Children who are deaf-blind need a variety of communication options. Communication systems should support natural social interactions and conversations through symbolic and nonsymbolic means. The use of selected tactile communication modes (e.g., objects, tangible symbols, textured symbols and signs) should meet the communication needs of an individual child and supplement the child’s body language and other means of communication. Just as hearing children are exposed to thousands of words before they begin to talk, children who are deaf-blind need extensive experience with objects, signs and other symbols during natural, everyday situations before they can understand their meaning.

Benefits for the Child who does not Learn Visually

Tactile strategies:

  • Address an important sensory mode
  • Help the child to anticipate familiar events
  • Direct the child’s attention to ongoing activity
  • Increase opportunities for social interaction
  • Support participation in activities
  • Give meaning to activities
  • Help the child learn
  • Support receptive and expressive communication

Benefits for Communication Partners

Tactile strategies:

  • Encourage thoughtful and organized interaction with the child
  • Increase observations and responses to the child
  • Promote an expectation of the child’s response
  • Support communication that is accessible to the child

General Interaction Tips

  • Greet the child by touching the back of his or her hand or shoulder.
  • Introduce yourself by saying your name and identifying yourself tactilely (e.g., name sign, symbol, or identification cue).
  • Pause and wait for the child's response.
  • Maintain contact with the child by sitting where you can see the child's responses and are available as a communication partner. Offer your hands to the child (e.g., under the child’s hands so the child can grasp your fingers or get your attention). Or place your hand (s) beside or slightly underneath the child’s hand(s) or part of the body that is engaged in the activity or movement.
  • Encourage the child to explore the environment tactilely, (e.g., to examine materials on table, to feel your own hands while engaged in a variety of activities, to examine the activities of others).
  • Place your hands under the child’s hands as you explore together.
  • Encourage a variety of communicative functions (e.g., request, reject, offer, comment and attention getting) in the conversation.
  • Engage in "tactile conversations" about things by touching them together with the child.
  • At the end of an activity or interaction sign FINISH and tactilely model for the child how to put objects in a finish box or push them away.
  • Say goodbye before leaving the child by using a goodbye gesture (e.g., wave, touch cue on shoulder) and having the child tactilely attend to this signal.

Be Responsive to Child Preferences and Actions

  • Determine the child’s preferences and use those actions or objects in your interaction and in your development of conversations.
  • Observe how the child responds to being touched and use the type of touch that is the least intrusive (e.g., put your hand beside the child’s so they are touching, observe his or her response to determine whether you should take his or her hand).
  • Provide time for the child to process information and observe the child for an anticipatory response. Wait longer than you might for a child of the same age who is not disabled.
  • Attend to, interpret, and respond immediately to the child’s communicative behaviors.
  • Allow the child to respond using the most efficient means for him or her (e.g., pointing, touching a symbol, or handing over a symbol).

Communicate During Everyday Activities

  • Use tactile communication frequently and consistently with the child during daily meaningful and age-appropriate activities and across home, school, and community settings.
  • Identify situations that motivate the child’s communication and in which tactile communication will be used consistently (e.g., offering choices).

Support Communication

Initial Steps

  • Select the communication system that will be the most efficient given the child’s needs, abilities, experiences, and daily activities. Cues and symbols should be accessible to the child, represent the child’s interests, and when possible, have a close physical association to the referent.
  • Use a few cues or symbols consistently and gradually expand them as the child understands their meaning.
  • Engage in parallel play using duplicate materials and provide opportunities for the child to participate in turn taking with objects and other communication means.
  • Create situations so the child can experience other peers and adults using the same communication system for similar purposes (e.g., Mary puts her hand under Sam’s to use his textured symbols while she talks to Sam).
  • Make it FUN!

Shape a Communicative Response

  • Get the child’s attention
  • Have the child feel the object or symbol
  • Wait for at least 5 seconds (wait time should be determined for the individual child)
  • If no response: Introduce 1 item under or on the back of the child’s hands, arm or leg
  • Accept any movement from the child on the item
  • Use hand-under-hand to accept the item from the child
  • Immediately engage in the activity
  • Provide opportunities within the activity to feel the item and to engage in conversation
  • Interpret the child’s reactions and respond appropriately
  • Repeat the communication cycle as appropriate

Create a Need to Communicate

  • Follow the child’s interests and preferences
  • Give the child a desired item that requires him or her to ask for help (e.g., a snack that he or she cannot open)
  • Give the child a limited quantity of something that he or she likes to encourage a request for more
  • Offer choices on a regular basis throughout the day
  • Offer the child something that is disliked or unwanted to allow a rejection
  • Place favorite objects out of reach for the child to request
  • Violate a familiar routine or expectation to allow the child to "coment" on item

Next Steps

  • Once a child seems to recognize an object cue or symbol (e.g., smiles or gets excited in anticipation of a favorite activity), check to see whether the child understands its meaning. How does the child indicate that he or she understands the meaning of the object cue or symbol? How does the child respond if you delay offering the anticipated activity or begin another activity instead of the anticipated one?
  • When the child makes the connection between object cues or tangible symbols and their referents, replace concrete object cues with more abstract ones and increase the number of cues or symbols to expand the child’s vocabulary.
  • Increase opportunities for the child to use familiar object cues or symbols in multiple situations, with different people including peers, and across settings.
  • When offering choices, increase the numbers of options

Requirements for a Communication System

  • The child’s educational team and family members should agree on the most effective communication system and tactile strategies that will be used with the child. They should have a picture and text dictionary of the child’s communication system so that selected cues, symbols, and signs are used accurately and consistently.
  • Communication symbols should be organized in a display (e.g., book, board, photo album, wallet, and calendar box). They should be portable and accessible to the child at all times.
  • Communication displays should reflect the child’s age, interests, physical abilities, daily activities, and experiences. They should be labeled (with word(s), phrases, questions) so communication partners can understand what they represent.
  • Service providers and family members should document how frequently they use the selected cues, symbols, or signs with the child. They should observe and note the child’s responses. Once the child has been exposed to consistent use of the communication system, service providers and family members should determine whether the child understands the meaning of selected cues, symbols or signs. For example, does the child understand the object cue (spoon) for lunchtime? What does the child do if you give him a spoon and wait for his response before offering the food?
  • Update the communication dictionary after regular family/team meetings on what is working, what needs to be changed, and what needs to be added.


Tactile Communication Strategies represents a synthesis of information from Project SALUTE’s focus groups, National Advisory Committee, staff activities, and a review of relevant literature such as the following bibliography.

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