Deaf-Blind

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

Hearing loss is the loss of sound sensitivity (partial or complete) produced by abnormality anywhere in the auditory system.
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 to Teaching the ECC: An Activities Based Curriculum for Teaching Students who are Blind or Visually Impaired (a 346 page pdf download)
Visual Efficiency & Near Magnifier Fluency Worksheets: TVI's Guide to the ECC Grab and Go Supplements (a 210 page pdf download)
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Lotto Cards

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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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