Communication & senses · England
Signing and communication through touch
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This guide is for people in England.
People communicate in different ways.
Ask which ways work best for the person.
British Sign Language is often called BSL.
BSL is a language with its own rules.
Sign Supported English uses signs with spoken English.
Makaton uses signs, pictures and speech.
These are different from BSL.
Some people have sight and hearing loss.
They may understand signs through touch.
Ask a deafblind specialist about suitable communication.
They can teach the agreed method.
Check before touching someone.
Learn how they say yes, no and stop.
Never force their hands to make an answer.
Ask for an interpreter with the right skills.
They may need experience of communication through touch.
Speak directly to the person.
Allow time and breaks for everyone.
Write down what communication support works.
Ask services to use this information.
What you can do next
Ask for communication support that works for you.
You can use more than one way to communicate.
Explore communication methods with Sense Web pageThis link opens another website.
It may use harder words.
More useful links
- Find or check a communication professional Web page
Search by profession, location or name; check relevant deafblind experience as well.
- Learn about Makaton Web page
Official information and routes to resources and training.
- Hand-under-hand communication Web page
Sense explains choice and control in communication through touch.
These links open other websites.
They may use harder words.
Sign language and communication through touch
Understand different signing methods, deafblind communication and getting the right communication support.
Children and adults · England
Start with the person’s language and choices
Ask how the person understands information and expresses themselves, including their preferred language, signs, objects, pictures, gestures or communication device. People can combine methods. A learning disability or hearing loss does not tell you which method they use. Record their own signs and meanings with permission; do not assume an unfamiliar gesture has the meaning you expect.
British Sign Language: a complete language
British Sign Language, usually called BSL, has its own grammar and word order. Facial expression and body movement carry meaning alongside hand movements. It is not spoken English translated word by word. Some Deaf people use BSL as their first language; others use speech or different methods. Learn with a suitably qualified teacher and practise with fluent users.
Sign Supported English and Makaton
Sign Supported English, or SSE, uses signs alongside English in English word order. Makaton is a communication programme combining signs, symbols and speech, also following spoken word order. It often signs key words. These approaches are not interchangeable with BSL. Makaton symbols can help people who cannot or do not want to sign. Ask a speech and language therapist about suitable options and use official Makaton teaching resources.
Communication when both sight and hearing are affected
A deafblind person may use visual frame signing, with signs kept within their usable field of vision, or hands-on signing, feeling signs through touch. Other people use deafblind manual fingerspelling, objects or other agreed tactile cues. Existing language, vision, hearing, movement, fatigue and preferences all matter. Ask a specialist deafblind service to assess access and teach the agreed approach. This guide is not instructions for teaching tactile techniques yourself.
Touch must offer choice and control
Explain or signal your presence in the person’s agreed way before touch. Learn their agreement, refusal and stop signals. Hand-under-hand approaches can let a person explore with their hand resting on another person’s hand and withdraw when they choose. Do not grab or move someone’s hands to make them produce a sign or an answer. Pause when they pull away, seem distressed or need a break; ask for skilled advice if the meaning is unclear.
Arrange the right professional
Tell the service precisely what communication is needed before an appointment. A BSL interpreter is not automatically experienced in hands-on or visual frame signing. Ask about relevant qualifications, registration and deafblind experience. The NRCPD register helps find and check communication professionals. NHS Accessible Information Standard guidance requires appropriate professional support and explains limited practical exceptions where a registered deafblind manual interpreter cannot be found; alternatives should be discussed with the person.
Support a real conversation
Address the person directly, rather than speaking about them to their interpreter. Allow interpreting time and pauses. Agree lighting, position, background noise, seating, breaks and whether remote interpreting is usable. Share preparation materials securely in advance. Familiar supporters can explain personal communication, but should not routinely replace a needed professional interpreter for important health or care decisions.
Build a reliable plan across places
Ask the service to record communication requirements and arrange them for future appointments. Put useful information in a communication passport with the person’s agreement. Agree how unfamiliar staff will learn, who will update it and what to do when equipment or usual support is unavailable. Consider specialist deafblind assessment when combined sensory loss affects communication, information or getting around.
Words you could use
“Please record my communication method and arrange someone with the skills to support it. This is how I show agreement, refusal and when I need a break: …”
More useful links
- Find or check a communication professional Web page
Search by profession, location or name; check relevant deafblind experience as well.
- Learn about Makaton Web page
Official information and routes to resources and training.
- Hand-under-hand communication Web page
Sense explains choice and control in communication through touch.
These links open other websites.
They may use harder words.
Where the information comes from
Links checked 1 November 2026.
These links open other websites.
They may use harder words.
- Sense: sign language Web page
BSL, SSE, hands-on signing and differences between approaches.
- The Makaton Charity: what Makaton is Web page
Signs, symbols and speech, personalised to communication needs.
- Sense: hand-under-hand communication Web page
Touch that preserves withdrawal, control and participation.
- Sense: working with an interpreter Web page
Appropriate skills, preparation, direct conversation and breaks.
- NHS England: Accessible Information Standard Web page
Communication professionals, recording needs and deafblind-specific exceptions.
- NRCPD: registration Web page
Public registers and professional standards.