Family communication patterns and processes will be defined in this chapter as the processing of information within the family or its subsystems, consistent with general systems framework. Communication requires a sender of a message, a form/channel of the message, a receiver, and interaction between the sender and the receiver. The sender is the person who is attempting to transmit a message to another person: the receiver is the target of the sender’s message: forms/channels are the routes of the message. communication extends (thoughts) of the sender, though space, to from the cognitions of the receiver. Communication modalities named in the broader communication literature include spoken, written, and media such as television or the Internet. The communication modality commonly addressed in interpersonal or family communication literature is spoken language. However, there are many families with members who cannot (or choose not to) fully participate in oral/aural communication modalities (e.g. , hearing mothers with deaf infants, Deaf parents with hearing chidren. Hearing impaired elders with grandchidren). (Note: The word deaf is capitalized to indicate adults who are part of a sociocultural Deaf community, and not capitalized when it refers to an audiological condition alone). In families with hearing impaired, Deaf or hard-of-hearing members, adequate family communication requires use of modalities other than speech and hearing (Koester, 1992). For example, signed language is the most usual modality for communication of families Deaf parts and hearing children (Jones, 1995). Late deafened elders may benefit form communication modalities using realtime captioning in group meetings or speechreading, which integrates more visual cues with the limited auditory input (Tye-Murray, Witt, 1997: Hallberg, 1996).