Code: C01
People who are deafblind have a significant impairment of both their hearing and vision. Some are totally blind and deaf, but others have some remaining use of one or both senses.
95% of what we learn about ourselves and the world comes through our sight and hearing, so people who are deafblind face enormous challenges, especially in learning to communicate, accessing information and finding out about the world around them.
The United Kingdom has an estimated 23,000 people who are deafblind. Some of these people will have been born with impaired vision and hearing while others will have acquired their dual sensory impairment later in life.
What are the challenges?
People who are deafblind may use, or be encouraged to use, different communication methods throughout their lives. It is likely that some people will always use more than one method of communication.
The communication challenges facing people who are born with impaired vision and hearing, will be very different from people who have had some experience of using their vision and hearing in their early years. It is important to stress that deafblind people have a great range of communication needs which may change over time. Also some deafblind people may use two more methods of communication to express themselves, but receive information by using a different methods(s).
For example:
- a child who has some sight, is profoundly deaf and has physical disabilities, may learn to understand sign language, but may need to find another means of expressing him or herself
- someone with Usher syndrome will probably have learned British Sign Language as a young person, but may need to adapt the way they receive signs as his or her vision begins to change
- an older person may have always used speech and hearing to communicate, but may need to learn to use hearing aids and low vision aids as his or her vision and hearing change over time
Total communication
It is important to be flexible when helping a person who is deafblind to communicate, and it may be helpful to use a range of communication methods together. This is often called the total communication approach .
Methods that can be used within the total communication approach might include:
- the use of speech
- writing words down
- finger spelling
- different types of sign language
- body language
- facial expression and gesture
- pictures
- significant objects of reference
- models
- symbols
- line drawings
- tape
- Braille
- Moon
Using body language
Some people, especially those born deafblind, may have no apparent means of communication. In these cases it is important to observe the person over a period of time to look for subtle movements of their face or body. This may indicate that they have an awareness of what is going on around them.
Over time, it is possible to set up a communication method which will allow the person to understand what activities are being offered, and that their subtle body language movements are being understood.
Without a recognised communication system, the person who is deafblind may be misunderstood.
It is vital that anyone who comes into contact with a person who is deafblind should be sensitive to the range of ways which may be used to communicate such as body language and some gestures to express themselves.
Offering the right environment
Every effort should be made to develop an environment which will meet an individual’s communication needs.
Conditions such as lighting, background noise and the time of day should be considered so that all interactions take place in the person’s own optimum environment as far as possible.
Some of the main methods of communication
Significant objects of reference:
Some people who are deafblind learn to use objects which symbolise a particular significant activity. For example a person may use a cup to show that they want a cup of tea. Other people may use this cup symbol to offer the person a drink.
British Sign Language (BSL)
This is a language in its own right and is a visual means of communication using hand signs and facial expression. Often used by members of the deaf community; it follows its own word order and grammar.
Finger spelling
In this means of communication the alphabet is represented by placing the fingers of one hand on the other in a variety of ways to represent different letters. This is used to complement signing systems (for names and places). It is not a signing system in itself.
Visual frame signing
People who are deafblind and have limited vision may be able to “read” British Sign Language signs, if the signs are presented within their remaining field of vision.
Hands on signing
Some people may use tactile or ‘hands on’ signing by placing their hands over the hands of the signer, so that they can feel the signs being used. People with Usher Syndrome may learn this form of communication as their sight reduces.
Makaton
This uses some of the main British Sign Language signs. No grammar is included within the Makaton system, and some people find this easier to learn.
Signed English
This is a form of British Sign Language that is generally used as a teaching tool. A sign is used for each spoken word and is delivered by the teacher simultaneously with speech.
Sign Supported English
With Sign Supported English, the person who is speaking uses signs for the significant parts of the sentence spoken.
Deafblind manual alphabet
This method uses the slightly modified finger spelling alphabet where the letters are spelt out by positioning the fingers on the receiver’s hand. Both people using this method will need to be able to spell confidently.
