Deaf-Blindness

By: Carmen Willings
teachingvisuallyimpaired.com

Deafblindness refers to a combination of hearing and vision loss. Most students who are deafblind are not completely deaf or blind, but have some degree of hearing and vision loss. The combined effects of the two sensory losses can have a very significant affect on the student's learning.

There is an added challenge for students who are deafblind to make sense of their world. As with other areas of visual impairments, it is essential to maximize the students use of their remaining hearing and vision, along with other senses and provide concrete methods of communicating in order to help them gain information and learn about their world.

Types of Auditory Impairments

1. Hearing loss is the loss of sound sensitivity (partial or complete) produced by abnormality anywhere in the auditory system.
2. Central auditory processing impairment occurs when there is no loss of sound sensitivity but sensory information is processed inadequately or not at all.

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).

Forms of Communication

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:

Sign Communication

• Manually Coded English. This type of sign communication uses signs in exact English word order.
• Simultaneous-Communication. This type of sign involves the simultaneous use of speech and manually coded English.
• American Sign Language (ASL). This manual language has its own syntax and grammar. It consists of hand signs, body movements, facial expressions and gestures.
• Contact Signing. This sign system uses ASL signs in approximate English word order and is used as a form of communication between users of ASL and English.
• Bi-Lingual & Bi-Cultural Communication. This uses a combination of ASL and spoken/written English and Cued Speech.

Aural Modes

• Auditory-Oral. This method maximizes a students use of hearing through amplification (hearing aids; cochlear implant). Speech reading (deciphering lip, cheek and throat movements along with gestures and context clues to understand spoken communication) is encouraged in this method.
• Cued Speech. This method combines speech reading with a system of hand shapes placed near the mouth to help students differentiate words that look similar on the lips or are hidden from view.

Total Communication

Total communication includes the use of any form of communication that is appropriate in meeting the unique needs of the student in a given situation, including signs, finger spelling, speech, speech reading, and amplification. If the student demonstrates strengths in using hearing and/or touch to communicate, the following are options:

• Auditory-Verbal. This emphasizes auditory skills and listening for communication, with aided hearing alone; no manual communication is used and the use of visual cues is discouraged.
• Tactile Signing. This uses signing under a student's hands or on a student's body so the signs can be felt by the student.
• Tadoma. In this technique, the student uses their hands to feel another person's mouth and throat in order to understand spoken language.

Amplification Options

• Ear-level aids fit behind the ear and are attached to a soft earmold placed in the bowl of the ear.
• Body aids are used with students with limited head control.
• Cochlear implants are electronic hearing devices that are implanted in a student's inner ear. They are designed to produce useful hearing sensations to those with severe to profound nerve deafness by electrically stimulating nerves inside the cochlea of the inner ear.

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!

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TVI's Guide Complete Set Bundle + BONUS Resources

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TVI’s Guide to Teaching the ECC: An Activities Based Curriculum for Teaching Students who are Blind or Visually Impaired
The TVI’s Guide to Teaching the ECC is a digital pdf available for download. It is designed specifically for fellow itinerant Teachers of Students with Visual Impairments (TVI’s), and consists of over 400 activities and topic areas of discussion for instructing students in the Expanded Core Curriculum. The activities are age-neutral and multi-sensory and therefore can meet the needs of the broad range of students served on an itinerant caseload serving. The activities can be individualized to the students various learning modalities and scaffold in order to challenge students but ensure success. Select those activities that align with the student’s learning objects based on the student’s unique visual needs and academic and developmental level. In addition to the core activity areas, each of the 32 Thematic Units incorporates additional unique ECC concepts and skills providing you with a years’ worth of activities. These units are cyclical and can be used repeatedly to help students build on prior knowledge and develop a deeper understanding of concepts. Each unit includes suggestions for activity adaptation associated with the unit. These include lists of objects, possible community-based experiences, environmental print, poems, children & young reader books, children's songs, pop culture songs, movies, and websites.


In addition to the book, the following two supplements are included:
·      TVI’s Guide to the ECC Concept Checklist
·      TVI’s Guide to the ECC Activities Checklist


For complete product details and additional images, visit the TVI's Guide product page.


