Individuals with vision and hearing impairments in combination with severe orthopaedic impairments often fail to demonstrate any clear awareness of contingent relationships between their own behaviors and environmental outcomes. Without contingency awareness, it is not possible to engage in intentional communicative behavior. A single case design is presented involving a deafblind child with severe orthopaedic impairments who demonstrated no contingency awareness. The study was designed to examine the use of microswitch manipulanda to facilitate the awareness of social contingencies as a potential foundation for the development of intentional communicative behavior. Results indicated that the child increased the targeted motor behavior (activating a microswitch) under conditions involving the delivery of social contingencies, but not under conditions involving the delivery of nonsocial contingencies. Subsequent clinical applications are described to illustrate the direct impact of these findings on procedures for training the child’s expressive and receptive communication skills.