Simplified Signs: A Manual Sign-Communication System for Special Populations, Volume 1.

Simplified Signs presents a system of manual sign communication intended for special populations who have had limited success mastering spoken or full sign languages. It is the culmination of over twenty years of research and development by the authors. The Simplified Sign System has been developed and tested for ease of sign comprehension, memorization, and formation by limiting the complexity of the motor skills required to form each sign, and by ensuring that each sign visually resembles the meaning it conveys.

Volume 1 outlines the research underpinning and informing the project, and places the Simplified Sign System in a wider context of sign usage, historically and by different populations. Volume 2 presents the lexicon of signs, totalling approximately 1000 signs, each with a clear illustration and a written description of how the sign is formed, as well as a memory aid that connects the sign visually to the meaning that it conveys.

While the Simplified Sign System originally was developed to meet the needs of persons with intellectual disabilities, cerebral palsy, autism, or aphasia, it may also assist the communication needs of a wider audience – such as healthcare professionals, aid workers, military personnel , travellers or parents, and children who have not yet mastered spoken language.  The system also has been shown to enhance learning for individuals studying a foreign language.

Lucid and comprehensive, this work constitutes a valuable resource that will enhance the communicative interactions of many different people, and will be of great interest to researchers and educators alike.

John D. Bonvillian was a faculty member in the Psychology Department at the University of Virginia for thirty-seven years. He also chaired the University’s Interdepartmental Program in Linguistics. He was known for his contributions to the study of sign language, child development, psycholinguistics, and language acquisition. His research focused on typically developing children, deaf children, and children with disabilities. For the last seventeen years of his career he worked on a simplified, manual sign-communication system. The initial focus of this work was to create an easily-adopted signing system for speech-limited populations, such as individuals with autism spectrum disorder (ASD), Down syndrome, or cerebral palsy. Later, he studied applications of the Simplified Sign System for foreign language acquisition and for children in limited language environments. He and his research colleagues developed and tested a lexicon of approximately 1850 easily-formed, highly iconic signs or gestures, some of which are presented in these volumes. Bonvillian received his Ph.D. in Psychology from Stanford University, where he held a National Science Foundation doctoral fellowship. His B.A. was from Johns Hopkins University in Psychology. He authored over 100 journal articles and was an editor of the journal Sign Language Studies. Before taking his position at the University of Virginia, Bonvillian taught at Vassar College. He also served as a visiting faculty member at Gallaudet University in Washington, D.C. and the University of Canterbury in New Zealand. He died in 2018.

Tracy T. Dooley was an undergraduate honors student at the University of Virginia and a member of Dr. Bonvillian’s research group in the early 1990s, where she studied handedness in the young sign-learning children of Deaf parents. After earning B.A. degrees in Linguistics and Spanish with a minor in Psychology, she obtained her Master of Divinity degree from Emory University’s Candler School of Theology in Atlanta, GA. While studying theology, she also pursued training in sign language interpretation at DeKalb College (now Georgia State University Perimeter College). After moving back to Virginia in 2003, Ms. Dooley rejoined Dr. Bonvillian’s research group, where she focused on the expansion of the Simplified Sign System to include more concepts, the writing and editing of volumes 1 and 2, and overseeing the development of the sign illustrations. After Dr. Bonvillian’s death, Ms. Dooley updated both volumes of the system in preparation for publication.

