Search the blog to see if your question has been answered here

Send any unanswered questions to deafblindness at gmail dot com

12/19/10

Deafblindness Quotes

Deafblindness Quotes - reprinted with permission from the author.

Life goes on after deafblindness. But it takes heart
and courage to embrace the deafblind lifestyle with
open arms and to follow one's own destiny.

Phantom vision and phantom sound is a reality
for most deafblind people. The brain is constantly
doing its utmost to fill in every void, thus creating an
alternate reality every time we close our eyes.

As we lose more of our vision and hearing, our sense
of touch, taste and smell becomes so much more
acute, exotic and, shall I say, erotic?

Deaf people fear blindness and blind people fear deafness
as if it were the dreaded plague. Yet it is not a terminal
disease. Life must continue into uncharted territory where
new discoveries await those who dare to dream.

Is it possible for a hearing-sighted or deaf-sighted person
to fall in love with a deafblind person 'til death do they part?
Of course it is! Love knows no boundaries and does not
discriminate against anyone, ever!

Many of us do not look deafblind though we may walk
amongst hearing and sighted people like aliens in disguise.
I find it amazing that people fail to recognize what they see
when we walk with our white reflective canes and dog guides.

How is it that Congress can be in the dark ages when it
comes to meeting the basic needs of deafblind people
everywhere? Where are our helpers, the Annie and Andy
Sullivans of the world, the Support Service Providers (SSPs),
and the support of our representatives and senators who can
give us assistance in training, mobility, communication,
technology and recreational access?

Does it surprise you to find that deafblind people can and
do get married, have children, go to work, cook and clean,
make love, read and write, surf the web, travel, shop, earn
their bachelor or masters degrees, teach, eat out and pursue
their favorite hobbies? Or that they can laugh or cry, become
angry or defiant, pleasant or calm, or mourn the loss of loved
ones? We all share the same human experience.

Being deafblind is an occupational hazard. Bright sunshine
and elusive shadows thwart our attempts to be safe. We
trip over curbs, potholes and steps. In the winter, we slip
and fall on snow and ice. At home, we walk into open
cupboard doors, open drawers, open dishwasher doors and
partly opened doors that are even more dangerous to us.
First, our bruises and injuries begin at the lowest level of
our bodies and as we lose more vision, they will continue to
work their way up from battered toes to ankles, knees, groins,
hips, fingers, hands, elbows, arms, chests, breasts, shoulders
necks and backsides. The last and worst bruising insults are to
our faces, eyes, ears, noses, chins, mouths, teeth, foreheads,
sideheads and rearheads as bruises and injuries become even
more painful and sensitive. If we tried to learn new defensive
strategies to protect ourselves, I'm afraid we'd only end up
hurting ourselves. The last resort is to wear armor. But then we'd
only fall down -- again!

Deafblind people are not all the same. Some are born
deaf and later become blind. Others are born blind and
later become deaf. Some are born with mild hearing or
vision losses and later become profoundly deaf and/or
blind. Some are born deafblind. Others are born with
multiple disabilities in addition to being deafblind. Some
learn to speak the oral way, others learn to speak using
their hands, communicating via American Sign Language
(ASL), Pidgin-Signed English (PSE), Signed Exact English
(SEE) and a variety of other contact languages. It seems
as if each language, whether spoken or tactual, must be
tailor-made to suit the unique needs of every deafblind
person who often ends up feeling alone and frustrated,
and out of touch with the world.

Copyright © Ipo 2010

I see with my hands and I hear with my body. I feel what you see and I
hear through vibrations.

-Anonymous

My computer is way more than just a computer.
I use it as a braille TTY to make a relay phone call.
I use it as a GPS system to figure where I'm going.
I use it to go to school.
I use it to jot down a note.
I use it to communicate with other deaf-blind people across the world.
I use it to communicate with people in the same room, who don't know sign language.
I use it to stay in touch with family.
I use it to do my grocery shopping.
I use it to find out if it's raining outside.
I use it to access the library and read books.
I use it to find out about any emergencies.
My computer isn't just a computer. It's my connection to the world.

-Anonymous

6/30/10

Deaf/Blind Students in the Classroom

Can deaf, blind, and deaf-blind people go to school?

Of course, provided a deaf/blind student has the proper accommodations, and their teachers stay on the same page throughout the entire school year. Accommodations need to be arranged months ahead of time so the disability office has enough time to make accommodations (such as hiring long-term interpreters, notetakers, and sending textbooks out to be transcribed into braille). Exam accommodations need to be arranged weeks in advance so that accommodations can be made (such as hiring an interpreter or reader/scribe). Most schools allow students with disabilities to register before other students so accommodations can be arranged in time.

What options does a deaf student who doesn't know sign language have for accommodations?

A non-signing, or oral, deaf student has at least three options for accommodations.

1) An oral interpreter
An oral interpreter sits in front of the deaf student and repeats everything that is said (by the teacher and other students) by mouthing it silently. This allows the deaf student to lipread without having to worry about lighting or the location of the speaker.

2) An FM system
For deaf or hard of hearing students that have enough residual hearing to understand speech, an FM system can be used. The teacher is fitted with a microphone and the auditory information is fed directly into the students hearing aid or cochlear implant. The only downside is that the deaf student can only hear the teacher and can't hear anything other students say.

3) Computer Assisted Real-Time Translation (CART)
CART works by having a professional transcriber type everything that is said in real time. The CART information can either be fed into a single computer screen for one deaf student, or projected onto a screen for several deaf students. It can also be displayed in large print or fed through a refreshable braille display for a deaf-blind student.

What other accommodations might a deaf or blind student need?

Deaf students need to be provided with a notetaker or notes on the lecture ahead of time so they can focus on watching the interpreter, reading lips, or reading the CART. Any videos that are shown in class need to be shown with the closed captions on. When a projector is being used in class, if a deaf student is watching an interpreter, they either need the lights on or need to have an individual light turned on near the interpreter so they can see clearly.

Before even starting the school year, blind students need an opportunity to tour the school and become familiar with their classrooms and the overall building layout before it's crowded by other students. Blind students need to have their school materials, including worksheets and text books, provided to them in the proper format (large print, audio, braille, or a combination thereof). Having what will be written on the blackboard provided in an accessible format ahead of time or at the beginning of the class is also extremely useful.

Blind students should also have any visual aspects crucial to the course content either described to them, or if possible, should have access to a model of it that can be explored tactually. (For example, in a math class where graphs are important, a blind student needs raised dot graphics or graphs made of string or wire so that they can appreciate the same concepts as sighted students). Generally, electronic format is best for writing papers and turning assignments in, because electronic documents can be magnified or converted to and from audio/braille much more easily. The school technology department also needs to make sure that any computer programs that will be used in a class are compatible with whatever magnification or screen reader software the student uses.

Blind students may or may not need someone to guide them to their classes. Any students with service animals may need a short break to give their service animal a chance to relieve themselves.

Deaf-blind students will need the same kinds of accommodations as deaf or blind students (specific accommodations obviously depending on the individual). A deaf-blind student may need to sit closer to an interpreter or may need to have a tactile interpreter. A deaf-blind student will probably also need a notetaker, and will need to have all their materials provided in a format they can read. Deaf-blind students may or may not need to be guided to their class.

The accommodations listed above are just some basic examples. Make sure to consult the school disability services, and any teachers specializing in special education or education for the deaf or blind for more detailed requirements specific to the student.

What to Consider When Employing a Deaf/Blind Person

What kind of work can a deaf, blind, or deaf-blind person do?

Almost any job a hearing/sighted person can do. What any particular individual can do depends largely on their skills, the extent of their hearing or vision loss, and the quality of their accommodations. When seeking employment, each individual potential worker needs to be assessed individually.

