Sign Language with People who are Deaf-Blind:
Suggestions for Tactile and Visual Modifications.

By Susie Morgan.


Technical Assistance Specialist National Technical Assistance Consortium for Children and Young Adults Who Are Deaf-Blind.

Communicating with individuals who are deaf-blind is a unique experience. The language, mode, style, speed, and aids and devices used to facilitate communication are different from person to person. If you are interpreting for an individual who is deaf-blind you will need to know what adaptations will be appropriate and what additional environmental concerns you
should be aware of. This article provides helpful hints about techniques that will enhance your comfort and ease your concerns when working with deaf-blind people.

The information in this article will be useful to a variety of communication partners such as interpreters, support service providers, intervenors, teachers, companions, and anyone else who is facilitating communication with an individual who is deaf-blind. It assumes that you are already fluent in the consumer's preferred sign language system and knowledgeable of cultural and linguistic differences that may affect your interaction. Due to the various etiologies, modes of communication, and cultural and linguistic differences among individuals in this population, some of these suggestions may be applicable to one consumer but not to another. It is imperative to ask the consumer his or her preferences on how the message should be conveyed and what additional auditory and visual information should be detailed.

Expressive Communication


Wear clothes that provide contrast for your hands. Consider the following guidelines when selecting clothing:

Many people wear a smock over regular clothes and keep one in their office or car for accessibility.

Wear plain jewelry that is not visually or tactually distracting. Avoid rings, bracelets and necklaces that may interrupt the flow of communication. Avoid sparkling or dangling earrings as they can reflect light and cause interference.

Fingernails should be short, neat, and filed smoothly. Rough edges can be irritating. A neutral color of polish may be worn, but avoid bright reds, dark colors, French manicures, or other frills.

Distance & Seating

The distance between you and the consumer will vary from situation to situation depending on the consumer's mode of reception. The consumer may use visual reception while you are signing in a reduced area sitting at a specified distance away. This situation may occur if an individual has peripheral vision loss and relies on central vision (also known as "tunnel vision"). Tracking is another possible visual modification. Tracking allows the consumer to keep your hands in a restricted signing space by grasping either your forearms or wrists.

When communicating tactually, close seating is necessary. There are a variety of seating arraignments. For example, when communicating with a one-handed tactile receiver, you and the consumer may sit side-by-side or at the corner of a table so that the consumer can rest his or her elbow. However, if the consumer is a two-handed tactile receiver, a comfortable position is to sit facing each other with legs alternating. Women may want to avoid short or straight skirts as they
are problematic for this configuration. Slacks or wider, full skirts allow more flexibility.

For both communicators, it is helpful if the levels of the chair seats compensate for the height differences of the signers. For comfort and in order to avoid fatigue, your bodies and signing spaces should be at similar levels.

Chairs with arm rests and back support are helpful. An additional chair may be placed next to each communicator. The back of the chair can then be used to provide support for either the signing or the receiving hand.

Signing Space

Be sure that both you and the consumer are comfortable with the personal and signing space established. When communicating with individuals who rely on residual vision (e.g., tunnel vision), you need to be cognizant of the location of your hands in the signing space. They should be held slightly below your face in front of your clothing to allow for color contrast. When
communicating tactually, it is helpful to move the general signing space down to the chest for postural ease.

During tactile signing, you must be comfortable using signs that come in contact with the body. The location of signs and consistency of placement are crucial for clear communication. Adaptations such as ducking your head to accommodate for the sign for "father" or "mother," for example, will cause confusion because the receiver determines gender by the height of the signer. In some cases, however, to be less obtrusive, simple modifications may be made to certain signs by either lowering or raising the hand slightly from its original contact position. For example, "home" which touches the face or "body/mine" which touches the chest.

Hand Positioning

The use of one-hand versus two-hand tactile reception of communication varies depending upon the preference of the consumer. Allow the consumer to place his or her hand(s) where he or she is comfortable and to follow your hands freely. Do not "squeeze" or pull the consumer's hand(s) toward you.

