Other Communication Disorders awarded Hall a $3.4 million, five-year grant to conduct a statewide study of language acquisition in deaf and hard of hearing children.⁷

In 2023, the American Academy of Pediatrics (AAP) issued guidelines recommending for the first time that deaf children receive access to a signed language regardless of whether they have cochlear implants.⁸ Those guidelines align directly with the evidence Hall and colleagues have produced. Hall was named to Forbes' inaugural Accessibility 100 list in June 2025, identified as a leading expert on language deprivation as a public health epidemic.⁹

Why it matters

The medical default Hall's research is correcting was assembled over a century. The 1880 International Congress on Education of the Deaf, held in Milan, passed resolutions condemning sign language instruction and mandating oral-only methods for deaf education. Hearing educators voted. Deaf educators were excluded from the ballot. Within a decade, sign language had been banned from most schools for the deaf across Europe and the United States, an act of abandonment embedded in institutional policy rather than carried out by any single actor.¹⁰ Alexander Graham Bell, who advocated for the oralist position, subsequently campaigned to remove deaf teachers from schools, delivered an 1883 address recommending that sign language be removed from residential schools and replaced with hearing faculty, and became the founding president of the American Association to Promote the Teaching of Speech to the Deaf in 1890.¹¹ Deaf children caught signing had their hands tied or were physically punished.¹² The Milan resolutions structured deaf education for over a century.

The cochlear implant era, which began in the 1980s, renewed the suppression. When the Food and Drug Administration approved cochlear implants for children in 1990, hearing medical professionals and implant advocates revived the claim that sign language exposure would undermine spoken language development and implant outcomes. Research conducted since then has not confirmed that claim. A 2024 study found that sign language exposure before and after cochlear implantation improves language outcomes.¹³ Yet as of a 2023 survey of caregivers of deaf children 12-18 months old, 47% of audiologists, 44% of otolaryngologists, and 43% of pediatricians still advised families to use spoken language only.¹⁴ The professional recommendations persisted after the evidence had moved, a pattern of clinical disinformation produced by institutional inertia rather than by any individual's intent to deceive.

The persistence reflects audism, a term Tom Humphries coined in 1975 to name the institutional assumption that hearing and spoken language are superior, operating as a structural feature of medical training rather than a conclusion derived from evidence.¹⁵ Deaf professionals remain underrepresented in audiology, otolaryngology, and pediatrics, and their clinical perspectives are absent from the spaces where families of deaf newborns receive guidance. Deaf adults who completed oral-only programs and now endure its psychological residue report internalized shame about their communication mode. Research published in 2025 linked that internalized ableism directly to depression and anxiety symptoms, independent of hearing status itself.¹⁶

The cochlear implant industry has a financial stake in sustaining the speech-only framework. Advanced Bionics Corporation and Cochlear Americas funded the Alexander Graham Bell Association's 2007 Cochlear Implant Fellowship Program, which granted $15,000 awards to cochlear implant centers and defrayed salary and professional conference attendance costs for auditory-verbal therapy professionals.¹⁷ Implant manufacturers sponsor the professional training infrastructure whose clinical guidance shapes what families receive from audiologists and otolaryngologists. Their business case rests on the proposition that implants alone can produce functional language development, which the bilingual research directly challenges. The ACLU characterized language access for deaf children as a civil right in January 2024, framing the failure to provide ASL access as an institutional obligation that healthcare systems, schools, and government agencies are failing to meet.¹⁸ The National Association of the Deaf named the current situation a "serious and urgent health crisis" in October 2023.¹⁹ Twenty-plus states have passed LEAD-K (Language Equality and Acquisition for Deaf Kids) legislation requiring that parents of deaf newborns receive written information about both signed and spoken language pathways.²⁰ LEAD-K represents a legal-protections mechanism that forces the information asymmetry into the open at the point of newborn screening. Without it, the burden of finding and evaluating competing recommendations against a medical default falls entirely on hearing parents, producing precarity for families whose child's language window cannot wait for accurate guidance to arrive.

The Deaf community has produced a sustained intellectual tradition that situates language deprivation not as medical oversight but as the forced assimilation of a linguistic minority. Harlan Lane's "When the Mind Hears" (1984) documented the Milan 1880 conference and the oralist movement as deliberate acts of cultural oppression, placing sign language erasure in the tradition of majority linguistic imposition on a minority community.²¹ H-Dirksen Bauman and Joseph J. Murray, in "Deaf Gain" (2014, University of Minnesota Press), argued that Deaf ways of being produce unique cognitive, creative, and cultural capacities, and that hearing-centric medicine misreads those capacities as deficits requiring auditory correction.²² The National Association of the Deaf's position statement on early cognitive and language development states that medical and audiology professionals who counsel families against sign language do so from "a profound misunderstanding about languages and language development," and affirms that all deaf and hard of hearing children have the right to acquire both a visual language and a spoken language.²³ Paddy Ladd's concept of "Deafhood," introduced in "Understanding Deaf Culture" (2003, Multilingual Matters), frames Deaf identity as an ongoing process of self-definition rather than a condition of audiological loss, a direct contestation of the curative premise that structured the speech-only approach from Milan onward.²⁴ Hall's research, produced by a deaf researcher inside a hearing medical institution, places Deaf expertise at the exact site where clinical guidance is generated, which is precisely the site from which the Deaf community has been excluded since 1880.

