Category — 2.5 Children with Sensory Impairments: Deaf/Blind

Children who are deaf/blind have significant sight and hearing loss. They do not have functional vision or hearing. Neither of these two essential senses can be used as a primary way to learn.

Children who are deaf/blind use some of the same techniques uses by  children who are deaf or children who are blind. They use Braille (see full Glossary) (Fig. 1) in order to read, and use sign language to communicate with others. When they want to get a message across, they use American Sign Language (ASL), and sign just like any child who is deaf. When they want to understand what others are trying to tell them, they have someone who “speaks” ASL sign into the palm of their hand. It is amazing to watch someone sign into the hand of a person who is deaf/blind, who then responds by signing on his or her own.

Figure 1. Using Braille

Deaf/blindness usually has serious effects on all areas of development:

• Cognitive and academic skills: most children who are deaf/blind take a long time to reach developmental milestones. They take longer to learn about colors and shapes. They also take longer to learn how to read, write and do math. Some struggle with attention difficulties. Others find it difficult to learn new and abstract concepts;
• Language and communication: children who are deaf/blind take a long time to achieve most language and communication milestones. They often struggle with pragmatic communication. Many do not speak orally. Instead, they sign;
• Motor: many children who are deaf/blind take a long time to reach developmental milestones. They can’t see, so reaching is delayed. So are sitting up and walking. Some children struggle with fine motor skills;
• Social/emotional: some children who are deaf/blind have difficulties with their social/emotional skills:
  • Social skills: because they cannot see or hear, children who are deaf/blind cannot rely on some of the methods that their sighted and/or hearing peers rely on. They cannot establish eye contact with others, nor can they read someone else’s body language. They often miss out of sarcastic remarks, because they cannot hear the tone of the person who is talking;
  • Emotional skills: many children who are deaf/blind take a long time to learn about emotions. They often struggle when it comes to identifying emotions, both in themselves and others. Some may have negative self-esteem, because they may not have a lot of friends;
  • Adaptive: children who are deaf/blind take a long time to learn most adaptive skills, including:
    • Dressing and undressing by themselves
    • Eating and drinking by themselves;
    • Bathing, showering and grooming;
    • Toilet training;
    • Sensory: because they are missing two of the five senses, some children who are deaf/blind have certain types of mannerisms. These mannerisms sometimes look like the self-stimulatory behaviors (see ECI Glossary) some children who have autism engage in. This includes rocking back and forth or moving their heads around. Children who are deaf/blind sometimes do these things because they are not getting enough sensory stimulation from their environment. That is because they are not getting any, or are getting very little stimulation from two of the five senses.

Children who are deaf/blind could benefit from the following services:

• Special educator with special training in the education of the deaf/blind: this person will use specific and highly specialized methods (please see below to reach and teach the child who is blind. This person will also help these children learn how to use Braille if they do not already know how. Some of the highly specialized methods that are used only with children who are deaf/blind include:
  • Hand under hand method: the educator places his or her hand under the hand of the child who is deaf/blind. This way the child can feel what the educator is doing (Fig. 2);
  • Hand over hand method: the educator places his or her hand over the hand of the child, or perhaps on his or her elbow, in order to allow them to do as much as possible by themselves;
  • Speech and language pathologist (SLP): the SLP will help children who are deaf/blind with all areas of language. They will help the child with receptive and expressive language, which are learned through sign language. They can also help them with pragmatic language;
  • Occupational therapist (OT): OTs can help children who are deaf/blind reach motor milestones. OTs with special training in sensory integration can help children who are deaf/blind with any difficulties they may be experiencing with sensory integration.

Figure 2. Hand under hand method

General strategies for working with those who are deaf/blind (adapted from the Provincial Outreach Program for the Deaf/blind):

• It is important that language be used when we are attempting to teach a child who is deaf/blind anything. Language can be oral or signed. Children need to be exposed to language if they are to develop it;
• Children who are deaf/blind can tell a lot by someone’s touch. We must be very careful about the way we touch children who are deaf/blind because the wrong touch could send the wrong message;
• It is very important that we do as much as possible with the child who is deaf/blind rather than for him or her. This is the one true way towards independence;
• It is crucial that children who are deaf/blind learn the concepts behind certain skills. A skill is about what we do. A concept is about understanding what we do, so skills are not enough. Children need to develop the concepts behind them too.

The vast majority of children who are deaf/blind catch up with their seeing and hearing peers in all areas of development. They attend school and go to university. Many get jobs and live on their own.

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