Makaton (trademark) is a system of communication that uses a vocabulary of "key word" manual signs and gestures to support speech, as well as graphic symbols to support the written word. It is used by and with people who have communication, language or learning difficulties. This includes people with articulation problems (for example, people with cerebral palsy), people with cognitive impairments which might be associated with conditions such as autism or Down syndrome, and their families, colleagues and carers.