Interpreting and working with Deaf-Blind people

David Bar-Tzur

Created 23 June 2008, links updated monthly with the help of LinkAlarm.

David Bar-Tzur with his friend Willie Wilkinson and another D-B person and an SSP at Seabeck 2004

Image: The author at the 2004 Seabeck convention in the State of Washington with his friend Willie Wilkinson and others.


Labeled picture of the eye

The iris, unfolds like a flower. The pupil (the hole formed by the iris) widens or shuts off depending on the light the body wants to receive. The cornea is a transparent layer over the iris. The lens focuses the light on the retina in the back of the eye. The macula is an area with a dense population of sensors. The optic nerves send a signal from the retina to the brain.


You don't need to memorize these types, but understanding them will help you voice for D-B people when they discuss their Deaf-Blindness and understand how and why you need to modify your interpreting depending on their needs.

Usher syndrome

A comparison of normal vision of a street scene with Usher Syndrome, where only central vision is present

Image: Lighthouse International - Retinitis Pigmentosa.

Alarm clock image focused on the retina

Image: (left) Anatomy and Physiology of the Eye - Low Vision Solutions, (right)

Sometimes misspelled "Usher's syndrome". Usher syndrome is the most common condition that affects both hearing and vision. A syndrome is a disease or disorder that has more than one feature or symptom. The major symptoms of Usher syndrome are hearing loss and an eye disorder called retinitis pigmentosa, or RP. RP causes night-blindness and a loss of peripheral vision (side vision) through the progressive degeneration of the retina.

A table of the variations of symptoms in Usher Syndrome I, II, & III

Image: Usher Syndrome.

A genogram showing how recessive characteristics work: 2 carriers -> 1 affected, 1 unaffected & two carriers in the children

Image: Usher Syndrome.

The retina is a light-sensitive tissue at the back of the eye and is crucial for vision. As RP progresses, the field of vision narrows, a condition known as tunnel vision until only central vision (the ability to see straight ahead) remains. Many people with Usher syndrome also have severe balance problems. There are three clinical types of Usher syndrome: type 1, type 2, and type 3. In the United States, types 1 and 2 are the most common types. Together, they account for approximately 90 to 95 percent of all cases of children who have Usher syndrome.

Approximately 3 to 6 percent of all children who are deaf and another 3 to 6 percent of children who are hard-of-hearing have Usher syndrome. In developed countries such as the United States, about four babies in every 100,000 births have Usher syndrome. It is caused by a recessive gene. For more info on Usher Syndrome, see The National Institute on Deafness and Other Communication Disorders - Usher.

Macular degeneration

A comparison of normal vision of a street scene with macular degeneration showing a scotoma (blind spot) in the middle

Image: Lighthouse International - Macular degeneration.

Macular degeneration is a medical condition predominantly found in elderly adults in which the center of the inner lining of the eye, known as the macula area of the retina, suffers thinning, atrophy, and in some cases, bleeding. This can result in loss of central vision, which entails inability to see fine details, to read, or to recognize faces. According to the American Academy of Ophthalmology, it is the leading cause of central vision loss (blindness) in the United States today for those over the age of fifty years.


A comparison of normal vision of a street scene with an overall fuzzy view with a cataract

Image: Lighthouse International - Cataract.

A cataract is an opacity that develops in the crystalline lens of the eye or in its envelope. Cataract derives from the Latin cataracta meaning "waterfall" (you can't see through white water). Cataracts develop from a variety of reasons, such as the secondary effects of diseases like diabetes, hypertension and advanced age. They are usually a result of denaturation of lens proteins, similar to a clear eye white clouding after cooking.


A comparison of a normal view of a street and a central view shaped like a spiral cell

Image: Lighthouse International - Glaucoma.

Although raised intraocular pressure is a significant risk factor for developing glaucoma, there is no set threshold for intraocular pressure that causes glaucoma. One person may develop nerve damage at a relatively low pressure, while another person may have high eye pressure for years and yet never develop damage. Untreated glaucoma leads to permanent damage of the optic nerve and resultant visual field loss, which can progress to blindness.

Diabetic retinopathy

A comparison of a normal view of a street and a view with spotty, grey, translucent areas

Image: Lighthouse International - Diabetes-Related Eye Disease.

Over time, diabetes affects the circulatory system of the retina. The earliest phase of the disease is known as background diabetic retinopathy. In this phase, the arteries in the retina become weakened and leak, forming small, dot-like hemorrhages. These leaking vessels often lead to swelling or edema in the retina and decreased vision.