Nicole Kissane Lee, M.D., Ed.M. had the privilege of formally starting the "Simplified Sign System” project with Dr. John Bonvillian in 1997 when she was a first-year pre-medical student at the University of Virginia. After many hours meticulously studying and testing the memory and recall of simplified signs, Dr. Lee and Dr. Bonvillian published the "Simplified Sign System” on the internet in the spring of 2001 which exponentially launched its soon-to-be international notoriety. Dr. Lee graduated from the University of Virginia in 2001 with High Distinction in Psychology under the mentorship of Dr. Bonvillian, with her thesis work on the "Simplified Sign System” gaining recognition for its unique innovation from The Today Show, CNN, The Washington Post, and CosmoGirl, to name a few. Dr. Lee went on to obtain her medical degree from the Medical College of Virginia, in Richmond, VA, her surgical residency training at the University of Florida, in Gainesville, FL, and fellowship training in advanced laparoscopic surgery at Massachusetts General Hospital in Boston, M.A. Dr. Lee continued her education while in Boston, obtaining additional fellowship training in Medical Simulation from Brigham and Women’s Hospital. She also obtained an Ed.M. with a focus in Technology and Innovation from Harvard University in 2013. Dr. Lee is currently a minimally invasive and bariatric surgeon at Indiana University. She is an Assistant Professor of Surgery and the Director of the Indiana University Surgical Skills Center. She is also Co-Director of the Indiana University Surgical Education Research Fellowship. Dr. Lee is an active member of the American College of Surgeons Accredited Education Institute (ACS/AEI) as a member of the Accreditation Review Committee, national site reviewer, and Co-Editor of the ACS/AEI Online Communities. Dr. Lee remains proud and grateful to be associated with the legendary works of her former mentor, Dr. Bonvillian. It was his enthusiasm in education and research which launched her career in medical education and related research.

Filip T. Loncke is a psycholinguist from Belgium who came to the United States in 1997 as a professor at the Curry School of Education and Human Development at the University of Virginia. Prior to his arrival in the U.S., he worked for twenty years as an educational psychologist and as a school superintendent for services for children with disabilities. He obtained his B.A. and M.A. degrees in Special Education from the University of Ghent, and an M.A. and Ph.D. degree in neurolinguistics from the University of Brussels. While in Belgium, he was a co-developer of a manual sign system that is currently still in use in parts of Europe. Since his arrival in the US in the late 1990s until Dr. Bonvillian’s passing, he collaborated with Dr. Bonvillian on several research projects related to the Simplified Sign System.

Val Nelson-Metlay was born hard-of-hearing in Chicago, IL and is now Deaf. It wasn’t until she was about twenty-five years old that she started to pick up ASL. She graduated from the University of Kansas with a B.F.A. and went on to work at several jobs: cartoonist for a small advertising agency, color separation for two greeting cards, pre-press keyliner, layout artist, and typesetter, book designer, newspaper editor and layout, and finally freelance artist. She is grateful for the opportunity to illustrate these volumes, and for the full support she has received from her family, her dear hearing friends, and many Deaf and hard-of-hearing friends.

Chapter 1 provides an introduction to the language and communication needs of various individuals who have difficulty expressing themselves either through speech and/or by using one of the full and genuine sign languages of Deaf people.  The authors propose the integration of the Simplified Sign System, a manual sign-communication system that is comprised of iconic and easily formed signs, into the environments of persons with various communication difficulties, including individuals with autism, aphasia, intellectual disability, or cerebral palsy.  Various misconceptions about sign training are tackled and countered by information highlighting the benefits of sign usage for many different people.  The authors then present the principles on which their sign system is based, including iconicity, ease of production, the relatively broad conceptual base of many signs, the standardization of the signs, and the provision of a core vocabulary.  These principles also make them easier to learn and remember by other potential users of the system, including international travellers, parents adopting children from other countries, elderly persons who have developed hearing impairments, foreign language instructors, and students learning an additional spoken language.

Chapter 2 presents multiple accounts of the widespread use of manual signs by hearing persons in diverse settings throughout history.  From an initial theoretical focus on the origins of language in humans, and the potential that language first emerged from gestural or manual communication, the reader is introduced to the views of various historical scholars who believed that signs and gestures are a natural means of communication and could potentially even be a universal form of communication.  Such a universal form of communication, however, meets with a substantial obstacle in that gestures may vary widely in meaning and usage cross-culturally.  Nevertheless, such a system was developed once before by the Indigenous peoples of North America, who spoke hundreds of different languages.  Native Americans used signs as a lingua franca across a wide geographical area to overcome the numerous spoken language barriers they encountered.  Also covered in this chapter are the use of signs in early contact situations and interactions between Native Americans and Europeans, and the development of signs by various monastic orders in Europe.