The most important issues to consider with a deaf candidate are:

1) Communication
How does the deaf person communicate? Do they use sign language? Do they speech read, write notes back and forth, or type on a PDA device? How good is their speech comprehension in one-on-one conversations, and how good is their comprehension in a group setting? How are their speech skills? Do they use their voice or sign language to communicate? It's important to consider one-on-one and group situations separately because the two affect a deaf person's ability to follow significantly. Generally, the same person will need more accommodations in a group setting.

2) Phone requirements
Does the job require using a phone? Some deaf people can hear on the phone with their hearing aid or cochlear implant on a special setting, or with a special amplification device. Some deaf people can hold brief conversations with people whose voices are familiar to them only. If a prospective employee can't hear on the phone at all, they may be able to substitute all phone needs with email and online conferencing (such as contacting business partners). If answering the phone is only a small part of the job, they may be able to make an agreement with another co-worker to trade the phone duty for another duty.

3) Auditory signals
Any auditory signals simply need to be supplemented with a visual or vibrating signal. (More often than not, machines that emit beeps or other signals already have a blinking light or other signal accompanying it.)

The most important issues to consider with a blind candidate are:

1) Mobility
Can the blind person get around? Give them some time to familiarize themselves with the building and their surrounding areas. Any in-the-way obstacles that can be moved to the side should be. Service aimal users will need to have occasional brief breaks so that their service animal can relieve themselves.

2) Lighting
Most blind people can see better in certain types of lighting. If the lights can be adjusted to their preference, go ahead and do that.

3) Reading format
Most blind people can read regular print, either with computerized magnification or optical aids. Blind people who rely on audio or braille are best off using electronic formats, which can easily be converted to and from print and braille/audio through a screen reader or special software program.

Deaf-blind candidates need to have the same issues as both deaf and blind candidates taken into account. Most deaf-blind people have some usable vision or hearing and will be able to use many of the same techniques as deaf or blind people. However, in the case of a deaf-blind prospective employee who has no usable hearing or vision, tactile communication will most likely be their only form of communication. Any employer or co-workers will benefit from learning basic tactile methods like the Deaf-Blind Manual Alphabet or tactile finger spelling. Employers and co-workers will probably also rely heavily on virtual communication, such as email and instant messaging, which can be fed through a braille display for the deaf-blind person.

Braille technology is expensive so definitely make sure to contact vocational rehab for any financial help. If they can't pay for braille technology in full, ask them for some other resources that can help cover costs.

If you're not exactly sure what your prospective employee needs, simply ask them. Also ask to get in touch with their vocational rehabilitation counselor. Vocational rehabilitation may be able to pay for adaptive technology and will probably train the person on any new technology for the job. Vocational rehab will probably also train them on any adaptive techniques needed to perform the same tasks as efficiently as a hearing/sighted person.

How do the ADA, DDA, and other laws protecting disabled employees work?

Laws protecting the disabled vary widely from country to country. However, the main idea behind these laws is: you cannot refuse to hire any applicant just on the basis of their disability. If an applicant's disability interferes with the very nature of the job, or compromises a large portion of the job, then you can refuse to consider their application. If the applicant can find alternative ways to do all the tasks required for a job, then they must be considered for the job along with any other applicants.

An applicant who has equal or better credentials cannot be disqualified from the applicant pool just on the basis of their disability either. They may need accommodations or extra training for the job. Vocational rehabilitation should provide any training related to using adaptive technology or adaptive techniques to perform the same tasks as efficiently as other workers.

Just remember: think in terms of tasks, not sensory loss, and ask--don't assume--what a candidate can and can't do.

6/29/10

Doorbell, Phone, and Alarm Clock Modifications for the Deaf and Deaf-Blind

How does a deaf or deaf-blind person know there's someone at the door if they can't hear the doorbell?

Deaf people often have their doorbell hooked up to at least one light in each room so that when the doorbell rings the light flashes. Deaf-blind people with at least light perception can use the same method or can opt for a system that sends them vibrations every time the doorbell rings.

How does a deaf or deaf-blind person make a phone call?

There are several options for making a phone call. Nowadays, with texting, email, and instant messenger, most deaf people elect to use these communication methods. However, some places (like hotels and doctor's offices) can only be contacted by phone.

Some deaf or hard of hearing people can hear on the phone with their hearing aid set to a special setting, specifically designed for using phones, iPods, etc. The setting is usually called a T-coil and receives the information directly from the phone.

A deaf person who can't hear on the phone can use a telecommunication device called a TTY or TDD. A TTY has a screen that shows letters and has a regular keyboard. The deaf person can type messages to another person with a TTY who then receives them. They can type back and forth.

Most places aren't set up with a TTY number and in this case, deaf people can use a relay service. There are four types of relay service.

1) Text relay
This can either be used from a TTY, done through a website, or set up from an instant messenger service. The deaf person calls 7-1-1 and gives a number to dial. Text relay works by having the deaf person type to a relay operator, who voices to the person on the other end of the phone line. Then whatever the hearing person voices is typed back to the deaf person via the relay operator.

2) Video relay
This works much like text relay, except instead of using text, the deaf person uses a webcam with a special service and gives a number to dial. The deaf person can then see a video relay operator in a webcam (much like a two-way webcam online) and can sign to the operator. The operator then voices to the hearing person on the other end of the line and signs back to the deaf person whatever the hearing person says.

3) Voice Carry Over
Voice carry over is used for deaf people who are comfortable speaking but just can't hear on the other end of the phone. The deaf person calls the VCO service and gives them a number to dial. Then just like with text relay, the operator types to them whatever is being said and indicates to them when it's their cue to speak. Then the deaf person voices whatever they want to say.

4) Captel
Some deaf or hard of hearing people can hear on the phone with visual assistance. The deaf/hard of hearing person has a regular phone call, both hearing the other caller and voicing themselves. The only difference is that the operator types whatever the caller is saying so that the deaf person can have visual support.

For deaf-blind people, the same methods above can be used with large print or braille modifications, such as a large-print TTY, large-print captel, or text relay set up through their computer that has magnification of its own.

For someone who can't read large print, they can use a braille TTY, called a TeleBraille. A deaf-blind person can also use whatever braille technology they might already have and use the same relay website, emails, instant messaging, or texting that sighted deaf people use through their braille display.

How does a deaf or deaf-blind person use an alarm clock?

A deaf or deaf-blind person can either get an alarm clock that rings extremely loud, an alarm clock that flashes a light, or an alarm clock that vibrates the pillow or shakes the bed.

How does a deaf or deaf-blind person use an alarm clock?

A deaf or deaf-blind person can either get an alarm clock that rings extremely loud, an alarm clock that flashes a light, or an alarm clock that vibrates the pillow or shakes the bed.

How the Deaf/Blind Think and Dream

When I think to myself, I have a running dialogue in my head. If someone has never heard a voice before, how do they think?

How a deaf person thinks depends on what kind of exposure they've had to language and life in general. A deaf person who has no hearing at all or who has never heard speech in any way doesn't know what voices or speech sounds like. Someone who has some hearing and can hear parts of speech does know what voices and speech sound like, but their idea of speech and voice is different from a typical hearing person's.

For deaf people who have never heard speech, they think in the same language that they use. A deaf person who uses sign language will think in sign language, and will "see" the signs in their mind's eye the same way hearing people "hear" a voice in their mind's ear. Similarly, a deaf-blind person who uses tactile sign language "feels" the signs in their hands in the same way a deaf person "sees" the signs in their mind. A deaf person whose main exposure to language is in its written form might visualize their thoughts like print on paper or handwriting on paper. Many deaf people also say they think in images or just concepts in general, independent of language. Of course the details of how a particular individual thinks varies, but deaf people can and do think independent of sound (and language when they've had little or no exposure to language).

When I think of a word, I imagine it written on paper in my head. How does a blind person visualize the spelling of a word?

Depending on the writing format they use the most, a blind person might also visualize a word or its spelling in print. If the blind person uses braille too, they can "visualize" the braille in their heads, in the same way as print. Some blind people "feel" the braille under their fingers in the same way a sighted person "sees" a word in their mind.

