Communication is the essential condition for a child's cognitive and physical development; likewise, it is a primordial necessity for coexistence in society. The child advances in communication competence, the contexts becoming more and more complex and diverse. By developing communication skills, children acquire a complex symbolic system that they will develop and perfect throughout their lives. In students with severe hearing impairment, communication competence, cognition, and pragmatic skills require simultaneous development, using a systematic program, students will follow the same developmental stages as a typically developing child. While communicating only involves sending a message, regardless of the presence or absence of hearing, children can communicate, but acquiring language is a step forward. While hearing children use verbal language, deaf children use sign language. Important is the existence of a language that can offer the possibility of interactions with those around. Deaf children simultaneously acquire several forms of communication: the verbal language (oral and written) which is presented as a tool for thinking, the digital alphabet and communication through gestures. Bilingualism is preserved during the whole life in the deaf communication activity.