The next stage is known as proliferative diabetic retinopathy. In this stage, circulation problems cause areas of the retina to become oxygen-deprived or ischemic. New, fragile, vessels develop as the circulatory system attempts to maintain adequate oxygen levels within the retina. This is called neovascularization. Unfortunately, these delicate vessels hemorrhage easily. Blood may leak into the retina and vitreous, causing spots or floaters, along with decreased vision.

In the later phases of the disease, continued abnormal vessel growth and scar tissue may cause serious problems such as retinal detachment and glaucoma.

Hemianopia (or Hemianopsia)

A comparison of a normal view of a street and hemianopia, where there is in this case no right field of vision

Image: Lighthouse International - Hemianopia.

Hemianopia is a blindness or reduction in vision in one half of the visual field (hemi as in hemisphere + opia as in myopia) due to damage of the optic pathways in the brain. This damage can result from acquired brain injuries caused by stroke, tumor or trauma. Stroke occurs when there is damage to a group of nerve cells in the brain often due to interrupted blood flow, caused by a blood clot or blood vessel leaking. Depending on the area of the brain that is damaged, a stroke can result in coma, paralysis of one side of the body, speech and vision problems, and dementia. The vision may be gone in the right half, left half, upper half, lower half, or the outer half (periphery), and in one eye or both.

ACTIVITY 1: Obtain a vision simulator card, write: The Guild, 15 West 65th Street, New York, NY 10023-6601. Phone: 212-769-6200 or 800-539-4845. E-mail: Watch a partner or videotapes of someone signing while looking through the various windows of the vision simulator card to get an understanding of what people with various vision problems see while you are interpreting.
A vision simulator card with windows that create the effect of various vision problems

Behaviors that may indicate a visual impairment

Because most Deaf-Blind people have Usher Syndrome and the symptoms only become obvious around the times that they are adolescents, you may well interpret for people that does not realize or are only coming to realize that they are deaf-blind. For this reason it is good to know behaviors that indicate a person has a visual impairment. One semester, the first day I interpreted for someone in an on-going assignment, I was already seated house right and he went over and sat on house left. I asked him if he wanted me to move and he told me to stay where I was. This told me that he probably had a scotoma (blind spot).

Does the consumer bump into objects? Move hesitantly or walk close to the wall? Searches for objects or touches them in an uncertain way? Tilts his/her head to see? Requests additional or different kinds of lighting? Holds books or other visual material close to the face? Drops objects or knocks them over? Shows difficulty making out faces or the numbers that designate rooms or floors? Act confused or disoriented; for example, walks into the wrong room by mistake?

Deaf-Blind, Deaf/blind, Deaf-Blind?

In 1991, Salvatore Lagati in Italy began a crusade to get international acceptance of the single word "Deaf-Blind" in place of the hyphenated word "deaf-blind." The single word would indicate a different, unique condition and that impact of dual losses is multiplicative rather than additive. This proposal faces an uncertain future in the United States. Terminology has been a hotly debated issue for some time in the United States. Political correctness also seems to have greater influence in the US than in many other countries. Recent synonyms have included "dual sensory impaired," "auditorally and visually challenged," person "with deaf-blindness," etc.

Editorial policy for Deaf-Blind Perspectives (Reiman, 1993) requires the use of the language "person who is deaf-blind." This usage seems to have general acceptance in the U.S. Perhaps, if Salvatore Lagati keeps up his crusade, "person who is Deaf-Blind" will have global acceptance in the future. The term "Deaf-Blind" implies a deaf-blind person who is culturally integrated into the D-B community, similar to the distinction between "deaf person" and "Deaf person". I will use the capitalized form. People with Usher Syndrome often prefer to be called USHER-SYNDROME PERSON ([U], PO away, FO up touches DS temple, then [S], PO away, FO up, touches the DS of the chin) as opposed to DEAF BLIND.


Image: Leader Dogs for the Blind: Deaf Blind Program.

Because Deaf-Blind people have lessened hearing and sight, they depend more on their other senses, which includes smell. One should try to avoid either too much natural body odor or too much artificial odors. This means one should bathe well, take care of oral and body odor, and avoid strongly perfumed products. One should also wash one's hands frequently to avoid passing one's own germs on to Deaf-Blind people, or from one Deaf-Blind person to another.

