THE FIVE SENSES AND COMMUNICATION
All Five Major Senses Working?
The chart below is not based
on any reliable data. Estimates are quoted in the literature that the percentage
of information that we take in via our eyes is anywhere from 60 to 90%. Of course,
if you are listening to an audio tape, vision doesnt matter at all. If you
are watching a film strip, hearing is of no consequence. In addition, some people
are visual learners and some people are auditory learners. It is well-known that
two people with identical audiograms may have strikingly different abilities to
understand speech and other sounds. Perhaps the one who understands speech better
is actually an auditory learner. But even that person misses information. If he/she
uses speech-reading extensively, then a vision impairment on top of a hearing
impairment will cut down on understanding as well.
Figure 1: Full access to information from all senses.
what happens if a child is visually impaired AND hearing impaired. If a child
has moderate visual impairment, the Vision bar might be half as high. If the child
is moderately hard of hearing, the Hearing bar would be shortened by half. Relatively
speaking, then, the other senses become more important.
2 and 3: Compare the differences when half of either vision or hearing is gone.
Now consider how less information is available when half of BOTH the
vision and the hearing are missing. Notice how much more important the senses
of touch and smell become.
Figure 4: Combined vision/hearing loss with half
of each gone.
What is DeafBlind?
Any combination of hearing and vision loss that interferes with access to communication
and the environment and requires interventions beyond those necessary for hearing
or vision loss alone. For educational purposes in most states, the child needs
to meet the criteria for deaf/hard-of-hearing as well as for blind/visually impaired. Contact the DeafBlind Project for more information.
rarely means totally deaf and totally blind. No other succinct term has been found
that fits all of the conditions listed in the table below. Dual sensory loss,
Hard of Hearing/Visually Impaired, etc. are cumbersome. Most parents and educators
have finally settled on DeafBlind even though that term is a somewhat inaccurate
and, often, a scary term.
The importance of having a DeafBlind
label, however, cannot be underestimated. The educational needs are truly different
when both senses are affected. It is not enough to have the consultants come in
and give their input without considering the effect of the other sensory loss.
The reason is that the techniques used to compensate for vision loss often involve
hearing and those used for hearing loss frequently involve vision. Note in the
table below that the term DeafBlind is used even if the child is found to be just
visually impaired and hearing impaired. The combination makes a HUGE difference
in the way information should be presented.
What Combination of Vision and Hearing is
When one or more senses are impaired, additional
education consultants are needed, even (or perhaps especially) during the Early
Childhood phase of development. Research out of Denver shows that, if a communication
system is established BEFORE six months of age, a deaf child can develop completely
normal language. Even if they learn to read sign language, they do not fall behind
their hearing peers in expressive language and reading. The implications are staggering.
Even though medical issues in CHARGE syndrome occupy the thoughts and minds of
parents and caretakers during the first 2 years of life, it would appear to be
very important to start some form of communication as early as possible.
table below introduces the kinds of special educational consultants needed to
address the vision and hearing issues. However, physical therapists, occupational
therapists and a variety of other consultants may also be needed (just like in
the hospital and clinic). Note that the kinds of modifications given depend on
the nature of sensory input.
|Hearing + Sighted||None|| || |
|Hearing + Visually impaired||B/VI teacher|
print, contrast, placement of student|| |
|Hearing + Blind||B/VI teacher|
O&M, audio tapes & instruction|| |
|Hard of Hearing + Sighted||D/HH teacher +/-SPL||Hearing
aids, +/- FM or other amplification, noise reduction, classroom placement|| |
|Deaf + Sighted||D/HH teacher
+/- Interpreter ||Hearing aids, +/- FM or other amplification, noise reduction,
classroom placement|| |
of Hearing + Visually Impaired||B/VI, O&M, D/HH, SPL, DBP consultant||Amplification,
large print, be within the "Communication Bubble"|| |
|Hard of Hearing + Blind||B/VI,
O&M, D/HH, SPL, DBP consultant||Amplification, Braille, O&M, +/-
+ Visually Impaired||B/VI, O&M, D/HH, DBP consultant ||Modified
sign language, O&M, large print, be within the "Communication Bubble"||Deaf-Blind|
|Deaf + Blind||B/VI, O&M,
D/HH, DBP consultant ||Modified sign language (possibly tactile), Braille,
= Blind/Visually Impaired
D/HH = Deaf/Hard of Hearing
SPL = Speech/Language
O&M = Orientation & Mobility (learning how to know where you are and move safely
with low or no vision)
DBP = DeafBlind Project
The Need to Establish A Communication BubbleEstablishing
what Susan Smith, the parent of two children with CHARGE Syndrome, calls the "Communication
Bubble" is essential if you want to make sure the child knows you are there
and are trying to communicate. The concept of a "bubble" is a good one
because you can imagine the space within which you need to be. As Eric Kloos says,
you need to be "on the childs radar." If you are outside the bubble,
you might as well not exist. Too many times, we think the child is tuned out,
not paying attention, or is too "retarded" to answer when, in fact,
he/she may not even know that you are trying to say something.
establish the bubble is found in a separate section.
Each parent should know how far a child can see, what kinds and colors of objects,
with or without movement, in different lighting conditions and against different
shaded backgrounds. The eye doctor will usually not be able to tell you this except
by guessing, though some do this kind of testing. A vision teacher, however, can
do a Functional Vision Evaluation to help establish these visual abilities. Figuring
out what the child hears clearly, at what distance and on which side is also important.
Neither of these is easy to determine so parents and team members will likely
have to engage in a continuing evaluation process.
Types Of Communication Systems Are Available?
language||Touch cues|| |
|Object cues|| |
Language supported manually||Cued Speech|
Auslan, etc. (the native sign language of a given country)|
Communication||Combination of oral and sign languages|
|Total Communication - combination
How Do You Choose the Right Method?
is no one right answer to this question. Too often, however, the confusion results
from passionate arguments for one method of communication, like spoken English
or American Sign Language, without fully understanding the effects of dual sensory
loss. The most important thing is to get language into that developing brain in
a form that can be consistent and effective. What that form takes will likely
be determined by a team meeting of the parents and professionals. We learn any
language by receiving it and then repeating it. We learn it fastest and best by
total immersion. Learning it for an hour in the classroom twice a week or in bits
and snatches with a word or sign here or there is simply not enough to become
fluent. This means that whatever method is chosen needs to be woven into everything
the child does, from getting up in the morning to going to bed at night. Keep
in mind that perfectly good language by whatever method is useless to the child
unless it is delivered within the communication bubble.
The other very important point is that a lot of communication precedes formal
language. Every mother can "read" her child’s communication regardless of whether
that child uses any formal language. Sometimes it is guessing, but the child will
let the mother know when she’s got it right. Therefore, it is important to lead
up to formal communication step by step. We use sight cues and verbal cues like
outstretched arms with some encouraging words to let a hearing/sighted child know
what we want to do next. For a child without good vision or hearing, concrete
cues and touch
cues are used instead. DeafBlind project staff can help the regular and special
education staff learn how to use these methods. As parents and educators we may
get hung up on wanting our children to speak our own language using the method
we use. That is as natural as immigrants wanting their children to continue speaking
their language and remembering their culture. However, the issue is not the form
but the substance. The child needs to learn that an object, touch, picture, word
or sign is a symbol that stands for a thought. Many of them strung together convey
complex ideas or stories. They include naming of objects, actions, remembering
the past, anticipating the future and, later, getting into abstract thoughts and
So, above all, just get to it! COMMUNICATE,
Sandra L.H. Davenport, M.D.
5801 Southwood Drive
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