There's a lot of variety in how people think so the ways mentioned above aren't necessarily the only ways people think.

How do deaf, blind, and deaf-blind people dream?

People's dreams generally reflect their reality. Whatever extent of hearing loss or vision loss a person has in real life will generally experience the same in dreams. Whether or not a person was born blind, deaf or went blind or deaf a long time ago also makes a difference. Someone who is born totally blind cannot visualize images. Someone born totally deaf cannot conceive of sound.

Both totally blind and deaf people can conceive of sound and images in different ways though. Some deaf people have visual associations with sound (such as moving lips) and also an association with vibrations. Blind people can "visualize" through their sense of touch, where their brain forms an "image" from tactile information. A blind, deaf, or deaf-blind person may also experience smells and tastes in their dreams more often.

People with progressive vision or hearing loss may either still be able to hear or see in their dreams, or their dreams may reflect their progressive loss with a delay in time.

Sometimes deaf or blind people mention having a sense of "knowing" where things are in their dreams even if they may not know where things are in real life. Some deaf people also mention a sense of telepathic communication or communication free of language in their dreams. Some deaf people also mention that their dreams come with automatic "closed captions" for all the dialogue in their dreams. Deaf people who use sign language often experience the people in their dreams signing, regardless of if the person knows sign language in real life or not.

Because of the variety in how people think there might be other ways that deaf, blind, and deaf-blind people dream that haven't been mentioned here.

How the Deaf/Blind Perceive Things Like Color and Music

Do blind people know what colors look like?

Some do and some don't. It depends on how much the person can see if anything at all, and when they went blind. Some blind people can see colors just fine and others can see colors but have a hard time telling them apart. People who were born totally blind or only with the ability to see light/dark or shadows won't know what colors look like. Someone who went blind a long time ago may or may not remember what colors look like. If you're wondering about a specific person, just ask them.

Can deaf people enjoy music?

Some can and some can't. It depends on the level of hearing loss and the individual. Even profoundly deaf people can feel the vibrations from really loud music. People with less severe hearing loss can usually enjoy music with hearing aids or special amplification devices, though some may not be able to enjoy it cause of the compromised quality of the music. It depends largely on the individual and how their brain makes sense of the music coming in. Memory can be helpful for late-deafened individuals, and their mind can sometimes fill in the gaps to songs they enjoyed while they were hearing.

Are deaf, blind, and deafblind people's other senses heightened?

Yes, deaf, blind and deafblind people have heightened other senses, but not in the way that is commonly thought. The average blind person scores the same on a hearing test as a sighted person and the average deaf person scores the same on a vision test as a hearing person. The difference is that sighted and hearing people who have information coming through five senses filter out a lot of information. In other words, the brain lets pass through any important information and throws out any useless information. In someone who is relying on four or three senses, their brain filters out less of their remaining senses, making it so that they are receiving more information from each sense.

The average deaf/blind person is more aware of information coming through their sense of touch and smell than the average hearing/sighted person. Deaf people compensate for hearing loss with their vision and blind people compensate for vision loss with their hearing. However it's also important to keep in mind that every individual is different. Some people are more sensitive than others and the same person is more alert at certain times of the day than other times.

Hearing Aids and Cochlear Implants

Does a cochlear implant make a deaf person hearing?

No, a cochlear implant does not necessarily make a deaf person hearing. Each deaf person is different because the success of a cochlear implant depends largely on how well the brain adjusts to the new incoming information. Some deaf people can function as hearing with their cochlear implant but most deaf people function as a hard of hearing person. Some can understand speech with their CI, some can in a quiet room only, and some can't understand speech at all. If you know someone who uses a CI, it's best just to ask them how well they can hear with the CI. A CI also doesn't make a deaf person hearing because if they turn the implant off or if the battery dies, they are profoundly deaf again.

Do hearing aids make a deaf or hard of hearing person hearing?

No, hearing aids don't make a deaf/hard of hearing person hearing. While there are very powerful hearing aids out there that can dramatically improve someone's functional hearing, wearing a hearing aid is not the same as being hearing. Some people benefit more from a hearing aid than others. Some people can hear perfectly or near perfectly with their hearing aid but other people are still functioning with a certain level of hearing loss. This depends a lot on the amount and type of hearing loss, so if you're wondering about a particular person, it's best just to ask them.

Why don't all deaf or hard of hearing people use hearing aids?

There are many reasons why someone with a hearing loss might not have a hearing aid.

1) Affordability
Hearing aids are expensive. Not all people can afford a hearing aid and most insurance companies don't cover the cost of hearing aids and many people don't have insurance.

2) Social stigma or Deaf Identity
Some people feel embarrassed about their hearing loss or don't want to have anything in their ears. As a result, even though they could benefit from a hearing aid, they choose not to. On the other hand, someone who identifies as Deaf, from a cultural perspective, may see using hearing aids as a way of sacrificing or trying to hide their Deaf identity, or they may simply see no point in aiding their hearing since they use visual language anyway.

3) Medical reasons
Some people simply aren't medically eligible for hearing aids. People who have a total hearing loss can't use hearing aids because they work by amplifying and shifting residual hearing. Some people get tinnitus (ringing in the ears or phantom sounds) from wearing hearing aids. Some people have tried many hearing aids and have found they don't help very much.

4) A combination of the above reasons

Blind People Who Wear Glasses or Sunglasses

How come some blind people wear glasses or sunglasses if they're blind anyway?

Most blind people (about 85%) have some residual vision. Depending on how much and what kind of residual vision they have, powerful lenses or shaded lenses may help them make the most of the vision they have. For example, someone whose eyes are light sensitive or whose eyes have trouble adjusting to new light levels may benefit from sunglasses. Someone who has extremely blurry vision may be able to use very powerful lenses to make their vision useful at a more comfortable distance. Some totally blind people like to wear sunglasses to take the focus off their eyes or to protect their face from obstacles such as hanging tree branches when walking or cabinet doors when walking around the kitchen.

Doing Everyday Things Blind or Deaf-Blind

How can blind and deafblind tell the time?

There are two kinds of watches that blind and deafblind people can use to tell the time: talking watches and braille watches. Talking watches can be set to announce the time at regular intervals (hourly, every 30 minutes, etc.) or at the push of a button. Despite the misnomer, braille watches don't actually require the knowledge of braille. They're simply tactile versions of analog (face clock) style watches. Typically, a braille watch has three raised dots at 12 o'clock, two raised dots at 3, 6 and 9 o'clock, and a single raised dots at all the other hour or 5-minute markers. Typically a braille watch has hour and minute hands but no second hand. The glass over the face of the watch can then be lifted, which automatically freezes the hands, so that the relation between the raised dots and hands can be felt for time-telling.

How can the blind and deaf-blind do house chores like cooking and cleaning?

When someone goes blind or experiences a significant decrease in vision, they are provided rehabilitation services that teach the person how to cook and clean. Alternative techniques and adaptive technology can be used in both cases. For examples the dials on a stove or washing machine can be marked with tactile markers or bright colors if the person has usable vision. The person is also taught how to be able to tell if a piece of meat is cooked, a pot of water is ready, by the sense of smell and sometimes by touch (if it's not dangerous). Other appliances like microwaves and blenders can be marked with braille or large print. A person with usable vision might also make use of other optical aids like magnifiers to check things visually.

How can a blind person match their clothes independently?

There are several ways to make sure your clothes match with vision loss. One of the ways is to just know the feel of different types of clothes and remember what color they are. For example, a pair of pants with specific buttons might be black and another pair with a zipper might be beige. Clothes that feel the same but vary in color can be labeled either with tactile markers or braille labels. Some blind people choose to invest in more expensive equipment that can be placed on fabric and announce the color of the fabric. When buying new clothes, a blind person who can't see well enough to tell colors apart themselves can ask a store person or sighted friend to help them.

