Makaton: the early years

The Makaton vocabulary was originally devised by MArgaret Walker, Senior Speech Therapist at Botleys Park Hospital, Chertsey, Surrey, KAthy Johnston and TONy Cornforth, Psychiatric Hospital Visitors from the Royal Association in aid of the Deaf and Dumb - hence its name MAKATON . Kathy and Tony have now left the Association, and Margaret Walker and other staff from the Royal Association continue the work.

In the late 1960s, staff from the Royal Association (RADD) working in the large Surrey Hospitals for the mentally ill and the mentally handicapped highlighted the problems of the deaf mentally handicapped resident, living amongst a hearing SSN community but completely isolated because of his/her lack of communication. Simple attempts were made to introduce some signing and the deaf residents responded eagerly.

Research project

In 1972-3 the RADD were invited to introduce signing to a group of deaf residents at Botleys Park Hospital. Mrs Margaret Walker joined the team and carried out a research project to evaluate the use of British Sign Language with a group of deaf mentally handicapped. This was the pilot study for the Makaton Vocabulary.

A group of fourteen residents was chosen from the hospital's Register of Deaf. The age range was from 16 to 68 years. Sex distribution was uneven, being eleven males to three females. Hearing loss ranged from moderate to severe. IQ was measured on the Performance Scale of the Wechsler Adult Intelligence Scales and the range was 35 - 98, the mean of the group being 54.3. Three subjects had rudimentary speech but it was not adequate for communication. Several had additional physical handicap or behaviour problems.

A vocabulary of 145 signs was selected, based on our experience of the language of SSN institutionalized people, and by reference to the work of other researchers - Mein and O'Connor (1960) and Mein (1961). Training was given for a two-hour period once a week over nine months.

Initially, twenty signs were introduced, then gradually over a period of four to five months the remainder were taught. Signs were always accompanied with normal grammatical speech.

Research aims

  1. To measure how easily deaf mentally handicapped people could learn sign language.
  2. To assess if they could develop an understanding of and learn language through the sign language.
  3. To attempt to discover if any factors, measureable before training began, could be used to predict ability in mentally handicapped people to learn sign language.

Summary of results

The research project results showed very convincingly that BSL could be learnt easily by mentally handicapped people, and that it could be a tool in teaching language.

Application outside a hospital environment

The results of the research project gave encouragement for the scheme to be developed further and expanded. The original version of the Makaton Vocabulary for use in hospital environments was completed. Then the vocabulary was given a trial in school in the community with mentally handicapped and autistic children who were not deaf, but had little or no expressive speech and poor comprehension.

Similar successful results to those described in the research project were gained with the children using the Makaton Vocabulary. The only criticism was that extra vocabulary appropriate to the school/home environment was needed. In 1976 the Revised Makaton Vocabulary was completed to overcome this and is now in curent use.

It is being used with:

  1. Mentally handicapped deaf children and adults.
  2. Mentally handicapped non-deaf children and adults with little or no expressive speech and poor comprehension.
  3. Mentally and physically handicapped (mild/moderate) children and adults.
  4. Autistic children.
  5. Young normal deaf children.
  6. Children with severe articulation problems, e.g. articulatory dyspraxia, as a temporary alternative means of comunication to relieve frustration and relax the children whilst intensive articulation therapy is being given. It also helps to train overall imitative ability.
  7. Some stamerers to relieve tension and frustration during treatment and until ongoing therapy begins to have effect.
  8. Certain normal adults suffering communication problems following e.g. strokes.

The Makaton vocabulary is also being used in other unexpected areas:

  1. Certain groups of trainers providing horse-riding facilities for the disabled are finding it helpful in their work with handicapped children, especially where the children have already been trained to use it.
  2. In some areas of the country, the adult Deaf Literacy Scheme are using the Makaton as a basic/foundation vocabulary for their work.
  3. Some teachers teaching reading to ESN(M) children find the signing very helpful in explaining word/language concepts and in helping children remember them.

The Revised Makaton Vocabulary (1976)

The revised vocabulary comprised approximately 350 words/signs presented in eight stages with a ninth stage for specific additional vocabulary. Each stage contains about 35 - 40 words. The vocabulary was devised after careful consideration of these factors:

  1. It had to be small and limited because it was envisaged as a basic vocabulary for communication and language learning.
  2. It was essential that it followed the normal development of language.
  3. It had to be appropriate for mentally handicapped people.
  4. It needed to be selected in such a way that the signs would easily combine into short phrases and thus provide a very basic and useful communication system.

