Ways of communicating with a person with deafblindness 

There are thousands of ways to communicate and connect – be it through speech, sign language, touch, movement, gesture, sound, pictures, objects or electronic aids. 

It is advised that people use whatever mix works best to help  people with deafblindness, multi-sensory impairments (MSI) and/ or complex disabilities to communicate and experience the world. 

This is called ‘total communication’ approach. 

Remember, it’s never too late to start learning a new way of communicating. Have a go and don’t worry about getting it wrong. 

Common ways of communicating include: 

• Sign language or Tactile Sign language 

• Makaton, a simpler version of sign language. 

• Braille uses raised dots to touch. 

• Deafblind Manual spelling words on to your hand. 

• Lipreading (Verbal communication) 

Types of communication 

These are the main ways of communicating that we use: 

Using touch 

• Braille uses raised dots to touch. 

Braille is a way of writing that can be read by touch. In braille, letters and numbers are made up of a rectangle with six dots in two columns. Each letter and number uses a different pattern of raised dots.  

• Block alphabet spells letters on to your hand. 

Block alphabet is a simple way to communicate using touch, not sight or speech. Words are spelt in block capital letters on to the palm of your hand. 

• Moon uses raised lines, curves and dots to touch. 

Where braille uses dots, Moon uses raised lines and curves, with added dots. These can represent sounds, parts of words, whole words or numbers. 

• Tadoma uses lipreading by touch. 

Tadoma is a way to understand what someone is saying by touch. This is why it is also known as “tactile lipreading”. 

You place your thumb on the speaker’s lips, your three middle fingers along the jawline and your little finger on the throat. 

You understand what the speaker is saying through motions of the jaw, facial movements and vibrations in the vocal cords in the throat. 

You can also tell when the speaker is saying letters such as N and M because the speaker puffs their cheeks and produces warm air. 

• Hand-under-hand signing using touch sometimes known as Tactile Sign Language. 

Using signs 

• Sign language 

Sign language is a way of communicating using hand gestures and movements, body language and facial expressions, instead of spoken words. Sign language is used mainly by people who have deafblindness, multi-sensory impairments and/ or  complex disabilities There are many versions of sign language used around the world depending on the local language/s spoken in the country.  

• Makaton, a simpler version of sign language. 

Makaton, or “key word signing”, is a simple and easy way of communicating using signs, symbols and speech. It’s not a formal sign language. Makaton will differ depending in the local sign language used in 

• Visual frame signing for people with reduced vision. 

With visual frame signing, the person communicating with you uses sign language, making the signs in a smaller area that stays in your smaller field of vision. E.g. if they have tunnel vision you can only use the space directly in front of their eye so need to keep the sign language small ‘within this visual frame’ 

• Objects of reference 

An object of reference is a whole physical object, or part of an object, that you hold or touch to represent or identify a person or place or activity etc. For example   

A person: a hat or a bracelet = a familiar friend 

A place: a pencil = school 

An activity: a spoon = mealtime. 

In the same way as informing someone of something, it can be used by the person with the disability to communicate a desire e.g. a cup can mean “I am thirsty, I would like a drink”.  

Using speech 

• Clear speech 

Clear speech is a way of speaking that means every word, sentence and idea is spoken clearly and simply. 

• Lipreading 

Lipreading is being able to recognise a person’s lip shapes, how they use their teeth and tongue, as well as understanding their gestures and facial expressions when speaking. 

• Non-formal communication without speaking, writing or signing. 

Non-formal communication is a way to express your feelings, wants and choices without speaking, writing or signing. This can include:  

• Body language.  

• Changes in breathing patterns.  

• Eye pointing.  

• Facial expression.  

• Gestures.  

• Making sounds (or vocalisations).  

• Pointing. 

• Intensive interaction treats everything as communication. 

Intensive Interaction is an approach to helping children and adults who are in the early stages of developing communication and social skills. 

The approach is based on the way we observe and respond to the actions and noises of babies, and interpret these as communication. It helps a person and their communication partner to connect and enjoy each other’s company more. 

It’s about watching closely how a child or adult responds to different situations through their body language, voice and facial expressions – and responding to this. 

This information has been provided by Sense, a leading disability charity based in the UK supporting people with complex disabilities, including deafblindness. 

This has been edited for an international audience (2024).