The Makaton Vocabulary provides an approach to the teaching of communication and language skills, using manual signs and/or graphic symbols, accompanied by speech. The vocabulary is open ended, based around a common core of functional concepts. It originated in the United Kingdom, and is now used internationally by students with a wide variety of language and communication difficulties, and those who share their lives. This paper outlines the development and application of the system.

Research suggests that few children who are reliant on manual sign for expressive communication progress beyond a basic level of sign combinations. However, they may be capable of expressing complex meanings by changing the form of their signs. This study investigated whether children with intellectual disabilities could be taught productive use of modified signs. Eight children participated in a matrix-based intervention program to teach sign modifications that were contrastive, generalized, and consistent. Results indicated that modified signs could be systematically taught. There was also evidence to suggest that the children were beginning to use modified signs productively. However, it is suggested that their patterns of use were more characteristic of a gestural than a linguistic system.

The use of sign language as an augmentative medium of communication is a well‐established approach in working with client groups who are handicapped in their effective use of verbal language. However, students with physical and learning disabilities may continue to experience problems in making themselves understood, because of inaccuracies in sign production which may be considered as analogous to phonological errors in speech. It is suggested in this paper that the evaluation and remediation of sign production errors is most usefully approached through an understanding of the phonological structure of sign language. The paper presents a review of the literature concerning the development of (1) motor patterns involved in sign production, and (2) the four major parameters of handshape, location, movement and orientation, in hearing‐impaired and hearing children whose first language is sign, and in students with mental handicaps. A framework for assessing and monitoring sign production is suggested, and possible approaches to the development of intelligible signing are discussed. It is argued that the analysis and remediation of sign errors should always be related to the communication needs of the individual, rather than developed in isolation.