• Who is a Deaf-Blind Person?
• Family Issues
• Modes of Deaf-Blind Communication
• Special Considerations in Communicating with Deaf-Blind People
• Other Sources of Information

Who is a Deaf-Blind Person?
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The issue of who fits into this category is not completely obvious. There are different levels of both deafness and blindness, and people become deaf and blind at different points in their lives. The process may also happen progressively, such that a person who starts out at one level of either condition may reach another level later in life. Depending on when and how completely a person becomes deaf and blind, their needs, manner of communication and culture will vary. A person who is deaf and blind from birth, for instance, may need assistance in moving around, will probably communicate with Braille or other tactile method, and will most likely adhere to the Deaf-Blind culture. A person who has limited vision and became hard of hearing later in life may need very little beyond a hearing aid and good lighting.

"Today there are more Deaf-Blind adults identified than 20 to 30 years ago, due in part to the early identification and support of people with Usher Syndrome (congenitally deaf with adventitious blindness) in their teens and young adulthood, and due in part to the children who became Deaf-Blind from Rubella who are now adults today."¹ Estimates of the number of Deaf-Blind people vary, but are commonly given at 21,000. Actually, the number is much greater since it does not account for those who have partial vision or hearing.² As a result of this and the greater education and professionalism of Deaf-Blind people, there is a greater need for skilled interpreters to work with Deaf-Blind people than ever before.

1.     Jamie McNamara, "Deaf-Blind Interpreting," Views, pp. 10 and 11 (Silver Spring, Md.: Registry of Interpreters for the Deaf) 14, no. 11 (December 1997).

2.     Loraine J. DiPietro, Ed., Guidelines on Interpreting for Deaf-Blind Persons, Public Service Programs, (Washington, DC: Gallaudet College) 1978).

Family Issues³
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• It is important that all family members learn the deaf-blind persons preferred mode of communication.
• Parents should help their child use any residual vision or hearing. 
• Deaf-blind people are frequently isolated. They need ample opportunities for socializing.
• All people with whom the deaf-blind person has regular contact need to be aware of the proper way to get the person's attention. Usually touching the hand or forearm is best.
• Encourage your deaf-blind family member, help him or her develop a positive self image.
• Family members themselves may need counseling and support, especially if they blame themselves for their loved-one's disability. 

3.   Linda M. Struck, M.S.W., Abuse and Neglect of Children with Disabilities, Commonwealth of Virginia, Department of Social Services Services, Child Protective Services.

Modes of Deaf-Blind Communication
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Just as hearing and seeing people vary in their preferences, so do Deaf-Blind people vary in their preferred mode of communication. Their preference may be visual for those with some vision, auditory for those with some hearing, or tactile. Their preference may also include choice of language, such as ASL or English. An interpreter should obtain as much information in advance as possible, evaluate the client's preferences compared to the interpreter's skills, and determine whether they are confident in meeting the client's needs. In addition, since tactile signing tends to be much slower than visual, it is important to determine in advance whether the client prefers a summary of what is spoken or verbatim signing.

Following is a list of the most common modes of communication used by Deaf-Blind people. It is arranged according to training and equipment required.⁴

Method Not Requiring Special Training or Equipment

• Print on Palm/Print on Back. The communicator prints in large block capital letters on the person's hand or back. Each letter is written in the same location as the previous letter.

Methods Requiring Special Knowledge of Training, But Not Special Equipment

• Tadoma. The Deaf-Blind person places his hand on the mouth, cheek, and chin of the person communicating. They read the voiced message by feeling vibrations. It works best with those able to speak their own response.
• Small Sign Language also known as Restricted Field Signing. Those with narrow vision may prefer to receive messages by signing in a very small area near the signer's mouth. Some signs may have to be adjusted. 
• Tracking Signing. Frequently used by people with Usher Syndrome, the Deaf-Blind individual holds the fore-arms of the signer and follows the signing visually, using their hands to know where to look.
• Tactile Sign Language. The communicator signs in a normal fashion and the Deaf-Blind person feels the shape of the signs by placing their hands on top of the signer's hands. Some adjustments need to be made for non-manual communications.
• Tactile Fingerspelling. Similar to tactile signing, the Deaf-Blind person touches the signer's hand during signing.
• Finger-Braille. The communicator uses six fingers in the Braille positions to indicate each letter. This method is not widely used in the US at this time.

Methods Requiring Special Equipment

• Alphabet Glove. "The letters of the alphabet are printed in indelible ink on a lightweight glove. The communicator touches the letters desired to spell out the message." It works best with people who can speak their own response.
• Alphabet Card. "This is an embossed index card with the letters of the alphabet raised. The communicator places the fingertip of the Deaf-Blind person's index finger on the desired letters to feel the shape of the raised letter."
• Braille Alphabet Card. This is like the alphabet card, using Braille instead of embossed letters. Ink-printed letters are included to facilitate use for the sighted communicator.
• Tellatouch. Similar to a typewriter with a standard keyboard, the output is in Braille. It is read one letter at a time.
• TeleBraille. The communicator types on a TTY keyboard. The recipient reads 20 Braille cells and then requests the next set. The Deaf-Blind person responds by typing.
• Braille Tape. "The communicator types in Braille and the letters are embossed on a long, thin strip of paper..." The tape can be read immediately or at a later time. 