Conveying the Message

Whether communicating tactually or visually with someone with reduced vision, you must identify who is talking and where the speaker is located. If it is known, use the sign name of the individual and point in the direction where they are seated. If a sign name is unknown and it is an inappropriate time to request one from the speaker, one can be created between the interpreter
and consumer to save time and establish consistency.

Before the activity, if at all possible, discuss the consumer's preferred mode, style, and speed of communication. In order to convey the tone and manner in an accurate way, attempt to follow the speed and fluidity of the speaker while meeting the speed of reception and processing time of the consumer. To ensure clarity, however, fingerspelling and number production should be
produced at a slower pace for both visual or tactile receivers.

One of the essential components to communicating visually is facial expression. If a consumer has tunnel vision, low vision, or complete blindness, many or all of these expressions can be lost. It is imperative that you become adept at adding facial expressions using hand and body language. Signs can be added to describe the apparent emotion of the speaker. For example, if a person is laughing, the signs for "smiling," "laughing" or "hysterically laughing" can all be added to aid in conveying the speaker's expression. If the speaker is angry, you may add the signs for "raised eyebrows," "frowning," or "mouth turned down."

When relaying facial expression, it is not necessary to constantly repeat the same expression but do convey any change in facial expression. If a person is upset, frowning, has tears in his eyes and then begins to cry, pulls out a handkerchief and blows his nose, all that information should be relayed. However, if a person is frowning and maintains this expression throughout the
conversation, it does not need to be repeated more often than at the beginning and end of the speaker's monologue.

Use body language to convey the message (spoken language or body language) of the speaker whenever possible. For example, if the speaker shakes his or her head dramatically, bends over in laughter, and grimaces in disagreement, the interpreter should relay this information by replacing head movement with hand movement and arm movement to replace upper torso movement.

Tactile Adaptations

When using signs that require and provide information from two hands ("highway," "garage," "meeting people," "total communication"), both of your hands should come in contact with the consumer's hand. This can be done either through a one-handed or two-handed tactile position. A skilled one-handed tactile receiver may not need additional contact for clarity. Use your judgment about when to move to a two-handed tactile approach in order to convey the message most accurately.

Some confusion or awkwardness in positioning can occur with various signs. For clarity, additional information may need to be added or a slight variation of the sign may need to be employed. Because a consumer may not visually be able to discriminate between "understand" and "don't understand" it is imperative to elaborate the interpretation to include the sign for "yes,"
"no," or "not" or provide head movement in the hand. Many signs are similar and can be easily misinterpreted by the consumer. Simple additions can provide clarity. Consider the following examples:

The print-on-palm method, instead of the tactile use of numbers, is sometimes preferred when conveying numbers and/or money. Use your index finger in the palm of the consumer's hand. The letters should be in capitals (except for "I"), block format. Stay in the palm area. Do not print down the hand toward the fingers.

Be very clear about where a question is directed. Depending on the context of the question, a different sign may be employed. If the speaker is directing a question to the entire audience you could use the sign for "question/question mark" in a circular manner. If the question is directed to an individual, you should sign in the direction of the individual, adding the sign name or
description of the person in question.

At times, it can be difficult to discriminate between a question and a statement. You may wish to add a question mark or question indicator after the statement to help avoid possible misunderstandings.

Describing the Full Environment

When entering a new environment, be sure to explain the surroundings. If you have entered a restaurant and there is a long waiting line and the customers look unhappy, relay this information. Describe the color of the walls and things in the room, decorative style, lighting, seating, table arrangement, and so on. Inform the consumer where things are located in relation to
his or her body. For example, a chair to the immediate left, handouts on the right of the table, a pitcher of water directly in front. Use of the "clock" or "compass" concept to describe items inthe environment may be helpful. You can say that the glass of water is at 12:00 o'clock or the brailled handouts are on the east end of the table.