3. Deaf Persons and Sign Languages

Chapter 3 introduces the reader to various aspects of sign languages, including their historical development and use within educational contexts by Deaf communities in Europe and the United States.  Also covered is the initiation of the field of sign language linguistics by William C. Stokoe, a linguist who systematically proved that American Sign Language (ASL) was indeed a language with its own distinct structure and properties that differed from any spoken language.  The phonological parameters of signs receive considerable attention, highlighting ways in which the unique properties of sign languages allow them to represent meaning in ways that are more consistently transparent and iconic than similar phenomena in the speech modality.  Despite these similarities across sign languages, the differences among the sign languages of the world led Deaf persons to create and develop the lingua franca of International Sign (previously Gestuno) for use at international conventions.  Finally, the similarities and distinctions between the processes of language development and acquisition across the modalities of speech and sign are discussed, as well as how signing benefits the learning of spoken language vocabulary by hearing children.

In Chapter 4, the authors begin an in-depth discussion of the use of signs with special populations, including an early study that occurred in the West of England in the 1840s with deaf students with intellectual disabilities.  Various types of intellectual disability are identified, including fragile X syndrome, Williams syndrome, Down syndrome, and Angelman syndrome.  The successes and failures of speech-based and sign-based interventions are covered for individuals with these syndromes (particularly the latter two) as well as in persons with multiple disabilities.  The authors next move on to a discussion of the relatively sparse research related to teaching signs to children who have cerebral palsy.  Recommendations for enhancing the sign-learning environment are provided so that all persons who use signs as an augmentative or alternative means of communication may derive the greatest benefit from their communicative interactions.  In addition to maximizing the positive atmosphere in which signing individuals interact with others at school, at home, and in public, the authors suggest that the types of signs employed may also have an impact on whether or not signing is successful.

Chapter 5 provides a comprehensive, historical overview of the defining characteristics of autism spectrum disorder (ASD) along with the various language therapies employed to improve the communicative success of minimally verbal individuals.  The various strengths and weaknesses of such approaches are analyzed as a basis for helping to determine which methods are likely to be the most successful.  The history of signing in persons with ASD is examined, with a special focus on the relatively recent realization that motor skills (both gross and fine) and imitation abilities in such individuals may be severely impaired, thus limiting the effectiveness of sign interventions that do not take into consideration the motor complexity of the signs used.  Since many parents and caregivers may also express reluctance to adopt a strategy that uses signs out of fear that this will prevent their child’s acquisition of speech, research dispelling this myth is provided.  In addition to coverage of sign-communication interventions and strategies for promoting spontaneous communication and generalization of sign use to multiple settings, other non-oral approaches employed with persons with disabilities are presented as options, including the use of real objects, the Picture Exchange Communication System (PECS), Blissymbols, speech-generating devices, and software applications.

Chapter 6 focuses on the language and communication impairments of adults and children that may be acquired after suffering a head injury, stroke, brain infection, tumor, or other similar trauma.  Such persons may have had intact language abilities before the trauma, but often present with varying degrees of severity of aphasia that may temporarily or permanently affect their receptive understanding of language and/or their production of language.  Although most of the literature examines such deficits in hearing persons and the resulting impact on spoken language, deaf persons may also experience aphasic impairments to their production and understanding of sign language.  An examination of apraxia, which often co-occurs with aphasia, provides another dimension that needs to be analyzed when addressing strategies for language rehabilitation.  The outcomes of sign-communication interventions in persons with aphasia are presented, along with a focus on Amer-Ind, pantomime skills, and the use of signing to facilitate speech.  Finally, the authors address speech and language disorders such as acquired childhood aphasia (Landau-Kleffner syndrome), developmental language disorder (formerly known as specific language impairment) in both hearing and deaf children, and childhood apraxia of speech.

In Chapter 7, the authors change focus from the use of signs by deaf persons and with individuals with disabilities to how signing may enhance the learning and processing of spoken language by typically developing hearing children and adults.  The first topic examined is the use of signs to foster infants’ and young children’s acquisition of their principal spoken language.  Signs may further serve as an effective intervention strategy in academic settings for children with ADHD or as a means to improving vocabulary acquisition and reading comprehension for children who lag behind their age group on various language performance measures.  Iconic signs and representative gestures may also be used to facilitate the acquisition of foreign language vocabulary when the signs are paired with the to-be-learned words.  Finally, various studies concerning the positive benefits of learning to sign promote the possibility that using the visual-gestural modality may confer increased skills in various cognitive domains such as spatial memory, mental rotation, and facial discrimination.

