The total communication philosophy has many variations. In general, they use a combination of various methods and approaches to meet the individual child's needs. A combination of sign language, fingerspelling and spoken words is often used. Sign lanuage used may vary: Signed ExactEnglish (SEE), Signed English, American Sign Language (ASL), or Pidgin Signed English (PSE). In addition, some programs may include the use of Cued Speech to assist the child in English Access. These programs may use speech and language therapists, audiological training, and assistive devices in the course of instruction for deaf children.

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