Developing Communication and Language Skills with Children Who are Deaf-Blind

The issue


Deaf-blindness is a condition resulting in limited access to the visual and auditory world in which we live. The nature and extent of deaf-blindness is often misunderstood.  The term may seem to mean a complete absence of hearing and sight, but in reality, it refers to varying degrees of hearing or vision loss.  It is critical for parents and family members to have resources for training and support to provide opportunities for their child to have access to the world beyond their limited hearing, sight, or reach.

What we know

We know that learning to communicate and developing language are the greatest challenges for a child who is deaf-blind. While this may seem like an insurmountable task, we know that such children can learn to communicate through touch. Familiar objects serve as communication cues for children to express their needs and wants (expressive communication) and understand that which is communicated to them (receptive communication) while developing language.   Communication cues are objects that represent familiar activities or time concepts.  The use of these cues is an effective way to provide a child with information to anticipate what is about to happen in their environment.   Picking up or moving a child suddenly without first giving her information can startle or cause confusion, even fear.  Commonly used communication cues are environmental, object, and touch cues to name a few:

  • Environmental cues give information related to activities.  For example, allowing the child to feel the car seat prior to buckling him in tells the child he is about to ride in the car; feeling a coat tells the child he is going outside; a piece of chain link cues swinging on the playground, etc.
  • Object cues give information related to concepts of time. For example, putting the child’s bib or spoon in her hand cues that it is meal time; giving the child her stuffed animal or blanket signifies bedtime; a washcloth or sponge tells the child it is bath time.
  • Touch cues give directions for movement in the environment.  For example, a light upward stroke on the child’s arm could signify to stand up; a gentle tap on the child’s elbow could direct the child to go or move forward.

Every part of a daily routine or activity is an opportunity to communicate and develop language. The child must have access to the objects used as communication cues to express his desires.   As a child grows in understanding, creating a series of boxes and placing the day’s objects in sequence, creates the child’s daily calendar.   This type of calendar system must be used consistently with every member of the family, each caregiver, and all educational partners.   Families and teachers need to work together to choose the objects which the child is most familiar and have the most personal meaning.  The number of objects can be increased over time.  Verbal communication and/or sign should be encouraged in addition to using the objects for tactile communication.

To establish a calendar system, objects are placed in sequential boxes prior to an activity.  The child is guided to her calendar to look at and feel all the objects in the boxes. After examining the sequence of objects, the child is guided to the first box, removes the object, and proceeds to that activity with the object in hand.  When the activity is complete, the child is guided back to the calendar and places the object in the ‘finished’ box at which time the child is guided to the next box for the following activity.  Calendar systems should be created for every environment in which the child is involved.

What we don’t know

It is impossible to know what individuals who are deaf-blind can see and hear. Keen observation of a child’s reaction to his environment is critical for families and educators to understand the child’s visual and auditory access to the world.


Communication between family members and professionals is critical.  This calls for educators and service providers to include families as integral members of a collaborative team.  When this communication exists, partnerships are formed to facilitate a positive school experience.   Children who are deaf-blind benefit when included in a school program created through this collaboration.  Connecting home and school broadens the child’s access to opportunities for the development of communication and language skills.

Posted on October 1, 2014 by
Judith M. Emerson
Georgia State University
jemerson {at}

Further reading

Knoors, H. & Vervloed, M.P.J. (2011). Educational programming for deaf children with multiple disabilities: Accommodating special needs. In M. Marschark & P. Spencer, (Eds.), The Oxford handbook of deaf studies, language, and education, volume 1, 2nd edition (pp. 82-96). New York, NY: Oxford University Press. view details

Van Dijk, R., Nelson, C., Postma, A., & Van Dijk, J. (2010). Deaf children with severe multiple disabilities: Etiologies, intervention, and assessment. In M. Marschark and P. Spencer (Eds.), The Oxford handbook of deaf studies, language, and education, volume 2 (pp. 172-191). New York, NY: Oxford University Press. view details