Deaf-Blindness

Carmen Willings
teachingvisuallyimpaired.com
​Updated June 13, 2025
Deafblindness refers to a combination of vision and hearing loss that significantly impacts a student’s ability to access information and communicate. Most students who are deafblind are not completely deaf or completely blind, but instead have varying degrees of both hearing and vision impairments. While each condition on its own presents challenges, the combination of the two can greatly affect a student’s ability to learn, interact, and make sense of the world around them. 
Supporting students with deafblindness requires a thoughtful approach that maximizes their residual hearing and vision, while also strengthening other senses (such as touch) and using concrete, accessible communication methods to help them acquire information and develop meaningful connections.

​Types of Auditory Impairments

  • Hearing Loss involves a partial or total reduction in sound sensitivity due to a problem anywhere in the auditory system.
  • Central Auditory Processing Disorder (CAPD) refers to a difficulty in processing auditory information in the brain, despite normal hearing sensitivity.

​Degrees of hearing loss

  • Normal (0-15 decibels and the student is able to detect and discriminate all speech sounds)
  • Borderline Normal (the loss is 16-25 decibels and the student has some difficulty hearing conversational speech)
  • Mild (the loss is 26-40 decibels and the student may have difficulty hearing quiet speech/sounds),
  • Moderate (the loss of 41-55 decibels and the student may have difficulty hearing normal conversations),
  • Moderate to Severe (the loss of 56-70 decibels and the student has difficulty understanding speech in most situations),
  • Severe (the loss of 71-90 decibels and the student may be able to identify environmental sounds, but is unable to hear conversational speech), and
  • Profound (the loss of 91+ decibels and the student may hear loud sounds and feel vibrations).

​Communication Options for Students Who Are Deafblind

There are different forms of communication that a student who is deafblind may use. The Hearing Impairment Teacher and/or Speech and Language Pathologist will provide input in selecting a method for communication. The method may be modified over time as the student's developmental level changes or if there is a change in the students hearing or vision. The following are the primary communication options:

Amplification Options

  • Ear-Level Hearing Aids: Fit behind the ear with an earmold in the ear.
  • Body Aids: Used for students with limited head control.
  • Cochlear Implants: Surgically implanted devices that stimulate the auditory nerve, offering sound perception to those with severe-to-profound hearing loss.

Online Resources for Deafblind 

The following resources offer valuable information, training, and tools to support students who are deafblind and those who work with them. (Secure links are embedded in each organization name.)

Additional Resources

  • Deafblindness: Educational Service Guidelines by Marianne Riggio provides a framework for creating a program for students who are deafblind. The guidelines, developed by a group of educators and family members, identify the knowledge and skills educators need to assist students who are deafblind reach their full potential and become successful contributing members of society.
  • Signing Savvy is a great web resource to use with students who are learning sign. It provides a searchable web dictionary and a video of how to sign the word or phrase!