TVI's Guide to the ECC Product details
·      Digital pdf download: 346 pages (11 pt font)
·      Publisher: Teaching Students with Visual Impairments
·      Author: Carmen Willings
·      Language: English


Visual Efficiency & Near Magnifier Fluency Worksheets: TVI's Guide to the ECC Grab and Go Supplements
The Near Magnifier Fluency Worksheets is a Grab and Go supplement to the TVI's Guide to Teaching the ECC. This workbook is a pdf download that can be printed on demand for use with students. It contains five different types of worksheets for developing visual motor skills and near magnifier fluency skills particularly with the use of a video magnifier. As a companion to the TVI’s Guide to the ECC, the worksheets correspond to each of the 32 ECC Thematic units. The worksheets, along with a list of environmental print for each thematic unit, are designed to help students refine their visual motor skills while reinforcing ECC concepts presented in the thematic units.  


For complete product details and additional images, visit the Visual Efficiency & Near Magnifier Product Page.


Visual Efficiency & Near Magnifier Fluency Worksheet Details:
·      Digital pdf download: 210 pages
·      Publisher: Teaching Students with Visual Impairments
·      Author: Carmen Willings
·      Language: English


Thematic Keyboarding & Braille Fluency and Maintenance Worksheets: A TVI’s Guide to Teaching the ECC Grab & go Supplement
The Thematic Keyboarding & Braille Fluency and Maintenance Grab and Go ECC worksheet packet is a print on demand workbook that contains worksheets in print and simulated braille to use for data collection. Present the student with a hard braille copy and use the worksheets to document accuracy and fluency in reading braille. As a companion to the TVI’s Guide to the ECC, the worksheets correspond to the ECC Thematic activities presented in the curriculum guide. These word lists and sentences will help the student refine their keyboarding or braille reading skills while bridging ECC concepts presented in the thematic units. Although the lists and passages can be produced using a manual braillewriter, you may also copy and paste the passages into any braille translation software for quick production on an embosser. They may also be entered into a typing program such as APH’s Talking Typer to build keyboarding fluency.


For complete product details and additional images, visit the Thematic Keyboarding & Braille Fluency & Maintenance Product Page


Thematic Keyboarding & Braille Fluency Worksheet Details:
·      Digital pdf download: 338-page print and simulated braille worksheets
·      Publisher: Teaching Students with Visual Impairments
·      Author: Carmen Willings
·      Language: English


Thematic Vocabulary Cards and Checklists: Grab & Go ECC Supplement
The Thematic Vocabulary Cards and Checklists Grab and Go ECC supplement is a 446 page pdf downloadable print on demand workbook that includes 2940 vocabulary card on 3 1/2" x 2" templates divided by each of the 32 Thematic Units along with a checklist of each unit words in print and simulated braille. As a companion to the TVI's Guide to the ECC, the vocabulary cards correspond to the ECC Thematic activities presented in the curriculum guide. 


Additional Use:
Teachers of Students with Visual Impairments can have a extremely varied caseloads. It is possible to go several years without having a student on your caseload who requires braille instruction. Like other skills, if you do not practice your braille regularly, it is easy to lose those skills. Use these checklists and cards to maintain your braille skills. Fold the checklist along the line dividing the print from the braille. Choose to either read the print and produce the word in braille using a braillewriter or read the simulated braille and decode it. Finally, these vocabulary cards and checklists may be used with family members or peers who are interested in learning and practicing the braille code.


For complete product details and additional images, visit the Thematic Vocabulary Cards & Checklists Product Page


Thematic Vocabulary Cards and Checklists Details:
·      Digital pdf download: 446-page print on demand resource
·      Publisher: Teaching Students with Visual Impairments
·      Author: Carmen Willings
·      Language: English


BONUS!
Lotto Cards
The LOTTO Cards Grab and Go Supplement includes 37 theme related unit cards along with activity suggestions that support activities within the TVI's Guide to Teaching the ECC.


On My Way File Folder Cards
Print and use these cards to represent locations the student may visit that are related to the current thematic unit. Use these with the On My Way File Folder Game outlined in the TVI's Guide to Teaching the ECC p. 27.

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