{"id":937,"date":"2022-02-21T14:35:22","date_gmt":"2022-02-21T14:35:22","guid":{"rendered":"https:\/\/www.sense.org.uk\/?page_id=937"},"modified":"2026-05-15T11:54:36","modified_gmt":"2026-05-15T10:54:36","slug":"hand-under-hand-signing","status":"publish","type":"page","link":"https:\/\/www.sense.org.uk\/information-and-advice\/ways-of-communicating\/hand-under-hand-signing\/","title":{"rendered":"Hand-under-hand communication"},"content":{"rendered":"\n<p class=\"is-style-intro\">This page explains what the hand-under-hand approach is, who uses it and how it works. You can also watch an example of a conversation using hand-under-hand signing.<\/p>\n\n\n\n  <div class=\"wp-block  box    is-style-textured-grey-tint-10  align-right  size-medium\">    <div class=\"acf-innerblocks-container\">\n\n<h2 class=\"wp-block-heading\">How Sense can help<\/h2>\n\n\n\n<p class=\"is-style-default\">We offer free and impartial information about living with complex needs, including deafblindness.<\/p>\n\n\n\n<p class=\"is-style-default\">We also offer services all over the UK, including <a href=\"https:\/\/www.sense.org.uk\/our-services\/support-for-adults\/day-services\/\">day services<\/a>, <a href=\"https:\/\/www.sense.org.uk\/our-services\/support-for-adults\/community-support\/\">community support<\/a> and <a href=\"https:\/\/www.sense.org.uk\/our-services\/support-for-adults\/residential-care\/\">residential care<\/a>. Talk to our team to find out more.<\/p>\n\n\n\n<p class=\"is-style-default\"><a href=\"https:\/\/www.sense.org.uk\/information-and-advice\/ask-us-for-help\/\"><strong>Get in touch by phone, email, post or through a BSL interpreter<\/strong><\/a><strong>.<\/strong><\/p>\n\n<\/div>\n  <\/div>\n\n\n\n\n<h2 class=\"wp-block-heading\">What is&nbsp;the hand-under-hand approach?<\/h2>\n\n\n\n<p>The hand-under-hand approach is a way of interacting and communicating using touch.&nbsp;<\/p>\n\n\n\n<p>If you are a child or adult who is <a href=\"https:\/\/www.sense.org.uk\/information-and-advice\/conditions\/deafblindness\/\">deafblind<\/a>, your hands can act as your eyes, ears and voice.&nbsp;<\/p>\n\n\n\n<p>To support someone who is deafblind using hand-under-hand, you can simply place their hand gently on top of yours.<\/p>\n\n\n\n<p>Using this approach, the person who is deafblind can:<\/p>\n\n\n\n<ul class=\"wp-block-list is-style-primary-bullets\">\n<li>Have more control.&nbsp;<\/li>\n\n\n\n<li>Play a more active part in tasks and learning.&nbsp;<\/li>\n\n\n\n<li>Focus on the objects they touch and not just on the other person\u2019s hands.&nbsp;<\/li>\n\n\n\n<li>Connect to the world.&nbsp;<\/li>\n\n\n\n<li>Learn at their own pace.<\/li>\n<\/ul>\n\n\n\n  <div class=\"wp-block  box    is-style-textured-pink-tint-10  size-medium\">    <div class=\"acf-innerblocks-container\">\n\n<h2 class=\"wp-block-heading\">Before you read on\u2026<\/h2>\n\n\n\n<ul class=\"wp-block-list is-style-secondary-bullets\">\n<li><strong>You can communicate using a mix of different ways. (We all do!)<\/strong><\/li>\n\n\n\n<li><strong>At Sense, we use whatever combination of speech, touch, sign or visual language works best.<\/strong><\/li>\n\n\n\n<li><strong>It\u2019s never too late to start.<\/strong><\/li>\n\n\n\n<li><strong>Have a go and don\u2019t worry about getting it wrong.