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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.
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 following resources can help learn more about deaf-blindness and instructional strategies. If you are aware of other helpful resources, please let me know so I can add them here! Links are embedded in the titles of organizations whose websites are identified as secure. 

Deafblind Online Resources

  • ​​A to Z of Deafblindness is a web resource that provides resources specific to deafblindness. Resources include web resources, mailing lists, unique equipment, poetry, videos, and listservs for people who are blind and deaf.
  • ​​The Alabama Institute for Deaf and Blind (AIDB) is a comprehensive education, rehabilitation, and service system serving children and adults who are deaf, blind and multi-disabled. Alabama Institute for Deaf and Blind (AIDB) has a wealth of resources and expertise to share related to services and information about hearing and vision loss.  The Reference Desk has online resources available.
  • The American Association of Deaf-Blind (AADB) ​​​​The American Association of Deaf-Blind (AADB) is a nonprofit national consumer group of, by and for deaf-blind persons and their supporters.
  • ​​Deafblindinfo.org ​​​The American Association of Deaf-Blind (AADB) is a nonprofit national consumer group of, by and for deaf-blind persons and their supporters.
  • ​​Helen Keller National Center for Deaf-Blind Youths and Adults ​Helen Keller National Center for Deaf-Blind Youths and Adults provides rehabilitation services, employment services, services for students, low vision services, as well as services for seniors and those with developmental disabilities.
  • ​Intervener Intervener provides information on interveners, those who work with students who are deafblind. In addition to information on interveners, it provides information on deafblindness, training, intervention, and additional resources.
  • ​​Listenclear Listenclear has put together an American Sign Language Resource Guide that includes several helpful resources.  ​
  • ​National Center on Deaf-Blindness This is a national technical assistance center funded by the federal Department of Education. It works to improve the quality of life for deaf-blind children and their families.
  • ​National Coalition on Deafblindness​. This is an organization of parents, professionals, persons who are deafblind and agencies that advocate for children who are deafblind. They run a discussion group on legislative and policy issues related to education.
  • ​National Consortium on Deaf-Blindness​. The National Consortium on Deaf-Blind is a federally funded, national information clearinghouse that identifies, coordinates, and disseminates information related to children and youth who are deaf-blind.  It provides publications, databases, and other resources for deaf-blindness.
  • ​​National Family Association for Deaf-Blind (NFADA). This national non-profit membership organization strives to empower and advocate for families of individuals who are deaf-blind.
  • ​​The SKI-HI Institute ​is a unit of the College of Education’s department of communicative disorders and deaf education at Utah State University, Logan. Outreach programs to Utah citizens and families and professionals in nearly all 50 states and Canada are a part of their focus. The Institute’s primary purpose is to identify and respond to the real needs of young children who are deaf/hard of hearing, blind/visually impaired, deafblind, multi-disabled, or who have any special needs.

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!
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