Deafblind communication is varied and evolves from the needs and competencies of the person who is deafblind. Factors affecting which method someone will use to communicate are also wide ranging, but are often based on what a persons first language is if they have acquired their sensory loss, and also what languages are used and adopted within their family, friends and social circles.

There are many different methods of communication used in the deafblind community. Below is a list of different communication methods and a short description / summary.

Human communication is incredibly complex and does not just focus on the linguistic elements of the interaction. Think about a situation where you meet a new neighbor for the first time, how they behave, their facial expressions, the clothes they are wearing and their body language may all give you far more of an impression about who they are rather than what they say. For a person who is deafblind, even though they may have means of understanding what is being communicated (perhaps through deafblind manual) often the complexities of other aspects of communication are missed.

When looking at communication with a person who is deafblind it is important to consider how a person receives and expresses communication. For example a person who has acquired their deafblindness in later life may need to receive communication through deafblind manual as they cannot hear speech or lipread due to their combined visual and hearing loss, but express themselves using speech – as this is their first language and even though they may not be able to hear their own voice, it’s more natural and efficient to express themselves in this way.

When we think about communication it is useful to consider how complex the processes are – using speech and hearing, the human brain can pick out a single voice from a crowd and focus I on the message given – ignoring the other sounds being created. When hearing and vision are impaired this process becomes much more challenging and when tactile language is used it is impossible. Tactile language tends to be one to one communication although the Nordic countries are developing third party interactions as a means of including people who are deafblind in social chat.

Below are some of the communication methods that may be used with people who are deafblind


It is very common for a person who is deafblind to still use speech expressively and receptively. With the advancement of hearing aids and portable listening devices, many people who would have relied solely on lip reading – can now access speech. It is very common for deafblind people to use a combination of speech and lipreading together. When there is more than one person speaking or there is background sound such as the radio, a person who is deaflind may struggle to differentiate sound so communication becomes unclear.

Lip reading

Lip reading is also a very common method for people who are deafblind to communicate. It is important to acknowledge that although lipreading can be very effective – only (%) of communication through lipreading is picked up and the brain makes adjustments for the missing information. Lip reading is therefore more exhausting than using speech. Please see our section on ‘good practice’ for more information on lip reading.

British Sign Language

British Sign Language (BSL) is the recognised sign language used in the United Kingdom, and is the first or preferred language of the Deaf community. It is approximated that almost 150,000 people in the UK use BSL. People who were born deaf and had BSL as a first language who later in life acquire their visual loss are likely to use BSL expressively and adapt their receptive communication in other ways listed below.

Signed English

Signed English borrows signs from BSL, but uses the grammar and sentence structure of the English Language. Signed English was developed by teachers of the deaf and other professionals to assist in the English literacy development of deaf (sign language using) children.

Makaton or Key Word Signing

Makaton is a language programme using signs and symbols to help people to communicate. It is designed to support spoken language and the signs and symbols are used with speech, in spoken word order. It is often used with children and adults with learning disabilities as a simplified and accessible signed communication.

Tactile Signing

Tactile signing takes many different forms and is very dependent on the comfort of the person who is deafblind as well as their communication partner.


Some people who are deafblind have some usable vision which enables them to follow signs by holding the signer’s forearm or wrist and using their eyes to follow the signs visually. Having the connection of using vision and touch together means the signs stay within the visual frame and are effectively ‘tracked’.

Co-active signing / Hands on Signing

The use of hands on signing or co-active signing is growing and as practice increases – so does the ways in which tactile sign language is received and expressed. Based on BSL this form of sign language has the hands of the person who is deafblind gently resting on top of the communication partner. When the partner signs the person who is deafblind will use their tactile senses to create a picture which links to their visual memory of the sign being expressed. The more this language is used the less reliant on visual memory the user becomes and the more the tactile memory of the sign is stored.

Visual frame signing

The use of visual frame signing is where the person who is deafblind has a reduced visual field (often as a result of Retinitis Pigmentosa). The communication partner must sign in a smaller area so the person who is deafblind does not loose any part of the hands if they move out of their field of vision.

Deafblind Manual Alphabet

The deafblind manual alphabet is a method of spelling out words onto a person with deafblindness’ hand – with each letter denoted by a particular sign or place on the hand.

