Mr. Phillip Block
English 201
09 May 2008
Research Paper on Deaf-Blindness
Have you ever thought about what it would be like to lose your sense of hearing or even your vision? Perhaps you have lost hearing for a brief period of time or have to wear glasses or contact lenses to correct your vision. Well, for citizens who are deaf-blind there is nothing that can be done to bring back their auditory and visual senses; glasses or contact lenses, hearing aids, or other devices cannot not fix this condition. Now, imagine having a baby born without vision or hearing and having to teach him or her how to communicate, interact with others, and live a normal life. Throughout this paper, one will learn some background information regarding the history of deaf-blindness and the advances that have been made since the first person who was deaf-blind received an education. Also, one will learn how deaf-blind children are taught to communicate and to live up to their potential using different devices and strategies both inside and outside of the classroom. Next, this paper will discuss some of the struggles that children who are deaf-blind face developmentally, emotionally, behaviorally, and physically. Lastly, this paper will discuss the importance of play and recreation in the lives of deaf-blind children and the education of students who are deaf-blind in the general education classroom.
According to Barbara Miles with the National Information Clearinghouse on Children Who Are Deaf-Blind, “deaf-blindness is a condition in which the combination of hearing and visual losses in children cause ‘such severe communication and other developmental and educational needs that they cannot be accommodated in special education programs solely for children with deafness or children with blindness’ or multiple disabilities” (1). There are multiple causes that can lead to the loss of hearing and vision. Some of the causes include syndromes, multiple congenital anomalies, prematurity, congenital prenatal dysfunction, and post-natal causes (Miles 1).
Throughout history, there have been programs to help educate the deaf-blind. Victorine Morriseau was the first person who was deaf-blind to receive a formal education in Paris, France (Collins 1). In the United States, Laura Bridgman was admitted to the Perkins School for the Blind in 1837 (1). In 1887, Anne Sullivan was sent to teach Helen Keller which “created a worldwide interest in the education of children who are deaf-blind” (1). Helen Keller and Anne Sullivan played a huge role in the education of children who are deaf-blind. Then, between 1962 and 1964, a “worldwide epidemic of rubella resulted in the birth of thousands of deaf-blind children” (1). This epidemic “highlighted the lack of facilities, manpower, and expertise to meet the needs of these children” (2). Consequently, many schools for the deaf-blind were started in all parts of the world, including the United States. For the next few years, Congress focused on passing laws to help set up programs directed to serve the needs of children and adults who are deaf-blind (2). In 1988, “The National Coalition on Deaf-Blindness was formed, to advocate for continuation of special services for deaf-blind children and adults nationally” (3). The Education of the Handicapped Act (known as the Individuals with Disabilities Education Act today) was reauthorized in 1990 to continue federal programs for children who are deaf-blind (3). It is apparent that the education of deaf-blind children and also the services available have changed remarkably throughout history.
The United States has a large number of people who are considered deaf-blind. Over 10,000 children are deaf-blind and range in age from birth to twenty-two (Miles 1). “It has been estimated that the adult deaf-blind population numbers 35-40,000” (2). The American Foundation for the Blind approximates that there are 93,000 visually impaired students and 10,800 of them are deaf-blind and are served in special education classrooms (2).
With so many children and adults who are deaf-blind, multiple communication devices must be available for deaf-blind people. Also, people who are deaf-blind need different safety devices to warn them of fires and even different devices to wake up in the morning or monitor their own children. Communication devices are always changing and becoming more technologically advanced for children and people who are deaf-blind.
Some devices that have been used by people who are deaf-blind include doorbell accessories and electroalarm clocks, alarm alert systems, nuvox sentinels, code-com sets with touch-tone telephones, univakts, vibravakts, special smoke detectors, sound horn type smoke detectors, vibrating alarms, autodigital vibrating alarm clocks, bed vibrators, portable auditory trainers, mono-fonator systems, travelear FM auditory training systems, personal FM system receivers, auditory training units, voice-lites, optacons, canon communicators, and mowat sensors (Carmen and Hurvitz 29-287). All of these devices help people who are deaf-blind every day.
