The three major forms of used in the United States are American (ASL), Pidgin Signed English (PSE), and Signed Exact English (SEE). While there are many similarities between the three, each follow their own rules.

(ASL) is a visual and very graphic language. The language originated at the American School for the Deaf in Hartford, Connecticut and has developed over time in the American deaf community. It is a language in its own and not usually written or spoken. ASL has its own grammar rules which typically follow the time + topic + comment structure.

Pidgin Signed English (PSE) is one of the most widely used in the deaf community. PSE combines ASL and English. The vocabulary is taken from ASL but follows the English word order. Words that do not carry information such as to, the, am etc. are usually dropped. It is an easier language to learn than ASL or SEE, since one does not use all English endings such as ed, s, ment etc.

Signing Exact English (SEE) was developed by Gerilee Gustason in 1972. SSE is very similar to ASL however expands words, prefixes, tenses, and endings to give a clear and complete visual presentation of the English language SEE does require more time actually signing since word endings and prefixes are used. Users of SEE believe that it helps with learning English, since it manually reproduces English word-for-word in the same order as English.

American Sign Language, Pidgin Signed English, and Signing Exact English are all widely used across the deaf community in America. However it is very much a case of personal preference among deaf and hard of hearing individuals.

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