Intellectual Disabilities and Deafblindness

For many years I have cooperated with a team of experts on deafness and deafblindness, at the Health Center of the Hospital of St. John of God, in Linz (Upper Austria), under the leadership of Dr. Johannes Fellinger. The Board of Directors of an Institution of Persons with Intellectual Disabilities asked the team to investigate whether:

  • “unidentified” people with deafblindness were in the Institution
  • people with deafblindness could be distinctly categorized

In cooperation with the Center’s medical and psychological staff, and with the Hospital’s Vision Clinic, 253 people with Intellectual Disabilities (ID) were assessed.

This study was published in the October 2009 issue of Journal of Intellectual Disability Research, pp. 874-881. The results are summarized below.


Background: Early identification of deafblindness is essential to ensuring appropriate intervention and support. Previous studies indicate that deafblindness is often overlooked. We aimed to discover the extent to which deafblindness in people with ID is undiagnosed.

Method: A survey was made of the 253 residents of an institute that provides residential and occupational facilities for people with ID. Otoacoustic emission testing was used to screen residents for hearing impairments. Those who did not pass were assessed by behavioural audiometry. Visual acuity was assessed with one of the following: EH-Optotypes, LH-Optotypes, Teller Acuity Cards, Cardiff Acuity Cards, or the Stycar Ball Vision Test.

Results: Prior to the study, of the 224 residents able to complete both auditory and visual assessments, hearing impairments had been diagnosed in 12.5% of the residents, and visual impairments in 17%. Upon completion of the study, these figures rose to 46% and 38.4%, respectively. Deafblindness was diagnosed in 3.6% of the subjects before the study, and in 21.4% after it was completed. Most of the deafblind individuals (87.5%) had profound ID.

Conclusion: Deafblindness is not usually identified by standard medical screenings, or by care staff. Individuals with this disability, however, require special care. Four categories of deafblindness are proposed, based on the severity of impairment in each sensory modality. The tests used in this study are noninvasive. They are appropriate for individuals with ID, and with children. Early and periodic vision and hearing screening is recommended for individuals with ID.

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