03 - Touch Cues
By Maurice Belote, CDBS Project Coordinator
Individuals who have limited or no functional use of their vision and hearing are often unable to understand what is about to happen to them. Touch cues are used to help individuals who are deaf-blind compensate for the auditory and visual cues they cannot access. While touch cues are frequently used with infants and young children, they are appropriate for individuals of any age who are at a pre-symbolic language level and/or have limited movement because of physical challenges. Touch cues can be an important part of a child or young adult’s receptive communication system.
Think for a minute about the information that infants and toddlers with typical vision and hearing gather naturally: they constantly scan the environment for any information that will help them prepare—physically and mentally—to respond. When a parent walks into a room wearing a coat and holding car keys, the child learns over time what this means and understands that a transition into the car seat will occur. When the parent is holding a diaper and a changing pad, the child is able to anticipate the activity of diaper changing. These visual cues, paired with the carefully chosen words the caregiver uses with the child, give the child clear and complete information about what is going to happen.
Because children who are deaf-blind may miss these auditory and visual cues, they may be living in a constant state of uncertainty. This can lead to anxiety and/or passivity that, over time, can result in withdrawal from social and learning contexts. The challenge is to give children and young adults with deaf-blindness the information they need to make sense of the activities that make up their daily routines, and to bring order and routine to what they might perceive as a fairly disorderly, chaotic world.
Touch cues are physical cues that are used in a consistent manner on the child or adult’s body to give a specific message about what is about to happen to the person. In most cases, the touch cue will be at or near the body part that will be affected and, if the touch cue is used to prepare the child for movement, the touch will give the child information about the direction their body will move. The following are examples of commonly used touch cues. It is important to remember, however, that touch cues are individualized for each child or youth with deaf-blindness. There is no standardized list of touch cues. Deciding on which touch cues to use with a specific individual will depend on how that person receives tactile information and how they prefer to be touched.
|Our Communicative Intent||Possible Touch Cue|
Individual who is lying down is about to be picked up
||Two or three gentle taps beneath the shoulders in an upward direction|
Individual is about to picked up from a chair
Two or three gentle taps in the armpits in an upward direction
Legs are about to be lifted for diaper changing
||Two or three gentle taps beneath the ankles in an upward direction|
|Young child who is being held by an adult is about to be placed in a high chair||Two or three gentle taps on the shoulders in a downward direction|
Individual is about to be suctioned
Gentle tap at the corner of the mouth with the plastic tube
It is important that family members, early intervention/school staff, and friends communicate with one another so that the child’s specific touch cues are used consistently across home and school environments. It is also important that the touch cues developed for a specific individual are clearly explained in the individual’s personal communication dictionary. This will help ensure consistency among team members.
Contact any CDBS staff member for help with implementing touch cues or other tactile cues. Also, check out CDBS Fact Sheet #4 for information on object cues, Fact Sheet #43 on information about tactile name cues, and Fact Sheet #25 on how to create a personal communication dictionary.
Fact sheets from California Deaf-Blind Services are to be used by both families and professionals serving individuals with dual sensory impairments. The information applies to students 0-22 years of age. The purpose of the fact sheet is to give general information on a specific topic. More specific information for an individual student can be provided through individualized technical assistance available from CDBS. The fact sheet is a starting point for further information.