<\/strong><\/li>\n<\/ul>\n\n<\/div>\n  <\/div>\n\n\n\n\n<p>With the hand-under-hand approach, if the person decides they want the activity to end, they can simply take their hand away at any time. This offers choice, control and a sense of freedom.&nbsp;<\/p>\n\n\n\n<p>It\u2019s a great approach for trying new activities, like introducing a child to a new way of playing.&nbsp;<\/p>\n\n\n\n<p>Your child may be hesitant to put their hand directly on an unknown object, for example. Using hand-under-hand they can still join in.&nbsp;<\/p>\n\n\n\n<p>The technique allows the person time to sense the movement of your hand, understand it is safe, and perhaps even feel comfortable enough to try it themselves, without your hand below theirs.&nbsp;<\/p>\n\n\n\n<figure class=\"wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio is-style-secondary\"><div class=\"wp-block-embed__wrapper\">\n<iframe loading=\"lazy\" title=\"Making play inclusive - Hand under hand communication\" width=\"500\" height=\"281\" src=\"https:\/\/www.youtube.com\/embed\/DxLCbFhlcms?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe>\n<\/div><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\">Who uses&nbsp;hand-under-hand signing?<\/h2>\n\n\n\n<p>Some people also use the hand-under-hand approach to communicate using <a href=\"https:\/\/www.sense.org.uk\/information-and-advice\/communication\/sign-language\/\">sign language<\/a>.<\/p>\n\n\n\n<figure class=\"wp-block-image size-full\"><img decoding=\"async\" width=\"2340\" height=\"1800\" src=\"https:\/\/www.sense.org.uk\/wp-content\/uploads\/2025\/01\/C4643.MP4.03_22_19_16.Still001-scaled.jpg\" alt=\"Richard and a Sense support worker communicating using touch.\" class=\"wp-image-64722\" srcset=\"https:\/\/www.sense.org.uk\/wp-content\/uploads\/2025\/01\/C4643.MP4.03_22_19_16.Still001-scaled.jpg 2340w, https:\/\/www.sense.org.uk\/wp-content\/uploads\/2025\/01\/C4643.MP4.03_22_19_16.Still001-600x462.jpg 600w, https:\/\/www.sense.org.uk\/wp-content\/uploads\/2025\/01\/C4643.MP4.03_22_19_16.Still001-1024x788.jpg 1024w, https:\/\/www.sense.org.uk\/wp-content\/uploads\/2025\/01\/C4643.MP4.03_22_19_16.Still001-768x591.jpg 768w, https:\/\/www.sense.org.uk\/wp-content\/uploads\/2025\/01\/C4643.MP4.03_22_19_16.Still001-1536x1182.jpg 1536w, https:\/\/www.sense.org.uk\/wp-content\/uploads\/2025\/01\/C4643.MP4.03_22_19_16.Still001-2048x1576.jpg 2048w, https:\/\/www.sense.org.uk\/wp-content\/uploads\/2025\/01\/C4643.MP4.03_22_19_16.Still001-500x385.jpg 500w, https:\/\/www.sense.org.uk\/wp-content\/uploads\/2025\/01\/C4643.MP4.03_22_19_16.Still001-1600x1231.jpg 1600w\" sizes=\"(max-width: 2340px) 100vw, 2340px\" \/><\/figure>\n\n\n\n<p>For example, Caroline was a British Sign Language user before losing her vision. As she became deafblind, she began to use hand-under-hand to communicate using BSL signs via touch.&nbsp;<\/p>\n\n\n\n<p>Caroline also expresses herself in different ways, including with body language and facial expressions.&nbsp;&nbsp;<\/p>\n\n\n\n<p>When someone is talking to Caroline, they use hand-under-hand signing so she can feel the signs they are using and vice versa.&nbsp;&nbsp;<\/p>\n\n\n\n<p>Watch Caroline using hand-under-hand signing to communicate in this video.