It’s the fourth most common language in the United States—and yet no one speaks it. American Sign Language (ASL) is a complete language composed of nonverbal cues rather than spoken words. You probably know it as the first language of many Americans who are deaf. But ASL is also used by people whose ability to speak has been impaired by other disorders, such as autism and stroke. Both adults and children can use ASL. But because it relies heavily on hand signing, it’s only an option for those with adequate hand movement and coordination. In addition, the person who’s signing needs someone to communicate with. That means family members and friends need to know sign language, too. How Sign Language Works ASL is a fully functional language complete with jargon and dialects. Words and sentence structure are expressed by: Hand shapes, position, and movement Gestures and body movement Body posture Facial expressions You can convey nuance with ASL just as you can with spoken English. For example, let’s say you want to turn the phrase “this house” into a question: “This house?” If you’re using ASL, you can signal that you’re asking a question by raising your eyebrows, opening your eyes wide, and tilting your body forward. Because ASL is a full-fledged language, it can take years to totally master it, just as it does when learning Italian or Japanese. However, you may be able to learn some key words and phrases in a matter of days. As with any new skill, frequent practice is important for retaining what you’ve learned. To Sign or Not to Sign Sign language isn’t the only option when you need to supplement or replace speech. You can also use communication aids, such as pictures or a speech generating device (SGD)—an electronic device that speaks for you with either prerecorded messages or synthesized speech. One advantage of sign language is that you always have the necessary tools—your hands and body—with you. One disadvantage is that not everyone can understand you the way they can with pictures or an SGD. People communicate in many ways. We whisper, gesture, draw, type, speak, and point. People with speech impairments should have several options as well. Their goal, then, is to learn multiple ways of communicating. For example, you might find it handier to use sign language at home, where your family understands it. But you might prefer to use pictures or an SGD when you’re out and about, where most people probably don’t know sign language. Meanwhile, you might also be working on your spoken language skills in speech-language therapy. Sign Language for Kids Some children with communication disorders find it easier to learn sign language than speech. For example, sign language is used by certain kids with autism and apraxia of speech (a disorder in which the brain has trouble coordinating the muscle movements needed for speech). Parents and teachers can help by moving the child’s hands to make the sign until the child can do it independently. Signing can open up a world of communication to kids who otherwise would be shut out. And there’s no evidence that using sign language delays the development of spoken language. However, learning sign language won’t necessarily speed up speech development either. In some cases, signs may serve as a bridge to spoken words. But in other cases, children continue using sign language as their primary mode of communication. Either way, signing may be a helpful option for kids who aren’t yet able to express themselves adequately through spoken language alone.