While some of these devices are used to communicate, some are also used as alarms; in the case of an emergency, a deaf-blind person may use a fire alarm or a simple alarm to wake them up. For example, the doorbell accessory for an electroalarm clock “allows a hearing-impaired person to sense the doorbell is ringing through the vibration of the bed pillow. It also functions as a signaling and wake-up device” (29). Another device that acts as an alarm is called the alarm alert. The alarm alert “can be used as a wake-up alarm clock, baby alarm/alert, smoke or fire alert, telephone or doorbell signal alert, or general emergency alarm” (51). A nuvox sentinel is a device which “alerts an individual to the ringing of a telephone or doorbell, a crying baby, or other such sounds” (53). It “is activated by sound and can turn on a lamp or a chair or bed vibrator” (53). The next device helps a “deaf-blind person to receive and send telephone messages” (81). This device is called a code-com set with a touch-tone telephone and Braille typewriter. The sender communicates using a form of Morse code or another type of code that is known by the receiver. “The message comes through a vibrating pad at the front of the Code-Com and is interpreted through the fingertips” (81).
A univakt is another device which is “designed to alert a hearing-impaired parent to sounds and movements of an infant” (127). A univakt works by having a microphone placed close to where the infant sleeps. “When any audible disturbance, such as crying, is detected, a continuous signal is emitted. This signal can be connected to different optical and tactile awakening devices, such as a blowing fan, flashing lights, or a vibrating bed” (127). Another device used by deaf-blind people is called the vibravakt. This device vibrates “when activated by an acoustic signal such as an alarm clock ring, telephone ring, or fire alarm” (129). Also, there are special smoke detectors for deaf-blind people.
Specialized smoke detectors for people who are deaf-blind work through a wiring system which vibrates to warn of a fire. There is another type of smoke detector which is called the sound horn type. It contains a detector to detect a fire, but the transmitter “will sound and send a signal to the horn receiver in the neighbor’s home” (135). Therefore, a deaf-blind person would have to rely on a next door neighbor in the instance of a fire. A number of alarm type devices use some sort of vibrations to wake a deaf-blind person. Some of these devices include vibrating alarms, electroalarms, autodigital vibrating alarm clocks, and actual bed vibrators.
Furthermore, there is a device, called a mono-fonator system, which is used to help “stimulate, control, and structure a person’s speech” (211). This device also “provides the necessary cues for controlling pitch, loudness, duration, inflection, and rhythmical patterns, and for learning production and coarticulation of vowel and consonant sounds” (211). The voice-lite is another device which relies on tactile stimulation. There is “a sensitivity dial on the unit [that] can be set to respond to an individual’s volume control problem” (255). Basically, the voice-lite helps people who are deaf-blind control their voice and help with breath control. The optacon is a very expensive device which “is a reading system that gives deaf-blind persons immediate and independent access to the world of print” (283). This machine “converts the image of a printed letter or symbol into a tactile form that can be felt with one finger” (283). When the letters are converted, they are printed in a larger, vibrating form.
Next, there are Canon communicators which allow deaf-blind people to communicate or acquire information from people who can see. “Letters or symbols are selected on the unit’s keyboard, and the message is printed out on a paper-tape display” (285). The only downfall of this device is that the deaf-blind person using it must be fairly accurate at spelling and good at fine-motor skills to use the keyboard (285). Lastly, there is a device called a mowat sensor. “This unit is a handheld, electronic travel aid for deaf-blind persons” (287). This device is similar to using a long cane or a guide dog and is used to direct a deaf-blind person (287). With all of these technological devices to help them, children and people who are deaf-blind wake-up in the morning, communicate, and take safety measures more easily. Children and adults who are deaf-blind also communicate through different communication strategies.
