Intended for speech and language pathologists, teachers, and others, the book serves as an introduction to the use of total communication with autistic and other severely impaired populations. A brief introduction addresses sign language adaptation, criteria for choosing a core vocabulary, and a hierarchy of receptive and expressive skills. Guidelines for the modified approach are given, along with descriptions of signing activities and a discussion of the rationale for teaching the manual alphabet. Activity descriptions contain information on goal, performance objective, materials, procedure, and suggested vocabulary. Appended are sample data sheets and photos of common signs. (CL)