Born deaf to deaf parents, identical twins Lola and Ella Scher, of Rockville, Md., learned from the beginning to talk with their hands. When they were 9 months old, they produced their first word: shoe.

If they had used American Sign Language, or ASL, they would have said “shoe” by tapping their fists together twice. But their parents used a different form of communication, cued speech. So they taught each girl to make an “L” shape with her right hand, touching her index finger to her chin. That wasn’t a symbol, like the ASL gesture; instead, it signaled how the word sounds in spoken English. They would have used the same gesture to say “shoo!”

Grace Consacro and Steve Scher had grown up using cued speech, and they taught it to their twins, now 5, and their deaf son, Max, who is 3. In May, the National Cued Speech Association recognized the family for its dedication to cueing.

“As far as we know, we’re the only family (in the country) that uses cued speech exclusively,” says Consacro, 34, who teaches cued speech at Flower Valley Elementary School in Rockville.

The better-known ASL is a language of its own, with unique grammar and syntax. In contrast, cued speech makes the sounds of an existing language visible, using a system of hand shapes and placements. The “L” shape (yes, like the teenage “loser” sign) means “sh”; positioning the index finger on the chin adds the “oo” sound.

By using eight hand shapes with four placements in combination with mouth movements, cuers can convey words in more than 60 spoken languages and dialects, from Somali to Spanglish.

Consacro and Scher always planned that their children would cue.

“It’s not intended to be anything more than an aid to learn a language,” says Scher, 37, a stay-at-home parent who most recently worked as public relations coordinator for the National Captioning Institute.

Cued speech was developed in the mid-1960s by Orin Cornett, former vice president of long-range planning at what is now Gallaudet University in Washington, to improve the poor reading comprehension and writing skills he observed in the deaf community.

Some argued that deaf children were earning these low marks because they had to learn two different systems: ASL for person-to-person communication and English for reading and writing. Because cued speech simply translates English sounds into a visual format, the student learns only one language.

“It is a great tool for an educator in support of literacy,” says Jane Smith, a communications specialist at Flower Valley Elementary School.

Another advantage of cued speech for the Scher children has been a relatively smooth transition into the hearing world.

Lola, Ella and Max all received cochlear implants before they were 2. These electrical devices can replace the function of certain cells necessary for hearing. They directly activate the hearing nerve so a deaf person’s brain can receive direct sound information, though with varying degrees of success.

Since they had already been exposed to English through cued speech, the Scher children were familiar with some of the words and sentence structures they were able to hear once they got the implants.

At the River School, a private institution in Washington where 15 percent of the students have hearing loss, Lola, Ella and Max are mainstreamed with their hearing peers. They hear most of what is said and rely on lip reading to understand the rest.

Parents of children with hearing losses should think holistically about what communication method is best for their family, advises John Niparko, interim director of the department of otolaryngology-head and neck surgery at Johns Hopkins Hospital.

“We can use sign language, voice, cued speech,” Niparko says. “Find what the child responds to … and use that as your early methodology of communicating.”

Sometimes, the Scher-Consacro twins misinterpret or mispronounce words; but they can now follow conversations and speak very much like hearing children.

“My kids are deaf,” Consacro says. “They have the miracle of the technology of cochlear implants, (and) they have the language from their dad and I cueing — it just works.”