When you first meet, touch the person's shoulder while you are standing in front of them to let them know you are there, if they are standing. If they are seated, touch the back of the hand, and when they raise it, slide your hand underneath theirs. If they are speaking with someone when you arrive, touch their shoulder from the front and wait until they stop their conversation. Some people keep their hand on the shoulder as a "reminder".

Don't tap from behind, since they won't expect to turn around. Be flexible with your communication method, your client may be new to Deaf-Blindness or have special needs. We will discuss communication options in a moment. State your name, name sign, and business first, then chat. Even a casual conversation (not an interpreted event) may lead to a need for guiding to the bathroom or to find someone so we will explain that procedure soon.

If you need to leave, explain why and when you will be back. Keeping the consumer is vital, so tell the person when you are back. Identify yourself each time you meet, that way there will be no confusion or embarrassment. Think of everything you say as a promise - "I'll be right back", "I'll see you at 8:00", "I'll tell Joe what you said." Trust! Respect their privacy. Don't ask personal questions (when did you become D-B? Are you lonely? Why did you divorce? Don't pass on private information, even if it was not gained as part of the interpreting process and is therefore not covered by the Code of Ethics.

For an intensive introduction to all aspects of Deaf-Blind work, see Smith, T. B. (October 1994). Linstok Press. ISBN: 1881133060.

ACTIVITY 2: Although we have not discussed how to guide a Deaf-Blind person yet, I want you to experience what it is like being guided by someone who doesn't know how. Hopefully they will be kinder than the one in the ad on the right. Find a partner and the two of you will take turns being the guide and being the Deaf-Blind consumer. Find an environment where you will need to pass through doors, take stairs, and walk on carpeted and uncarpeted floors if possible. After you both are done, discuss what your likes and dislikes were as a guide and as a consumer. The easiest way to make a blindfold, if you don't have one, is to take a sock and safety pin it around your eyes.
A Diesel jeans ad with someone dashing across a pedestrian crossing in a daring way with a blind person

Image: Diesel jeans ad, source unknown.


For all styles

Notice if consumers seem to move their head as if avoiding blind spots in their visual field. You may need to adjust where you are sitting or change your signing space. Clothing contrast is still important: Dark green, brown, or grey is best for light complexions and light shades of those colors for dark complexions. Many Deaf-Blind people are even more sensitive to bright colors than a sighted Deaf person. Begin slowly with a new person until they are used to you and you see how best to communicate. The lighting you are in should be bright without glare. Don't face the Deaf-Blind person into the sun or major light source. If you are using your voice, hard-of-hearing Deaf-Blind people may need you at their better ear and to sit away from noise.

Close visual (CV)

Determine the best distance to be. If you see consumers moving their heads, you may be signing too large. Be aware that although the consumers may see you, they may not sees other visual information (the board, PowerPoint, who is speaking). Vision in the same person may change depend on health, sleep, and emotions. What people see one day, they may miss the next day.

Tracking & tactile signing

With tracking, the Deaf-Blind person will hold onto your wrists, partly to limit your arm movement and partly to reinforce how the hands are moving. Two short squeezes (or pats on the hand) usually means, "Yes, I understand what you are saying." One long squeeze usually means, "I didn't get that." It could mean, "Oh my goodness!" Judge by facial expression.

If there is pause, you can put your hands down, but it is best to maintain contact by putting your hands and the client's onto your knee or lap. Negation with only the head is hard to see, add NOT, #NO, NONE, etc. Questions may need a QM (question mark) or D-I-D. If the person uses both hands to receive ASL, it's best to sit facing with knees interlaced. If one-handed, 45-90 degrees is best. Sign with energy and clarity, despite feeling restricted, but don't be wild.

Don't duck your head to make signs like MOTHER, since it will obscure the difference between signs that differ only in location, such as MOTHER, FATHER, and FINE. Hunching also makes your signing space smaller. Information about affect that is usually conveyed by facial expression should be added by additional signs, such as FOR~SURE, DOUBTFUL, QUESTION-MARK, and so on.

If you are signing, pause slightly before fingerspelling a word and slightly afterwards to check for comprehension. When Deaf-Blind people puts out their non-dominant hand, they are requesting (back-channel) feedback. Respond with YES, OH-I-SEE, WHAT-CAN-I-SAY, and so on. Touch is especially important for Deaf-Blind people. It is their link with the world. It can show you are nervous, withdrawn, friendly, tired, or bored.

You may be uncomfortable "holding hands" during pauses, but it is best to wait for the Deaf-Blind person to break contact. It keeps that link and makes it easier for the Deaf-Blind person to get your attention. Later, when you know the person better, touch will also include an occasional squeeze, stroke, pat on the back, walking close, or a hug of greeting and farewell.

