What is the Makaton Vocabulary?

Margaret Walker
Research Speech Therapist, Psychiatry of Mental Handicap, London University, and Project Coordinator, Makaton Vocabulary Development Project
Dr Aaron Armfield
Professor of Special Education, University of Nebraska at Omaha

First published 1981 in Special Education: Forward Trends, 8, 3, 19-20.

Establishing communication with children and adults who have never gained or who have lost the capacity to speak can be a complicated challenge which may require choosing one of several approaches or a combined approach.

In responding to this challenge teachers and therapists in more than 80 per cent of the ESN(S) schools in Great Britain are using signs from British Sign Language (Kiernan, 1979) and in the majority of instances, these signs are being used in conjunction with a language programme called 'The Makaton Vocabulary' as an aid to developing language in those with severe communication impairments.

The use of alternative communication approaches with those who have severe communication disorders has also been popular in the United States. Fristoe and Lloyd found in their survey of persons using non-speech communication that some form of American Sign Language was the favoured approach and that other formal sign systems, gestures, symbols (such as Bliss Symbolics and Rebus) and a Non-Speech Language Programme were reported as receiving use (Fristoe and Lloyd, 1978). They also described rationale associated with choosing from a variety of approaches in their article 'Planning an Initial Expressive Sign Lexicon for Persons with Severe Communication Impairment' (Fristoe and Lloyd, 1980). Reasons reported by these authors for choosing signs/words included: ease of signing production and demonstration; importance of the sign/word to the child; guessability of signs; potential for eventual combinations to convey meaning.

The Makaton Vocabulary

The design of the Makaton Vocabulary appears to be unique and its widespread use prompts these questions: what is the system, what appears to make it so effective and what implications might it have for the study of language development among those with severe communication disorders?

The Makaton Vocabulary began in 1972 in Surrey, as a project to teach sign language to deaf mentally handicapped adults (Walker, 1977). It was soon revised to be used for children and has become the system used to stimulate language development in the majority of ESN(S) schools in Great Britain.

Makaton is the applied use of a specific developmental vocabulary. It has been designed to provide a controlled method of teaching approximately 350 signs from British Sign Language (BSL) to mentally handicapped children and adults and other language handicapped people, in order to provide a basic means of communication; to encourage expressive speech wherever possible; to develop an understanding of language through the visual medium of the signs and the logical structure of the sign language (Walker, 1978).

The vocabulary words/signs were developed through careful observation of normal vocabulary while applying it to children and adults with severe communication handicaps It does not pretend to be a description of acquired vocabulary in a precise sequence for normal or multihandicapped people.

It is an a priori description of vocabulary sequentially acquired as a child (or perhaps an adult) proceeds through developmental stages of language - from the very basic to a small, but useful, vocabulary. Because a severe communication disorder frequently restricts those affected in initiating an early vocabulary with which to communicate, a teacher or therapist has to decide which language concepts might be taught which will develop into the most useful vocabulary for the most diverse situations that the child or adult might face. The Makaton approach is an attempt to guide, within developmental stages, the acquisition of a Core Vocabulary of a highly useful set of concepts/words with efficient multiple use. These can be further combined into a wide range of phrases and sentences. It may also be used experimentally with signs, symbols, pictures, objects or any combination of alternative communication tools.

The use of Makaton

The 1976 Revised Makaton Vocabulary is now in use with:

  1. mentally handicapped deaf and nondeaf children and adults who have little or no expressive speech and poor comprehension;
  2. children and adults who are both mentally and physically handicapped;
  3. those considered to be autistic;
  4. some young deaf children in the ordinary range of intelligence;
  5. children with severe articulation or speech rhythm problems who need a temporary alternative;
  6. certain normal adults with acquired communication problems.

Experience has shown that in addition to the development of concepts and language other positive results can occur. These are reported to be increased:

  1. eye contact
  2. attention
  3. sociability
  4. vocalisation and
  5. expressive speech.

A marked reduction in inappropriate behaviour is also reported. For those with severe communication impairments, signing can stimulate rather than interfere with language development. These positive side effects fall into a pattern that cannot be easily explained but do raise questions about the use of attention focussing devices as they relate to concept development and the contribution that a communication priority system such as Makaton can make to general language development.

Those who teach and use the system Include speech therapists, teachers, occupational therapists, psychologists, parents, instructors and school and/or hospital staff. They are provided with training in one-day workshops.

Guidelines to the system

To ensure the efficient use of the system the following guidelines are recommended by the Makaton Project.

