Forms of communication and deafblindness

Most hearing and visually impaired people have some hearing. If they wear a modern hearing aid and if the people they are talking to adapt their behaviour to the situation, a spoken conversation is possible. Because background noise is very irritating for hearing aid wearers, you should choose a quiet location that is also visually calm and neutral. In addition, it is important to speak clearly but not too loudly. Many affected people hear better in one ear than in the other, so you should ask the affected person where it is best for you to sit or stand before you start talking with them. If the hearing and visually impaired person also needs to lip-read, you should ask them to tell you how far away you should sit or stand.

Telephone calls are also possible. These are sometimes easier than talking to someone directly, because a range of technical aids is available for use with the phone which give the impression that the other person is speaking directly into the hearing aid. The lack of irritating background noise can also make the speaker easier to understand.

Many deaf people are experienced lip-readers. People with a hearing impairment also use lip-reading to supplement what they have heard. The facial expression of the person speaking also provides information. All of these things make this method of communication useful for many hearing and visually impaired people.

However, there are several rules that you must follow. You should only begin speaking when the affected person is looking at your mouth. It is also important for you to stand in a position where your face is well lit and where the affected person is not dazzled by light from a window, a lamp or the sun, for example. In addition, it is helpful if you make the affected person aware of the subject of the conversation at the beginning.

You should also take care not to speak and point to something at the same time. Before you indicate something, you should explain the topic or the object that you are going to point to. This makes it clear to the affected person what they should look for.

Even if you follow all the rules, you must remember that the affected person can only understand about 30 percent of what is said by lip-reading. They find out about the rest of the conversation using a combination of different methods.

The finger alphabet is used by deaf people to supplement sign language (for the names of people and places and new words etc.). With the finger alphabet, you can spell out every letter using the fingers of one hand. People with some vision can see the letters. If visual recognition is not an option, the letters can also be tapped out into the hand of the deaf person.

EDLS is a system of codes that allows you to make spoken language visible. Using the shape of your lips and your hands and the area of your face where you position your hand, you can make all types of sounds visible and supplement lip-reading.

This form of communication requires good vision. However, anyone who is already experienced in using it and whose sight subsequently deteriorates can still attempt to see the hand shapes if the lighting is good and the person speaking is the right distance away. A tactile version of the system can also be tried.

If the affected person has very poor hearing or is deaf, but can still see a little, sign language can often be used.

Sign languages are fully fledged natural languages with their own grammar and syntax. Sign language is expressed visually in the signing area with the hands, the facial expression, the mouth and the upper body. It is perceived using the eyes.

When we communicate, our bodies constantly send out signals, either consciously or subconsciously. Body language provides us with a great deal of non-verbal information. The clear and restrained use of body language, facial expressions and gestures can help considerably with mutual understanding. It is important to be aware that the meaning of body language is open to interpretation and dependent on the person’s culture. It can therefore also lead to misunderstandings.

If the affected person has good enough vision, you can write information on paper clearly and in block capitals. You should always carry a felt pen in your pocket, if you want to communicate with people who have a hearing and visual impairment. The person will tell you how large your writing should be, how thick and what colour the pen should be and what colour paper is best (for example, white paper can in some cases be too dazzling). Another option is writing on a computer, a tablet or a smartphone. The affected person reads from the screen where the font size and colour are set to suit them. Some affected people can also feel and recognise letters if you write them with that person’s finger on a table, for example.

Letters sent on paper or in electronic form should be in a normal font size so that the recipient can process the text themselves to suit their visual impairment. The same applies to handwritten letters. Text messages and e-mails are good means of communication, as are chat programs.

In this hand alphabet, the letters are made by touching and stroking the palm of the hand. Generally the letters are written on the deafblind person’s left hand. You should allow the “receiving” hand of the affected person to rest on your left hand in a relaxed way.

A light tap on the receiving hand means “the end of the word”. Two taps mean “the end of the sentence”. You should ask the affected person if they want this information. A light knock on the hand means “yes”. A rubbing out movement means “no” or a correction to the word that has been “spoken”. You must adapt the speed to the affected person, because the Lorm alphabet requires a lot of concentration.

SNABLIND has developed an app in German and French that teaches the Lorm alphabet. The app is available for Android phones and iPhones and can be downloaded from the Google Play Store or the App Store. The app allows you to practise using the Lorm alphabet on a hand on the screen, which provides direct feedback about whether you have touched the right point on the hand to represent the letter. The app also includes short video clips which demonstrate the right points and movements.

The letters of the alphabet are represented using six dots that are either embossed on paper or take the form of small moving pins on a Braille display for electronic devices. The dots can be felt with the fingertips and the letters can be read. All the letters of the alphabet, numbers and punctuation symbols can be represented using Braille.

Braille displays with eight dots have been developed for use with computers and other electronic devices. These make it possible to represent capital letters and other special characters and symbols. You can also find the place where you are currently writing. These Braille displays can also be used for direct communication. If someone types what is being said on a normal keyboard, the person with a hearing and visual impairment can read it on the Braille display.

Braille is also used for direct communication. In finger Braille the first, second and third finger of both hands represent the six dots.

The two people who are communicating sit opposite one another. The person who is writing puts the first, second and third fingers of each hand on the back of the corresponding fingers of the affected person. They write in the same way as on a Braille keyboard. Both people must have a very good knowledge of Braille to be able to communicate in this way.

Sign language can be felt instead of seen. This involves an affected person putting their hands on the hands of the other signing person. The visual elements, such as the facial expression and mouth shape, which are no longer visible, are also signed with the hands.

With tracking, the affected person holds the forearm of the person who is signing. This makes it easier for them to feel the signing movements. It also helps them to orientate themselves (by the arm and head position of the signing person). You must remember to use a small signing area (as in visual frame signing) and to adapt what you are doing to the needs of the affected person. You must sign “normally” and clearly, but not too quickly.

With the tactile finger alphabet, every letter can be recognised from the position of the hand and fingers. The person who is “speaking” makes the letters with one hand. A hearing and visually impaired or deafblind person puts their hand over the hand of the person “speaking”, feels the position of their fingers and recognises the letters.

Porta is a Swiss-German collection of 500 signs (as of June 2022) which are intended to meet the needs of people with a learning disability and multiple (sensory) impairments. Porta can be used in conjunction with speech and with Swiss-German Sign Language (DSGS).

In some cases, hearing and visually impaired and deafblind people and/or their relatives have no access to the communication methods and technologies described here or have difficulties learning them. Often these people develop their own communication strategies and communicate in a way which is specific to them. In addition, in some relationships and/or institutions, people use their own body signs or other signs that are unique to them or the institution.

“Tactile writing” can be used with people who know the letters of the alphabet. The “speaking” person writes normal, large capital letters (and numbers) one after another with their first finger on the deafblind person’s palm. It is also possible to write with the deafblind person’s finger on a surface.

The advantage of this form of communication is that everyone is familiar with the letters. The disadvantage is that it is very slow and requires a lot of concentration from the deafblind person. For this reason, tactile writing is rather rarely used.

For some people who have had a hearing and visual impairment from birth individual forms of communication have been developed. The same applies to people with multiple disabilities as well as sensory impairments. Their communication can consist of a combination of spoken language, gestures, facial expressions and signs made on the hand (and/or other areas of the body). They may also use tactile symbols, reference objects, structural aids, individual signs, drawings and pictograms. Pictograms are simplified drawings of symbols or relief figures. These forms of communication are always specific to one person or to an organisation/group and require a great deal of familiarity with the affected person. In Switzerland, pictograms have been specially developed for use in early intervention and in specialist schools and residential institutions for people who were born deafblind.