Try to think of ways to communicate through touch to make up for smiles and frowns. (Pat hand, #HA-HA, a gentle nudge.) Don't tease by poking, tickling, or jostling, even though your intentions are friendly. We can see things like that coming and are startled when we don't. If the person's hands are heavy, it may mean they are tired or having difficulty understanding. Be aware of a need for a break in the conversation or interpretation. If Deaf-Blind people start a private conversation that you sense they may not want to share with others, remind or inform them if other people may be watching. They may have forgotten or the people may have shown up after you first began chatting.

If someone interrupts your conversation, tell the Deaf-Blind person what is happening and interpret or allow access to the conversation. Don't leave a Deaf-Blind person waiting during a lengthy conversation. If a hearing person is busy with a Deaf-Blind person, another hearing person can say hello to the first Hearing person who can respond without looking away. When a Deaf person is busy with a Deaf-Blind person, they must break their eye contact and therefore their concentration. It's better to wait until the Deaf-Blind person is free to look your way. With two Deaf-Blind people chatting, it is even more of an interruption and you definitely should wait until there is a lull in the conversation. Help other people who are new to the Deaf-Blind world learn to communicate with them. Don't be surprised if people, even Deaf people, are reluctant to communicate with them tactily.

All deaf people like an interpreter with the right attitude - someone who is flexible and there to make communication go smoothly, not a machine. This is even more important for the Deaf-Blind. Take off rings or bracelets, and keep fingernails trim. Some Deaf and most Hearing people feel awkward or uncomfortable communicating with a Deaf-Blind person. Try to be calm, friendly and flexible. Your mood will set the tone for others. Communication, stimulation and companionship are essential to human beings. It is a two-way street. Enjoy the conversation, shows warmth and joy of life, teach, see life through a different perspective.

Tactile fingerspelling

If the Deaf-Blind person needs all fingerspelling, pause slightly between words. Some people use Braille abbreviations. If you will be doing this often, you may want to learn them. Give yourself and your consumer rest breaks when possible.

Print on palm (POP)

Print on palm means to draw the letters of the words, one-by-one, on the palm of the Deaf-Blind person. Some Deaf-Blind people need this for numbers only, drawing a "7", for example, instead of spelling out S-E-V-E-N or signing it. There is a preferred stroke order which is illustrated above. HKNC recommends, "With your index finger, print your message in the palm of the hand of the person who is Deaf-Blind. Use capital letters only, except for the letter 'i' which is lower case. Print only in the palm area. Do not connect letters. Pause after each word. If you make a mistake, 'wipe' the palm, then print the correct letter. If the person has speech, he or she may say each letter and word aloud as you spell it. This is a good way to know that your message is being understood."
A chart demonstrating the stroke order for Print on Palm

Image: Guidelines for Helping People Who Are Deaf-Blind.


In Deaf-Blind interpreting you need to add a description of what is happening during an event outside of what is said. Imagine as an example a graduation, where you would tell the consumer, "A graduate has presented a card with her name on it to a woman standing on house right. Sally Smith has been called to receive her diploma and is now walking to the middle of the stage. She is being handed a flat diploma holder and she is shaking hands with President Harris. She hugs president Harris and wipes away a tear in her eye..."

Here is a list of some of the things you might describe: What the room where you are seated looks like, how many people are here, who is speaking (name or description, not just "a woman"), any emotion you see by is not necessarily revealed in what is said, read to the consumer what written information is being shown or distributed when there is time (handouts, PowerPoints, writing on the board that is not actually read out loud), the names of people present that the you and the Deaf-Blind person know.

ACTIVITY 3: (1) The working interpreter (A) faces the computer screen to watch one of the videos listed below. The "consumer" (B) looks away so that s/he can not see the screen. (2) A describes what is seen in ASL to B for the duration of whichever video is watched. (3) When the video is over, B watches the video for him/herself. (4) B tells A whatever features s/he felt were missed that were important to the story or anything that B feels was misleading in the environmental description. (5) B now repeats the procedure with A as consumer.

Do these descriptions "cold", that is, do not watch the videos before you try them on someone. It should be clear that A and/or B could be Deaf. Remember that Deaf people do act as Deaf-Blind interpreters. If you find this activity helpful, you can repeat it with a different video. Here are some possibilities for your use:

The face of Mr. Bean

Image: Rodaje de 'Bean II', con Rowan Atkinson.