How does a blind or deaf-blind person know where they're going?

A blind or deaf-blind person can know where they are going by memorizing landmarks. Just as a driver might know where to turn because of a specific visual landmark, a blind person can use auditory landmarks, and both a blind and deaf-blind person can use tactile landmarks. Smells and air currents can be helpful too. By traveling in the same area over and over again, a mental map can be formed in the brain. Some blind or deaf-blind people choose to use portable GPS systems with auditory or braille output to help them with directions and give them extra information.

When using public transportation, how does a blind or deaf-blind person know which bus or train to get onto?

In big cities, most buses and trains have a voice that announce the route. If this isn't the case, the blind or deaf-blind person can ask another traveler to tell them when a certain bus or train arrives, or may also carry a card that asks to alert them when a certain bus or train arrives.

How does a blind or deaf-blind person know their bus or train stop?

There are several ways to be able to tell when it's the right time to get off the bus or train. In the case of trains and buses that stop at every stop, the stops can be counted. If a bus doesn't stop at every stop, the blind person can often get a feel from hills and turns. If a blind or deaf-blind person feels unsure, they might ask the driver or another passenger to tell them when they arrive at a certain stop.

In many larger cities, buses have a voice that announces each stop, or the bus driver is trained to announce them verbally. A deaf-blind traveler might still ask for the driver to tap them on the shoulder. Another more high-tech option is to use a portable device with a built-in GPS and either audio or braille output, which can alert the person to when they arrive at their stop.

How do blind people handle money?

Some blind people have enough residual vision to see the number of a denomination with or without an optical aid. Some blind people don't have enough vision to tell the number on the denomination and use another system.

Some countries vary the size, shape, or texture of their currency denominations for blind people. Other countries don't. In countries where the denominations are uniform in shape, size, and feel, blind people generally use a system of folding. For example, single bills might be left unfolded, fives folded width-wise, tens folded length-wise, twenties folded in both directions, etc. In order to first find out what a denomination is, a blind person can either rely on a sighted person or invest in expensive technology that determines the denomination electronically.

Coins are distinguishable by size, shape, and the presence or absence of ridges on the edge.

Questions about Braille and Sign Language

Is sign language universal?

No, sign languages, just like spoken languages, are not universal. Different countries have different sign languages, and sign languages do not necessarily correspond to spoken languages. For example, the U.S., the U.K, Australia, and New Zealand all have English in common as the spoken language, but all have completely unrelated sign languages. Canada shares one sign language in common with the U.S. (American Sign Language) but also has other sign languages not used in the U.S.

Are sign languages related to spoken languages?

No. Sign languages have their own grammar and sentence structures, separate from the spoken languages in the same regions. The only aspect of spoken language that is reflected in the same region's signed language is the alphabet. Most sign languages have a manual alphabet, or a series of handshapes that represent each letter or character of the local writing system. It's generally used to spell out words that don't have a signed equivalent, like personal names and some place names (although common place names tend to have a sign of their own).

Is braille universal?

No, braille is not universal. Braille, unlike sign language, is not a language but a system of encoding the written word. Braille codes correspond to written systems, so there is a braille code for the Latin alphabet, for the Arabic alphabet, for the Cyrillic alphabet, Devanagari (the script used in many Indian languages), Hangul (the Korean script) and so on.

How does Braille work?

Braille works by a system of raised dots. One full braille cell contains six raised dots and is three cells tall and two dots wide. Each dot in a braille cell is numbered one through six, starting from the top left going down and then from the top right going down. Depending on which of the possible positions contain a dot, the overall braille cell changes meaning. (An empty cell is a space in braille.) Braille is written from left to right, regardless of the original direction of the alphabet being transcribed (which means that even Arabic, Hebrew, Chinese, and Japanese braille are always written from left to right, even though Arabic and Hebrew are written right to left in print, and Chinese and Japanese can be written vertically or horizontally). The reader can then feel the dot combinations under their finger or fingers. Braille does not use separate characters for capital or lowercase letters, or regular and italic, but it does have specific braille characters that tell the reader the following letter or word is capitalized or italicized.

What's the different between Grade 1 and Grade 2 Braille?

Grade 1, or uncontracted braille means that each character in print is represented by a character in braille, or in other words, there is a one-to-one ratio of print characters to braille characters. Contrary to popular belief, this includes all symbols and punctuation. Grade 2, or uncontracted braille uses a system of contractions to shorten the braille in order to save space. A single braille character can stand for a word or a group of letters, and two or more braille characters can stand for a word part or a whole word as well. Unlike shortcuts used in print, contracted braille is standardized and used for all literary publications with the exception of materials written for beginning readers.

How can Braille be produced?

There are several ways to produce braille. The most portable and low-tech way is with a slate and stylus. A slate is a metal or plastic frame with holes in the braille patterns. The stylus is a small utensil used to punch the braille dots in the holes. A piece of paper is inserted into the slate and the stylus is used to punch the holes into whatever patterns necessary.

A second way is to use a Perkins brailler, or braille typewriter. A braille typewriter works much like a regular typewriter, except that instead of having keys for each letter of the alphabet, there are keys for each dot of the braille cell along with a space bar and an enter key. The typist uses a method called "chording" where any one to six of the cells are punched at once to produce dots within the braille cell.

A third way is to produce braille electronically, through a computer. It can either be produced by typing into any text document and using software to convert to braille or it can be typed with specific software that emulates the key layout of a Perkins brailler, either on a regular QWERTY keyboard or on a hardware device that has the same keys as a Perkins Brailler. Some braille users also have a hardware device attached to their computer that gives them braille output by a system of raised and lowered pins.

How is braille produced on paper?

To produce paper braille, a special braille printer called an embosser is used. Rather than using ink to print, it punches the braille patterns into the paper. Special paper that is slightly thicker than usual needs to be used so that the braille dots aren't punched all the way through. Braille can be printed on one or both sides, just like inkprint.

6/28/10

Driving, Sexuality, Schooling, and Capitalization

Can deaf people drive?

Yes. Deaf people can drive. Just think of when you're in your car driving with the music on full blast, or with all the windows closed. That mutes out a lot of outside sounds but you still manage to drive just fine. The same goes for a deaf person. Deaf drivers are also in the habit of checking their mirrors more often for emergency vehicle lights. Deaf people are statistically safer drivers than hearing drivers because of their heightened visual awareness.

Do deaf, blind, and deafblind people have sex?

Deaf, blind, and deafblind are no different than the rest of the population. Deaf/blind people have the same range of sexuality and sex drive as the general population.

Why are the words "Deaf," "Blind," or "DeafBlind" sometimes capitalized?

"Deaf" with a capital D denotes a cultural identity surrounding a signed language and a set of cultural norms separate from the mainstream local culture. Deaf people who capitalize the D see their deafness as more than just a physiological state, also as an identity. The same applies for DeafBlind people, and for some Blind people, who, while sharing a language in common with the mainstream, may feel part of a smaller community.

Do deaf or blind people go to special schools for the deaf and blind?

Some do and some don't. Some deaf students thrive better in a school specifically targeted towards deaf/hard of hearing students. Some blind students also thrive better in a school for the blind, although nowadays it's more common for students with multiple disabilities including blindness to attend a school for the blind. Most students whose only disability is blindness go to a mainstream school.

How Come Deaf Can't Speak Well?

How come Deaf people sound weird or speak or type in broken English?

Deaf people who had hearing loss before or around learning to speak have had to rely on visual and tactile methods of learning speech and have had to go through speech therapy. While the vocal cords of deaf people are perfectly intact, it's much harder to speak correctly without a feedback system. It's much like when you hear someone singing to their iPod and they're singing totally out of key and sound crazy, even if they can sing well (or relatively well) when they hear themselves.

With deaf people who have never heard their own voice or the voice of others, it's much harder to self-monitor speech. It's also impossible for someone who is born deaf to know what some or all sounds sound like (depending on the extent of their hearing loss.) So for example, if someone has never heard an "s" sound, it's hard to emulate it.

