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About combined hearing and vision loss

More than 1.5 million people in the United States live with both significant hearing and vision loss. This is sometimes referred to as dual sensory loss. 

People with dual sensory loss may identify as DeafBlind or deaf-blind. Others may identify as having combined hearing and vision loss. Dual sensory loss occurs on a spectrum, meaning that each person’s situation is unique. No two people have exactly the same experience with their vision and hearing loss. 

People can experience dual sensory loss at any age. Causes include illness, injury and family genetics, such as Usher Syndrome. Aging is another common cause. In fact, seniors represent the largest and fastest-growing population with dual sensory loss. 


It is important to remember that most people with significant hearing and vision loss have some remaining hearing or vision that they can access. The best communication option will depend on the person’s type and degree of hearing and vision loss, how the person communicates, and the communication environment. 

For example, people with significant vision loss who lose all or part of their hearing after learning to speak may continue to express themselves through speech. They may need a new way to receive language. Options may include:

  • Using large print options
  • Reading and writing in braille
  • Tracing the shapes of letters on the palm of a person who is deafblind (known as print-on-palm).

As another example, people with significant hearing loss who lose all or part of their vision after learning American Sign Language may continue to use ASL to express themselves. They may need a new way to receive information. Options may include:

  • Tactile sign language
  • Signing within the person’s field of vision
  • Protactile communication.

Additional tools for independence

  • Assistive technology such as screen readers and braille readers make telecommunications equipment, tablets, computers, cell phones and other mobile technology accessible. This is useful to communicate with people who are unfamiliar with more specialized communication methods. 
  • Interpreting services can greatly expand a person’s access to education and employment or vocational training. Interpreters also provide access to community, social, recreational, and cultural events. Interpreters are vital in critical situations, such as counseling, medical care, and interactions with law enforcement or the legal system. 
  • Support service providers (SSP) are trained guides who communicate visual information to people who are deafblind. An SSP may accompany a person who is deafblind on trips to the bank, community events, shopping and other errands.
  • Other tools for independence and personal safety include canes, transportation services and guide dogs. Always remember that you should never pet or play with a working guide dog.

Fact sheets

Tips for interacting with people who are deafblind

It is difficult for people who are deafblind to participate in group settings and pick up on social cues because they can’t clearly see or hear what is happening around them. 

  • To get the attention of someone who is deafblind, gently touch the person on the arm or shoulder. Wait for the person to acknowledge you, then identify yourself. Do not assume that he/she knows who you are. 
  • Always let the person who is deafblind know if you are leaving the immediate area. 
  • If others are present, let the person who is deafblind know who they are and where they are located. 
  • Let the person who is deafblind know if you move an object (for example, a glass of water or a chair). This helps prevent accidents, reduce confusion and avoid embarrassment. 
  • When walking with a person who is deafblind, offer your elbow or shoulder as a guide. Hold your guiding arm close to your side to provide stable contact. Walk slightly ahead of the person who is deafblind. Pause slightly when you arrive at stairs or a curb. 
  • Express yourself clearly in a natural way. Relaxing or exaggerating your gestures may result in confusion. 
  • Learn to use whatever method of communication the person prefers. If you know of another method that might be helpful, share that information. 
  • Check periodically to make sure the person understands your message. Summarizing important points at the end of a conversation is often helpful. 
  • Invite the person to enter the conversation, especially in group conversations. 
  • Ask the person who is deafblind for effective communication suggestions. 
  • Remember communication is a two-way street! Pay attention to the person’s reactions and adjust your communication approach as needed.
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