4.     Sheryl B. Cooper, PhD, IC/TC, RSC, "A Glossary of Some Communication Methods Used with Deaf-Blind People," Views, pp. 6 and 7, (Silver Spring, Md.: Registry of Interpreters for the Deaf) 14, no. 11 (December 1997).

More often than not, the Deaf-Blind person has some vision. Where and how well they can see will be the main question. If the person has Usher's Syndrome (which often includes tunnel vision), the interpreter may have to be far away; for cataracts the interpreter needs to be very close and sign in a small, limited area. Some may have no peripheral vision, others may have only peripheral vision. Some may have clear sight in their area of vision, others may have only blurred or minimal vision. In any case, the interpreter must be especially careful to wear solid, highly contrasting colors. Additionally, the client may be sensitive to certain colors or find certain colors easier to read. 

Those with partial hearing may wish you to voice along with your signing. Possibly you will be asked to voice into a hearing-aid type device, such as a pocket talker. Or you may just need to sit at closer range when you speak. In some cases the person can voice their responses, but lack of clarity will require you to repeat or "voice over" them.

There is now some belief that Deaf-Blind people have their own dialect, known as "Tactile ASL."

Although many of ASL's signs are the same as TSL's, the Deaf-Blind language has had to make adjustments for non-manual ASL signings. 

Special Considerations in Communicating with Deaf-Blind People
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It is important to give Deaf-Blind people warning of changes in their environment, approaches of other people, or the need to change locations. Chances are you will need to help the Deaf-Blind client move around. Do not grab the client's wrist and pull them. Instead, communicate with them that it is time to move, place their hand inside your bent elbow, and lead them. If you are walking in a narrow or crowded space, your elbow should be held slightly in back of you, indicating that the person should follow behind. When approaching a step to a curb or stair, raise or lower your arm slightly and pause a little, allowing the client to prepare to step up or down. 

In addition to mobility needs, the client may require assistance in obtaining food and taking medicine. Establish codes to identify such situations as rest room, coffee, exercise, and meal breaks. If participation will be a factor, establish how their participation will be signaled and carried out.

Because of the need for close proximity during communication, it is sometimes best that the communicator be of the same gender as the client. This becomes especially important when the Deaf-Blind person needs to use the rest room. If you are interpreting for a Deaf-Blind person of the opposite sex and have no appropriate team mate, recruit and train a volunteer in advance to take the person to the rest room. 

Since you may be sitting quite close to the client, do not wear perfume or cologne, and be careful of other odors as well. This is not the day to eat garlic and onions! Hand lotion may be advisable for tactile signing if your hands are dry or chapped. The person may require stronger lighting, and certain types of lighting may be better than others. It is also wise to wear slacks or a pants suit, since you may be sitting knee-to-crotch while signing. 

Slower signing is usually necessary for tactile signing. Be very clear in your signing and pause between sentences. Check for understanding and be ready to repeat as necessary.

Always identify who is speaking, including yourself. Be aware that the person may need you to tell them a great deal about the environment: where things are located, who is talking to whom, whether the event has begun and in what stage of the event are you currently experiencing. Find out in advance how much and what type of information they wish you to convey. 

Other Sources of Information
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1. Ronda Jacobs, CI and CT,  "Deaf-Blind Interpreting 101," Views, pp. 8 and 9, (Silver Spring, Md.: Registry of Interpreters for the Deaf) 14, no 11 (December 1997).
2. Jodene Downer, CCASSD Level III, Generalist, "Tactile Interpreting - Are You Ready?" Views, p. 12, (Silver Spring, Md.: Registry of Interpreters for the Deaf) 14, no 11 (December 1997).
3. Carol Gregg, CT, and Jeffrey Bohrman, Ph.D., "Deaf-Blind Interpreting -- International Style," Views, pp. 13 and 14, (Silver Spring, Md.: Registry of Interpreters for the Deaf) 14, no. 11 (December 1997).
4. Julie Devich, "Definitions of Alternative Communication Styles with Deaf-Blind People," Views, p. 15, ( Silver Spring, Md.: Registry of Interpreters for the Deaf) 14, no. 11 (December 1997).
5. Candace Steffen, CI, "The Acquisition of Tactile Sign Language (TSL) By Deaf-Blind Adults," Views, p. 18 and 19, (Silver Spring, Md.: Registry of Interpreters for the Deaf) 14, no. 11 (December 1997).
6. Ruth Sandefur, RSC, OIC:V/S, "The Dilemma of Deaf-Blind Interpreting," Views, p. 20 and  21, (Silver Spring, Md.: Registry of Interpreters for the Deaf) 14, no. 11 (December 1997).
7. Marthalee Galeota, "Community Commitment To Nuturning Deaf-Blind Interpreters," Views, p. 22, (Silver Spring, Md.: Registry of Interpreters for the Deaf) 14 no. 11 (December 1997).
8. Barbara Miles, DB-LINK Fact Sheet, http://www.tr.wou.edu/dblink, October 1999.