The purpose of our examination paper is to examine, describe and analyze preschool teacher ́s knowledge about manual signing in a preschool setting. Furthermore, we want to examine if preschools teacher ́s use manual signing in Swedish preschool ́s in a pedagogically purpose. The questions that we want to answer with our work is if preschool teachers are aware about the sign language used in Swedish schools and if they use manual signs for pedagogically purposes or not. Our data was gathered from four different preschools in the Stockholm region, where both interviews and observations were conducted to study the aim of our paper. Seven different preschool teachers participated in the interviews and we observed the environment in the different preschools. Our theoretic basis for our paper is Säljö ́s perspective on Vygotsky's sociocultural theory. The part of the theory that are most relevant for our work and that we use in our analysis are communicative interaction, artefacts and mediation. We also base our work on earlier research done by Skans about the preschools didactic practices and by DiCarlo et al. about effect on manual signing on communicative verbalizations in inclusive classrooms. With the help of our analysis we can make different conclusions about preschool teachers work with manual signing. One such conclusion is that there is an awareness among preschool teachers about the manual signing. All of the teachers that participated in our interviews work in one way or another with manual signing in a pedagogically purpose. Beside the manual signing the preschool teachers also use different alternative communicative methods. There is a positive attitude among the preschool teachers to use alternative communicative methods with children in a pedagogical purpose.