Some deaf people speak in broken English cause English is not their first language. For deaf people who have grown up with American Sign Language, or whatever other local sign language, English is their second language. So much like a foreigner, they tend to apply the grammar of their own language to English. Just as a foreign speaker might create phrases like "I go to store" or "She do it at her own," someone whose first language is a signed language is speaking English as a foreign speaker as well.

Contrary to popular belief, American Sign Language (and other sign languages in English speaking countries like British Sign Language, Australian Sign Language, or New Zealand Sign Language) have their own rules for grammar and syntax. They have their own ways of forming sentences properly and ordering words and conjugating verbs and so on. They are not just visual representations of the spoken language. This is made evident by the fact that even though the U.S., the U.K. Australia, and New Zealand all have English as a spoken language, they have their own sign languages. So if a deaf person speaks in broken English, think of it as the same as a foreign speaker.

If you are thinking "but this person has grown up in an English-speaking country" or "but this person can read English," it's important to understand that even so, a pre-lingual deaf person hasn't had the same accidental exposure to spoken language as hearing people do growing up. So they have never overheard conversations and had the opportunity to correct their mistakes from exposure.

The only exposure a deaf person has to spoken language is intentional exposure, such as speech therapy or being in a school that advocates speech only. Not only that, but children are taught to read much later than they are taught to speak, so if a deaf person has not had access to signed language, their first access to language is much later than a hearing person's, which can affect the brain's ability to grasp language.

Even though deaf people and hard of hearing people have full access to written language, someone born deaf/hard of hearing doesn't have the same sound associations to letters on the page that someone with hearing does. So they might know the words in written form, but they aren't sounding them out in their heads when reading the way a hearing person is. As a result, even people with hearing loss who have exposure to written language often still miss out on details that are only audible.

If you listen closely, you'll notice the most common mistakes relate to minor changes in sounds (like word endings), such as saying "I wants" (where it's easy to see how a deaf person might miss out on the "s" at the end of "wants") or "I am heated it" (where it's easy to see how someone who hasn't had a lifetime of exposure of when to use "heated" vs. "heating" might mix up the two usages.)

It's important to remember that even if a deaf person has a strange sounding voice or doesn't speak fluent English, it doesn't mean that they're any less intelligent than a hearing person. It's simply a matter of not having the same exposure to spoken language that a hearing person has had. When deaf people are taught visual language, they have no trouble grasping a language.

It's also important to remember that even though some deaf people have a "deaf voice" or speak in broken English, other deaf people master speech and language quite well, so it's impossible to tell the full extent of someone's hearing loss based on their speech and language skills.

How do Blind and Deafblind People Use Computers?

How do blind and deaf-blind people use computers?

Depending on the extent of vision loss, blind people might either use magnification or text-to-speech. Magnification means a certain software program on the computer magnifies everything on the screen to be large enough for the person to see. These programs often also have options for increasing contrast, inverting colors, or changing to other color layouts that make it easier for the person to see. Blind people using magnification may or may not be able to see pictures and other graphics (such as smilies). It's best just to ask them if they can.

Text-to-speech is a software that converts text on the screen into a computerized voice. While many people have a hard time understanding synthetic speech, most blind people are used to it and can understand it fine. Speech readers have limitations in what they can interpret. Blind users with speech output can't see photos, and can't read documents that are image-based, such as scanned-in PDF files or websites that are formatted in image-based formats. Special programming (called alt-text) can allow computer users to add descriptions to photos, but unless this is specifically done, most images are simply read as "image" or the file name the image was saved as.

Deaf-blind and some blind people use braille output. Braille technology is extremely expensive so it's generally only used by those who really need it, such as deaf-blind people with not enough hearing to understand speech output and blind people who have jobs that require using the phone at the same time or looking closely at coding or punctuation. Braille output uses the same software as speech output, but rather than being read in a synthetic voice, the text on the screen is displayed on an attached hardware device with braille cells, called a refreshable braille display. The pins in a braille display move up and down into braille patterns and change as the screen changes or as the blind person interacts with the computer.

Like speech output, a braille output user cannot see images or any sort of image-based output. Unlike speech readers, braille users always have access to punctuation whereas speech reader users have to change their settings to be able to hear all punctuation.

Many blind or deaf-blind people use a combination of the three above mentioned adaptive technologies, such as speech and braille side by side, or braille and magnification. This aids them in being able to have more options for interface.

How can blind people type?

Most sighted people can look at the screen and don't need to look at the keyboard because their fingers know where the keys are. The same applies for most blind people. Blind people can also feel the grooves on the F and J keys to ensure correct placement. For blind or low vision people who haven't memorized the keyboard, there are large print and braille stickers that can be placed on the keys. There are also some keyboards available with large print or braille directly on the keys.

Ways to Communicate with a Deaf-Blind Person

Ways to Communicate with a Deaf-Blind Person

There are many ways of communicating with a deaf-blind person. If you happen to come across a deaf-blind person, let them tell you how to communicate with them. This list is just to help familiarize you with some of the ways beforehand. Before reading the list, please note that most deaf-blind people have some usable vision or hearing. Because a deaf-blind person can't compensate for the loss of one sense with the other, even a partial loss of both senses can be considered deaf-blind. So a "deaf-blind" person might be totally blind and hard of hearing, totally deaf and partially sighted, or may be close to totally blind and close to totally deaf but have some usable vision and hearing. Generally people that are only a bit vision- and hearing-impaired are referred to as vision-impaired/hard-of-hearing. But for someone who is totally one and partially the other, it's not uncommon to be considered deaf-blind.

Because of the wider definition of deaf-blindness, some deaf-blind people can use auditory or visual ways to communicate, but just need these ways to be modified for their poor vision or hearing. A good number of deaf-blind people can use some vision or hearing in some situations but are functionally totally deaf-blind in other situations. Some deaf-blind people are truly completely deaf and completely blind and therefore can only use tactile methods of communication in all situations.

1) Print on palm
This method involves printing letters on the palm of the person's hand. The way it works is that you use your finger as a writing utensil and write on the palm of their hand. When doing this, draw big, clear block letters. Make each letter fill up the whole palm. It takes a lot of concentration and effort on the deaf-blind person's (for most people), so make the letters as clear as possible when doing this. Small letters or cursive letters are nearly impossible to distinguish by touch. Though this may seem obvious, remember to write on their palm and not your own.

2) The Deaf-Blind Manual alphabet
The Deaf-Blind Manual alphabet is a modified version of the British Manual Alphabet, or the hand shapes used to finger spell in British Sign Language. This method can be found all over the Internet and learned quickly. It's just 26 hand shapes to indicate each letter of the alphabet. The original British alphabet uses two hands to form each letter, but the Deaf-Blind alphabet is modified so that you move your hand on the deaf-blind person's passive hand. Depending on where and how you make contact with their hand, it forms a letter. When finger spelling, make sure to do it clearly because many of the letters feel the same with sloppy signing. Better clarity than speed.

3) Large Print Notes
For someone who is totally deaf and legally blind, they might be able to see enough to see big letters on paper. In this case you might exchange notes on paper just as you would with a deaf-sighted person, but you would need to write or type in large bold letters. Let the person tell you what is easiest for them to read (all caps, bold, which font works best on a computer, etc.)

4) Speech with amplification
For someone who is totally blind and hard of hearing, they might still be able to understand speech through a hearing aid or FM system, which are both ways of amplifying speech. An FM system only amplifies, which makes speech louder but not clearer. Therefore several people talking in a room at once or a lot of background noise will still make it hard or impossible for the blind/hard-of-hearing to understand. Hearing aids are custom-made to the person's hearing loss so they tend to improve speech comprehension much more effectively. However, it can still be hard to make sense of sound in a noisy area.