  • You can fingerspell on the individual’s left or right hand – check with the individual which hand they prefer to use
  • Avoid gripping the individual’s wrist, rather support their wrist with your open hand underneath
  • Check whether a sitting or standing position suits both of you and the situation
  • Comfort and support of both of you is very important

Deafblind manual – sometimes shortened to just manual – is a tactile form of communication, taking it’s roots from the English language and using some of the form of BSL fingerspelling. It has been used since the 19th Century and is also used in Australia and New Zealand. It’s simple and quick to learn to express but takes more time and concentration to learn to receive, as with any language which uses touch, concentration is required and therefore frequent communication breaks should be offered.


Probably the easiest deafblind tactile language to express – the block alphabet is based on English capitol letters, drawn onto the palm of the deafblind person.


Tadoma is rarely used in current times as it requires the person who is deafblind to place parts of their hands on their communication partners, throat and or lips and cheeks. It works on the combination of vibration and lip patterns.

Social Haptics

Touch is said to be the earliest developing and longest lasting of our senses.  When a person who is deafblind receives information tactually it is mostly focused on the content of the message i.e. the meaning of each sign or coding of letters to form words. It is common for the other complexities of communication to get left out. Social Haptic Communication is designed to compliment other tactile communication forms and to offer the person who is deafblind a richer and more immersive communicative experience, describing things like emotional reactions, art, music and feelings.

This system originated in Finland and was created by Dr Ritta Lahtinen and Russ Palmer.

Social Haptics can be used by a many different deafblind people including those with fully formed signed or spoken language as well as those with congenital deafblindness who may not have developed formal language yet. It can be anything from a gentle squeeze of the hand to indicate, excitement to a complex drawing of a meeting room including it’s occupants and environment.


Is a tactile writing system originally developed with embossed paper, but now assessable through refreshable braille displays. English Braille has three levels of encoding: Grade 1 – a letter-by-letter transcription used for basic literacy; Grade 2 – an addition of abbreviations and contractions; and Grade 3 – various non-standardized personal stenography.


Invented 16 years after Braille – Moon was the English version of raised lettering for visually impaired readers. It’s patterns followed a more visually recognisable English letter formation. Very few people still use moon for their written communication.

Body language / Facial expressions

Communication is not just words, signs or written concepts – humans are communicating from a very early developmental stage – much earlier than we had only recently recognised. With our increased understanding of the human mind we can recognise very early stage interactions have communicative intent. Human babies are hard-wired to communicate and make bonds. Our smiles, body language and they way we copy others are all evolutionary designs to enable us to bond with others around us. For people who are deafblind it can be challenging to miss out on this information and it’s important for communication partners to consider giving additional information to enrich the exchange.


People who are deafblind with residual vision may use pictures and photos to identify activities, objects or sometimes more abstract concepts. It’s really important when looking at any pictorial communication method to consider what the person can actually see in terms of size and colour contrasting – but also that it’s really hard to have a conversation with pictures. Other methods of communication should also be considered to give a fuller communicative experience.

Objects of reference

Less of a communication system – more of a means to refer to an activity or event. Objects of reference can be really helpful in developing understanding of language development and choice making. E.g. a parent of a deafblind child may use a sponge to tell their child it’s about to be bath time. Later that child may develop the understanding that sponge means bath but flannel means shower – the parent can then offer a choice – flannel (shower) or sponge (bath). Again – similar to pictures, it’s important that this means of communicating is not the only method used with the person who is deafblind as it’s fairly limited. Other tactile communication should be considered and developed so communication is more than just factual exchange.

Written (large print writing or typed information)

When considering written communication – the general industry standard for clear text is the font Arial 14 – This may not be accessible to many people who are deafblind so it’s essential to keep a record of what format someone prefers to receive their written communication. Font sizes can be increased and sometimes printing on a pale yellow background gives and even better colour contrast than printing on plain paper.

Use of communication devices

Increasingly technology is having a huge impact on communication. E.g. Portable listening devices can be linked via Bluetooth to hearing aids to localize and clarify sound. Also assistive communication devices can be used by children and young adults with MSI.