Along with communication devices, there are also a number of basic communication strategies that are taught to deaf-blind children and adults.
Principal communication systems for persons who are deaf-blind are these: touch cues, gestures, object symbols, picture symbols, sign language, fingerspelling, signed English, Pidgin signed English, Braille writing and reading, Tadoma method of speech reading, American Sign Language, large print writing and reading, and lip-reading speech. (Miles 4-5)
Along with various communication strategies, there are also a number of different communication systems. These systems include receptive communication systems and expressive communication systems (Alberto and Wolff 2).
The most common types of receptive communication systems are speech, written communication, graphic and nontactile symbols, tactile symbols and object cues, gestures, movement cues, manual sign language, tactile sign language, Braille, and touch cues. (2)
A couple of the most important things to keep in mind when communicating with deaf-blind people is the type of communication system being used and how partner friendly the means of communication is when interacting (2). According to Alberto and Wolff, “the most commonly used expressive communication systems are the same as receptive communication systems except for idiosyncratic systems” (2). Idiosyncratic systems are specific ways of communicating between partners that is understood by the people using them. “Idiosyncratic systems vary in their level of familiarity, may be difficult to interpret, and limit the student’s ability to express himself or herself” (2). Essentially, it is important to take into consideration the communication system being used when interacting with a student who is deaf-blind because it will make the interaction more meaningful.
Next, there are many different types of gestures that can be used by children who are deaf-blind. First, “gestures are actions that are produced with the intent to communicate. They may be expressed by the hands, head, or entire body” (Bruce et al. 637). Gestures can be categorized as “either primitive and conventional or as contact and distal” (638). “Primitive gestures usually include the physical manipulation of oneself and others, such as pushing or pulling another” whereas “conventional gestures are less idiosyncratic to a child’s experiences which makes them more interpretable” (638). Conventional gestures can be used in a variety of settings and situations which makes them easier to interpret. According to Bruce et al., “children and adults with disabilities who expressed themselves through conventional gestures communicated more often and produced more frequent communicative repairs” (638). On the other hand, “contact gestures involve physical contact with objects and people” (638). With these types of gestures, less communication occurs (638). A study done by McLean et al. in 1991, “found that three of the four distal gesturers they studied had higher rates of expressive communication and initiated communication more often” (Bruce et al. 638). “Distal gesturers are able to gesture about objects, people, and events that are at a distance from their bodies” (638). However, “children who are deaf-blind often struggle to make the transition from primitive to conventional gestures and have been described as having a limited repertoire of conventional gestures” (640). Overall, gestures are a huge part of communication for children and people who are deaf-blind.
Additionally, in a study recorded in the Journal of Visual Impairment and Blindness, seven children who were deaf-blind and between the ages of four and eight were observed in order to monitor the types of gestures they used (641). “All of the participants communicated between Levels III and VIII of the Communication Matrix” (641). The levels of the Communication Matrix are:
Level III: intentional communication (presymbolic and nonconventional), Level IV: conventional communication (intentional and presymbolic), Level V: concrete tangible symbols (an optional level experienced by only some children), Level VI: single abstract symbols and Level VII: combinations of two to three abstract symbols. (Bruce et al. 642)
Overall, the study found that the participants used forty-four different gestures (643). Also, “the participants expressed primitive or contact gestures more frequently than conventional or distal gestures” (643). Moreover, the frequency of gestures varied among students who were deaf-blind. One student gestured 326 times in a six hour period while another student only gestured 38 times in a six hour period (646). In addition, the function of the actions varied, but “four children used gestures most often to express the function of requesting an action” (646). Other functions of the gestures included requesting an object, protesting, or commenting on an action (647). In summation, this study shows how much young children who are deaf-blind need to communicate through a variety of gestures and how often they depend on gestures to learn and meet their needs.