5) Tactile finger spelling
Some deaf-blind people like to use what is called the Rochester Method, tactually. This is where you finger spell the American Sign Language (or whatever other sign language is used locally) into their hand. This obviously requires knowing the sign language alphabet. Don't assume all deaf-blind people know sign language. (Some went deaf later in life and haven't learned sign language.) But if both you and they know finger spelling, this method can be used. Keep in mind to let the deaf-blind person choose where to place their hand to interpret your finger spelling. Resist the temptation to correct their hand placement or hold their hand. They know where to hold their hand to understand, not you.

6) Close range sign language
Some deaf-blind people use full blown sign language at a close range, most commonly deaf-blind people who grew up or have spent a lot of time in a Deaf community using sign language for communication, and have lost some vision but still have enough to see signing up close. This obviously requires you knowing sign language. So if you do, you can sign to them, closer than usual.

7) Tracking sign language
This is used most often by deaf-blind people who grew up or have spent a long time using sign language and now have tunnel vision and can only see in the central part of their field. The way this works is that you sign normally, but let them hold your wrists to ensure your hands stay within their visual field. Sometimes this is done by you standing farther away than usual and signing within a small space so as to stay within their tunnel vision field.

8) Tactile sign language
Deafblind people that know sign language but have no useful vision for taking in signs visually receive it tactually. This means that as you sign to them, they place their hands lightly over yours and feel your signs. This requires you to sign in a smaller space than usual, so as to relieve the stress on their arms and shoulders. Let the deaf-blind person choose how to place their hands. They know what placement helps them understand best. Resist the temptation to sign big, exaggerated signs, because this ends up in extremely sore arms and shoulders for both of you the next day. Generally this requires an advanced knowledge of sign language so you can know how to make signs more neutral in space without sacrificing their meaning. The signs used are the same, except for some occasional modifications to make up for lack in facial expression and to disambiguate some signs that are hard to distinguish by touch. Usually this is done by finger spelling the sign right before or after signing it, or by coupling it with another sign. (An example is disambiguating "chicken" and "twenty" by signing "number twenty" and "chicken c-h-i-c-k-e-n.")

9) A deaf-blind communication device or braille display
Some deaf-blind people have a specific device for facilitating communication, where you can type back and forth, and where you receive visual output and they receive braille output. This can also be done with a TeleBraille (braille TTY, kind of like a phone for the deaf-blind) or a computer attached to a braille display. Again, you simply type to them, let them read the braille, and they can either type back to you or speak back to you, depending on if they can speak or not.

10) Braille card
This method is generally used for deaf-blind people that don't know print well or that have a hard time understanding print-on-palm. This involves having a card with the alphabet on it, both in print and braille. The way it works is you place their finger on the braille characters and spell out your message. Remember to point their finger onto the braille character and not the print character above/below it. Though this may seem obvious, remember to point their finger to the card and not your own.

11) Tadoma Method
This method is rarely used nowadays but you might still come across it. It's essentially tactile lipreading. The deaf-blind person places their hand or hands on your nose, mouth, jaw, and neck to feel the vibrations of your speech and understand your speech through these vibrations. The accuracy of comprehension from this method varies.

12) Co-active signing
This involves using sign language, but instead of signing in your own space and on your own body, you sign on the deaf-blind person's body. This method is generally reserved for deaf-blind people with a cognitive disability, but might also be useful for deaf-blind people with tactile issues who have a hard time interpreting direct tactile information and therefore need added kinesthetic information. A way to do this with letters is to move the deaf-blind person's arm, wrist, or finger in the shape of the letters.

13) Finger braille
This method is generally used with deaf-blind people who are familiar with a braille but don't know (enough) sign language. A braille typewriter, or Perkins brailler, has 6 keys representing each of the 6 dots of braille, and a space bar. To type braille, the person uses "chording" (where they hit one or more of the keys at once) corresponding to each of the 6 possible positions in the cell that is dotted for a particular cell. Finger braille works by typing on a virtual Perkins brailler, formed by three points on each wrist or palm. Each hand rests on the palm or the wrist of the person in the same configuration as the Perkins keys, and then you "type" to them.

Please remember that not all deaf-blind people know sign language or braille, or they might not feel fluent enough to use it as a method of communication. Braille doesn't come with blindness, nor sign language with deafness. They come with practice and usage. Let them offer which method to use so you don't have to play a guessing game. Another thing to keep in mind is that some deaf-blind people can speak and some can't. Some can speak but prefer not to because they have trouble making themselves understood. Speech skills don't necessarily relate to hearing loss, so just because someone speaks well doesn't mean they hear pretty well.

Generally speaking, people that went deaf before or around the time they started learning to speak have much more obstacles to overcome in terms of learning to speak. If they've gone deaf before/around learning to speak, they've had to rely on visual or tactile methods to learn speech, which is a lot harder to do than learning it by ear. Despite the added difficulty, some pre-lingually deaf people have achieved great speech skills and you might not even be able to tell they're deaf/hard-of-hearing based on their speech.

On the other hand, late-deafened people have learned to speak before they lost some or all of their hearing, so in general, these people have normal or close to normal speech. Generally late-deafened people have a harder time with volume control but otherwise maintain clear speech. For people that have become progressively deaf over a long period of time, they might have been able to keep their speech up, or they might have started to forget what words sound and feel like and might start slurring or mispronouncing words.

The important thing to remember is that each person has a different ability in terms of speech. If the deaf-blind person uses speech, they can reply to you that way (unless you require a different method yourself), and if not, they will use other methods such as communicating back to you the same way you communicate to them (typing, finger spelling, signing, etc.)

Another thing to keep in mind is that a partial vision or hearing loss can mean useful hearing/vision in some situations and functional total deafness/blindness in other situations. Just because someone can read large print in a dim room doesn't mean they can in the bright sunlight, or just because someone can understand speech in a quiet room doesn't mean they can understand speech in a noisy room.

Other factors such as fatigue, hormonal changes, or the very nature of their cause of deafness/blindness may cause their level of hearing/vision loss to vary. Please make sure to understand that someone's functional hearing or vision isn't always the same, and that when they say they cannot hear you or see you now, even though they could last night/yesterday/last week, doesn't mean that they're lying or being lazy. It just means that for whatever reason, their functional hearing or vision is worse now because of the lighting/sound conditions or other factors mentioned before. Sometimes when fatigue sets in from trying to use residual hearing or vision itself makes the person unable to continue using it.

The variation in functional vision/hearing also means that many deaf-blind people use more than one form of communication depending on the situation. Someone who can hear speech in total silence may need tactile signing in a noisy place, and someone who can see signing in bright light may be totally blind in the dark and need to receive it tactually, etc. Adjust your communication method with them based on their needs. If you're not sure, let them tell you what they need for communication.

How Can a Deaf or Blind Person Know I'm There?

How can a blind, deaf, or deaf-blind person know I'm here?

Blind, deaf, and deaf-blind people have many ways of being able to tell when someone is in their presence, so it shouldn't come as a surprise to you if a deaf/blind person reacts to your arrival.

For blind people, a blind person can hear your footsteps, anything shaking around in your bag. For deaf people, they may be able to feel your footsteps in the floor if you're coming from behind. They may also see you coming in a shadow on the wall or in the reflection of an object. For deaf-blind people, as well as deaf, or blind, people, they may be able to smell your cologne, feel the wind of you passing by, or sometimes just feel your presence. The same way many people can feel someone staring at them from behind works for some deaf/blind people, who can sometimes just feel the presence of another person.

Some deaf or blind people are more sensitive than others, so while some deaf/blind people may be able to tell you've arrived, others may not be able to tell and may need to have you let them know of your presence. Many people can tell in some situations and not others, and for many people it's simply a factor of how focused or distracted they are. It's always nice to inform a deaf, blind, or deaf-blind person that you are leaving or have come back because a deaf/blind might not always realize you left or came back.

How do I guide a blind or deaf-blind person?