50 million dollar painting (5:50).
At the Bus Stop (6:09).
Christmas (3:51).
In the garage (3:42).
In the toilet (3:31).
Making a sandwich (6:47).
Merry Christmas (5:17).
Mr. Bean meets the queen (6:26).
Mr. Bean rides the train (4:22).
Mr. Bean's car (6:04).
The Guardsman (6:35).
The hotel room (5:46).
The swimming pool (4:13).
To the dentist (6:56).


SSP means a support service provider. Sometimes there are individuals that will provide this service separately from the interpreter. Sometimes the interpreter needs to provide some or all of these services her/himself. As general etiquette, remember four important components of Deaf-Blind etiquette: (1) Information, (2) empowerment/choice, (3) independence, and (4) comaraderie.

Information: Ninety percent of Deaf people have hearing parents. Many of these parents never learn ASL, although it would be helpful for communication. As interpreters we have heard stories of how Deaf people have been left out of family get-togethers and don't know basic things about their family history that most children do. Most Deaf-Blind people were among these Deaf people and want to know as much about what is happening about them as possible. For this reason is important for an SSP/interpreter to share relevant information with them, although hearing people might feel "It's nothing. I'll tell you later." "Later" has too often meant "never".

Empowerment/choice: All of us want to be independent, but Deaf-Blind people often have decisions made for them, even when it is not necessary. Needless to say, this happens with many differently-abled people. For this reason it is important when you are trying to be helpful to give your consumers options about what they need and how they want to be assisted.

Independence: One of the options in how people wants to be assisted is that they just may want to do it themselves altogether. Be sensitive to this. If you notice that the person takes the initiative in situations that most don't, you may need to step back and let them do for themselves.

Comaraderie: When I first meet any Deaf consumer, I am very friendly and wait for a reaction. If the person is quiet, I tone it down. If they respond in a similar fashion I keep it up. Since Deaf people are often isolated from people who know how to communicate with them during the day (perhaps night too), they sometimes appreciate a chance to talk. Even more so with Deaf-Blind people.

Woman guiding a blind man by letting him hold onto her armA close-up of how a blind person grasps the arm of the guide

Image: Sharing Vision: Guiding a blind or vision-impaired person.

Walking: In general, the easiest way to guide a Deaf-Blind person is to have them hold onto the back of your upper arm and walk slightly behind you. In this way, they can feel when you turn, stop, step up to a higher level or down to a lower one. You should pause slightly before any change in motion (turning, stairs, change in walking surface) to alert your partner, but you don't need to explain every little change. If you will stand still for more than a moment, you should explain what the hold up is.
Crowded spaces: Put your leading arm slowly behind your back to indicate that your partner should move directly behind you if the passage will be narrow for a brief time. If it will be for more than a moment, you can put your partner's hand on your shoulder and guide them in this way until the passageway clears up.
Guide places her leading arm behind her back to indicate that her partner should move directly behind

Image: BlindVoice UK - Sighted Guide Techniques.

Woman guides a blind man through a doorway

Image: Sharing Vision: Guiding a blind or vision-impaired person.

Doorway: If the door will open on the same side as your leading arm, open it and place your partner's hand against what was the other side of the door before it opened and continue walking. If the door will not be on the same side, open the door and continue walking. Let the door slowly close until your partner is holding his/her body against it as you pass.

Stairs: Some people want to be told that there are stairs, some people just want you to pause, step down or up onto the first stair and then proceed. If there is a hand rail, I usually place my partner's hand on it and then they can continue to hold onto me with their other hand or use their cane if they have one.
Guide and partner have usual stance and partner is using the handrail

Image: BlindVoice UK - Sighted Guide Techniques.

Bathroom: If you guide people to the bathroom and you are of different genders, ask if they want someone of the same gender to help them. Some strangers are willing to do this. If not, put their hand on the bathroom doorknob and leave them to it. If both of you are female and the bathroom has more than one toilet, ask her if she would like you to go in with her and guide her. If so, put her hand on the stall door and wait for her to finish, then guide her to the sink and put her hand on the faucet, so she knows where it is. Guide her to paper towels or the hand drier. If both of you are male, I would add, ask him SIT, STAND WHICH? and guide him to the appropriate area. Continue as above.

Guide places her partner's hand on the back of the chair where he will sit

Image: Sharing Vision: Guiding a blind or vision-impaired person.

