Title: Language and Communication in People Who Are Deafblind
Abstract: The development of language and communication in people who are deafblind requires child rearing, interaction, and teaching methods that match each individual's cognitive development, level of functioning, and interest; that can be perceived on a sensory level; that provoke responses that match the individual's linguistic and motoric level; and that also t with the language and communication skills and resources of people around them.This chapter describes all these di erent aspects of language and communication in children who are congenitally deafblind (and who seldom acquire symbolic communication) as well as people with acquired deafblindness.It also gives an overview of the way access to communication and language can be accommodated, including assessment, augmented and alternative communication, and sta training.The world association promoting services for people with deafblindness, DeafBlind International, uses the term "deafblindness" to refer to people with varied combinations of visual and hearing disabilities (DeafBlind International, 2014).This chapter deals with the language and communication challenges people who are deafblind meet.First, some de nitional issues and some examples of causes of deafblindness are described to set the stage for descriptions of how deafblindness a ects language, communication, and other developmental domains; how to assess language and communication; and, nally, how to promote language and communication in people who are deafblind.Downloaded from https://academic.oup.com/edited-volume/38692/chapter/336049510 by Rijksuniversiteit Groningen user on 13 June 2023The term "deafblind" covers not only people who are completely deaf and blind but also those with various gradations of visual and hearing disabilities, that is, deafness combined with partial sightedness, blindness combined with partial hearing loss, and partial sightedness combined with partial hearing loss.The amount of functional vision and hearing that a person with deafblindness has, his or her so-called residuals, in uences the development of language and communication at least in part by determining what modality of language input can be perceived.Fellinger, Holzinger, Dirmhirn, van Dijk, and Goldberg (2009) distinguished four subgroups on the basis of these residuals: (1) people with some functional hearing, but no functional vision; (2) people with some functional vision, but no functional hearing; (3) people with both some functional vision and hearing, and (4) people with no functional vision or hearing.In people with dual sensory loss, but with some functional hearing and/or vision, their residual sensory modalities can be used for linguistic and communication practices.This is an advantage in comparison with people who have no vision and hearing left.For instance, the rst and third group described earlier may be able to communicate through spoken language.Whereas the rst group will miss all visually based communication information, the third group will miss only some of this information.The second group, those with functional vision only, may be able to communicate by means of sign language, while the fourth group, people totally blind and completely deaf, may be limited to tactual sign language.The level of communication skills attained, however, will be heavily a ected by the level of intellectual abilities of the person, the amount of special training received, and whether before the onset of the deafblindness the person learned to communicate by verbal or signed language. p. 326With regard to the de nition of deafblindness, Ask Larsen and Damen (2014) state that there is heterogeneity in de nitions and inclusion criteria of deafblindness.In their study of the literature, two types of de nitions were found: "medical/functional" de nitions and "ability/functioning" de nitions.De nitions that were medical/functional were based on sensory impairment measures.Deafblindness was then de ned according to the criteria for visual impairment and hearing impairment such as formulated by the World Health Organization (2001).In contrast, the ability/functioning de nitions consider the total outcome of deafblindness on ability and functioning in relation to communication, access to information, and mobility (Ask Larsen & Damen, 2014).In line with the ability/functioning de nition of deafblindness, the term "deafblindness" is used to emphasize that living with a dual sensory loss is a unique and complex form of existence.It acknowledges that having disabilities in the functions of both sight and hearing involves more than just the sum of the two disabilities (Damen & Worm, 2013;Knoors & Vervloed, 2011).People with these combined functional disabilities always have major challenges in learning, getting information, communication, and orientation and mobility (DeafBlind International, 2014).The severity of the challenges people with deafblindness face is not only determined by the degree of hearing and vision loss but also by the age at which the combination of visual and hearing disabilities manifests itself for the rst time.Based on age of onset, three types of deafblindness are generally distinguished: (1) congenital deafblindness: the combination of visual and hearing disabilities is developed before birth, is present from birth, or is acquired before language development starts, which is usually within the rst year (Dammeyer, 2010); (2) acquired deafblindness: the combination of visual and hearing disabilities occurs after the start of language development (Dammeyer, 2010); and (3) elderly deafblindness: a form of acquired deafblindness where the age of onset is after age 55 (Vaal et al., 2007).The last type of deafblindness is most common.