Before guiding a blind or deaf-blind person, ask if they want to be guided first. If they do, then you can let them take your arm and guide them. Make sure to factor both yourself and them when moving around objects. Always offer your arm to the side that isn't holding a cane or guide-dog harness.

If the blind or deaf-blind person isn't using their cane or guide dog, it's useful to inform them of changes in terrain, such as curbs, hills, drops, when stairs begin, end, when you've arrived at an elevator, or when you're getting ready to make a right or left turn. If they are using their cane or guide dog, it's not necessarily to inform them of these changes because they're already getting this information from their cane or guide dog. While it's more common for blind people to take your arm, some deaf-blind people might want to take your hand if you are also using tactile sign language. Let them decide where to hold you.

When passing through narrow areas, extend your arm behind you. Most blind or deaf-blind people know to take this as a cue for single-file and will follow directly behind you. A significantly taller blind or deaf-blind person can also put their hand on your shoulder, and a significantly shorter blind or deaf-blind person can take your hand instead of your arm.

How to Get a Deaf or Deaf-Blind Person's Attention

How to Get a Deaf or Deaf-Blind Person's Attention

Something many people often don't know is how to get the attention of a deaf or deaf-blind person. For someone who is only deaf, there are several ways. For deaf people:

1) Wave
You can wave to them. Most deaf people have a heightened visual awareness and will notice your wave even if they're focused on something else. Wave small if you're close by and larger if you're far away.

2) Stomp your foot or knock on the table
You can send vibrations through the floor by stomping your foot or through a table you're both sitting at by knocking on it. Some floor types carry vibrations better than others. For example, a wooden floor will carry vibrations whereas if you stomp on a sidewalk, the deaf person probably won't even receive any vibrations.

3) Flash the lights
This is a more last resort way, especially if the deaf person is doing something like reading. But if the floor doesn't conduct vibrations well and you're behind the person, you can flash the lights.

4) Tap them on the shoulder
You can tap the deaf person lightly on the shoulder. This should also be used more as a last resort since being tapped can startle a lot of people easily.

For deaf-blind people:

1) Wave right in front of them.
A lot of deaf-blind people have some residual vision and may be able to see you waving your hand if you stand directly in front of them. For some totally blind people, they might be able to feel the wind your hand creates, but there are more useful ways to get the attention of a totally blind deafblind person. (Waving your hand directly in front of someone's face can feel disrespectful to some people.)

2) Stomp on the floor or knock on the table
This works the same way as with sighted-deaf people. Deaf-blind people can also feel the vibrations through the floor or a table you're both sitting at (provided they have their arm or hand on the table).

3) Touch their hand
You can touch the hand of a deaf-blind person lightly. This implies you want to start communication.

4) Tap them on the shoulder
Like with a deaf person, you can tap them on the shoulder, although this should be used as a last resort since it can startle them easily. This especially holds true in a street setting where the deaf-blind person might not be expecting someone to get their attention.

Speech Reading

Speech Reading

As is commonly known, many deaf people use speech reading to communicate with others. Some deaf people use it as primary means of communication, whereas others only use it when writing notes or using sign language isn't an option. Speech reading, unlike lip-reading, refers to understanding speech based on not only the movement of the lips, but facial expression, body language, and social context. Many lip-readers who have residual hearing also make great use of this hearing to make sense of lip movements. Speech reading skills vary from person to person, and aren't necessarily based on hearing loss levels, though residual hearing can be helpful. Speech reading is something that comes more naturally to some people than others, and that can be improved with practice for some but not all. Certain factors make it easier or harder for someone to speech read.

1) Lighting
Good light, especially on the face, make it easier to speech read. On the other hand, if someone is silhouetted against another light source behind them (like the sun or a strong lamp), then it's impossible to see their face and therefore speech read.

2) Distance
It's easier to lipread someone who is closer than someone who is far away, for obvious reasons (a better view). If someone is walking around or keeps turning around (which is common in classroom situations) then it makes it impossible for someone to speech read.

2) Facial hair and lips
People with facial hair make it very hard or impossible to lipread because the facial hair is obstructing the lips. Lipstick can help make lipreading easier, especially for people with low vision.

3) Accents or mumbling
People with accents or people who mumble are hard to lipread because the way they pronounce words (or fail to) looks different on the lips.

4) Exaggerated speech
People who exaggerate their lip movements or over-anunciate make it impossible to read their lips because the shapes they are forming aren't the ones naturally made with spoken language.

5) Natural gesturing
Most people gesture or use their hands at least a bit when speaking. This can help convey meaning for deaf people who are relying on the entire body language to understand what's being said. Be careful not to use exaggerated gesturing because this can be considered obnoxious or rude, and isn't helpful to comprehension. Pointing to things you're talking about is reasonable though, such as pointing to the gravy when you're asking "do you want your mashed potatoes with or without gravy?"

6) Topic changes
Speech reading or understanding speech with hearing loss requires heavy reliance on context. This is because it's much like trying to read something with letters missing, where the gaps have to be "filled in." How to fill in the gaps depends on the topic. If a sudden topic change occurs, it can become hard for a speech reader to follow. It's helpful to inform someone speech reading of sudden topic changes.

7) Shouting
Shouting doesn't help. The reason shouting doesn't help is because hearing loss not only effects how loud things sound, but also the clarity. When people shout, their speech often becomes even less clear than usual. It's also much harder to speech read someone who is shouting than someone who is speaking naturally.

Understanding Speech with Hearing Loss

Trying to understand speech with hearing loss takes a lot of mental energy and can be tiring after a short while. To make an analogy, speech reading is like landing in a country where you sort of speak the language but have to put more energy into understanding it. If you get tired, then it becomes much harder to understand. If you spend all day talking, you get tired and need some time alone or with your native language. The speakers you talk to most generally become the easiest to understand.

Well-paced, clear speech is generally easier to understand than fast and half-articulated speech. A lot of this works the same way for someone trying to understand speech with hearing loss. While they may be able to understand you fine, it does take an added mental effort. Just like with a foreign language, it's generally easier for a hard of hearing person to understand voices that they're more used to. And of course context helps a great deal. In a foreign country, if someone is handing you a cup while they say "coffee?" its much easier to understand. Likewise context helps a great deal with understanding speech.

To understand how speech and hearing loss work, hearing loss is defined by both frequencies and decibels. Frequencies relates to pitch, how low or high a note is, and decibels relates to volume, or how soft or loud something is. People with partial hearing loss can usually hear better in certain frequency ranges than other ones. Most deaf people even have a tiny bit of residual hearing, but it's not usually very useful. There are some completely deaf people too, though, who can't hear a thing.

For some people, they have some hearing in the range of speech, and for others, speech is completely out of their range of hearing. Obviously this will affect their ability to understand speech, along with their speech reading skills. Because of the complex nature of speech in terms of the frequency combinations, it's pretty common for someone to be able to hear environmental sound and music but have trouble understanding speech. It's important to keep in mind that just because someone can enjoy music or reacts to sounds doesn't mean they can understand what you're saying. There is a big difference between hearing speech and understanding it. Someone may be able to hear you speaking but it sounds garbled, muffled, or canned, so they can't make sense of what you're saying. Keep this in mind by not assuming that just because they can tell you're trying to speak to them, that they can understand you.

Yelling doesn't help because it only increases volume, often at the cost of losing clarity. Avoid the temptation to shout in deaf people's ears. Don't assume that a deaf person doesn't know you're shouting either. They can usually tell visually that you're yelling at them, and it can seem pretty insensitive even if that's not your intention.

The White Cane Law

The White Cane Law

There's a law, called the White Cane Law, that's supposed to protect white cane users, as well as guide dog users. It varies from state to state, from country to country. But the main premise is: keep an eye out for blind* people, cause they can't keep an eye out for you. So rather than comparing the details of one state or country's law to another's, let me just lay out the practical applications for this (or these) laws.