Seating: The guide should place the partner's hand on the back of the chair where the blind person will sit. This assumes that there are no obstacles to the seat, such as theatrical seating that is not on the aisle.

Activity 4: Now that we have taught you the standard ways to guide for the kinds of activities you will practice now, you can repeat the guiding activity with some improvements. Pick a pathway with your partner that will include doors, stairs, walk around, the bathroom (try to pick someone of the same gender so that you can go in with them, take them back to their seat, your partner should remove his/her blindfold, and switch roles. If you are more adventurous, you could read about escalators, crossing the street, and other things below and try those, too. A good place to practice these skills is a hotel or college building.

Entering a car: Some people prefer to enter the car with only the assistance of having their hand lead to the door handle. For others the procedure is as follows - Open the door of the car and guide them to stand between the open door and the "doorway". Put one of their hands on the top of the door and the other on the top of the door rim by the roof. They should be able to feel their way to their seat. Stand close in case they fumble with the seat.

Guide puts her hand on the door handleBlind person is guided to door handle

Image: Sharing Vision: Guiding a blind or vision-impaired person.

Elevator: Inform your partners that you are waiting for an elevator. Ask which floor if you do not know while you are waiting, to make for a smooth entry and exit. Pat their hands when the doors open and when it's time to exit.

Escalator: Notify them what's ahead. Walk onto the steps with them and guide their hand to the handrail. Continue to watch behind you for loss of balance. They will notice that the end is near with their cane and the falling away of the handrail, if they decide to separate from you. If you remain together, walk off the escalator without pausing.

B lind person standing in a cafeteria food lineMeal on a plate with 3, 6, 9, and 12 o'clock illustrated
Food line: Read the menu to your partners while in line. Give them a tray with utensils if necessary. Get a tray and utensils for yourself as well. Announce each option as you come to it. Your partners may carry their tray with one hand and put the other hand on your shoulder. In this way you can get for both of you at the same time. After seating them as described above, describe where food is on their dish by using a clock face: "Your vegetables are at 3 o'clock, your meat is at 6 o'clock, and your potatoes at 9 o'clock."

Sit down/banquet meal: You could read the entire menu to the D-B person, but it is better to tell them the broad categories: "appetizers, seafood, meat", etc. Inform the D-B person when the food has arrived (FOOD, move their hands). Later, when the server asks if everything is alright, don't answer first because they will leave before your partner has an opportunity to answer. Say, "Just a moment please while I ask." After your partner has answered, you can ask for whatever you need.

Guiding outdoors: If there is an overhand, such as tree branches or hanging decorations, if you can't easily go around it, pause, hold the overhang out of the way while you pass with your partner and continue. While crossing a street, pause, inform if necessary, step down, make sure the Deaf-Blind person "follows", and continue. Don't cross against the light, even if it seems clear. Some Deaf-Blind people love extreme terrain (rocks, sand, sticks). Help them do it safely, if you have an adventurous spirit.


It's proper to let Deaf-Blind people speak for themselves about their culture. Here are some links to videos that will show the human side of Deaf-Blind life. Watch these and then consider the questions below them.

DrDtheLiteracyQueen. (2007, August 5). Family - Deaf Blind Triplets.

The story is told in a melodramtic way (that's part of American news style), but there is a "tragic" element for parents and those who had vision/hearing before. What are the frustrations/disappointments? Some of the forms of denial for newly-aware deaf-blind people: refusing a cane, to give up driving, or to use tactile ASL. Is acceptance possible?

tactiletheworld. (2007, June 15). Becoming Blind: What I Will Miss Seeing.

What are some of the things she will miss? What responsibility does that give us as interpreters to include as information in the setting we interpret?

gwasny. (2007, July 26). Eddy Morton of Deaf-Blind Services Society of BC.

This is an example of a well-adjusted and productive Deaf-Blind person. Intervenors (intervention) = SSPs. Why is there a need for intervention services? What are the communication barriers? What are the misconceptions and discrimination faced by the deaf-blind? Why do deaf-blind people need to get out more in their community?

itn. (2008, February 12). Professional deaf-blind theatre.

"Na l'ga'at" (the name of the group) means "Please touch." What is the role of art in general? How can Deaf-Blind people use art to teach Hearing and Deaf people what their perspective is?

tactiletheworld. (2007, April 22). The A-Z's of Deaf-Blindhood.

What are some of the emotions that Coco experienced in her poem? How can interpreters/SSPs help as friends and as professionals?


