Cued speech is a visual system of communication used with and among deaf or hard-of-hearing people. It is a phonemic-based system which makes traditionally spoken languages accessible by using a small number of handshapes, known as cues (representing consonants), in different locations near the mouth (representing vowels) to convey spoken language in a visual format. The National Cued Speech Association defines cued speech as "a visual mode of communication that uses hand shapes and placements in combination with the mouth movements and speech to make the phonemes of spoken language look different from each other." It adds information about the phonology of the word that is not visible on the lips. This allows people with hearing or language difficulties to visually access the fundamental properties of language. It is now used with people with a variety of language, speech, communication, and learning needs. It is not a sign language such as American Sign Language (ASL), which is a separate language from English. Cued speech is considered a communication modality but can be used as a strategy to support auditory rehabilitation, speech articulation, and literacy development.