1) Most blind people can hear cars, most of the time. For the most part, blind people can hear you coming. Engines make noise and that noise can be pinpointed to a certain location. So generally speaking, blind people aren't nearly as oblivious as they're thought to be. Of course, there are some exceptions. A blind person may not be able to hear you if:
a. It's really noisy. Noise is the auditory equivalent of fog in your visual field. Trying to pinpoint a specific car in a noisy area is like trying to pinpoint a specific mountain in a distant mountain range on a foggy day. So blind pedestrians may not be able to hear your car specifically.
b. A silent engine. If your car makes very little or no noise, a blind person can't hear you. A guide dog might mistake you for a parked car if you're stopped at a red light.
c. Sound shadow. You might be in a "sound shadow," meaning that the noise your car is emitting might be blocked by another car or building between you and the blind person. In this case, they won't be able to hear that your car is there.
d. The blind person might also be deaf/hard-of-hearing or not be accustomed to relying on their hearing for navigation yet. In either case, the (deaf)blind person can't hear you. (In some countries, a white cane or white cane with a red tip indicates a hearing-blind person, and a striped red-and-white cane indicates a deaf-blind person. If the pedestrian has a striped red-and-white cane, or a guide dog with a red-and-white harness, it means they are both deaf and blind.)
e. Blind people, just like sighted people, sometimes get distracted, either by another outside stimulus or by their own thoughts. In general, blind people are in the habit of paying extra close attention as a way to compensate for their vision loss, but getting distracted happens to the best of us.

2) Most blind people know where they're going, most of the time. If you see a blind person walking, chances are they know exactly where they're going. If a blind person is lost, they know to ask for help. If a blind person doesn't know an area well, they know to arrange for help. If a blind person is alone, it's because they feel comfortable traveling alone. Just let them be, unless:
a. They ask for help.
b. They look lost (walking back and forth, standing still with a confused expression on their face), in which case, offer help. If they accept, then help. If they decline, then let them be. They might want to try to figure it out on their own, or they might just be waiting for someone.
c. There's an obvious temporary obstacle ahead. Something like a construction site might not have been there the last time they were here. A cane will find it and a guide dog will guide around it, but if it requires crossing the street a block ahead or at an intersection that has been moved from its original place, it's helpful to let them know. If it's a big puddle, it can be circumnavigated on the same side of the street and a cane or dog will find it, no problem.
Whatever you do, don't call the cops (unless the blind person is doing something illegal)! This may seem obvious, but it happens to me all the time. (My local police department told me they get calls about me on a daily basis.) So just wanted to put that out there.

3. Blind people have the right of way. If a blind pedestrian starts crossing the street, stop. Even if it's your light. Obviously they thought it was theirs, so let them cross. The time this happens the most often is on turn signals, where it's either green for both of you, or it sounds like it's green to them. Turning cars sound like they're going straight at first, which is the auditory cue for a green light. If a blind person starts crossing on a turn signal, don't turn! You could end up snapping their cane in two, or injuring them, which is way worse than pissing off the drivers behind you who also want to turn. Some major exceptions here are:
a. Don't stop on a green light to let a blind person cross who hasn't crossed yet. There's two reasons for this. One is, they already know it's your light, which is why they're waiting. Secondly, if there is more than one lane to the street, while you may have stopped for them, another car might come zooming because, well, it's their light. And they might not have the reaction time to stop for the blind pedestrian. This is one of the most common ways that blind people get killed crossing streets, so do yourself and them a favor and don't stop for them on your light if they haven't started crossing yet!
b. At an intersection with a stop sign, if they know you're there but aren't crossing, it's because most likely because they want you to cross first, so that they can ensure the road is clear and that you won't start going when they start crossing. It might also be because they're waiting to cross the other way, are debating which way to go, or they don't intend on crossing at all. If it looks like the blind person is aware of you being there but they aren't crossing, just go ahead.
Just some other miscellaneous tips that aren't necessarily about the White Cane Law, but that are relevant to street navigation.

1) You can offer to help a blind person cross the street but don't insist. If they decline, just let them cross alone.
2) If they accept your help, let them take your arm. Don't grab their arm. This scares the living crap out of people. And definitely don't grab their arm before offering help at all.
3) If a blind person asks for directions, don't use the terms "here" and "there," or "this way" and "that way." Words like "this" or there" only make sense when you're pointing somewhere, and the blind person can't see you pointing, so these words are useless. Use words like "straight ahead," "left," and "right."
4) While some blind people do have residual vision, since you don't know exactly how much the person you're talking to sees, use reference points that they can make use of. Don't tell them "it's the building with a blue and white awning." Tell them something like "it's the very first building on the block," or "it has some steps leading up to the entrance."
5) If the blind person doesn't respond to your offer, it might be because they are deaf/hard-of-hearing. Try waving your hand directly in front of them (respectfully). (The most common cause of deaf-blindness is a condition that causes tunnel vision and hearing loss, so they may be able to see you if you're directly in front of them.) If that doesn't work, try touching them lightly on the hand or tapping them gently on the shoulder. If they then respond and it turns out they are deaf-blind, let them tell you how to communicate with them. There are many ways of communicating with a deaf-blind person, but each person uses a different method, so just leave it to them to tell you what method to use.

*blind for the purposes of this post mean anyone with a significant visual impairment, whether partially or totally blind

Top Do's and Don'ts

Top Do's and Don'ts When Dealing with Deaf or Blind People (in no particular order)

1) Don't: treat us like we're stupid. Deafness or blindness does not affect cognition.
Do: treat us like you would anyone else. The average deaf/blind person has the same intelligence level as the average hearing/sighted person.

2) Don't: feel bad for us. Most deaf or blind people are adjusted to their deafness or blindness and are okay with it and have accepted it. If a deaf/blind person seems like they're having a bad day, there are just as many possible reasons why as for a hearing/sighted person. They aren't necessarily lamenting their condition.
Do: offer support if someone is clearly still adjusting, but don't join their pity party.

3) Don't: treat us like we're gods. We don't need our every little whim met and we don't have the right to boss you around either.
Do: use your usual standards for consideration and thoughtfulness, as you would anyone else. If you open doors for people, then feel free to open a door for us too.

4) Don't: yell. A blind person's hearing is perfectly intact and doesn't need to be yelled at. Yelling doesn't help a deaf person understand what you're saying either. Deaf, blind, or both, yelling gets you nowhere.
Do: use the communication method the deaf/blind person specifies.

5) Don't: avoid terms like "hear" and "see." We're perfectly aware of our sensory loss and don't need you to verbally walk on eggshells to feed our denial.
Do: use the same expressions as you would with anyone else, such as "see you later" or "did you hear about that?"

6) Don't: talk through another person to us. Don't ask a blind person's spouse what they want to order for dinner. Don't look at a deaf person's interpreter when speaking.
Do: speak to the blind or deaf person directly, even when speaking through an interpreter in the case of a deaf/deafblind person.

7) Don't: be afraid to ask about when or how we went blind or deaf, or how we do things.
Do: make it only one of the many topics you discuss. Deaf and blind people, like anyone else, like to talk about more than just one topic.

8) Don't: make fun of us. Some of us have a sense of humor, and some of us don't. Better to let the person set the tone first.
Do: treat us respectfully like any person, and do feel free to join in once the person has set a humorous tone.

9) Don't: assume we need help.
Do: offer it, and don't insist on helping if we decline.

10) Don't: try to take advantage of our deafness or blindness.
Do: realize that we often have alternative ways of finding out about the same things you use your ears or eyes to find out about.

11) Don't: take or touch a deaf or blind person's disability aid, such as a cane, hearing aid, cochlear implant, or guide dog.
Do: treat any disability aid like an extension of the person's body. If you are really curious, ask first and don't be surprised if the person declines.

12) Don't: assume we can't do the job.
Do: lay out the specific tasks that will be needed for a job and ask if we can do it, and if we will need accommodations.