Off-line communication

To read recorded messages, there is Braille. (A) It uses a pattern of two columns and three rows to represent individual letters. (B) One finger remains still to hold the place and the other scans over the bumps to read words letter by letter. (C) This makes for very bulky reading materials and Type II has abbreviations to make materials more compact. (D) Braille may be punched out by hand using a template, (E) typed out using a Perkins Brailler, or (F) inputed by keyboard and punched out by a computer onto Braille paper later. (G) CCTV (Closed Circuit Television) has a camera that converts a magnified image onto a screen. This allows a person to read any printed matter or look at pictures. (H) ZoomText is a computer program that magnifies the image that appears on a computer screen. There are various other methods of magnification with lenses.

The six positions in a Braille cell
The alphabet in Braille
One hand is held in place on a line of Braille while the other hand scans by feeling
Boy sitting in front of a Brailled book
template for punching out Braille letters
Perkins Brailler
Perkins keyboard integrated onto a regular computer keyboard
Closed Circuit Television
A demonstration of ZoomText

Real-time communication

(J) For those people who have difficulty reading a regular TTY, there are large display TTYs. This technology is on the way out for sighted Deaf people, but some Deaf-Blind people use it for phone calls as well as in the presence of someone who can't sign. (K) For those who can't see even a large display TTY, there is TeleBraille, which translated the output of the sending TTY to a grid that pushes up little nubs in Braille patterns. The people receiving can go at their own pace because the Braille stays there until they refresh it by pushing a button, then the next series of Braille patterns appears.

Mobility and orientation

Canes are an old technology to allow blind people to feel the environment in front of them. (L) Folding canes allow for compact storage when they are not need. (M) Radar devices can be attached to a cane that beep or vibrate before a person has actually touched the obstacle. (N) Guide animals (dogs and small ponies!) can be trained to guide a blind person away from danger and even crouch to warn of overhangs!


(O) The technology used for deaf people can be modified for blind people by vibrating or sending a signal to a wrist band that vibrates. These receiver-transmitters are used for alarm clocks, doorbells, fire alarms, and so on.

The alphabet in Braille
A telebraille
A folding cane extended and in a Z pattern
Boy sitting in front of a Brailled book
small horse as guide animal
remote receivers



"Tadoma is a method of communication used by Deaf-Blind people, in which the Deaf-Blind person places his thumb on the speaker's lips and his fingers along the jawline. The middle three fingers often fall along the speaker's cheeks with the little finger picking up the vibrations of the speaker's throat. It is sometimes referred to as 'tactile lipreading', as the Deaf-Blind person feels the movement of the lips, as well as vibrations of the vocal cords, puffing of the cheeks and the warm air produced by nasal sounds such as 'N' and 'M'. It is sometimes used in the United States, but it is rather rare.

In some cases, especially if the speaker knows sign language, the deaf-blind person may use the Tadoma method with one hand, feeling the speaker's face; and at the same time, the deaf-blind person may use their other hand to feel the speaker sign the same words. In this way, the two methods reinforce each other, giving the deaf-blind person a better chance of understanding what the speaker is trying to communicate."

In addition, the Tadoma method can provide the deaf-blind person with a closer connection with speech than they might otherwise have had. This can, in turn, help them to retain speech skills that they developed before going deaf, and in special cases, to learn how to speak brand new words.

The Tadoma method was invented by American teacher Sophie Alcorn and developed at the Perkins School for the Blind in Massachusetts. It is named after the first two children to whom it was taught: Winthrop "Tad" Chapman and Oma Simpson. It was hoped that the students would learn to speak by trying to reproduce what they felt on the speaker's face and throat while touching their own face. It is a difficult method to learn and use, and is rarely used nowadays. However, a small number of Deaf-Blind people successfully use Tadoma in everyday communication." - Tadoma - Wikipedia, the free encyclopedia.

Image: "Patrick Dowdy and Robert Smithdas using the Tadoma Method",
Photographer: Robert Barrett.

Lorm (Europe)

"LORM is nor just a random aggregation of several abbreviations but it is a name – a pseudonym of a Deaf-Blind poet, philosopher and battailous journalist, native from the Southern Moravian city Mikulov Heinrich Landesman (9. 8. 1821 – 3. 12. 1902), who due to persecutions used pseudonym Hieronymus LORM. Due to a sudden loss of hearing ability at the age of 15 and due to a slow worsening of his sight Hieronymus LORM became a creator of one of the systems of hand touch alphabet of the Deaf-Blind, so called Lorm's alphabet, which is still in use in the CR [Czech Republic] as well as is many other countries.

