Whereas the focus of chapter 7 was the logistics of therapist communication with different family members and only alluded to intrafamilial communication, this chapter specifically focuses on intrafamilial communication in deaf-member families during the therapy session. How does a therapist enact communication among deaf and hearing family members in a family in which the hearing parents and siblings do not sign, and the etiologic factors and audiologic configuration of the deaf member’s hearing loss are such that his or her primary mode of communication is manual communication rather than spoken English? Does the therapist negleet to comment on the words and sentences that the deaf member misses, in favor of focusing on other interactional factors of the family system? Does the therapist modify the conversational pace of the meeting (e.g., by instructing people to speak slowly & in sequence, etc.) to increase the deaf member’s verbal participation in the session? Does the therapist attempt to sign some or all of the discussion for the deaf member? If the deaf member has unintelligible speech, does the therapist attempt to voice for him or her for the benefit of the hearing members? Should an interpreter be present?