With the change of administration in the United States, concepts of diversity, equity and inclusion have been thrust even further into the public discourse. The global response has seen a welcome conversation about their importance. But in thinking about diversity, we need to go well beyond the broad brushstrokes of gender, disability, language, culture, or age.

Often—and wrongly—these groups are reduced to their headline label. But the rich diversity within groups, needs much greater appreciation.

Children who are deaf or hard of hearing, for example, are not, and never have been, a homogenous group. By extension then, we should not apply a one-size-fits-all approach when we support them to develop and learn.

When discussing issues like early cochlear implantation, using signed or spoken language in early intervention, or engaging children with Deaf culture, it’s easy to get caught in a binary trap. “Spoken language or sign language”, “cochlear implantation or sign language”, or even “learning the home language or learning English” are all false dichotomies.

If we respect that reality is complex, keep diversity of need front-of-mind, and think about child wellbeing in the broadest possible terms, the range of pathways for deaf and hard of hearing children and their families become much clearer.

The alternative? We put children at potential risk of long-term disadvantage through linguistic and social deprivation.

Thirty years of evidence from well-controlled studies has delivered a clear imperative: intervene early and you will provide a child with the most natural path to develop their first language—whatever that language happens to be—and establish foundations for their cognitive, social, and emotional development.

During those 30 years, two major advances — universal newborn hearing screening and the advent of cochlear implantation for infant children — fundamentally changed the landscape of early intervention. This ensured the development of spoken language became the focus of intervention for most deaf and hard of hearing children.

Research, like the Longitudinal Outcomes of Children with Hearing Impairment (LOCHI) Study, has demonstrated that early and effective access to the sounds of speech through cochlear implantation has made age-appropriate spoken language abilities achievable for more children who are deaf than at any time in history.

However, the road to this point has had some potholes. Along the way, early intervention programs for children with cochlear implants typically sought to restrict children’s access to sign language. This approach was based on a binary and often very strongly held view that learning to sign would hamper the development of spoken language skills.

Unsurprisingly, this approach led many members of the Deaf community to conclude that the purpose of the cochlear implant and associated interventions was to subvert the possibility of a child identifying or engaging with their community. This has had an undeniable and longterm impact on the attitude of the Deaf community towards cochlear implantation.

But there was another insidious effect of this approach. For children who did not achieve the expected outcomes from using their cochlear implants, the rigidly held binary view about language access all-too-often led to long delays in them receiving access to sign language. This effectively squandered the enormous developmental benefit of learning a language at the earliest possible time.

Fortunately, thinking has evolved. There have been remarkable strides in recognising the role that cochlear implants can play in the diverse ways that someone can live a life as a deaf or hard of hearing person. Learning more than one language or way of communicating is no longer seen as a barrier to developing spoken language skills for children with cochlear implants.

Conversations around choice are becoming more nuanced and efforts to identify whether alternative pathways are needed or wanted are much more focussed in the early stages of children’s development. Those conversations are being driven by families themselves and by organisations like NextSense, which have a focus on tailoring support to child and family needs and goals.

These are conversations that are critical for service providers to have with families. And they can be complex. They need to consider what it means to learn one language or two, and what family resources are needed for that to occur.

For example, in order to develop their first language, children must be able to access all the elements of that language and be surrounded by mature users of the language who can consistently and continually interact with them.

This is easy to achieve for hearing families of deaf children who use English or another spoken language to communicate. For children learning Auslan as their first language, it’s much harder for hearing families with no signing background to achieve. So, it’s not surprising that spoken language is the option most often pursued by hearing parents of children with cochlear implants.

However, this does not, and should not, exclude the potential for their child to learn Auslan as a second language.

For some families, a valid and supportable decision can be to pursue their child’s simultaneous development of spoken English and Auslan. When the conditions for learning both languages can be provided (i.e. through bilingual program for early intervention and providing a strong bilingual language environment at home) this can support good outcomes for both languages.

Such scenarios are vastly different from the past, where all children who received cochlear implants were predestined to be monolingual and were provided access to a sign language only when they didn’t develop adequate spoken language abilities.

There are some fundamental principles we can adopt to ensure the best possible outcomes when children’s hearing loss is identified early, and they receive a cochlear implant.

We should acknowledge that children who are deaf and receive cochlear implants have multiple potential pathways to acquiring language and communication abilities.

Bilingualism and biculturalism are entirely possible for any child that receives a cochlear implant. But there are many possible paths, and we shouldn’t seek to demean or subvert any one of them.

All language and communication choices should be respected, including a path to the acquisition of Auslan—whether that be later, based on strong first language abilities in a spoken language, or simultaneously in the context of a bilingual educational approach.

This means that those of us who work with families should be mindful of not closing doors prematurely. In partnering with families, we should respect their choices and be willing to openly explore all options with them in the context of the best possible information.

Finally, and importantly, we must continue to research this area and build our knowledge, so we can support family decisions with the best information about evidence-based approaches.

This op-ed was originally featured in Deafness Forum Australia's One in Six newsletter.