Concepts and ideas that children develop about their world occur through seeing and hearing events over and over again, and through moving in and interacting with the world around them. Due to their sensory loss, children with deafblindness are unable to learn about concepts through seeing and/or hearing events repeated. These children also lack curiosity and motivation to seek out new situations in the world around them due to their sensory loss. Other additional disabilities, such as cerebral palsy, may further limit the child with deafblindness from being able to actively move about and interact with the environment.
The child with deafblindness may have difficulty learning about such concepts as the properties of objects (e.g., big versus little, round versus square), spatial relationships (e.g., in versus out, near versus far), time constraints (e.g., night versus day, sequence of days/events), cause and effects (e.g., that pushing a ball causes it to roll away), object permanence (e.g., that the ball which has rolled away is still there even though it is out of reach). In addition, daily living skills such as self-feeding, dressing, and hygiene may be difficult to master since the child with deafblindness may be unable to learn these skills by imitating others.
Concept development requires that any child: 1) have an awareness of what is happening; 2) learn to perform or achieve acquisition of the skill using adult assistance such as physical supports, prompts, etc., which are gradually faded; 3) achieve application of various parts of the skill to various situations; and 4) achieve generalization of the skills to other circumstances and events.
Techniques to enhance concept development need to center around familiar routines and activities that are meaningful to the child. When vision and hearing are impaired, skills relates to concept development may need to be taught through touch. Placing the child's hands either over or under the adult's hands during an activity can help give the child the coactive movement input necessary to assist exploration of objects leading to skill and concept development. Allowing the child with deafblindness to have more time to explore may be necessary for learning to occur. Concept development can also be encouraged by assisting a child with deafblindness to move through the environment and explore through touch, and to learn where things are located in relation to each other and where things come from or belong (e.g., toys are on the shelves in the child's bedroom, milk comes from the refrigerator). The challenge of helping children with deafblindness develop concepts is to afford them opportunities to interact with the environment, ensuring they understand the result of their interactions.