Designed for teaching the related services staff, residential care providers, and families of individuals with severe hearing and vision impairments, this booklet explains the issues related to developing a communication system using textures. The texture symbols described are intended for use by individuals with dual sensory and multiple disabilities. The first section of the guide includes an overview of the sense of touch and the use of textures. It also provides guidelines for who should use textured symbols. The next section provides guidelines for choosing materials and activities. In addition, there is information on making textured symbols and display formats. The four phases of instruction are then outlined, including: (1) creating an association between a textured symbol and a referent; (2) teaching a requesting behavior; (3) practicing textured symbol use within functional activities; and (4) generalizing textured symbol use. Appendices include a list of the seven levels of communication, suggested textured materials, a list of textured making tools and materials, and an illustration of display formats. (CR)