The philosophy behind the Makaton was to structure into graded steps the signs to be taught, in the hope that knowledge would be gained progressively and that when the limit was reached the child/adult would have at least a workable communication medium related to its understanding and ability. Those people with basic intellectual functioning would therefore have a small basic communication system, and those more able intellectually would progress through the stages, gaining a larger vocabulary suitable to their ability. If any were able to complete the entire vocabulary, then they would, if required, be able to progress to Total Communication.

The need to adhere to the stages of the vocabulary is vital. Even when confronted with a mentally handicapped person above the mental age range of the first stage, it is still necessary. The technique is to work progressively from Stage 1 to each subsequent stage in order to establish the foundation of the scheme. If the person is more able, they will learn the first stages very rapidly, so there is little delay or frustration.

The Makaton Vocabulary - Summary

The Makaton Vocabulary is presented, with the exception of Stage 9, in stages of increasing complexity.

Stage 1 (language level approx 1 - 1.5 years)

This stage presents extremely basic vocabulary upon which the other stages build. By using single signs or short phrases of combined signs from Stage 1, basic needs and simple instructions may be expressed, e.g. come (and) sit down; go (to the) toilet; give me (a) drink please; good morning, how are you? The number of words in Stage 1 is deliberately kept small to facilitate learning. The aim is that one should communicate within this small nucleus of signs and thus help the learner to become familiar with them quickly and realize the impact of this form of communication. Some signs (e.g. doctor, nurse) may not be appropriate to everyone's environment while others (e.g. teacher) may be needed at Stage 1 if a child is already at school. Do not change more than a noun for a noun or the developmental sequence of language will be disturbed.

Stage 2 (language level approx 2 - 2.5 years)

This stage presents additional basic vocabulary at an early language level and serves to enrich the vocabulary taught in Stage 1.

Stage 3 (approx 3 years), Stage 4 (approx 3.5 years), and Stages 5 and 6 (approx 4 - 4.5 years)

Stages 3 - 6 increase the growth of vocabulary in a structured manner and gradually introduce language concepts which are graded according to the normal development of language.

Stages 7 and 8

Stages 7 and 8 are slightly different. The vocabulary in these two Stages provides complex language concepts and vocabulary necessary to expand previous stages, if the ability of the learner is high enough to comprehend them.

Stage 9 (Additional vocabulary)

There will inevitably always be some words/signs that are needed in a specific environment which are not included in the Makaton. Absolutely essential items may be added, but the size of this vocabulary should be limited to 30 - 40 at most. Care must be taken to evaluate the language level of these additional signs.

Workshops and reports

One day workshops have been held to:- (a) provide instruction in signing; (b) to illustrate teaching methods and the use of the language programmes; (c) to provide opportunities for discussion on the practical application of the scheme; (d) to put the participants in contact with their local signing expert, e.g. chaplain or social worker with the deaf, for further instruction and support.

Attendance at a workshop provides the best all-round introduction to the scheme.

The first workshop was held in July 1976 at Botleys Park Hospital, Chertsey, Surrey, and up to the end of 1977 many others were held there and at other venues in Britain. Considerable interest has also been shown from Europe, Scandanavia, Israel, Israel, USA, Australia, New Zealand and Japan. Through these workshops well over 1000 people - teachers, speech therapists occupational therapists, nurses, social workers, psychologists, parents and others were trained. Many more have also gained expertise from those people who attended.

References

Walker, M. (1973) An experimental evaluation of the success of a system of communication for the deaf mentally handicapped. (Unpublished MSc thesis available for reference from author or from following libraries: RNID, Gower Street, London; The Hilliard Collection, John Ryland's Library Manchester University) (Pilot study for Makaton Vocabulary)

Walker, M. (1975) Teaching sign language to deaf mentally handicapped adults. (Summary of MSc Thesis above) Conference Proceedings Language and the Mentally Handicapped 3, Institute of Mental Subnormality. Wolverhampton Road, Kidderminster.

Sheridan, M.D. (1975) Children's Developmental Progress: from birth to five years. NFER Publishing Co. Ltd.: Windsor, Berks

This historical review was based upon the paper:
Walker, M. (1978) The Makaton Vocabulary. In T. Tebbs (Co-ordinator) Ways and Means 1. Basingstoke: Globe Education for Somerset Education Authority.)