For people whose vision and hearing is restricted, they may experience difficulties communicating and interacting with those around them. Limited information of what is happening may affect their ability to understand and make sense of their environment.
When there is a breakdown in communication it can lead to isolation, a feeling of being detached from society and losing contact with people, places and sources of information.
Isolation and having limited or no communication with those around them has the potential to cause a person to become withdrawn and depressed; in many cases depression can lead to more serious mental health issues.
People acquire dual sensory loss and different stages in their lives, and are left with varying degrees of vision and hearing and because of this, their needs in relation to communication will be very different. Therefore for an individual to maintain connection with family, friends, carers or others around them they will require an individual approach adapting to an alternative form of communication. Adjusting emotionally to these changes may take some time.
People who were born Deaf may have been educated through Deaf education systems and learned sign language such as Auslan or Keyword Sign. When vision deteriorates consideration for adapting the way they communicate and use sign language may be necessary. Others may have always used speech or lip-reading.
Adapting communication for Auslan users
When signing with people with vision impairment it will be necessary to establish how they use their vision and where you will need to be positioned so they can see as much of you as possible. For some people this will mean being in close proximity, or others they may need you to step further away.
Restricted visual field (or outer vision) is often referred to as tunnel vision. People with loss of visual field will need to receive signed communication within their range of vision. You may need to move further away so that your hands can be seen. Visual Frame Signing (or Box Signing) may be the most effective method, it is therefore important to keep your hands within the person’s visual field so they can follow the movement and shape of your hands. Lighting and contrast will also influence how visible you are. Other people may need to have physical contact with your hands to enable them to control where your hands should be positioned and keep them within their visual field.
People who are blind may need to communicate with hand-under-hand signing which involves placing your hands under the Deafblind person’s hands so they are able to feel the shape and movement of Auslan signs together with the movement of your body and fingerspelling to convey a message.
Tactile Fingerspelling using the Auslan alphabet to spell words on a person’s hands is another way to interact and communicate. Some people will have abbreviations and shortcuts that may be commonly used with this form of communication, or they may be individual abbreviations they have decided on themselves. This can reduce the time taken of fingerspelling each word, for example fingerspelling “GD” for the word “good”, or words shortened to one sign on the palm. Any shortcuts will need to be agreed to ensure consistency in communication.
Tactile fingerspelling can be taught to people who are not sign language users.
Alternatively using the block alphabet to spell letters on the person’s palm or taking their index finger and spelling letters onto a table can be a way of connecting.
A CD Deafblind Communication Methods is a useful resource available from Senses Foundation Inc.
For people who prefer to use speech, they may have hearing aids or a cochlear implant, establish with them where you should sit, their hearing may be better on one side than the other. If there is background noise you may need to move to a quieter environment for the person to hear you, they may also lipread therefore understanding where you need to be positioned so they can see you is important as is lighting, avoiding situations where glare may distort their vision.
Likewise for lipreading positioning is vital when a person has limited vision. Making sure you are visible by checking light sources are not behind you to facilitate more effective communication.
Written communication should be adapted for an individual’s needs such as large print, Braille or audio formats to make information more accessible.