“…in many reports, participants with aSD learned only a limited number of sign vocabulary words, and teaching of these few signs often required much time and effort (Carr, Binkoff, Kologinsky, & eddy, 1978;Carr, Kologinsky, & Leff-Simon, 1987;falcomata, Wacker, ringdahl, Vinquist, & Dutt, 2013;Hinerman et al, 1982;Kee, Casey, Cea, Bicard, & Bicard, 2012;remington & Clarke, 1983;Valentino & Shillingsburg, 2011). finally, much of the literature in support of using manual sign language includes anecdotal reports, case studies (Bonvillian & nelson, 1976;Kee et al, 2012;Konstantareas, Hunter, & Sloman, 1982), and underpowered group designs (Watters et al, 1981).…”