One of the most important features on Deafblindness is its heterogeneity. Therefore, the group forming Deafblind people presents a great and complex diversity due to the large number of variables to determine the different individual characteristics, as well as the different particularities in each deficit presented in one person, and so the combination of both deficits.
Those features are determined by:
Type of sensory loss: stable or progressive visual and hearing deficiencies. Conductive or neurological-sensory hearing impairment. Visual impairments affecting sight acuity, sight field, or both.
Sensory loss level: complete or partial loss. Remains in both directions, with sight remains and without hearing remains, or vice versa, or any remain at all (complete Deafblindness), as well as the functionality of each remain for communication, mobility, access to information and the general development, etc.
Life time and order in which each deficit appears: Both deficiencies can be congenital or acquired, both congenital or both acquired, one congenital and another acquired, etc. It is important to highlight the hearing loss time of appearance importance because it will determine the priority and natural communication system for the Deafblind person, since it essentially determines the development of communication and language.
Maturation and communication level, Deafblindness etiology or cause, the educational level reached, the existence or not of any other deficiencies, etc., are also variables that, in combination with the mentioned above, contribute to Deafblind heterogeneity and the differentiation of each person and their different form and function to face the difficulties that Deafblindness imposes.
However, and according to the variable at the time of occurrence of each of the deficiencies, the following classification is widespread. While taking into account so many other variables, such as those mentioned above, helps make the following classification of Deafblind people:
PEOPLE WITH CONGENITAL DEAFBLINDNESS
PEOPLE WITH ACQUIRED DEAFBLINDNESS
- People with congenital Deafblindness are those that are born Deafblind or acquired Deafblindness at very early age.
- People with Deafblindness acquired can be subdivided into three groups:
- DeafBlind people with congenital hearing impairment and sight loss acquired during the course of life.
- Deafblind people with a congenital sight impairment, and hearing loss acquired throughout life.
- People born without sight or hearing deficiencies and who suffer hearing and sight loss during the course of life.
PEOPLE WITH CONGENITAL DEAFBLINDNESS
This group includes people who are born with sight and hearing seriously affected by root cause, or those who become Deafblind shortly after birth, in the period in which even the language has not been developed.
If there is no intervention, people with congenital Deafblindness do not develop communication naturally, or they communicate in a basic form using natural gestures. If there is any functional hearing remaining they can use single words or short phrases.
- Frequently, they have auto stimulating rituals or problematic behaviors, derived in many cases from the stimulus deprivation they are exposed to.
- They are usually placed in special education centers or in their houses until they come into contact with any specific program for Deafblind.
- If there is no hearing or visual remain, living in a world inconsistent, they don’t know what is happening around them.
PEOPLE WITH ACQUIRED DEAFBLINDNESS
Deafblind people with congenital hearing impairment and loss of vision acquired during the course of life
In this group we find people born with hearing impairment, or who acquired such deficiency shortly after birth, and that because of endogenous or exogenous causes acquire a sight deficiency.
- They tend to be educated in centers for the deaf until sight loss is evident.
- Sign language is usually both expressive and receptive communication system. They usually have difficulties to understand in detail written language.
- As sight gets more affected, they lose the ability to rely on lip reading in order to understand the oral message. In those cases that they have received speech therapy treatment, they tend to use oral language, depending on the level, with more or less complete phrases.
- They need to be trained in the understanding of Tactile Sign Language and adaptations required for this communication system, when the view can not be used to capture visually the signs or vision is completely lost. To do this, they must learn to place their hands on the correspondent ones in order to follow their movements and understand the message.
- They present psychological difficulty to adapting to new situations.
- They have serious problems of access to information and training.
DeafBlind people with a congenital visual impairment and hearing loss acquired throughout life
Is the group of people who are blind or with serious sight problems, by endogenous or exogenous causes, and lost totally or partially their hearing at an specific moment or throughout their life.
- They tend to be educated in schools for the blind or with specific educational support for this group, appropriate techniques and resources for this type of disability (they can get to know the braille system).
- Their usual communication system is the spoken language. If their hearing deficit already not allows to receive messages (even with the hearing technical AIDS necessary and suitably prescribed), they need training on alternative communication systems to receive messages through touch, primarily alphabetic systems, being the most appropriate manual alphabet on the hand system. But if they know the spelling of the alphabetic letters, capital letters in the hand system can also be use.
- In general they have learning difficulties in marked communication systems.
- If there is hearing remain, they try to continue using the oral form of the language as input system.
- Psychological difficulty for adaptation to their new situation.
People born without sight or hearing deficiencies and who suffer a hearing and sight loss throughout life
Brings together people whose Deafblindness ensues while the person previously revealed no sensory deficiency. Sensory losses can occur simultaneously or not, at any time of life, and may be both similar or completely different.
- They have received their education in ordinary schools, so they tend to have a good knowledge of spoken and written language.
- Their expressive communication is oral.
- They need to be trained in alternative systems, preferably alphabetical, which may be perceived through touch, although they can also learn Sign Language. Writing capital letter on the hand is generally the first system used, since everybody generally knows the spelling and shape of the the alphabet letters outline.
- If they have hearing remains, despite the understanding problems, they refuse to learn and manage new communication systems.
- Psychological difficulty to adapt to their new situation.
- Access to information is limited depending on the sight remain, until they manage to dominate the braille system, especially in those cases where their hearing rest does not allow access to sound and verbal information or they have a complete hearing loss.
In any group there is a factor that has a decisive influence and which is important to keep in mind: the remains in either of the two deficits. While the Deafblind person can handle him/herself by taking advantage of the remains that fit and keep communications systems which already knows, she/he will refuse to learn and manage any new communication systems.
From all said above, we can deduce the importance on professionals knowing all communication systems used by DeafBlind people, in order to be able to apply them to communicate with them and also to understand them. Because, regardless of the time and how they have acquired their disabilities, Deaflynd people will always require special communication methods.
On the other hand, whether or not there are any deficiencies added, the situation of motivation or environmental deprivation that surrounds Deafblind, the moment the intervention starts, along with the individual capabilities genetically determined, give us as a result Deafblind persons with different possibilities for operation and that give us a classification of Deafblind people in three groups.
Low functioning level
Deafblind children, youth and adults of those who it is estimated that their communication is limited to basics does not achieve what Fravel (1977) calls “cognitive motivation”.
The cognitive motivation describes the impulse/childish desire to interact and learn about the environment by the simple pursuit of knowledge. Even when there is no practical need to do so and there is no reinforcement controlled externally, either social or material to control such conduct.
The intervention will be made on objectives and activities aimed to develop a form of communication as structured as the characteristics of the Deafblind person permit and a job in basic skills, to help getting a personal autonomy according to their characteristics.
Middle functioning level
Deafblind children, youth and adults who are capable of caring for the world cognitively (by the people and things), capable of general strategies on resolution of problems and lead a life half-independent.
The intervention should envisage goals aimed at developing a communication system, useful skills in daily life, social skills and strategies that enable developing a protected labor activity.
High functioning level
Deafblind people without any another cognitive limit derived from Deafblindness, demonstrating problem-solving strategies and interests that make us think that they could lead a life and be tough normally with the necessary aid.
The intervention should always consider the introduction of academic and/or cultural content.
It is essential to take into account the inclusion of the appropriate aid techniques depending on the characteristics of the Deafblind person and the needs of each program level.
These two ways of grouping the population of Deafblind people (by time and order of appearance of each of the deficits and by functioning levels) are very useful for structuring the psycho-pedagogical intervention. The first one brings us the choice of the most appropriate communication system and second favors the sequencing and proposed objectives, according to the individual characteristics, the development of programs.