As mentioned before, there are other means of communication strategies besides gesturing which are effective for children who are deaf-blind to communicate. In order for communication to be purposeful it must meet certain criteria. “Alvares and Sternburn (1994) defined [guidelines for] functional communication as interactive, mediating subsequent events, used effectively in everyday settings with adults and children, achieving material and social outcomes, and progressing to higher levels of efficient and effective communication” (Engleman et al. 2). Some forms of nonlinguistic communication that children who are deaf-blind use are intentional behaviors, objects, signals, and natural gestures. Furthermore, these different nonlinguistic modes are often combined with other forms of communication (7). McLetchie and Riggio think “it is important to distinguish between intentional and nonintentional behaviors” (7). This is an important aspect to keep in mind when other people are working with deaf-blind students because “it is possible to assist children to demonstrate intentionality by teaching them to use deliberate actions when indicating choices” (7). Touch cues along with prompts help children with deaf-blindness communicate information to others (7). “For example, a certain type of touch may indicate that it is time to stand up, or sit down. Teachers can begin by introducing three or four touch cues and then add more as these cues are mastered” (7). Touch cues are important in the early years of education for children who are deaf-blind.
Children who are deaf-blind also use object cues. “Object cues provide children who are deaf-blind with reminders of the activity that needs to be completed. Initially, real objects are used as cues” (7). However, over time, the real objects may be diminished to a raised-tactile pictures or natural cues such as “the car door opening, meaning ‘time to get out’” (7). Along with intentional behaviors and touch/object cues, there are also different calendars and communication shelves that help children who are deaf-blind communicate. “Calendars can help bring order into the world of children who are deaf-blind” (7). These calendars or shelves “include objects, drawings, pictures, words, or some combination of these symbols that represent items that are meaningful to the individual” (7). There are multiple advantages to using communication shelves for children.
First, the child who is deaf-blind gains knowledge of the order of activities in the day. Even though these activities can change, the overall consistency and structure provide a sense of security. In addition, the child learns that activities have a beginning and an end. This knowledge is important in building concepts of sequence and time, as well as linking types of activities to each other. The communication shelf also uses the components of everyday routines to establish a correspondence between words and their meanings through naturalistic activities. (Engleman et al. 7)
Next, there are signals which children who are deaf-blind use to communicate. Everyday signals used by children who are deaf-blind include reaching for an object, pushing away an object that is not wanted, or pulling a person toward a specific destination (8). These are all forms of nonlinguistic communication in which deaf-blind children interact to meet their needs.
In addition to the nonlinguistic forms of communication, there are also ways that children who are deaf-blind communicate linguistically. However, “some do not develop either the receptive or expressive capacity for speech” (8). It is important to keep in mind that “children who are deaf-blind develop slowly because of their sensory deficits and limited experiences and interactions with others in the environment” (8). One form of linguistic communication is American Sign Language (ASL). Another type of sign language that is used is tactile sign language. “In this type of tactile signing, the communicator’s hands are placed under the receiver’s. The communicator then uses manual signs, touching the receiver’s hands and moving them when necessary” (9). Yet another means of linguistic communication is the Tadoma system. “In the Tadoma system, the hand of the ‘listener’ is placed over the face and neck of the speaker to monitor actions of the face associated with speech, and the listener’s fingers sometimes touch the speaker’s mouth” (9). Overall, there are multiple means of linguistic and nonlinguistic communication that help children who are deaf-blind interact with society. In addition, there are even different communication systems. There are also lots of special devices for children who are deaf-blind and families to help them out on a day to day basis. Communication is especially important for children who are deaf-blind to develop positive relationships with other people.