<\/p>\n\n\n\n<figure class=\"wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-4-3 wp-has-aspect-ratio is-style-primary\"><div class=\"wp-block-embed__wrapper\">\n<iframe loading=\"lazy\" title=\"Say Hello to Caroline - Audio Description\" width=\"500\" height=\"375\" src=\"https:\/\/www.youtube.com\/embed\/OmPu7HRBHVA?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe>\n<\/div><\/figure>\n\n\n\n\n<details class=\"wp-block    accordion__item\"> \t<summary class=\"accordion__title\">\n\t\t<h3 class=\"accordion__toggle\">\n\t\tAudio transcription of Caroline&#039;s video\n\t\t<\/h3>\n\t<\/summary>\n\n\t<div class=\"accordion__content\">\n\t\t<div class=\"acf-innerblocks-container\">\n\n<h2 class=\"wp-block-heading\">Transcript<\/h2>\n\n\n\n<p>Meet Caroline. Caroline uses hand under hand signing and dance to communicate.<\/p>\n\n\n\n<p>Steph and Caroline sit side by side in a dance studio. We see them interact with hand under hand sign. We also see footage of Caroline dancing.<\/p>\n\n\n\n<p>The best way to say hello to Caroline is to use hand under hand signing and say hello.<\/p>\n\n\n\n<p>Caroline uses dance to communicate. When Caroline is dancing she becomes alive and present and connected to the people around her.<\/p>\n\n\n\n<p>Sense. Connecting sight, sound and life. No one left out of life.<\/p>\n\n\n\n<p>www.sense.org.uk<\/p>\n\n<\/div>\n\t<\/div>\n<\/details>\n\n\n\n\n<h2 class=\"wp-block-heading\">Who uses hand-under-hand communication?<\/h2>\n\n\n\n<p>Hand-under-hand communication is used by children and adults who are deafblind.&nbsp;<\/p>\n\n\n\n<p>When you have both hearing loss and sight loss, your hands can be an important tool for communicating and exploring the world.&nbsp;<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">How does the hand-under-hand approach work?<\/h2>\n\n\n\n<p>To use the hand-under-hand approach, allow the person who is deafblind to rest their hands on yours.&nbsp;<\/p>\n\n\n\n<p>You can then guide, gently, from underneath. This gives the person the choice to move their hands freely.&nbsp;&nbsp;<\/p>\n\n\n\n<p>The more opportunities a person has to use their hands and the safer it feels to explore, the more confident and motivated they will be to connect with the world, discover and learn.<\/p>\n\n\n\n  <div class=\"wp-block  box    is-style-textured-secondary-tint-10\">    <div class=\"acf-innerblocks-container\">\n\n<p>You can use the hand-under-hand approach to:<\/p>\n\n\n\n<ul class=\"wp-block-list is-style-primary-bullets\">\n<li>Introduce&nbsp;an object.&nbsp;<\/li>\n\n\n\n<li>Show&nbsp;how to do an activity or task.&nbsp;<\/li>\n\n\n\n<li>Encourage the&nbsp;person&nbsp;to get involved in things.&nbsp;<\/li>\n\n\n\n<li>Stimulate a person&#8217;s curiosity to reach out to the world beyond themselves.<\/li>\n\n\n\n<li>Prepare for and teach tactile signing.<\/li>\n\n\n\n<li>Explore items together through touch.&nbsp;<\/li>\n\n\n\n<li>Use on-body signing.&nbsp;<\/li>\n\n\n\n<li>Do things with the person, not for them.&nbsp;<\/li>\n<\/ul>\n\n<\/div>\n  <\/div>\n\n\n\n\n  <div class=\"wp-block  box    is-style-textured-red-tint-10  size-medium\">    <div class=\"acf-innerblocks-container\">\n\n<h2 class=\"wp-block-heading\">Stay in touch<\/h2>\n\n\n\n<figure class=\"wp-block-image alignright size-large\"><img decoding=\"async\" width=\"1024\" height=\"683\" src=\"https:\/\/www.sense.org.uk\/wp-content\/uploads\/2022\/03\/ths-sense-harry-sarah-storyteller-13337-scaled-1024x683.jpg\" alt=\"A woman and her son lie on the floor, reading a book. The mother, Sarah, is smiling. The boy, Harry, who has blue glasses and an orange t-shirt on, is concentrating on the book.