Key Word Sign

What is key word sign?

Key word sign is the use of signs and natural gestures to support communication and the language development of children and/or adults with communication difficulties. It is a form of Augmentative and Alternative Communication (AAC) (i.e. a communication method other than speech – e.g. using pictures, sign or a communication device).

Signs are used for the words in the message that hold the most important information versus signing every single word. For example, if someone said, “Dry your hands” the key words that would be signed would be ‘dry’ and ‘hands’.

Key word sign uses a core vocabulary of specifically selected words containing concepts and ideas. Key Word Sign Australia was previously known as Makaton Australia. Each word or concept is matched to a hand sign. In Australia, the language used by the deaf community is Auslan (Australian Sign Language). Key word signing uses signs from Auslan.

The main features of key word sign include:

Using sign and speech together.
Signing the key words but saying the whole sentence.
Using visual strategies such as body language and facial expression.
Using symbols where appropriate.
Some use of finger spelling.

Why is key word sign important?

Speech is the most efficient and effective way people communicate. However, the use of sign and gestures can be an important way for individuals to develop communication particularly to:

Help a person’s understanding.
Help a person communicate effectively if their speech is slow to develop.
Supplement/support the speech attempts of a person which may not be articulated clearly (e.g. the person is unable to clearly say the word ‘water’ but can use the gesture for ‘drinking’).
Be used as an alternative for someone who has no speech.

Key word sign used in isolation may not sufficiently meet the communication needs of an individual. Other strategies such as the use of pictures or photos may also need to be used to facilitate an individual’s communication.

What are the building blocks necessary to develop key word sign?

Fine motor skills: Development of fine motor skills to enable the physical performance.
Imitation: A child needs to be able to copy what someone else is doing in order to produce the signs themselves.
Lack of tactile sensitivities: A child must be able to tolerate being touched so that someone can assist them to manipulate their fingers to produce the signs.
Planning and sequencing: The sequential multi-step task/activity performance to achieve a well-defined result.
Receptive (understanding) language: Comprehension of language.
Working memory: The ability to temporarily retain and manipulate information involved in language comprehension, reasoning, and learning new information; and to update this information as change occurs.
Body awareness: Knowing body parts and understanding the body’s movement in space in relation to other limbs and objects.

How can you tell if my child has problems with learning key word sign?

If a child has difficulty learning key word sign they might:

Get frustrated when they can’t get their message across.
Revert to grunting, pointing or tantrums when they can’t get their message across.
Struggle to coordinate their fingers to make the signs.
Have low muscle tone or difficulties with gross motor skills.
Fail to maintain attention long enough to copy the sign.
Be resistant to having someone help them to produce the sign.
Fail to retain the sign learnt from moment to moment or day to day.

What other problems can occur when a child has key word signing difficulties?

When a child has key word signing difficulties they might also have difficulties with:

Coordination: Ability to integrate multiple movements into efficient movement.
Fine motor skills: finger and hand skills.
Planning and sequencing: The sequential multi-step task/activity performance to achieve a well-defined result.
Expressive (using) language: The use of language through speech, sign or alternative forms of communication to communicate wants, needs, thoughts and ideas.
Receptive (understanding) language: Comprehension of language.
Articulation
Imitation
Working memory: The ability to temporarily retain and manipulate information involved in language comprehension, reasoning, and learning new information; and to update this information as change occurs.
Hearing

What can be done to improve key word signing?

Workshops: There are workshops that you can attend to learn Key Word Sign which are run by Speech Therapists at Novita Children’s Services (www.novita.org.au).
Family involvement: The more people in the child’s life that can be using key word sign, the more practice and reinforcement for the child.

Consistency: Using a small number of key word signs as a start and mastering these first, before introducing too many more will ensure a child is able to develop the use of sign reasonably quickly.

What activities can be used to help improve key word signing?

In play: When playing with the child:
- Give the child instructions to follow, sign the key concepts within the command (e.g. “Put the doll in the bed”).
- Sign the key concepts about what you and the child are doing when using toys in play (e.g. teddy bear jump, doll eating, big banana).
Books: When looking at books with the child:Sign key concepts when completing routines throughout the day such as taking a bath and getting ready for bedtime (e.g. shoes off, in the bed).
- Sign the question word and key information when asking questions (e.g. “Where is the girl?).
- Sign the key words within you or the child’s comments when describing the picture and/or answering a question (e.g. “the girl is under the table”).
- Get the child to answer questions using sign (e.g. adult: “Where is girl? child: Under the bed”).

Sing songs/nursery rhymes and sign the key words within the song (e.g. star in ‘Twinkle Twinkle’, the different animals in ‘Old Macdonald’).
Daily Routines: Encourage the child to use key word sign during daily routines. For example:
- When asking for food (e.g. “I want apple please”).
- When asking for a drink (e.g. “Can I have water please?”).
- To go to the toilet (e.g. “I need to go to the toilet“).
- To ask for help (e.g. when they need assistance with a toy or need help to open something – “Help me please”.

Why should I seek therapy to develop key word sign?

Therapeutic intervention to help a child develop key word sign is important because:

Learning key word sign can help to reduce the levels of frustration experienced by a child who can’t express their wants and needs.
Learning key word sign can assist a child who is having difficulties understanding information as it provides a visual representation of what is being said.
Some children have difficulty forming the signs. A Speech Therapist or Occupational Therapist can help a child to develop more accurate signs.

If left untreated what can a lack of key word signing lead to?

When children have difficulties developing key word signing, they might also have difficulties with:

Behavioural difficulties as a child’s frustration levels increase because they are unable to express their wants and needs.
Social isolation as a child is unable to communicate with their peers and may resort to other unwanted behaviours such as pushing or hitting to try and get other people’s attention.
Coping in the academic environment as a child may be unable to understand the expectations if there are no visual prompts (e.g. sign) and may be unable to participate in activities due to a lack of expressive language.

What type of therapy is recommended to teach key word sign?

If your child has difficulties with learning key word sign, it is recommended they consult a Speech Therapist.

If there are multiple areas of concern (i.e. beyond just key word sign) both Occupational Therapy and Speech Therapy may be recommended to address the functional areas of concern. This is the benefit of choosing Kid Sense which provides both Occupational Therapy and Speech Therapy