Sometimes, ASL users may ask a question by tilting their bodies forward while signaling with their eyes and eyebrows. Just as with other languages, specific ways of expressing ideas in ASL vary as much as ASL users themselves do. ASL users may choose from synonyms to express common words. ASL also changes regionally, just as certain English words are spoken differently in different parts of the country. Ethnicity, age, and gender are a few more factors that affect ASL usage and contribute to its variety.
Parents are often the source of a child's early acquisition of language.
A deaf child who is born to deaf parents who already use ASL will begin to acquire ASL as naturally as a hearing child picks up spoken language from hearing parents. Some hearing parents choose to introduce sign language to their deaf children. Hearing parents who choose to learn sign language often learn it along with their child. Nine out of every ten children who are born deaf are born to parents who hear. Other communication models, based in spoken English, exist apart from ASL, including oral, auditory-verbal, and cued speech.