\" class=\"wp-image-1512\" \/ style=\"object-position: 49.95% 35.13%;\" srcset=\"https:\/\/www.sense.org.uk\/wp-content\/uploads\/2022\/03\/ths-sense-harry-sarah-storyteller-13337-scaled-1024x683.jpg 1024w, https:\/\/www.sense.org.uk\/wp-content\/uploads\/2022\/03\/ths-sense-harry-sarah-storyteller-13337-scaled-450x300.jpg 450w, https:\/\/www.sense.org.uk\/wp-content\/uploads\/2022\/03\/ths-sense-harry-sarah-storyteller-13337-scaled-768x512.jpg 768w, https:\/\/www.sense.org.uk\/wp-content\/uploads\/2022\/03\/ths-sense-harry-sarah-storyteller-13337-scaled-1536x1024.jpg 1536w, https:\/\/www.sense.org.uk\/wp-content\/uploads\/2022\/03\/ths-sense-harry-sarah-storyteller-13337-scaled-2048x1366.jpg 2048w, https:\/\/www.sense.org.uk\/wp-content\/uploads\/2022\/03\/ths-sense-harry-sarah-storyteller-13337-scaled-1050x700.jpg 1050w, https:\/\/www.sense.org.uk\/wp-content\/uploads\/2022\/03\/ths-sense-harry-sarah-storyteller-13337-scaled-900x600.jpg 900w, https:\/\/www.sense.org.uk\/wp-content\/uploads\/2022\/03\/ths-sense-harry-sarah-storyteller-13337-scaled-600x400.jpg 600w, https:\/\/www.sense.org.uk\/wp-content\/uploads\/2022\/03\/ths-sense-harry-sarah-storyteller-13337-scaled-350x233.jpg 350w, https:\/\/www.sense.org.uk\/wp-content\/uploads\/2022\/03\/ths-sense-harry-sarah-storyteller-13337-scaled-1600x1067.jpg 1600w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" \/><\/figure>\n\n\n\n<p>Get updates about our vital work, including volunteering, making a donation or supporting Sense campaigns.<\/p>\n\n\n\n<div class=\"wp-block-buttons is-layout-flex wp-block-buttons-is-layout-flex\">\n<div class=\"wp-block-button is-style-white\"><a class=\"wp-block-button__link wp-element-button\" href=\"https:\/\/www.sense.org.uk\/sign-up-for-our-emails\/\">Sign up today<\/a><\/div>\n<\/div>\n\n<\/div>\n  <\/div>\n\n\n\n\n<h2 class=\"wp-block-heading\">How to get started with a child who is deafblind&nbsp;<\/h2>\n\n\n\n<ul class=\"wp-block-list is-style-primary-bullets\">\n<li>Let the&nbsp;child put their hands on top of yours to feel what you are doing.&nbsp;<\/li>\n\n\n\n<li>Practise doing this from different angles to see what works best.&nbsp;<\/li>\n\n\n\n<li>Work from behind the child&nbsp;so that your hands and the child\u2019s move in&nbsp;the&nbsp;same direction.&nbsp;<\/li>\n\n\n\n<li>When the child is very young, sit them on your lap.&nbsp;<\/li>\n\n\n\n<li>When the child is older, sit behind them and reach your arms around.&nbsp;<\/li>\n\n\n\n<li>Let the child know you&nbsp;are&nbsp;going to do something&nbsp;by touching&nbsp;their&nbsp;shoulder or elbow.&nbsp;<\/li>\n\n\n\n<li>Bring&nbsp;an&nbsp;object up and under the hands of the child.&nbsp;<\/li>\n\n\n\n<li>Start an activity under the hands of the child&nbsp;and describe&nbsp;verbally what you\u2019re doing with your hands.&nbsp;<\/li>\n\n\n\n<li>Before you show your child how to do something,&nbsp;try it yourself with your eyes closed. Pay attention to the steps&nbsp;you take.&nbsp;<\/li>\n\n\n\n<li>If&nbsp;the&nbsp;child pulls away,&nbsp;keep doing&nbsp;what you&nbsp;were doing and&nbsp;gently&nbsp;invite the child again to take part.