If you are born without the ability to hear, decisions taken when you are very young about your education can dictate almost everything about the way you live the rest of your life.

For parents of deaf children, choosing one school or another can mean excluding them from wider society or making them feel at home in the deaf community. They are burdened with an almost impossible dilemma about how they want their child to communicate when they are still at a tender age.

Teachers of the deaf are a rare and highly skilled group of professionals who not only have to guide pupils through exams and the national curriculum, but also help them and their parents to adjust to this disability.

They, like the parents of the children they teach, are, however, still faced with wide-ranging debates about the best way for deaf children to communicate. This means that families have to make difficult choices early on about how they want their son or daughter to interact with others.

While some schools use British Sign Language (BSL) as a teaching medium, others opt for English in the hope that children will develop proficient speaking and lip-reading skills of their own accord.

This schism has led to much controversy because the stakes are so high. A child who becomes fluent in BSL gains “entry” to the deaf community - but this could limit their opportunities in the wider world. If a deaf child is taught orally, they might “fit in”, but their hearing problems could still make them feel like an outsider.

The solution, according to staff at one specialist school for the deaf, is for children to become bilingual in English and BSL. Frank Barnes School, a primary for deaf children in north London, is rated one of the 12 best special schools in the country by Ofsted because of the way teachers help children to develop educationally, emotionally and socially.

Ninety per cent of Frank Barnes pupils moved from a mainstream school because they were failing to flourish. Key stage 1 pupils go on regular trips so they get exposure to the “real” world. Every year, the whole school goes on a “journey” - this year to Center Parcs. In this way, children are encouraged to embrace their deaf identity and yet become part of wider society.

“The choice of communication is a big question for everyone,” says head Karen Simpson, who has worked at the school for 20 years. “We believe that if you deny children access to BSL, you deny them access to the deaf community. We think children need to develop a sense of their deaf identity.

“We nurture children and tell them they are very lucky. Indeed, 60 per cent of our teaching staff are deaf, so there’s equality.

“We might be a special school, but our pupils have a good knowledge of the world. They also ask questions about current affairs in assemblies and take an active part in school council debates.”

But the experience of pupils at Frank Barnes is increasingly rare. About 80 per cent of deaf children are educated in special units within mainstream schools and only 4 per cent of profoundly deaf pupils are taught bilingually. About 5-8 per cent attend special schools, mainly because they have additional physical, learning or emotional needs.

There are just 21 specialist deaf schools in the UK - 50 years ago there were 75. Most are private. One-third, including Frank Barnes, teach children bilingually, a third teach children orally and the remainder use a “signed support” system in which teachers use English and BSL at the same time (see box).

Deaf children were the first to experience “inclusion”, a controversial policy which critics say has resulted in the closure of many special schools. In fact, these children started attending mainstream schools as early as 1948. It was thought that it would be easy for teachers to accommodate pupils with hearing problems, but according to experts the policy has left children vulnerable to bullying and loneliness.

Nicoletta Gentili runs the only psychiatric in-patient unit for deaf children in England. Young people aged eight to 18 come to Springfield Hospital in south-west London to receive help with their problems, which are caused by family difficulties and poor experiences in school.

Dr Gentili is critical of specialist units in mainstream schools and thinks they leave deaf children “isolated”.

“They might be in a class with only one other child of their age; when they mix with other children they are often bullied,” she says. “They can’t be included unless the whole school knows sign language. Because the children don’t really see any adults who are deaf, they grow up thinking they will be able to hear when they are older.

“I believe deaf schools are the best option. Children can see deaf adults who are successful. They get taught in small classes with their peers by a fluent signer who is very aware of their needs.”

Because of the difficulties they face, deaf children are more likely to have psychological problems: 40 per cent have mental health issues. Dr Gentili says these are often misdiagnosed as attention deficit hyperactivity disorder (ADHD) or autism.

But deaf schools have a specialist curriculum to help children overcome their difficulties. This involves teaching children how to express their emotions.

Frank Barnes has fewer than 30 pupils. In the past it has had a roll of up to 80, but numbers have decreased since the Inner London Education Authority was abolished and school planning was left to individual councils, most of whom did not acknowledge the need for specialist deaf education.