Oralism/auralism methods
Some people who are deafblind use an approach which emphasises the use of spoken language together with lip reading and correctly fitted and adjusted hearing aids.
Block
This method is sometimes used where either person does not know the deafblind alphabet. Each letter of a word is spelt out in capital letters onto the receiver’s palm.
Print or Large Print
Some people who are deafblind, who are used to reading and writing as a means of communication, may request that words are written using print or large print.
Braille and Moon
These are both tactile means of producing text. Braille uses a series of raised dots to represent letters or groups of letters. Moon uses raised symbols many of which are quite close to ordinary block letters in appearance.
Tadoma
With this method the deafblind person feels the speaker’s lips and the speech vibrations from the speaker's throat.
Use of technology
Increasingly, deafblind people are making use of new technology to communicate. The types of technology that will be suitable will depend on the type and degree of visual and/or hearing impairment. Deafblind people may use computers, for example, to communicate in a large variety of ways. Examples include:
- text on a disc can be printed out in large print for people with partial sight
- text on a disc can outputted onto a braille keyboard for braille readers
- text on a disc can be read out by a voice synthesiser for people with partial
- hearing
- people with multiple disabilities may be able to use computers for learning opportunities.
Other examples of technological advances include:
- an amplifier on a telephone
- textphones - which are like telephones with a text display
- loop systems for hearing aid users
This is only a very brief summary of some of the uses of technology. There are many more technological adaptations, and more are being developed all the time.
Symbol Systems
Some communication systems can assist people to communicate. Examples include Blissymbols, Rebus symbols and Makaton symbols.
Blissymbols
This is an abstract symbol language which is designed to meet the vocabulary needs of a person without speech. It combines other symbols - for example a symbolised picture of an ear can be combined with another symbol to represent “quiet”, or with a different symbol to represent “noisy”.
Rebus symbols
These are line drawings of objects or actions as well as some abstract symbols for use as a communication aid.
Makaton pictures
These are pictures and symbols linked to the Makaton sign vocabulary.
Where can I go for help?
If you would like to find out more about deafblindness, or the services for deafblind people in your area, you should contact the Sense Regional Adviser for your area.
Other useful addresses
Council for the Advancement of Communication with Deaf People (CACDP)
Durham University Science Park
Block 4
Stockton Road
Durham
DH1 3UZ
Tel: 0191 383 1155
Fax: 0191 383 7914
Text: 0191 383 7915
Email: durham@cacdp.org.uk
Royal National Institute of the Blind
105 Judd Street
London
WC1H 9NE
Tel: 020 7388 1266
Fax: 020 7388 2034
Helpline: 0845 766 9999
E-mail: helpline@rnib.org.uk
Website: www.rnib.org.uk
Royal National Institute For Deaf People
19-23 Featherstone Street
London EC1Y 8SL
Tel: 0808 808 0123 (freephone)
Textphone: 0808 808 9000 (freephone)
Fax: 020 7296 8199
E-mail: informationline@rnid.org.uk
Website: www.rnid.org.uk
National Deaf Children's Society
15 Dufferin Street
London
EC1Y 8UR
Tel: 020 7490 8656
Text: 020 7490 8656
Fax: 020 7251 5020
Email: ndcs@ndcs.org.uk
Website: www.ndcs.org.uk
Freephone Helpline: 0808 800 8880 (voice or text)
Deafblind UK
National Centre for Deafblindness
John and Lucille van Geest Place
Cygnet Road
Hampton
Peterborough
Cambridgeshire
PE7 8FD
Tel/text: 01733 358 100
24 Hour helpline: 0800 132 320
Fax: 01733 358 356
Website: www.deafblind.org.uk
If you require information in alternative formats including braille, large print, audio or disk then please contact the Communications department:
tel: 0845 127 0060
fax: 0845 127 0061
textphone: 0845 127 0062
This factsheet was produced by:
Sense
101 Pentonville Road
London N1 9LG
Copyright Sense November 2003