&nbsp;<\/li>\n\n\n\n<li>If&nbsp;the&nbsp;child throws an object you are trying to show&nbsp;them,&nbsp;it\u2019s OK to&nbsp;hold on to it tightly or move&nbsp;it.&nbsp;&nbsp;<\/li>\n\n\n\n<li>If the child&nbsp;chooses to show you that they like to throw things,&nbsp;this may be their way of coping with someone guiding their hands. So, if they do this:\n<ul class=\"wp-block-list\">\n<li>&nbsp;Find&nbsp;some suitable&nbsp;things to throw, let the child throw them and then you throw them.&nbsp;&nbsp;<\/li>\n\n\n\n<li>Try&nbsp;doing a little something with the object before you throw it,&nbsp;and with&nbsp;every throw, take a little bit more time.&nbsp;&nbsp;<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<div class=\"wp-block  slab    is-style-textured-primary-tint-10  align-full\">\n  <div class=\"wrap\">  <div class=\"acf-innerblocks-container\">\n\n<h2 class=\"wp-block-heading\">Top tips&nbsp;<\/h2>\n\n\n\n<ul class=\"wp-block-list is-style-secondary-bullets\">\n<li>Be patient, gentle and persistent.&nbsp;<\/li>\n\n\n\n<li>Most children&nbsp;need&nbsp;to try a new task several times before they learn it, so be patient.&nbsp;<\/li>\n\n\n\n<li>Some children&nbsp;don\u2019t want to try&nbsp;new activities. They\u2019ll pull their hands away and won\u2019t want to touch.&nbsp;&nbsp;<\/li>\n\n\n\n<li>If they do this, try to respect&nbsp;what&nbsp;they\u2019re&nbsp;telling&nbsp;you.&nbsp;<\/li>\n\n\n\n<li>But remember, if&nbsp;a&nbsp;child&nbsp;who is deafblind&nbsp;is&nbsp;never encouraged to try new things,&nbsp;learning will take longer.&nbsp;&nbsp;<\/li>\n\n\n\n<li>So,&nbsp;it\u2019s OK to persist.&nbsp;Remember, though&nbsp;\u2013 don\u2019t try to control.&nbsp;Just coax gently, allowing the&nbsp;child the freedom to choose and discover.&nbsp;&nbsp;<\/li>\n\n\n\n<li>And always remember to:\n<ul class=\"wp-block-list\">\n<li>Follow their pace.&nbsp;<\/li>\n\n\n\n<li>Be creative.&nbsp;<\/li>\n\n\n\n<li>Be flexible.&nbsp;<\/li>\n\n\n\n<li>Find things they are interested in.&nbsp;<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n<\/div>\n  <\/div>\n<\/div>\n\n\n\n  <div class=\"wp-block  box    is-style-textured-blue-tint-10  align-center\">    <div class=\"acf-innerblocks-container\">\n\n<h2 class=\"wp-block-heading\">Other types of communication<\/h2>\n\n\n\n<p>These are the main ways of communicating that we use:<\/p>\n\n\n\t\n\t\t<ul class=\"iconList  iconList--columns  iconList--big\">\n\t\t\t\t\t\t\t<li class=\"\">\n\t\t\t\t\t<div class=\"iconList__item\">\n\t\t\t\t\t\t<i class=\"iconList__icon\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" width=\"150\" height=\"150\" src=\"https:\/\/www.sense.org.uk\/wp-content\/uploads\/2022\/12\/communication_touch_Orange_RGB-150x150.png\" class=\"attachment-thumbnail size-thumbnail\" alt=\"Touching an object\" srcset=\"https:\/\/www.sense.org.uk\/wp-content\/uploads\/2022\/12\/communication_touch_Orange_RGB-150x150.png 150w, https:\/\/www.sense.org.uk\/wp-content\/uploads\/2022\/12\/communication_touch_Orange_RGB-500x500.png 500w, https:\/\/www.sense.org.uk\/wp-content\/uploads\/2022\/12\/communication_touch_Orange_RGB-450x450.png 450w, https:\/\/www.sense.org.uk\/wp-content\/uploads\/2022\/12\/communication_touch_Orange_RGB-300x300.png 300w, https:\/\/www.sense.org.uk\/wp-content\/uploads\/2022\/12\/communication_touch_Orange_RGB-100x100.png 100w, https:\/\/www.sense.org.uk\/wp-content\/uploads\/2022\/12\/communication_touch_Orange_RGB.png 600w\" sizes=\"(max-width: 150px) 100vw, 150px\" \/> \t\t\t\t\t\t\t\t\t\t\t\t\t<\/i>\n\t\t\t\t\t\t<div class=\"iconList__content\"><p><b>Using touch<\/b><\/p>\n<ul class=\"is-style-primary-bullets\">\n<li><a href=\"https:\/\/www.sense.org.uk\/information-and-advice\/communication\/braille\/\">Braille<\/a>\u00a0uses raised dots to touch.