The Coalition government has expressed support for special schools, but some of its new policies could cause problems for teachers of the deaf, who fear the impact of the new-style academies on their work. For instance, how will units for the hearing impaired, which are funded by councils, be run in schools that have opted out of local authority control? Opposition parties wanted to amend the Academies Act to ensure that local councils kept their funding for deaf education.

There are other challenges, too. Teachers of the deaf are an ageing community: 40 per cent are over 57. They used to train and then apply for jobs; now the only way they can qualify is through a two-year course completed while they are working. All teachers who work with deaf children must hold the Government-run qualification. It means they are not only fluent in BSL, but also have the skills to tailor lessons for children with hearing problems.

The qualification is important because teaching the deaf requires practitioners to work in a very different, visual way. The teacher must be adept at keeping children’s attention and make sure all communication is face to face.

Education Secretary Michael Gove wants more specialist teachers of the deaf and better acoustics in classrooms. He believes there has not been enough “focus” on deaf children, partly because their disability is hidden and because they tend to “cope without the support they deserve”.

It is unclear whether funding will be made available for Mr Gove’s plans during a time of public spending cuts, but one thing that reassures the deaf community is Mr Gove’s knowledge of the situation. His sister is deaf and attended a specialist deaf school, and he counts a Frank Barnes governor among his friends.

Mr Gove says he is in favour of both inclusion and special education for deaf children and wants them to achieve more. About 64 per cent of all pupils get five good GCSEs including English and maths, but for deaf children the figure is just 43 per cent.

“One of the problems we have had for a long time is that there has been an assumption that deaf children face,” Mr Gove told members of the National Deaf Children’s Society. “These challenges mean that they can’t succeed at the same rate as other children, and we see that sometimes in bullying, and we see that sometimes in the attitude from more old-fashioned teachers.

“I think that’s quite wrong and we need to point out that the situation we have at the moment, where deaf children haven’t achieved the same academic results as other children, is unjustifiable, that deaf children should expect to get the same sorts of exam results and have the same job opportunities as other children. A situation where deaf children aren’t at the moment doing as well is wrong.”

The British Association of Teachers of the Deaf wants a range of different provision to be available.

“We don’t expect more specialist schools to close as pupils who attend them have a range of complex needs,” says association secretary Paul Simpson. “We want to see their work continue, but we do need more teachers to be trained.”

Despite the looming public sector cuts, Frank Barnes is about to enter an exciting new period in its history.

Teachers and staff have now moved from their old home in north London’s Swiss Cottage so another special school can become an academy on the site. Children and staff at Frank Barnes will use temporary accommodation until their new building, near King’s Cross station, is completed in 2013-14.

There was some uncertainty over the future of Frank Barnes while negotiations over the building took place. This has affected pupil numbers and has been “destabilising”, says Mrs Simpson. Pupil numbers have fallen from 45 to the current 30 since the plans were announced.

But with an “outstanding” Ofsted rating and word-of-mouth recommendations generated by thankful parents, places at Frank Barnes remain sought after by families who feel they have been let down by other schools.

“To be an outstanding school, you have to look outwards,” Mrs Simpson says. “We network, train other teachers and support parents. We have to be broader than just a school. We have to offer something different or parents won’t choose us.”

While the pupils, teachers and head of Frank Barnes can look to the future with confidence, there are still plenty of debates and policy wrangles ahead for the wider community of deaf education.

COMMUNICATION IS KEY

Oral - The emphasis is on speaking and listening, with children using lip reading. Many pupils use technology to be able to hear.

Signed support - This is used in oral schools for children who need extra help. Teachers and pupils use a form of simple signing that, unlike BSL, mirrors English-language grammar patterns. Teachers can speak at the same time.

Total communication or bilingual - Teachers and children work in English and BSL - but not at the same time.

Cued speech - For children who have difficulties lip reading. Teachers speak and make simple gestures that relate to the words they are using. The movements are designed to act like a clue. Some words - for example, food and you - look identical to lip readers.

Makaton - A very simple form of signing for young children using symbols and signs.