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Travelers with dual sensory losses present the rehabilitation professional with additional tasks and responsibilities that expand the instructional curriculum. Effective instruction in rehabilitation and orientation and mobility includes teaching strategies and tools for dealing with unfamiliar people through communication (conveying information) and interaction (knowing when and how to use specific communication techniques). Incorporated in those two skills are acknowledging the public's typical lack of awareness of the nature of deaf-blindness, understanding that the traveler knows his or her own needs better than others do, and being able to assert one's needs effectively. Teaching effective techniques for communication and interaction, skills that are critical elements for the quality of everyday life, is a necessary component of comprehensive rehabilitation. Unless instructors address these additional needs of students who are deaf-blind,1 comprehensive rehabilitation is not possible.
Although travelers who are deaf-blind present challenges because dual sensory loss may affect many interpersonal transactions, professionals can and should design instruction that addresses real-world circumstances and assist travelers in overcoming barriers found in everyday activities. The past several decades have seen the development of various approaches to addressing many of these challenges (DeFiore & Silver, 1988; Florence & LaGrow, 1989; Franklin & Bourquin, 2000; Gervasoni, 1996: Lolli & Sauerburger, 1997; Sauerburger, 1993; Sauerburger & Jones, 1997). In this article, we assume knowledge of these strategies and methods and will not present a detailed review of those approaches. Rather, we consider the communication and interaction of people who are deaf-blind with the public and the teaching techniques that we have found effective. The techniques we present are the results of our collective experiences with people who are deaf-blind, including several decades of instructing these travelers in community-based and residential settings.
Effective Communication Strategies
Basic Considerations
Choosing which communication strategy to use depends on the person's hearing, vision, and language skills; cognitive abilities; comfort; and assessment of the risk. The more methods that the person can use skillfully, the easier communication with the public will be. People who are deaf-blind can communicate with the public through gestures, in writing (prepared or ad hoc), orally (spoken or prerecorded), or by presenting symbols and pictures. The public can respond to the person who is deaf-blind by tapping the person on the arm or shoulder, some...