  1. Participation in a basic one-day workshop organised by the Makaton Project is essential. This provides an introduction to signing, background to the scheme and guidelines on the recommended teaching procedures for implementing it.
  2. Further practice In signing is needed to maintain quality and increase signing fluency. Advanced courses are available and/or the project's local representative will give signing instruction and advice on implementation, if required.
  3. When teaching the vocabulary the teacher or therapist should follow the stages in sequence. However, the words within each stage are not necessarily taught in the order listed. The instructor should use his or her judgement about the communication needs of the child or adult within each stage. Unless he or she is highly experienced in language development and knows the student very well, any deviation from the stage sequence should be carefully considered.
  4. Signs are accompanied by normal grammatical speech.
  5. Appropriate facial expression and general body language should accompany the signs.
  6. Approximations of signs are accepted from those students beginning to sign and those with motor handicaps but the instructors providing the 'model' are expected to be consistently accurate - as with spoken language. Whenever possible teachers/therapists should practise signs among themselves to maintain quality and fluency.
  7. Left hand or right hand signing makes no difference as long as it is consistent.
  8. When and if speech develops students may discontinue the use of some expressive signs on their own initiative. However, their instructor should continue signing to them, as frequently as they will continue to depend on signs to extend their comprehension. Again judgment must be used.
  9. Since the Makaton Vocabulary is a complete language programme, a structured teaching approach is recommended. A manual of language programmes (Walker, 1976) provides programmes to teach every stage of the vocabulary, equipment lists and suggestions for revision and over-learning which are essential for the scheme's success. Another Important factor in addition to teaching the scheme formally from language programmes is that it must also be extended into daily living experience.

What makes Makaton effective?

Some observations of the Makaton system can be made.

  1. Makaton appears to be the only alternative communication system which has been divided into 'developmental stages'. Other vocabulary lexicons have been studied and/or prepared, but Makaton provides a set of vocabulary lexicons organised in stages which are increasingly complex.
  2. The vocabulary provides a guide for even the most experienced language development teacher or therapist - as well as for those new to vocabulary development - to deciding on priorities in developing communication and it also offers a guide to planning and measuring progress. The stages suggest a realistic and an economical- limit on vocabulary instruction attempted in a sequence for children with very limited abilities, while the freedom of choice within the stages allows for as much creative judgment as the instructor wishes.
  3. The range of vocabulary has been carefully chosen so that as the concepts are learned they can be used to connect and combine into two or three word sentences and longer. This design feature is present from the earliest stage and throughout the entire vocabulary.
  4. A source of frustration for many who wish to explore sign language as an alternative means of communication is that initial training requires weeks of study before an adequate vocabulary is acquired. This is not so with the Makaton Vocabulary because the graded stages permit communication to begin immediately at the most basic level.
  5. It is a potential guide for uslng alternative communication Systems other than BSL for persons with severe communication impairment. Symbol, picture, and other alternative communication systems usually rely solely on the judgment of the teacher/therapist for selection of the vocabulary to be taught. Makaton provides a guide for selecting vocabulary - especially initial vocabulary.
  6. Because the System is widely used throughout the United Kingdom, it offers an exceptional opportunity for collecting data on the language development of persons with severe communication impairrnent. Extensive data gathering could provide information pertinent to learning more about the teaching and acquisition of normal language development.

Implications for research

In relation to (6) above the extensive network of users has the potential for gathering data concerning some basic questions about Makaton's use, its refinement, and its value as a means of learning more about the effecttveness of educational programmes for persons who have one or several significant handicapping conditions. Record keeping sheets are now being used and they help identify the initial concepts learned along with the length of time it takes before a sign is spontaneously expressed by a student.

The Makaton Research Committee is studying procedures whereby data can be collected into a central bank that will provide Information on certain basic questions. Among those questions being considered for central collection are:

  1. the date that a sign/word is introduced;
  2. the date that the sign/word appears to be included in the student's receptive language;
  3. the first date that the sign/word is spontaneously expressed;
  4. the combination of signs/words which form the student/client's initial two or three sign/ word sentences.

While a broad base of data is collected on such questions, experimental programmes conducted by the Makaton Project's own network of regional representatives, are gathering data on specific questions. Independent research is being encouraged and collaboration with other researchers in the United Kingdom and abroad is under way.

General information, details of training courses, publications, name of local representative and current and proposed research plans may be obtained from: The Administrative Secretary, The Makaton Charity, Manor House, 46 London Road, Blackwater, Camberley, Surrey GU17 0AA.

References

Fristoe, M. and Lloyd, L. (1978) A survey of the use of non-speech systems with severely communication impaired. Mental Retardation, 16, (2),99-103.

Fristoe, M. and Lloyd, L. (1980) PIanning an initial expressive sign lexicon for persons with severe communication impairment. Journal of Speech and Hearing Disorders, 45, (2), 170-180.

Kiernan, C. C., Reid, B. and Jones, L. (1979) Signs and symbols - who uses what? Special Education, 6, (4), 32-34.

Walker, M. (1976) Language Programme for use with the Revised Makaton Vocabulary. Makaton Vocabulary Development Project.

Go symbol Walker, M. (1977) Teaching sign language to deaf mentally handicapped adults.
(Institute of Mental Subnormality Conference Proceedings) Language and the Mentally Handicapped, 3, 3-25. British Institute of Mental Handicap, Wolverhampton Road, Kidderminster, England.

Go symbol Walker, M. (1978a) The Makaton Vocabulary
In T. Tebbs (Co-ordinator) Ways and Means, Basingstoke: Globe Education on behalf of Somerset Education Authority