Total communication is gaining widespread acceptance as an alternative or supplemental form of communication for language delayed hearing children for whom oral language training alone is inadequate. The authors address several issues pertinent to designing environmentally based total communication assessment and training programs. Major issues discussed include (a) Who are the appropriate clients for total communication training? (b) What criteria are useful in selecting a sign system? (c) What linguistic model is appropriate for selecting valid language targets and designing generalization? (d) What adaptations in an oral language teaching program are necessary for a manual mode of communication training? These questions and corollary issues are addressed from theoretical and clinical perspectives.
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