Chapter 8 provides background information on the development of the Simplified Sign System.  These steps are included so that investigators may replicate research findings and/or develop additional signs for their own sign-intervention programs.  The authors first discuss efforts to find highly iconic or representative gestures in the dictionaries of various sign languages and sign systems from around the world.  If necessary, signs were then modified to make them easier to produce based on the results of prior studies of signing errors made by students with autism, the sign-learning children of Deaf parents, and undergraduate students unfamiliar with any sign language.  These potential signs were then tested with different undergraduate students to determine whether the signs were sufficiently memorable and accurately formed.  Signs that did not meet criterion were either dropped from the system or subsequently modified and re-tested.  Initial results from comparison studies between Simplified Signs and ASL signs and between Simplified Signs and Amer-Ind signs are presented as well.  Finally, feedback from users influenced the course of the project.  Memory aids were developed, especially for those persons who have less familiarity with sign languages, to help explain the ties between each sign and its referent in case that relationship is not readily or immediately apparent to a potential learner.

In Chapter 9, various approaches to teaching signs to non-speaking or minimally verbal persons are examined, including general exposure, an incidental or milieu approach, games and group activities, and specific training sessions.  Learning goals are identified not only for the main or primary user of the system, but also for that person’s communication partners (family members, caregivers, friends) and persons in the wider environment.  Guidelines for using the Simplified Sign System with the target populations are provided in order to establish good and consistent communication practices that will help to maximize users’ success with the system.  Such guidelines or strategies include ensuring a positive signing environment, establishing visual contact, using key word signing, accepting errors in sign formation from the main user, rewarding progress, using facial expressions and environmental cues or contextual information to enhance vocabulary acquisition, and adapting the rate and frequency of signing.  Finally, the authors anticipate and address many of the questions or concerns that teachers or caregivers may have as they embark on a program of using Simplified Signs.

The Preface of Volume 2, written by the primary author (John D. Bonvillian), offers an overview of many of the various themes and topics covered in Volume 1. This overview is accomplished through the historical lens of Dr. Bonvillian’s life, educational training, and decades-long career, with a view of the corresponding changes in the attitudes of linguists and the public toward signing and Deaf people as various advances in sign language research were made. Highlighted are the similarities and differences between spoken languages and signed languages, the history of sign use in the education of deaf students, and the introduction of signing into communication intervention programs with non-speaking or minimally verbal children with autism, an intellectual disability, cerebral palsy, or aphasia. Bonvillian points out the variable outcomes of teaching signs to such individuals before addressing possible reasons for this disparity: delaying the introduction of signs (often because of parental fears that signing would inhibit the development of speech skills), the lack of a supportive signing environment, and the characteristics of the signs themselves. He stresses the characteristics of signs that tend to be more easily learned, remembered, and produced by non-speaking individuals: highly iconic signs, signs with a single movement, signs with basic or easily formed handshapes, signs that make contact with the person’s body or non-dominant hand or arm, and signs that are highly relevant to that individual’s life. Also mentioned are the emotional and intellectual benefits of learning to sign, the ways signing can support speech, and how signing may be used to teach words from a person’s native language or to acquire a foreign or additional spoken language.

Chapter 10 provides an introduction to the organization of the Simplified Sign System lexicon and its supporting materials. This chapter explains the various conventions used in the sign illustrations so that learners can accurately interpret the drawings, including the numbering of initial, intermediate, and final positions; the size, shape, and repetition of arrows, quotes, and other marks that depict the sign’s movement; and the provision of facial expressions on signs that convey emotional information. Drawings and expanded written descriptions of the handshapes used in the Simplified Sign System are provided, along with information on how prevalent each handshape is in the system and a sampling of the particular meanings that a handshape can convey within the system. Drawings and written descriptions of the various palm orientations and finger/knuckle orientations used in the system are provided as well so that family members, educators, and other professionals will be able to accurately interpret each sign’s written description. Also discussed in this chapter are the memory aids provided with each sign, natural variations in sign formation and production that are to be expected, as well as what to do if a sign learner has functional use of only one hand and arm.