<\/li>\n<li><a href=\"https:\/\/www.sense.org.uk\/information-and-advice\/communication\/deafblind-manual\/\">Deafblind Manual<\/a>\u00a0spells words on to your hand.<\/li>\n<li><a href=\"https:\/\/www.sense.org.uk\/information-and-advice\/communication\/block-alphabet\/\">Block alphabet<\/a>\u00a0spells letters on to your hand.<\/li>\n<li><a href=\"https:\/\/www.sense.org.uk\/information-and-advice\/communication\/moon\/\">Moon<\/a> uses raised lines, curves and dots to touch.<\/li>\n<li><a href=\"https:\/\/www.sense.org.uk\/information-and-advice\/communication\/tadoma\/\">Tadoma<\/a> uses lipreading by touch.<\/li>\n<\/ul>\n<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/li>\n\t\t\t\t\t\t\t<li class=\"\">\n\t\t\t\t\t<div class=\"iconList__item\">\n\t\t\t\t\t\t<i class=\"iconList__icon\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" width=\"150\" height=\"150\" src=\"https:\/\/www.sense.org.uk\/wp-content\/uploads\/2022\/12\/communication_sign_hands_Orange_RGB-150x150.png\" class=\"attachment-thumbnail size-thumbnail\" alt=\"Two hands signing\" srcset=\"https:\/\/www.sense.org.uk\/wp-content\/uploads\/2022\/12\/communication_sign_hands_Orange_RGB-150x150.png 150w, https:\/\/www.sense.org.uk\/wp-content\/uploads\/2022\/12\/communication_sign_hands_Orange_RGB-500x500.png 500w, https:\/\/www.sense.org.uk\/wp-content\/uploads\/2022\/12\/communication_sign_hands_Orange_RGB-450x450.png 450w, https:\/\/www.sense.org.uk\/wp-content\/uploads\/2022\/12\/communication_sign_hands_Orange_RGB-300x300.png 300w, https:\/\/www.sense.org.uk\/wp-content\/uploads\/2022\/12\/communication_sign_hands_Orange_RGB-100x100.png 100w, https:\/\/www.sense.org.uk\/wp-content\/uploads\/2022\/12\/communication_sign_hands_Orange_RGB.png 600w\" sizes=\"(max-width: 150px) 100vw, 150px\" \/> \t\t\t\t\t\t\t\t\t\t\t\t\t<\/i>\n\t\t\t\t\t\t<div class=\"iconList__content\"><p><b>Using signs<\/b><\/p>\n<ul class=\"is-style-primary-bullets\">\n<li><a href=\"https:\/\/www.sense.org.uk\/information-and-advice\/communication\/sign-language\/\">Sign language<\/a>.<\/li>\n<li><a href=\"https:\/\/www.sense.org.uk\/information-and-advice\/communication\/makaton\/\">Makaton<\/a>, a simpler version of sign language.<\/li>\n<li><a href=\"https:\/\/www.sense.org.uk\/information-and-advice\/communication\/visual-frame-signing\/\">Visual frame signing<\/a>\u00a0for people with reduced vision.