Hieronymus Lorm (1820 – 1902), native of Mikulov in Moravia – he suddenly lost his hearing ability at the age of 15 during his studies at lyceum in Vienna and at the same his sight worsened. At the beginning of his thirties he was not able to lip-read any longer. In 1882 he lost the remains of his sight. For his personal use he created a touch alphabet, by which he was able to communicate with his family as well as friends. The daughter of H. Lorm made this alphabet public six years after his death - in 1908. It had quickly spread through the whole Europe and undergone many modifications. A healthy person, who does not know the touch alphabet, may for the communication with the Deaf-Blind use a one colored fabric glove with the indication of the individual letters." - What is Lorm - o.s. LORM.

The LORM alphabet is explained

Image: The Lorm Deaf-Blind Manual Alphabet.

The Deaf-Blind person shows the palm of his right hand (or the other side of the left hand) to the speaker, who uses mostly the tips of his fingers to point into the Deaf-Blind persons hand. The hand of the Deaf-Blind person stays in the same position; His fingers are a little spread.

for B, strike downwards along his index finger from the tip till just above his palm (so don't touch the palm).
for C, touch the middle point of the lowest part of the palm of his hand.
for D, strike downwards along his middle finger from the tip till just above his palm (don't touch palm).
for E, touch the tip of his index finger.
for F, gently squeeze together the tips of his index finger and his middle finger.
for G, strike downwards along his ring finger from the tip till just above his palm (don't touch palm).
for H, strike downwards along his little finger from the tip till just above his palm (don't touch palm).
for I, touch the tip of his middle finger.
for J, gently squeeze the tip of his middle finger.
for K, touch with all your tips together in the middle of the palm of his hand.
for L, strike downwards with three tips along his index, middle and ring finger from tip till just above his palm (don't touch palm).
for M, touch with three tips the higher part of the palm of his hand in a horizontal way.
for N, touch with two tips the higher part of the palm of his hand in a horizontal way.
for O, touch the tip of his ring finger.
for P, strike upwards on the outside of his index finger.
for Q, strike upwards on the outside of his hand (on the side of the little finger).
for R, drum slightly with several of your tips in the middle of the palm of his hand.
for S, make a circle in the middle of the palm of his hand.
for T, strike downwards on the outside of the thumb.
for U, touch the tip of his little finger.
for V, touch with one tip in the palm (left side) between the basis of the thumb and the index finger.
for W, touch with two tips (in a vertical way) in the palm (left side) between the basis of the thumb and the index finger.
for X, strike horizontal (from left to right) over the wrist.
for Y, strike horizontal (from left to right) over the center of all the fingers.
for Z, strike horizontal (from left to right) over the center of the palm of his hand.

Tactile Fingerspelling in England

British fingerspelling uses two hands, but for tactile fingerspeling the receiver holds out a flat palm and the sender uses a modified system where the letters are spelled onto the receiver's palm. See a comparison of the two below. I was surprised to learn at an American Association of the Deaf-Blind conference from a Deaf-Blind Brit that although there are some Deaf people who used to sign, once they become Deaf-Blind, they all revert to tactile fingerspelling.

Regular BSL fingerspelling

Image: The Two-Handed Manual Alphabet for the Deaf.

Tactile BSL fingerspelling

Image: The Deaf-Blind Manual Alphabet Page.

Japanese Finger-Braille

"Finger-Braille was invented for the Deaf-Blind to communicate in real time in Japan, and it became one of the commonly used communication methods among Deaf- Blind people in Japan. In Finger-Braille method, the fingers of Deaf-Blind are regarded as keys of a Braille typewriter, and translator types the 6-dot Braille codes on the back of the fingers. Some examples of the translation are shown in table 1. Regardless of the language, Braille systems consist of 6 dots; the pattern for "na" under the Japanese Braille system is the same as "K" under the English one. Therefore it is easy to translate Braille into Finger-Braille under all languages. The Finger-Braille method enables Deaf-Blind people to obtain textual information as if they are listening in real time. For the user who usually employs a Braille typewriter, it is easy to learn the Finger-Braille method since it is similar to the input method of Braille typewriters." - T. Amemiya's Research Interest. The images below are also from this site.

A chart demonstrating how to produce an English letter and a Japanese letter in finger Braille
A close-up of hand-on-hand finger brailling
A long shot of hand-on-hand finger brailling

For more information on Deaf-Blindness in America and around the world, see my Resources for working with Deaf-Blind people.