After reading about some of the different devices and strategies that children use to communicate on a daily basis, now one may begin to understand some of the play and recreational habits of children who are deaf-blind. A study done by Lauren J. Lieberman and Janet M. MacVicar “analyzed the current and recreational practices and the barriers faced by 54 youths who are deaf-blind” (755). Children who are deaf-blind have “fewer opportunities for play and recreation than do youths who are hearing and sighted. These lesser opportunities have direct consequences for their levels of physical activity and overall health” (755). The National Center for Chronic Disease Prevention and Health Promotion found that “in the population of people who are hearing and sighted, regular physical activity benefits both physical and psychological health and reduces the risk of heart disease, diabetes, high blood pressure, obesity, and stress-related illnesses” (755). However, children who are deaf-blind do not always have the opportunity to be a part of physical education programs due to their disability (756). Many physical education teachers were not including children who are deaf-blind due to “inadequate professional preparation in teacher certification programs in physical education” (756). Therefore, children who are deaf-blind could be at risk for obesity, diabetes, and other health-related problems.
Play and recreational activities are also important activities in a child’s life. “Play is an important arena in which to develop locomotor and social interaction” (756). Furthermore, “recreational activities fulfill a variety of needs for people who are deaf-blind. First, recreation is an excellent way to facilitate communication among these individuals” (756). Also, “recreation is an essential part of an individual’s transition from school to vocational life, since positive recreational experiences can fill the time when an individual is not working or engaged in activities of daily living” (757). Lastly, “recreation can contribute to the development of a fuller presence and participation in the community, foster friendships, and other opportunities to build relationships, and strengthen employability” (757). Furthermore, recreational activities involve children who are deaf-blind in physical fitness activities that can improve their health (757). Therefore, recreational activities play a huge part in a child’s life. This is why it is so important to include children who are deaf-blind in recreational activities more often.
In the aforementioned study, Lieberman and MacVicar used a questionnaire asking the child who was deaf-blind and his or her family multiple questions regarding their play and recreational habits both inside and outside of their home. What the study revealed was that many parents were not happy with their child’s current level of physical activity, and some parents were not even sure if their child took part in a physical education program at school (762). The study also found that children who are deaf-blind were not given many opportunities in the community to participate in recreational type activities despite the incredible amount of free time many of them have each week (763). “This study found that the most common activities that the deaf-blind youths participated in were swimming, swinging or rocking, walking, using climbing equipment, [and] biking” (763). However, this study also found there are a number of “barriers” that stop children who are deaf-blind from participating in play and recreational activities. “The most common barriers were the disability itself and the lack of knowledge, appropriate programming, staff, communication, time, money, accessibility, and transportation” (764). Overall, children who are deaf-blind do not always have access to appropriate recreational activities due to various reasons which can be dangerous to their overall health.
Along with the struggle of being deaf-blind, these children also have many other struggles developmentally, emotionally, behaviorally, and physically. “Deaf-blindness is often accompanied by additional disabilities” (Miles 2). One cause of deaf-blindness, called maternal rubella, can have effects on the heart and brain (2). Also, “some genetic syndromes or brain injuries that cause deaf-blindness may also cause cognitive disabilities and/or physical disabilities” (2). Along with these struggles, “behavioral and emotional difficulties often accompany deaf-blindness and are the natural outcomes of the child’s or adult’s inability to understand and communicate” (3). Perhaps the greatest struggle that children who are deaf-blind face is trying to learn means of communication (3). In addition to these struggles, children who are deaf-blind also have to deal with “the challenge of learning to move about in the world as freely and independently as possible” which “depends in large […] upon the education they have received since childhood, and particularly upon the communication with others that they have been able to develop” (3). In summation, education is a huge factor in a deaf-blind child’s future. So, not only do deaf-blind children face struggles, but the family, educators, and caregivers of the child who is deaf-blind also have to meet the unique challenges that the deaf-blind individual presents (3). “The most important challenge for parents, caregivers, and teachers is to communicate meaningfully with the child who is deaf-blind” (3). All in all, children who are deaf-blind do not have easy lives; however, with a great education and family support, deaf-blind children’s lives can be fairly normal.
