The subject, an adolescent boy at a school for students with severe mental retardation, communicated by speaking single words only. Intervention to promote spontaneous use of spoken word combinations was incorporated into the class timetable, as no extra resources were available. Multi-element output was achieved and practiced when cued by the graphic system Sigsymbols. The teaching project consisted of two programs, directed toward form and use of utterance, respectively. In the former, simple pictures provided stimuli for structured utterances; at times these were additionally cued by a sequence of Sigsymbols. In the latter program, Sigsymbol sequences on permanent display cued the subject's manually signed and spoken requests relevant to his classroom routine. It appeared that manual signing came to function as a mediator for the spoken sequences. Acquired ability to utter word combinations in response to specific stimuli generalized to spontaneous untaught structures. This case study provides information on Sigsymbols, the instructional role of which appeared to be facilitative.