Yes. Children who have both vision and hearing loss usually have difficulty understanding speech as well as communicating with others. Sometimes the way the child communicates is very subtle, such as through gestures, body movements, and facial expressions. It is important to pay attention to these forms of communication and respond to them.
A child who is deafblind may communicate in a variety of ways. Some of these include: behaviors, body movements, facial expressions, gestures, sign language, objects, pictures, tactile items, communication devices, written messages, Braille, and speech.
It is important to observe what method of communication the child is currently using and support whatever efforts the child is making. The IEP team (which includes the parent) should work together to determine what type(s) of communication will be taught. The communication system selected should be based on the child's motor, sensory, and cognitive ability, as well as ease of use, portability, and preference. Children often us a combination of methods and this should be encouraged. For example, children often use both gestures (or signing) and objects (or pictures). Whichever type(s) of communication is selected, it is important that the child be taught to use the system and have the system available to him at all times.
There are many ways to promote communication. Some of these include having materials/activities present that are interesting to the child, having a desirable item in view but out of reach, providing inadequate portions of a desired item, and giving choices. For example, if the child likes to be rocked on a rocking horse, the adult can rock the child and then stop. The child may then communicate he wants to continue being rocked, or the adult may teach the child to sign "more" to indicate he wants more rocking. After the child communicates (or is helped to do so after waiting a sufficient time), the adult continues rocking. Another example is giving the child half of her favorite cookie. The child is then encouraged to communicate, "Want cookie." There are many strategies that the school and family should work on together to help the child effectively communicate.
Children with severe vision and hearing loss may not know when someone approaches them. It is important to first greet the child by rubbing the back of the child's hand (or some other movement) to indicate that someone is there. This helps prevent the child from being startled. Next, individuals should identify themselves to the child by having the child touch something the person consistently wears (e.g., ring, unusual watch) or by making a name sign (a gesture that represents who that person is). This will let the child know who is there.
The child who is deafblind should be informed about what is going to happen next. For children who do not understand speech, there are many ways this can be achieved. For example, you may touch the child in certain locations (e.g., touch the child's lips to let him know it is time to eat), make a certain movement with the child (e.g., making a scooping motion to let him know it is time to eat), hand the child an object (e.g., hand the child a spoon to let him know it is time to eat), sign to the child (e.g., sign "eat"), or point to a picture (e.g., point to a picture of food or a child eating). Whichever type of communication is selected, it is important that it is consistent so the child will learn it and not be confused. Some teachers construct "object calendars" which have objects representing each activity of the day, thereby allowing the child to know what will be occurring.
Contact the Georgia Deafblind Project for more information. They can suggest materials, techniques, and specific suggestions for each child's individual needs.