Describe items of importance or items that draw attention such as a woman wearing a violet suit, a video camera in the corner recording the meeting, people who appear to look uncomfortable, and so on. Additional visual information should be shared such as the news that a person in the meeting has fallen asleep, a couple is fighting across the street, or a person sitting across the table keeps sneezing. To the best of your ability, try to relay what is happening in the environment without allowing your personal opinion to influence the information that is being communicated. Describe how many people are in the environment and ask the consumer if he or she would like to know, by name, who is there.

When you are describing an event, it may be helpful to move from a one-handed tactile approach to a two-handed tactile approach to allow for a fuller description. For example, if you are describing Michael Jordan getting ready to shoot a basket, it helps to add his facial expression, or that he is sweating, or his legs are in the air, and so on.

Receptive Communication Issues

Environmental Concerns

Numerous environmental factors can hinder the flow of communication. These include the following:

Consumer Feedback

If you are working with the same consumer over a long period of time, establish a system that works for both of you. Certain tactile feedback provided by the consumer can aid the flow of communication. Examples include the following:

Team Interpreting/Duration of Interpreting

Due to the additional weight and unusual positioning used while interpreting tactually or communicating with visual modifications, you will want to work in partnership with someone else. To avoid fatigue or undue stress, you should switch often with your partner, approximately every 15 to 20 minutes. Try to coordinate this exchange with a natural pause to avoid interrupting the flow of communication.

Cumulative motion injuries can occur whenever there is repetition and extensive use of the hands. In addition, for consumers who receive information through tracking method or tactile sign language, taking breaks to rest and stretch the arm of the receiving hand may be necessary. Some consumers prefer to receive information in their nondominant hand to provide relief to
their dominant hand. If you can perform sign communication with your nondominant hand at the same level as with your dominant hand, offering to switch hands may be greatly appreciated by the consumer.

Additional Information

Do not consistently interrupt the dialogue to check for clarity. Instead, it is helpful to set up a system with the consumer beforehand. For example, at the start you may say, "If I am not clear, please stop me." It is then the consumer's responsibility to ask for clarification. Continually asking, "Do you understand me?" or "Am I clear?" can be disrupting and insulting.

Due to the ambulatory issues of individuals who are deaf-blind, you may be asked to "sight guide" a consumer. It is helpful to become familiar with basic sighted guide techniques.

Discuss with the consumer what symbol or sign to use in an emergency. Some consumers and interpreters are familiar with the process of printing a large "X" across the back of the consumer. An "X" is a clear indicator that an emergency situation has occurred, sudden movement is necessary, and explanations will follow. However, even though this symbol is somewhat
universal, not all consumers are familiar with this method.

Remember to rely on other communication partners in the environment for additional visual activity or information that may have been missed. Teamwork is essential!

Be honest about how the environment is affecting you. A consumer can tell if you are in a hurry, frustrated, mad, lazy, tired, scared, nervous, sloppy, don't care, and so on. If you think it will affect your work, discuss your mood with the consumer. Remember to take breaks and stretch.

Finally, when in doubt ASK!

Special thanks and appreciation goes to M.J. Shahen, Kathy Zarate, Maricar Marquez, Stacey Sullivan, and Rich McGann. Without their expertise, experience, and support, this article could not have been written.

For Further Reading.

Cooper, S. B. (1997) A glossary of some communication methods used by deaf-blind people. Views, 14 (11), 6-7.
Jacobs, R. (1997). Deaf-Blind Interpreting 101. Views, 14 (11), 8-9.
Sauerburger, D. (1993). Independence without sight or sound: Suggestions for practitioners working with deaf-blind adults. New York: AFB Press.
Smith T. B. (1992). Guidelines for working/playing with deaf-blind people. Distributed by DB-LINK (800-438-9376).
Smith, T. B. (1994). Guidelines: Practical tips for working and socializing with deaf-blind people. Burtonsville, MD: Sign Media, Inc.

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