Deafblind manual alphabet

Also called Deafblind manual, Manual alphabet on the hand, Deafblind fingerspelling

Spelling words onto a deafblind person's hand, using the British fingerspelling alphabet moved from the air to the palm.

What it is

The deafblind manual alphabet is a way of spelling words to a person who cannot see or hear well enough for speech or signing in the air. The speaker takes the deafblind person's hand and makes each letter on it: the vowels are touches to the fingertips, exactly as in fingerspelling, and the consonants are shapes and strokes made on the palm and fingers. The person feels the letters and reads the word.

It is the British two-handed alphabet adapted to touch, so anyone who can fingerspell is most of the way to it already, and a deafblind person who learned to sign before their sight went usually picks it up fast. It is slower than speech and much slower than BSL, but it is exact, it works in the dark and in noise, and it needs no equipment.

It is one of a family of touch-based methods that also includes the block alphabet, which is simpler and needs no learning, and hands-on signing, which is full BSL received by touch.

Who it can help

People who are deafblind, which means a combined sight and hearing loss serious enough that neither sense can compensate for the other. Many acquire it with age; some are born with it; some have Usher syndrome, where a deaf child gradually loses sight in their teens and twenties. The Health A-Z entry on deafblindness covers the causes.

It suits a person who knows how to spell and has enough feeling in the hand, which rules out some people with severe neuropathy or dementia. For someone with a learning disability as well as dual sensory loss, on-body signing and objects of reference are usually a better fit than an alphabet.

It also helps the people around a deafblind person: family, carers, ward staff and communicator guides, each of whom can learn it in an evening and be understood by the next day.

How it works

The deafblind person holds out a hand, palm up. The speaker uses their own index finger to make the letters on it. The five vowels are touches to the tips of the thumb (A) and the four fingers (E, I, O, U), in the same order as the fingerspelling alphabet. Consonants are made on the palm and fingers: some are traced shapes, like C and L, and some are grips or positions, like the way B is made by placing the fingers across the palm.

Words are spelled in full, with a small movement or pause between them, and a longer pause for a sentence. Experienced pairs develop shortcuts: a single letter for a name that comes up a lot, a tap on the palm for yes and a rub for no. The reader's other hand is free, and many people spell back with it for a two-way conversation.

Speed comes with practice. A fluent pair can go at something like a slow reading pace; a beginner goes at the pace of a child learning to write.

Getting started

Learn the fingerspelling alphabet this week if you do not know it, then move the vowels onto the person's fingertips and learn the consonant shapes from a printed guide; Deafblind UK and Sense both publish one. Practise on your own hand first, then with a sighted friend with their eyes shut, then with the person.

Start with names, yes and no, and the words the person needs most: tea, toilet, pain, nurse, home. Agree a signal for "I did not catch that". Spell slowly and let the person set the pace.

On a ward or in a care home, write the person's method on the front of the notes and in their hospital passport, and make sure at least two people on every shift can use it.

Where to get help

Deafblind UK and Sense are the two national charities for deafblind people and both train families and professionals in the alphabet. Every council must identify deafblind people and assess their needs under the Care Act, which includes communication support; a communicator guide is the service to ask about. The Health A-Z entry on deafblindness has the clinical route.