With education being so important in a deaf-blind child’s life, one has to look at where these children are being educated. As mentioned at the beginning of the paper, there are roughly 10,800 deaf-blind children who are educated through the special education program (American Foundation for the Blind 2). However, in the Journal of Visual Impairment and Blindness, there was an article published on ways to “facilitate social supports for students who were deaf-blind in general education classes” (Goetz and O’Farrell 1). Furthermore, “a growing body of literature indicates that students who are deaf-blind are being educated in general education classrooms (1). There are a number of positive outcomes for including students who are deaf-blind in the general education classroom (1). Some of these positive outcomes include “differences in outcome measures of social competence [and] the quality of objectives of Individualized Education Programs” (1). However, “the [deaf-blind] students’ unique educational needs for communication, mobility, and sensory functioning, and the heterogeneity of their cognitive and functional capacities make it challenging to design and deliver effective educational services to them” (1). Through one study done in California, the researchers came up with a “social support package” which was designed to create a rich social context that promoted ongoing interactions among students, teachers, and staff” (4). This social support package addressed three different social support strategies including:
the ongoing provision of information about the individual strengths and needs and about deaf-blindness through a variety of classroom activities and formats, the provision of interactive, multimedia communication systems that are appropriate for the student’s needs and in classroom contexts, [and] the continuous facilitation of social interactions between and among classmates through a range of planned and spontaneous activities and strategies. (2)
What the researchers found was that these different strategies addressed some major issues regarding the education of students who are deaf-blind. The study showed that there are a minimal number of students who are deaf-blind who are attending local school districts; although many educators are providing services for these students, several people may not have sufficient knowledge about deaf-blindness to work with deaf-blind students in a beneficial manner (4). The study also found a greater need for “highly individualized communication systems that rely on a variety of media that is a characteristic of persons who are deaf-blind” (6). Lastly, the study showed that many students who are deaf-blind are often isolated. This stresses the importance of having these students involved in the general education classroom setting. Studies such as this point out the fact that there is so much more that could be done to help these students. For example, this study showed the significance of involving students who are deaf-blind in the general education classroom and other studies have shown the increased need for recreational programs. This just goes to show that there is still a lot to be learned about students who are deaf-blind. While it appears that there are lots of communication techniques and devices for children who are deaf-blind, there is still more that can be done so that these students can live up to their full potential. Educators may have come a long way in meeting the needs of these students, but there is still a long way to go to meet the student’s unique educational needs.
In addition to improving education for children who are deaf-blind, there is also plenty that can be done to improve communication with deaf-blind children. One way to help deaf-blind students is by “conduct[ing] multiple assessments over time and contexts” (Engleman et al. 4). Also, when conducting these assessments, the educators should take into account the environment “because children who are deaf-blind may have difficulty generalizing skills from one situation to another [and] because some environments may require more adaptations than others” (4). By using multiple assessments, educators are able to see the child’s needs and how they are constantly changing along with how to best meet those needs across different environments (4). It is essential that educators use the information they gain from the assessments to help children who are deaf-blind receive a more individualized education that fits his or her educational needs.
Another way to improve communication is by using a team approach involving the family, community members, and educators. By using a team approach in communicating with children who are deaf-blind, the deaf-blind students will feel more included in the school and community environment (4). Along with using the team approach in communication, using inclusive programming is also important. Basically, inclusive programming involves the student more in school activities and in the community, both of which allow for more social interactions (4). Yet another way to improve communication is by developing receptive communication and the residual senses:
[Some] practical strategies for increasing receptive communication and using the residual senses include maintaining interaction at eye level or with special accommodations to visual conditions, using touch cues to initiate or terminate interactions, teaching other communication partners to communicate with the child who is deaf-blind using modes that the child will understand, adapting communication to the child’s needed pace, establishing a respectful and trusting relationship with the child, and interpreting some of the things going on in the environment. (5)
By using these strategies, deaf-blind students may learn to communicate better, and communication may come more naturally. Also, it can help with social interactions in school and among family members. Providing a need or motivation for communication is also important for children who are deaf-blind. Teachers can help motivate children who are deaf-blind by involving the students in many different communication activities and using experiences that are common to the child (5). One of the main keys in communicating with children who are deaf-blind is having consistent communication cues while still using multiple cues. “This multiple systems approach can also help the children generalize their skills to various environments and use progressively more abstract levels of thought in the communication process” (5). By using many different cues, deaf-blind students can interact in many different ways depending on the person they are communicating with.