<\/li>\n<li><a href=\"https:\/\/www.sense.org.uk\/information-and-advice\/communication\/objects-of-reference\/\">Objects of reference<\/a><\/li>\n<\/ul>\n<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/li>\n\t\t\t\t\t\t\t<li class=\"\">\n\t\t\t\t\t<div class=\"iconList__item\">\n\t\t\t\t\t\t<i class=\"iconList__icon\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" width=\"150\" height=\"150\" src=\"https:\/\/www.sense.org.uk\/wp-content\/uploads\/2022\/12\/voice_speech_bubble_2_Orange_RGB-150x150.png\" class=\"attachment-thumbnail size-thumbnail\" alt=\"Speech bubble\" srcset=\"https:\/\/www.sense.org.uk\/wp-content\/uploads\/2022\/12\/voice_speech_bubble_2_Orange_RGB-150x150.png 150w, https:\/\/www.sense.org.uk\/wp-content\/uploads\/2022\/12\/voice_speech_bubble_2_Orange_RGB-500x500.png 500w, https:\/\/www.sense.org.uk\/wp-content\/uploads\/2022\/12\/voice_speech_bubble_2_Orange_RGB-450x450.png 450w, https:\/\/www.sense.org.uk\/wp-content\/uploads\/2022\/12\/voice_speech_bubble_2_Orange_RGB-300x300.png 300w, https:\/\/www.sense.org.uk\/wp-content\/uploads\/2022\/12\/voice_speech_bubble_2_Orange_RGB-100x100.png 100w, https:\/\/www.sense.org.uk\/wp-content\/uploads\/2022\/12\/voice_speech_bubble_2_Orange_RGB.png 600w\" sizes=\"(max-width: 150px) 100vw, 150px\" \/> \t\t\t\t\t\t\t\t\t\t\t\t\t<\/i>\n\t\t\t\t\t\t<div class=\"iconList__content\"><p><b>Using speech<\/b><\/p>\n<ul class=\"is-style-primary-bullets\">\n<li><a href=\"https:\/\/www.sense.org.uk\/information-and-advice\/communication\/clear-speech\/\">Clear speech<\/a><\/li>\n<li><a href=\"https:\/\/www.sense.org.uk\/information-and-advice\/communication\/lipreading\/\">Lipreading<\/a><\/li>\n<\/ul>\n<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/li>\n\t\t\t\t\t\t\t<li class=\"\">\n\t\t\t\t\t<div class=\"iconList__item\">\n\t\t\t\t\t\t<i class=\"iconList__icon\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" width=\"150\" height=\"150\" src=\"https:\/\/www.sense.org.uk\/wp-content\/uploads\/2022\/12\/Choices-sign_Orange_PNG_RGB-150x150.png\" class=\"attachment-thumbnail size-thumbnail\" alt=\"An orange paint brush mark illustration of a sign post pointing in different directions, representing choices.\" srcset=\"https:\/\/www.sense.org.uk\/wp-content\/uploads\/2022\/12\/Choices-sign_Orange_PNG_RGB-150x150.png 150w, https:\/\/www.sense.org.uk\/wp-content\/uploads\/2022\/12\/Choices-sign_Orange_PNG_RGB-600x600.png 600w, https:\/\/www.sense.org.uk\/wp-content\/uploads\/2022\/12\/Choices-sign_Orange_PNG_RGB-1024x1024.png 1024w, https:\/\/www.sense.org.uk\/wp-content\/uploads\/2022\/12\/Choices-sign_Orange_PNG_RGB-768x768.png 768w, https:\/\/www.sense.org.uk\/wp-content\/uploads\/2022\/12\/Choices-sign_Orange_PNG_RGB-500x500.png 500w, https:\/\/www.sense.org.uk\/wp-content\/uploads\/2022\/12\/Choices-sign_Orange_PNG_RGB-450x450.png 450w, https:\/\/www.sense.org.uk\/wp-content\/uploads\/2022\/12\/Choices-sign_Orange_PNG_RGB-300x300.png 300w, https:\/\/www.sense.org.uk\/wp-content\/uploads\/2022\/12\/Choices-sign_Orange_PNG_RGB-100x100.png 100w, https:\/\/www.sense.org.uk\/wp-content\/uploads\/2022\/12\/Choices-sign_Orange_PNG_RGB.png 1201w\" sizes=\"(max-width: 150px) 100vw, 150px\" style=\"object-position: 50% 50%;\" \/> \t\t\t\t\t\t\t\t\t\t\t\t\t<\/i>\n\t\t\t\t\t\t<div class=\"iconList__content\"><p><b>Also<\/b><\/p>\n<ul class=\"is-style-primary-bullets\">\n<li><a href=\"https:\/\/www.sense.org.uk\/information-and-advice\/communication\/non-formal-communication\/\">Non-formal communication<\/a>\u00a0without speaking, writing or signing.<\/li>\n<li><a href=\"https:\/\/www.sense.org.uk\/information-and-advice\/communication\/intensive-interaction\/\">Intensive Interaction<\/a>\u00a0treating everything as 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