Fashionable jewelry with an amazing purpose. A silver 24 inch necklace with four charms. Charms may vary slightly. Each charm is double sided and includes the following Smarty Symbols: Yes; No; Hungry; Thirsty; Stop; Pain; Tired; Bathroom. This necklace can be used by therapists, patients; nurses; families. Simple wear the necklace and show the symbols anytime needed.