Deafblindness and communication

Also called Dual sensory loss, Dual sensory impairment, Multi-sensory impairment, MSI

When both sight and hearing are affected, touch becomes the channel: the manual alphabets, hands-on signing and the legal duty every council has to assess.

What it is

Deafblindness is a combined sight and hearing impairment severe enough that neither sense can compensate for the other, and the Health A-Z covers it as deafblindness. Few deafblind people have no sight or hearing at all; most have some of each, and the mix decides what communication works.

Some are born deafblind, or become so in childhood, and learn communication through touch from the start. Many more acquire it: a Deaf BSL user losing sight through Usher syndrome, a blind person losing hearing, or an older person whose sight and hearing both fade. Each route needs a different plan, and the acquired routes are where people most often end up isolated because nobody thought to change the method.

Who it can help

Deafblind people of any age, their families, and the care staff, interpreters and communicator guides who work with them. Anyone supporting an older person with both hearing aids and a magnifier, which is far more people than the word deafblind suggests.

Councils in England have a specific duty under Care Act guidance to identify deafblind people and to have them assessed by someone with deafblind training. Ask for that assessment by name.

How it works

The channel is touch, in several forms. The deafblind manual alphabet spells words onto the person's hand, with each letter a position or movement on the palm; hearing people learn it in an hour. The block alphabet traces capital letters on the palm and needs no learning at all. Hands-on signing lets a Deaf BSL user feel the signs with their hands over the signer's. Braille and Moon give reading. Tactile symbols and objects of reference support children and people with additional learning disabilities.

Where some sight or hearing remains, it's used: large bold print, a strong light, hearing aids with a loop, a phone with big text or a braille display. Technology such as screen readers and refreshable braille has opened email and messaging to people who were cut off for decades.

Communicator guides, provided through social care, are trained sighted hearing people who support the person to communicate and get about. Deafblind interpreters are the professional route for meetings and appointments.

Getting started

Learn the block alphabet today: trace capital letters on the person's palm, one at a time, with a pause between words. Then learn the deafblind manual alphabet from Sense's free guide.

Announce yourself by touch on the arm or shoulder and sign your name or initial in the same way every time. Tell the person when you're leaving.

Ask the council for a specialist deafblind assessment under the Care Act, and for a communicator guide if the person would benefit. Get the person's own communication method written into a communication passport.

Where to get help

Sense is the national deafblind charity, with a helpline, services, and guides to every communication method. Deafblind UK supports adults, with a helpline and befriending. The council's sensory or deafblind team assesses and arranges communicator guides; the GP refers to audiology and ophthalmology, and both should know about the other loss.