The term deaf blind is often misunderstood as ‘deaf and blind’.  But the term deaf blind means a person who cannot ‘see’ as well as hear. Deaf blindness is  a unique disability – a combination of both vision and hearing loss. Yet throughout the world there are hundreds of thousands of deaf blind people – children, young adults and old people.

How is it caused?
There  are many causes of deaf blindness but the two main causes are Rubella and usher syndrome. Other causes include traumatic accidents, age related illnesses and CHARGE syndrome, which lead to deaf blindness in children or adults.
· Usher's syndrome
· Rubella
· CHARGE
The challenges facing a child who is deaf blind.
- The most significant difficulty facing children who are deaf blind is their inability to receive undistorted information from the world around them.
- They have great difficulty in anticipating events and recognizing people, places, objects and activities and may remain at a pre-intentional level of communication unless they receive appropriate specialist education
- Receiving clear intelligible information, relating to other people and learning to communicate and get around safely.
These are all enormous challenges.
Children who are deaf blind have great difficulty in communicating with others, developing concepts, and building social relationships and self esteem. They are reliant upon others to connect them with people and the environment. They must be carefully and thoughtfully taught the things that other children learn informally by overhearing, observing and naturally interacting with others.
 

Ideas and Activities for Parents   of Children with Hearing and Vision Difficulties

Touch is the most important source of information for children who have difficulty seeing and hearing and they learn about you and the world around them through touch.  They will be sensitive to how they are touched.  A touch for a person who does not see or hear can convey emotion, intention, goodwill or lack of it, haste or ease, approval or disapproval.  Here are some ideas of things to do with your child to help her understand her world.

 

	Introduction.  Touch your child on the arm or shoulder to let her know that you are going to interact with her then give your own 'signature' so that she knows who is doing the talking. These 'touch signatures' let your child know that a particular person is interacting with them.  The clue used should always be a distinctive feature for that particular person so that the clue is always consistent.   For example:   Appa - moustache/beard/watch  Amma - ring/nose pin/earring /bindi/hair decoration (if it is always worn)  Akka - pigtail/ribbon/necklace  Tambi - hair/cheek  Pati - bindi/nose pin etc (but different from mother's signature)
Give touch clues to your child to warn her that you are going to touch or move her.   Gently lift her arms and then pause before lifting her up.   Gently tap her bottom before cleaning her.   Stroke her face before wiping it with a cloth.   Giving these gentle touch clues will let her know what is going to happen next.
	Hand over hand   Hold your hands very gently under the palms of your child's hands and move along with your child's movements.Take great care when you are handling the hands of your child.  Always use gentleness and sensitivity, and never handle them roughly or force her to touch.In this way the child will experience what the movement feels like and eventually she will learn to carry out the activity without your help.   Father :Now put the soap on the cloth.
	Routine  Keep to a set routine so that your child can begin to anticipate what will happen next. Knowing what is going to happen next will make your child feel more secure than when things happen randomly. For example:   Early morning routines - getting up > washed > dressed happens each morning in the same sequence and each activity is carried out in its own place each day   Meal times - same seating position each time > touch clue by helping your child to touch the feeding bowl or spoon.  (Always let your child know when you are going to put food into her mouth by giving a touch clue such as touching her cheek or chin.)   Bed time - bath > into night-time clothes > special time > bed.   Try to end each day with some 'special time' where you and your child have some quiet time together, singing a song and moving in time to it, telling a story, playing with a toy.
	Using objects as signals   choose an object to act as a signal for each of the daily events that a child experiences,e.g. a spoon to signal a drink, soap to signal bathing. before you start the particular activity with  your child you must let her feel the objects well . This will help her to understand what is about to happen to her. Eventually she will learn to anticipate the activity by the signal she is given.
	Order  With a child  who has difficulty with both vision and hearing,  you should always keep household equipment and furniture in the same place. This order should be kept from day to day.This will enable the child to learn  where things are and to be able to find for himself things that she wants.In the long term, this will mean that the child can be more independent.
	Sensory input  Because of the impairment with vision and hearing, a child who is deaf and blind really need to be encouraged to use her senses of touch, smell and taste in order to learn about her world. we must give her lots of opportunities in this way.   Father :  Feel  appa's beard!!  Mother : Oh the flower smells sooo nice!
Hang or hold interesting objects that make a noise or spin when they are touched. Place them within your child's reach so that when she moves her arms or legs around she hits the objects.  This will encourage her to make more deliberate movements in order to make the noise happen again or make an object move or spin.
	Sing songs to your child while she is sitting on your lap or in your arms and move her in time to the music.
Your child needs to know that you are touching an object along with her and sharing the experience.We can touch with our hand very slightly under her  hand so as not to stop her from feeling the object. If she reaches out to touch our face, for example, we can touch along with her  without controlling, as if to say, "Oh, you see my face."
	Physical contact   Make physical contact with your child as often as you can - this way she can learn about your moods, movement, breathing and body tension and relaxation.   This helps to strengthen the bond between you and your child during every day activities.  This bonding is important for developing communication skills.
Respond to your child's own movements.  This will let her know that you are aware of her moods and her tension and relaxation.  The more you respond to her, the more she will use her body to send you messages about how she feels.