Deaf children who reach school without a first language arrive with impaired verbal memory organization, disrupted executive function, weaker theory of mind development, and reduced mastery of numeracy and literacy.⁵ Brain imaging research on deaf individuals who acquired language late shows abnormal development of the dorsal stream in the left hemisphere, which handles morpho-syntactic processing, and deficits in ventral and dorsal white matter tract connectivity compared to those who acquired sign language from birth. These structural differences persist into adulthood.²⁵ Deaf and hard-of-hearing children experience mental health problems at roughly twice the rate of hearing peers, with those who lack adequate family communication access at elevated risk.²⁶ Developmental researchers describe a sensitive period for language acquisition that closes around age five. Damage from deprivation during that window does not fully reverse with later intervention. The harm is structurally produced. A medical profession trained to treat deafness as pathology advised parents to prioritize hearing technology and withheld the ASL access that would have protected language development in parallel. No single clinician is responsible for the pattern. The pattern was embedded in training programs, professional guidelines, and institutional practice long before any individual practitioner graduated.

Hall's research shifts the arrangement at the builder-side: at requirement-setting, by providing the evidence base that allowed the AAP to update its guidelines in 2023, and at content, by producing the knowledge parents and clinicians can access when making decisions in the critical window. The 2023 AAP guidelines name the obligation, but pediatricians trained before the shift still recommend speech-only approaches based on the professional formation they received. Pediatric professional associations and medical schools have not yet addressed the retraining gap the guideline shift created, and policy documents cannot close it on their own.

Real-world examples

In the news

How locally developed AI tools are helping parents of Deaf children learn ASL (January 2025)
-- WXXI News

• Hall and colleague Dr. Zhen Bai developed augmented reality and AI tools at URMC to help hearing parents of deaf children learn ASL faster. The project addresses the structural problem that most hearing parents cannot wait months for a sign language class while their infant is in the critical language window. The tools provide a partial builder-side response to a distribution problem that the research community has identified but the clinical system has not yet resolved at scale.

In the news

Wyatte Hall awarded $3.4 million to study language acquisition in deaf and hard of hearing children (May 2024)
-- URMC Clinical and Translational Science Institute

• The National Institute on Deafness and Other Communication Disorders (NIDCD) funded a five-year statewide study of language acquisition in deaf and hard of hearing children in New York. The grant funds the longitudinal data collection that makes guideline-level claims possible. Without this infrastructure, clinical recommendation changes rest on smaller samples and are more easily dismissed by practitioners.

In the news

Language Access is a Civil Right, For Both Children and Adults (January 2024)
-- ACLU

• The ACLU framed language deprivation for deaf children as a civil rights violation, placing accountability on institutions rather than individual families. Healthcare systems, schools, and government agencies bear the obligation to ensure language access. Hall's research provides the evidential basis that makes the rights claim empirically grounded.

In the news

Study recommends exposing deaf children to sign language before and after cochlear implantation (April 2024)
-- Medical Xpress

• A 2024 study found that bilingual sign and spoken language exposure before and after cochlear implantation improves language outcomes compared to speech-only approaches. This directly contradicts the clinical advice still given by 44% of otolaryngologists. The study illustrates the gap between the research frontier and professional practice.

• Hall's 2017 paper "What You Don't Know Can Hurt You" established the theoretical and empirical framework for language deprivation as a syndrome, identifying the neurological, cognitive, and psychiatric consequences of the critical window being missed.⁵ It has been widely cited in subsequent clinical and policy literature.

• The AAP's 2023 guidelines update was the first time the professional association representing U.S. pediatricians recommended signed language access as a core component of language development for deaf children, treating it as a language development intervention in its own right.⁸ The 2025 AAP policy statement reinforced this with specific guidance on bilingualism for deaf and hard of hearing children.²⁷

• As of the 2023 survey data, 47% of audiologists and 44% of otolaryngologists still advised families of deaf infants to use spoken language only, two years after the research consensus had shifted.¹⁴ The guideline-to-practice gap is the live frontier of this problem.

• The LEAD-K legislative campaign, active in over 20 states, requires that parents of deaf newborns receive written information about both signed and spoken language pathways.²⁰ Without that legislation, the information asymmetry between what researchers know and what families are told persists as a structural feature of the newborn hearing screening system.

What care sounds like (builder-side interventions)

Care at requirement-setting and content involves providing families with the full evidence base from the moment of newborn hearing screening:

• "Your child's hearing test result is one piece of information. Language development is the goal. Here is evidence on what early bilingual ASL and English exposure produces."
• "Cochlear implants and sign language are not competing options. Here is the research on outcomes when children have both."
• "The critical window for language development is 0 to 3 years. We need to get ASL access started now, while you are also pursuing hearing technology."
• "We track language outcomes across our patients. Children with early ASL exposure reach age-expected milestones at the same rate as native signers."
• "Our referral pathway includes both auditory-verbal therapy and a connection to the local Deaf community."

