Gianluca is a 24-year-old hearing young man with cognitive delay. At four months old, he was diagnosed with West syndrome—brief epileptic seizures that caused brain damage, especially in the areas responsible for language (Broca’s area) and cognitive development (frontal lobe). The prognosis: he would never be able to understand or express himself in any language.
Multimodal Communication
Dr. Gibellini explains the communication approach she has used with Gianluca and many other children, both hearing and deaf.
Multimodal communication is the educational approach promoted by the Le Farfalle Cooperative for hearing children and teens with severe communication disabilities. It’s not a method but a methodology that combines several tools: spoken and written Italian, Italian Sign Language (LIS), symbols, and images.
When a child shows the intention to communicate but struggles to use spoken language, LIS can provide an alternative language that—at least temporarily—meets their communicative needs, without ruling out the possibility that they may learn to speak Italian later on. The first attempts in Rome date back to 1996. Before that, some educators had already offered bilingual education to deaf children, recognizing the importance of letting them acquire their natural language.
“Every deaf child, regardless of the degree of hearing loss, should have the right to grow up bilingual. Through the use of both sign language and spoken/written language, the child can fully develop cognitively, linguistically, and socially.” (François Grosjean) Thanks to our experience with bilingual education for deaf children, we began teaching hearing children with severe communication disabilities to ‘speak with their hands’.
At first, we simply wanted to offer an alternative language to children who struggled to articulate words. But soon we realized that using LIS could actually help improve comprehension of Italian too. The children we worked with often had additional challenges—epilepsy, dyspraxia, cognitive delay, and behavioral issues often rooted in communication barriers. These children struggled to decode spoken language, but sign language, with its more visual and concrete structure, allowed them to “see” the meaning of a message.
At the time, we were living in Belgium. Gianluca had the chance to start, at age two, a pilot program designed for children with Down syndrome that introduced gestural communication from a very young age. After returning to Italy, we tried many different forms of augmentative and alternative communication. But by age 12, I realized that traditional speech therapy had reached a dead end.
At that point, Gianluca was using “personalized” gestures understood only by those who saw him daily. That’s when I heard about Dr. Luisa Gibellini, founder of Le Farfalle, who was using LIS with hearing children with disabilities. I contacted her and asked if she would consider working with my son. That’s when Gianluca’s transformation began.
Many people thought I was taking a risk. More than ten years ago—and still today—some believe that introducing LIS as a primary communication method would isolate children or prevent them from learning to speak. Few understood the value of developing a form of communication that could meet both cognitive and emotional needs. As Valentina Colozza explains in a recent article: “Language development in early childhood is essential for an egosyntonic1In psychology, a thought or behavior is “egosyntonic” when it is in harmony with the self, consistent with one’s identity and desires. development. When that development is blocked, it affects all areas of growth, from cognition to mental health. The inability to express thoughts forces people to use their bodies to express emotions—often resulting in aggression, behavioral disorders, or psychosomatic symptoms like chronic pain, eczema, asthma, or dermatitis.”
When I started this journey with Gianluca, I didn’t know much about LIS. Like most people, I thought of it as a kind of miming. But through courses, I discovered that LIS is a full language in every sense: it uses a visual-gestural channel, where the eyes listen and the hands speak, with its own grammar and syntax. I also learned it’s not universal—sign languages vary by country, just like spoken ones, and are rich in dialectal variations. LIS is learned just like any spoken language!
So at age 12, Gianluca began learning this new language. A language that demands fine motor skills, laterality, coordination, and awareness of others—all of which he lacked but developed thanks to his strong desire to communicate. It wasn’t easy. He worked hard, supported by people who were passionately committed to teaching LIS. He received three hours of weekly LIS speech therapy, took part in a neurological development program from the Fay Institutes, had Silvia (a communication assistant) at school, Fabiana at home, his sisters, Fattha (his personal assistant), and myself—we all learned and used LIS at home. A true full immersion.
And it paid off. Today, Gianluca can express himself verbally in simple situations and uses LIS for more complex communication. He sees a signing psychologist who helps him address emotional challenges, has started a path toward independent living with the Ceralaccha Association, acts with the Julien Inclusive Theatre Workshop, and even drives go-karts…
I don’t believe there’s a single or perfect solution for our children’s communication difficulties. But refusing to consider LIS means denying them access to a flexible, empowering, and effective tool. Of course, there are challenges. When Gianluca has a problem on public transport, he can’t easily ask for help. If he gets lost, he can’t call home to tell us the street name. His peers often look at him like he’s from another planet—so do strangers. But the choice is between communicating with part of the population… or not communicating at all. Between developing one’s abilities… or living without hope.
Gianluca has come a long way. And he’s done it thanks to the incredible commitment of so many people. There are truly countless people I thank with all my heart—for believing in him, and for always standing by him.
– by Maria Valeria Spinola
- 1In psychology, a thought or behavior is “egosyntonic” when it is in harmony with the self, consistent with one’s identity and desires.
