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achieved action agglutinations Amer-Ind Code Amer-Ind program American Indian Hand aphasia aphasic appropriate signal apraxia apraxic patients behavior cerebrovascular accident clinical clinician color communication concept label criteria degree angle demonstrated dysarthria elbow electrolarynx execution extended forward facilitation fifty signals fingers are folded fingers pointing flexed front of body gestures glossectomy goal GOODBYE group sessions hand is elevated hand is extended hello imitation impaired index finger Indian Hand Talk indicate initial interpretation kinetic kleenex laryngectomee Left arm Left hand Left index manual manual communication meaning mentally retarded mode moved movement needs number of signals object oral palm forward palms facing percent persons phonation presented rehabilitation repetitive replication response retrieval right hand scores shelter signal program signal repertoire situations social signals specific speech speech pathologists speechless patients static stimulus success tasks tester thumb touching transmission treatment verbal viewer walk wash wrist wrist drop