This paper is an update of that written by Grove in the early eighties and reports on literature published mainly in the 1990s, relating to the use of manual sign in the promotion of communication abilities in individuals with learning difficulties. The use of sign as an augmentative and alternative communication (AAC) system to speech has become an accepted and widely used intervention with people with ID and communication needs. Although dating from 1999, this remains a useful and clear text about manual sign and its uses with this population.

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