Compensatory Skills

Concept Development
  • Demonstrates awareness of objects
  • Demonstrate understanding of object permanence
  • Plays with toys – takes adv. of characteristics
  • Open container to locate noisemaker
  • Demonstrate interest in toys
  • Object identification
  • Match/Classify objects by shapes
  • Match/Classify objects by size
  • Time awareness and concepts
  • Spatial awareness
  • Quantity Concepts
Alternative Communication
  • Body responses & gestures for communication
  • Choice Board (object/tactile/picture)
  • Communication system (calendar boxes)
  • Sign language/tactile sign (deafblind)
Emergent Literacy
  • Explore pictures/objects from story
  • Explore & turn pages
  • Proper care of books
  • Awareness of environmental print/braille
  • Pretend to read/write print/braille
Access Print
  • Use low vision tools to access near print
  • Use low vision tools to access distance print
  • Use technology to access digital print
  • Use screen sharing to access print at distance
  • Access variety of print formats
  • Identify print size needed
Pre-Braille
  • Tactile discrimination of symbols
  • Identify spatial position of dots in braille cell
  • Identify the dot number in a braille cell
  • Track a line of dots from left to right
  • Track a row of dots
  • Identify beginning/end/breaks on a braille line
  • Tactually explore a braille page
  • Track braille sentences when read aloud by adult
  • Orients braille book correctly
  • Turn pages in a braille book one at a time
  • Locates the first braille line on a page
  • Locate the page number in a braille book
  • Use two hands to track braille
  • Use pointer finger as lead finger
  • Use pinky finger to detect the end of a line
  • Use light touch
  • Use two hands separately to track and return
  • Locate name in braille
  • Identify same/different braille shape
  • Identify the braille alphabet
  • Identify the literary braille numerals 0-10
Braille Code
  • Read/write the alphabet
  • Read/write whole-word alphabet contractions
  • Read/write whole and part word contractions
  • Read/write short form words
  • Read/write lower signs
  • Read/write part word signs
  • Read/write whole word signs
  • Read/write initial letter signs
  • Read/write final letter signs
  • Read and produce literary numbers
  • Read and produce braille indicators
  • Read and produce symbols and punctuation
  • Braille Reading Fluency
  • Read back personal writing and edit
  • Access a variety test & worksheet formats
  • Apply rules for contractions, punctuation, comp.
  • Use alternate braille codes (ex. Language, music, etc)
Braille Formatting
  • Locate beginnings of paragraphs
  • Writes paragraphs, indenting two spaces
  • Read/write lists
  • Locates and read transcriber’s notes, picture captions
  • Locates headings/subheadings in a text
  • Reads/write columned materials and tables
  • Read/write format for poetry and plays
  • Write outlines in correct (literary/textbook) format
  • Locate preliminary pages, special symbols page
  • Use table of contents, glossary and index
  • Locate/read words and definitions in dictionary
  • Use a multi-volume textbook
Braillewriter
  • Locate/name parts on a braillewriter
  • Make random braille dots
  • Insert/remove paper from braillewriter
  • Operate line advance/carriage return
  • Operate backspace
  • Use correct fingers on keys
  • Produce uniform dots using correct finger strength
  • Erase errors with a braille eraser
  • Use spacebar appropriately
  • Set margin stops on braille writer
  • Change margin for various format needs (ex. column)
  • Spatially arrange math problems
  • Proofread writing and make corrections
Slate & Stylus
  • Identify the dot numbers in cell on a slate
  • Load paper in the slate
  • Create legible, uniform dots
  • Skip space on a slate
  • Create letters, words, and numbers
  • Use slate & stylus to complete tasks
  • Proofread writing and make corrections
Tactile Graphics
  • Explore Tactile graphics
  • Locate/identify title, key and symbol
  • Identify meaning of various textures on globe/map
  • Interpret graphical information (e.g. graphs & charts)
nemeth code
  • Read/write numerals in Nemeth Code
  • Read/write signs of operation (+, -, x, /)
  • Read/write linear mathematical equations
  • Read/write horizontal mathematical equations
  • Read/write symbols of comparison (<,>, =)
  • Read/write symbols money using signs: $, ¢, .)
  • Read/write fractions
  • Read/write mixed numerals
  • Read/write temperatures using sign for degrees
  • Read/write percent
  • Read/write grouping symbols ( , ) , [ , ] , { , }
  • Read/write Nemeth punctuation (, -, : )
  • Read/write modifier signs for lines, arrows, rays, bars
  • Read/write shape indicator (circle, square, etc.)
  • Read/write signs/format for parallel & perpendicular
  • Read/write signs for angles
  • Read/write adv. symbols of comparison (i.e. ≠, = )
  • Read/write square roots
  • Read/write subscripts/superscripts
  • Read/write algebraic expressions
  • Read/write chemical equations
  • Read/write braille clock/watch
  • Write time
  • Measure to the nearest centimeter, ½”
  • Construct/draw measure geometric figures & label
  • Use braille/tactual tools to measure
  • Display data on tactual graph
  • Interpret data in various tables and graphs
  • Read/write standard/metric measurements
  • Read/write advanced Nemeth code symbols
  • Apply rules to complete grade level problems
Access Classes
  • Use of charts, graphs, maps
  • Measurement tools
  • Handwriting (legibility)
  • Develop a consistent signature
  • Use signature writing guide
  • Use of needed accommodations
  • Interpretation of Tactile graphics
Abacus
  • Identify all parts of the abacus
  • Demonstrate understanding of set, clear and count
  • Set numbers in the ones column
  • Set numbers in the tens column
  • Set and read whole numbers according to place value
  • Demonstrate understanding of 0/9 exchange
  • Add/subtract 0-4 on the abacus
  • Add/subtract numbers 0-19 on abacus
  • add/subtract 1-4 digit # to/from a 2-5 digit #
  • Add 1-4 digit # to a 2-5-digit numeral on abacus
  • Set and read decimal numbers to place values
  • Subtract decimals using abacus
  • Add decimals using abacus
  • Multiply decimals on abacus
  • Set/read mixed fractions using 1 or 2 abacus
  • Set/read complex fractions using 1 or 2 abacus
  • Add/subtract simple fractions using 1 or 2 abacus
  • Add/subtract mixed/complex fractions using 1 or 2
  • Multiply/divide [simple; mixed; complex] fractions
  • Set and read multiplier and multiplicand
  • Multiply/divide 1-3 digit #s to 2-5 digit #s
  • Compute ratios on the abacus
  • Compute percent on the abacus
Organization
  • Put items away where they belong
  • Organize Items in backpack/desk
  • Independently store and retrieve personal items
  • Label or mark personal care items
  • Trial a variety of labeling & filing materials
  • Trial a variety of office supplies
  • Maintain personal address/phone directory
  • Organize information & documents
Study Skills
  • Take and read back notes
  • Search and scan written materials
  • Use reference materials
  • Research Skills
  • Demonstrate map, chart, graph reading skills
  • Use scanning techniques in primary reading medium
  • Use library on level commensurate with peers
  • Take notes and access them
  • Ident. Key words, dates, def. in text and in lectures
  • Use of live reader
Time Management
  • Ready on time
  • Is prepared as activities begin
  • Follow daily schedule
  • Create daily to do list
  • Access recreational materials in unstructured time
  • Demo. ability to use a watch/clock
  • Keep schedule of activities for day, week, month
Listening Skills
  • Respond to oral instructions
  • Follow along during oral reading
  • Organize oral info. into retrievable medium
  • Repeat words/phrases just heard
  • Identify word missing
  • Follow 1 or multiple step commands
  • Identify likeness or diff. between sounds
  • Discriminate Words of different or similar sounds
  • Discrim. between emotions (angry, happy, sad, etc)
  • Identify dominant sound
  • Follow directions among background noise
  • Identify direction of environmental sounds
  • Repeat sounds in sequential order
  • Repeat 1-4+ letters/words/#s in order
  • Remember and repeat familiar phrases or rhymes
  • Repeat and follow 1-3 step verbal commands
  • Recall facts from information given
  • Recall details from a story heard within time intervals
  • Ident. sim./diff between words/sentences/paragraph
  • Attend to speaker and select information required
  • Select items of info which are pertinent and respond
  • Identify what information heard was pertinent