It is not well recognised that profoundly deaf people usually have little or no speech and many find it difficult to read or write even day-to-day English, since it is an unheard foreign language. People who are born profoundly deaf cannot read, speak or write and many grow up in a family where no-one signs to them (90% of parents are hearing and 90% do not learn fluent sign language). Most deaf children leave school with few or no educational qualifications, with an average reading age of only 8.5 years. Sign’s outreach workers work with many cases of severely isolated deaf adults who grew up completely protected in the family home, but who are unable to fend for themselves when their parents become too frail to look after them. These deaf adults cannot lip-read and use only ‘home sign’ – home-grown idiosyncratic gestures with no grammatical structure. They have acquired learning difficulties and acute dependence on others after years of little or no meaningful communication. Very specialist support is needed to enable these people to achieve any degree of quality of life and outreach is a vital part of this. It costs more than £350,000 each year to help deaf people across the UK to manage their tenancies, pay bills, attend education or training courses, use public transport, shop for themselves, keep themselves and their homes clean and tidy or understand official / legal situations.