The next way to improve communication in children who are deaf-blind is by increasing the child’s engagement. “Schwartz and McBride (1995) defined engagement as the total amount of time children spend actively involved in activities that are educationally appropriate” (6). Some ways to increase engagement for deaf-blind students is through setting goals that are age-appropriate for their level of functioning and by allowing more play (6). Also, “the classroom environment is an important factor for heightening levels of engagement” (6). Having students’ desks arranged so the students face one another, appropriate lighting, and an easily accessible classroom can all help increase the child’s engagement, thus increasing communication opportunities (6). Overall, the classroom environment plays a role in the amount of communication that occurs with children who are deaf-blind.
In general, there are multiple ways that educators can help improve communication by simply moving the desks into an order which provides opportunity for social interaction, using different cues, and various other ways. Education is such an important part of deaf-blind children’s lives that educators need to be aware of the advancing studies and technology that are available to help teach these unique students. When children who are deaf-blind are given opportunities for interaction it helps them develop their communication skills and allows for more positive peer communication within the classroom.
Overall, there are many ways that children who are deaf-blind communicate. Also, children who are deaf-blind have many struggles and difficulties because of their disability. However, deaf-blind children are not the only ones who have problems to face; the parents have to deal with a lot, along with educators and other people in the deaf-blind child’s life. While technological advances are being made to help this group of people, there are still more advances to be made. Education is an important part of deaf-blind children’s lives. Educators need to be aware of the latest technological advances, communication techniques, and recent studies to help teach children who are deaf-blind. In summation, this paper touched on the history of deaf-blindness, communication and other devices, communication strategies, some of the struggles that children who are deaf-blind face, and ways that communication can be improved for children who are deaf-blind.
*Just as a side-note, I used the phrasing “children who are deaf-blind” because in special education we put the person first rather than their label. I tried to stay consistent with this throughout but all of my research varied in how they worded it-just wanted to let you know because I know it sounds weird in some cases.
Works Cited
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Bruce, Susan M., et al. “Gestures Expressed by Children Who Are Congenitally Deaf-Blind: Topography, Rate, and Function.” The Journal of Visual Impairment and Blindness 101.10 (2007): 637-52. Academic Search Premier. EBSCO. U. of South Dakota, I.D. Weeks Lib., Vermillion, SD. 6 April 2008
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Lieberman, Lauren J., and Janet M. MacVicar. “Play and Recreational Habits of Youths Who Are Deaf-Blind.” Journal of Visual Impairment & Blindness 97.12 (2003): 755-68. Academic Search Premier. EBSCO. U. of South Dakota, I.D. Weeks Lib., Vermillion, SD. 9 April 2008 < http://web.ebscohost.com/ehost/detail?vid=3 &hid=117 &sid=165523 5d-07e0-4812-b350-ef72da36c1f4%40sessionmgr106>.
Miles, Barbara. “Overview on Deaf-Blindness.” The National Information Clearinghouse on Children Who Are Deaf-Blind (2005). MedlinePlus. U. of South Dakota, I.D. Weeks Lib., Vermillion, SD. 1 April 2008. < http://www.dbli nk.org/lib/overview.htm>.
“Statistical Snapshots.” American Foundation for the Blind (2008) MedLine Plus. U. of South Dakota, I.D. Weeks Lib., Vermillion, SD. 9 April 2008 < http://www.afb.org/section.asp ?SectionID=15#num>.
