Yes, it does include spoken English, but through the use of ASL as the first language. And this is where early intervention and preschool programs would be especially beneficial as early support for both L1 langauge development, and L2 language development. Children at this age are quite capable of acquiring an L1 language while learning an L2 langauge. When bilingualism is acquired in early childhood, the benefits for other cognitive are evident. And while ASL would be the L1 langauge (native), when English as an L2 language is introduced in the early ages, fluency develops very naturally and easily.