What neglect sounds like (builder-side interventions)

• "Sign language will confuse your child and interfere with learning to speak."
• "Focus on the implant. Once it's working, she'll develop language like any other child."
• "We recommend against sign language until we see how the implant performs."
• "Most families in our practice go speech-only and do well."
• "We don't have a referral for ASL instruction, but you could search online."

What compensation sounds like (navigator-side compensations)

• "The audiologist told us not to sign. We found Hall's research ourselves at 3 a.m. and realized we'd been given bad information for six months."
• "I had to bring a printed study to my son's pediatrician before she would refer us to a Deaf community contact."
• "We joined a Facebook group for hearing parents of deaf children because that's where we actually learned what the research says. The clinic didn't tell us any of it."
• "My daughter is seven now. We started ASL at four because we didn't know. I think about the years we lost."
• "Every appointment I have to re-explain why we're doing both. The system isn't set up to treat bilingualism as the default."

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All observations occur within the context of newborn hearing screening and early language intervention systems in the United States, with specific reference to clinical practice in New York State and federal public health research conducted through the University of Rochester Medical Center.

Footnotes

1. Wyatte C. Hall, MA, PhD -- University of Rochester Medical Center ↩

2. Implications of Language Deprivation for Young Deaf, DeafBlind, DeafDisabled, and Hard of Hearing Children -- National Association of the Deaf ↩

3. Age-Expected Language and Academic Outcomes for Deaf Children With Hearing Caregivers -- Finton, Hall, Berke et al., Journal of Deaf Studies and Deaf Education, 2025 ↩

4. Deaf children need language, not (just) speech -- Matthew L. Hall, Wyatte C. Hall, Naomi K. Caselli, 2019 ↩

5. What You Don't Know Can Hurt You: The Risk of Language Deprivation by Impairing Sign Language Development in Deaf Children -- Hall et al., PMC, 2017 ↩ ↩² ↩³

6. Wyatte Hall Joins Congressional Briefing on Language Access for Deaf Children -- URMC, February 2023 ↩

7. Wyatte Hall awarded $3.4 million to study language acquisition in deaf and hard of hearing children -- URMC, May 2024 ↩

8. Hearing Assessment in Infants, Children, and Adolescents: Recommendations Beyond Neonatal Screening -- American Academy of Pediatrics, 2023 ↩ ↩²

9. Wyatte Hall Named to Forbes' Accessibility 100 -- URMC, June 2025 ↩

10. Linguistic Neglect of Deaf Children in the United States -- Ballard Brief, BYU ↩

11. Alexander Graham Bell and His Role in Oral Education -- Social Welfare History Project, VCU ↩

12. Oral Training in Signing Schools -- Gallaudet University Museum, History Through Deaf Eyes exhibit ↩

13. Study recommends exposing deaf children to sign language before and after cochlear implantation -- Medical Xpress, April 2024 ↩

14. Speech, Sign, or Both? Factors Influencing Caregivers' Communication Method Decision Making for Deaf/Hard of Hearing Children -- Jones and Roberts, Journal of Speech, Language, and Hearing Research, 2023 ↩ ↩²

15. Audism -- Britannica ↩

16. Internalized oppression and deaf people's mental health -- Scientific Reports (Nature), 2025 ↩

17. Cochlear Implant Fellowship Program -- AudiologyOnline, 2007 ↩

18. Language Access is a Civil Right, For Both Children and Adults -- ACLU, January 2024 ↩

19. Language Deprivation is a serious crisis -- National Association of the Deaf, October 2023 ↩

20. Over 20 states have set developmental standards for deaf kids. Will Missouri be next? -- Missouri Independent, May 2023 ↩ ↩²

21. When the Mind Hears: A History of the Deaf -- Harlan Lane, Random House, 1984 ↩

22. Deaf Gain: Raising the Stakes for Human Diversity -- H-Dirksen L. Bauman and Joseph J. Murray, University of Minnesota Press, 2014 ↩

23. Position Statement On Early Cognitive and Language Development and Education of Deaf and Hard of Hearing Children -- National Association of the Deaf ↩

24. Understanding Deaf Culture: In Search of Deafhood -- Paddy Ladd, Multilingual Matters, 2003; reviewed in Disability Studies Quarterly ↩

25. Effects of Early Language Deprivation on Brain Connectivity: Language Pathways in Deaf Native and Late First-Language Learners -- Hirshorn et al., Frontiers in Human Neuroscience, 2019 ↩

26. Deaf and hard-of-hearing children and adolescents' mental health, Quality of Life and communication -- BMC Psychiatry, 2023 ↩

27. Embracing Bilingualism for Children Who Are Deaf and Hard of Hearing -- American Academy of Pediatrics, 2025 ↩