COMMUNICATION
ASSESSMENT OF VISION OF DEAFBLIND PERSONS

Motto:
There are few human activities we value more, understand less, and perform worse, than person-to-person communication.
(Robert M. Soucie 1979)

Foreword

SINCE 1981 the Nordic Staff Training Centre for Deafblind Services in Dronninglund, Denmark has arranged courses for all personal categories involved in the care of visually impaired-hearing impaired individuals. In that work we experienced that communication was often the most difficult problem when developing services for this group of people. Although the problem was recognized it was not possible to set aside money and time for studying it until Dr. Arthur Jampolsky suggested that I spend a sabbatical year at Smith-Kettlewell Eye Research Institute, which was made possible by a grant from National Science Foundation through the Academy of Finland.

This text is an updated version of the book "Assessment of Vision and Hearing in Deafblind Persons" that was written at Smith-Kettlewell in 1987-88 and printed by Globe Press Pty Ltd in Brunswick, Australia for the Royal Victorian Institute for the Blind in Melbourne, Australia. It is a result of the clinical examinations of numerous deaf patients with retinitis pigmentosa, macular degeneration or other less common eye diseases. During these examinations Lindsay Gimble was my interpreter, research assistant, social worker and secretary and afterwards analyzed the videotapes with me. Her contribution may not be clearly enough visible in the final product, but without her vast experience in communication and her willingness to try to communicate, even when it seemed to be impossible, this work would never have been completed. The project involved almost everyone at the Institute and was always given enthusiastic and skilled support, for which I would like to express my deep gratitude.

I would like to express my appreciation to the many hearing impaired-visually impaired persons who have taught me about their problems in communication and about deaf culture. It has been one of the most rewarding experiences in my work as an ophthalmologist and vision researcher.

SF …1988

Contents

Part I
Communication During Assessment of Vision of Deafblind Person

Deafblind Patients in Departments of Ophthalmology

General Expectations During Communication

Some Facts about Sign Language and Interpreting

Different Types of Communication used by Deafblind Patients

Ethics of Interpreting

Planning for the Examination

Interpreting During a Medical Examination

Relay Interpreting Using an Intermediary Person

Adult Patients with Minimal Language Skills and/or Multiple Impairments

Patients who have forgotten communication

Should the Eye Doctor know Sign Language?

Part II
Interpreter's Role in the Assessment of Vision

Interpreter's Role in the Assessment of Vision

Ophthalmological examinations

Establishing the communication

Demonstration glasses for field defects

Illumination during examination

Clothing

Relocating in the office

Guiding the patient

Breaks

Scheduling

Ophthalmological Instruments and Procedures

Ophthalmological Terminology

Questions

Devices used by Deafblind Persons

Optacon

Videomagnifiers

Magnifying systems for screens

Communication devices

Part III
Tests and Techniques