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Oralism is the education of deaf students through oral language by using lip reading, speech, and mimicking the mouth shapes and breathing patterns of speech. Oralism came into popular use in the United States around the late 1860s. In 1867, the Clarke School for the Deaf in Northampton, Massachusetts, was the first school to start teaching in this manner. Oralism and its contrast, manualism, manifest differently in deaf education and are a source of controversy for involved communities. Oralism should not be confused with Listening and Spoken Language, a technique for teaching deaf children that emphasizes the child's perception of auditory signals from hearing aids or cochlear implants.