Communication options for deaf children with additional needs

Some children with additional needs communicate using a combination of approaches and communication aids.

Language-based communication

• speech
• sign language
• lip-reading
• tactile signing
• giving and receiving information in large print, braille and block alphabet

Sign systems

• Makaton
• cued speech
• Sign Supported English or Welsh

Sign systems may use independent sign, on-body sign or hand-under-hand sign.

Symbol systems

• using objects of reference (real objects and object symbols)
• Widgit
• Picture Exchange Communication System (PECS)
• line drawings, pictures and photographs

Non-verbal communication

• body movements
• breathing patterns
• eye pointing

Other aspects of communication

Textures, smells, temperature, intensive interaction and routines may also support communication by supporting a child to know what’s going to happen next.

Whichever communication approach or combination of approaches your child uses, keep an open mind and be flexible.

Using one communication approach should not rule out using another. For example, a child who uses speech could also communicate using signs, pictures and objects. Many parents will use speech and support this by using other visual cues.

For example, a child might:

• choose an object to let you know they are hungry or want to play
• sign an important word and use pictures to support their meaning
• use their voice with symbols

The important thing is to have a system of communication that:

• you and the other people in your child’s life agree with, use and understand
• can be used at home and school
• allows your child to express themselves and join in with everyday activities

A total communication approach uses any and all types of communication. It’s a flexible approach which aims to get meaning across in whatever way works best.

Using a total communication approach means families and professionals can work with a child’s individual strengths to find the best way to communicate. For example, if your child understands signing but finds it difficult to sign back, they might use a different communication method, such as gestures and eye movements, to express themselves.

If your child uses total communication, it may be helpful to list their preferred communication methods on a personal passport, as a reminder to professionals working with them.

Children with autism may struggle with eye contact and joint attention (when parents naturally draw their child’s attention to something by looking at it themselves or using gestures). This can make communication approaches often used by deaf children, such as lip-reading or sign language, more difficult.

Deaf children with autism who don't learn to sign from an early age may benefit from support to help them understand, such as:

• visual schedules
• calendars
• cues for routine activities
• objects of reference

These can be accompanied by programmes to help with interpreting facial expressions or learning how to use language in social situations.

Whatever method of communication your child uses, it should be used consistently, both at home and in education. A speech and language therapist and other professionals working with your child will be able to provide support and advice.

PECs is a communication system which uses pictures to help children with additional needs to communicate and make choices. Children are encouraged to make simple requests by choosing a picture of the thing they want and need, with the aim of building up to more complex sentences.

For more information, visit the PECs website.

Some deaf children with additional needs are offered support to learn a sign system like Makaton instead of a sign language like BSL. Their family may be told that the sign system is more appropriate for their child or that their child will not be able to understand sign language.

In fact, sign languages like BSL can be adapted to deaf children with additional needs in the same way that spoken languages like English can be adapted or simplified. 

Learn more about the difference between a sign system and a sign language.

Tactile signing is a way of signing which uses touch. This can allow deafblind children, or deaf children with visual impairments, to access sign language. In the UK, tactile signing is usually based on BSL. 

Find out more about tactile signing.

Communication aids are designed to support children who have difficulties with speaking, signing or understanding.

This might include children with cerebral palsy, autism or learning disabilities.

Low-tech communication aids include aided language displays (ALDs) and E-Tran frames (where a person uses their eyes to point at different letters, pictures, or symbols on a board).

High-tech communication aids include computer systems and software, such as speech output devices.

You may see these referred to as augmentative and alternative communication (AAC) tools.

Not all deaf children will be able to access a communication aid. If your child is assessed for a communication aid, make sure the assessor understands how their deafness affects them.