Block alphabet

Also called Block, Print on palm, Palm writing

Drawing capital letters on a deafblind person's palm with a fingertip. Nothing to learn, and any stranger can use it in a minute.

What it is

Block is the simplest tactile communication method there is. You take the deafblind person's hand, palm up, and draw each letter of the word on it with your fingertip, in plain capital letters, one on top of another. The person feels the shape and reads the word.

There is no alphabet to learn, no course, no equipment. The only rule is capital letters, the block kind, drawn large and clear, because lower-case letters and joined-up writing are hard to feel. That is the entire method, and it is why it matters: a deafblind person who is stopped in the street, taken to A&E or met by a new care worker can be communicated with by anyone who can write, as long as the person tells them how.

It is slow, and for daily use most deafblind people prefer the deafblind manual alphabet, which is faster once learned. But Block is the backstop, and every deafblind person and every family should have it.

Who it can help

Any deafblind person who can read, including those who lost sight and hearing late in life and never learned a manual alphabet. It suits older people with combined age-related loss, who make up the largest group of deafblind people in the UK, and for whom learning a new alphabet in their eighties is a big ask.

It helps the people who meet them: paramedics, receptionists, shop staff, neighbours, and the family member visiting from abroad. Its whole value is that the hearing, sighted person needs no preparation.

It does not help someone who cannot read print, so a person who has always been blind and reads Braille may not know the shapes of capital letters well enough, and it does not suit someone with a learning disability that makes letters meaningless. And it needs a hand with sensation: people with severe neuropathy in the fingers may struggle to feel the strokes.

How it works

Hold the person's hand steady with one of yours, or let them rest it on a table. With the index finger of your other hand draw one letter at a time in the centre of the palm, using the strokes you would use on paper, drawn upright from the person's point of view. Make each letter fill most of the palm. Pause briefly between letters and longer between words, or wipe the palm with a flat hand between words so the boundary is clear.

Keep to capitals and keep it short: sentences of two or three words, not paragraphs. Names, yes, no, wait, help, tea, pain. Ask closed questions and agree a reply: a nod or a thumbs up for yes, a shake for no, or the person can Block back onto your palm.

If a letter is not understood, draw it again; if it still fails, choose a different word. Numbers are drawn the same way.

Getting started

Try it today on a friend with their eyes closed and you will understand in five minutes both how easy it is and how large and slow the letters need to be. Then use it with the person and let them tell you what size and speed work.

If you are deafblind, or supporting someone who is, put the method on a card the person carries: "I am deafblind. Please draw capital letters on my palm with your finger." Deafblind UK produces communication cards of this kind. Put the same instruction in the person's hospital passport and on their care plan.

Learn the deafblind manual alphabet as well if you will be communicating regularly; Block is for strangers and emergencies, and the manual is for daily life.

Where to get help

Deafblind UK and Sense both teach Block and the other tactile methods and can supply communication cards. Your council's sensory team is the statutory route: deafblind people have a specific right to a specialist assessment under the Care Act, and a communicator guide can be part of the result. See deafblindness in the Health A-Z for the conditions behind it.