The number of service users with communication difficulties is increasing. Training in the use of alternative communication and aids, such as Makaton, is valuable and should be made available to nurses and other healthcare professionals, in particular to students in the first year of their nursing degree. Early introduction of Makaton could encourage staff to be proactive in their communication skills throughout their career and inspire other workers to learn the same techniques. The author discusses the evaluation and use of basic signing in Makaton following a session for children’s nursing students at one UK university.