Communication Skills and Sensory Substitution
Choosing a communication modality
Communication instruction is a matching problem, not a loyalty test. Options include braille (contracted and uncontracted), large print, audio (human-read and synthesized), screen readers, screen magnification with speech, refreshable braille displays, OCR apps, handwriting and signature guides, touch typing, and labeling systems. The right choice depends on reading history, tactile sensitivity, hearing, cognition, motivation, current and anticipated tasks - not on allegiance to one medium. Most consumers use several modalities and choose by context: speech for quick messages, braille for labels and notes, large print for mail.
Teach the underlying skill, not just the device: listening efficiency (speed, navigation, skimming), keyboarding, file and folder organization, contact management, note-taking, and safe handling of personal information. For deafblind consumers, address tactile communication - tactile sign language, print-on-palm, Tadoma, and refreshable braille paired with a phone - plus relay and interpreter services. Braille literacy has declined in absolute numbers but remains a strong predictor of literacy and employment for people with no functional vision.
Traps
Assuming braille is obsolete, or conversely that it suits everyone (diabetic neuropathy, tremor, and cognitive change can make it difficult). Assuming audio fits every learner regardless of hearing loss or auditory processing. Forgetting that 'large print' is not a fixed size and must be verified with the consumer.
Worked example
A retired teacher with profound hearing loss and recent total vision loss wants to keep a journal. Audio would fail on the hearing side. The plan: a refreshable braille display paired with a notetaker, taught in short daily sessions, with uncontracted braille on paper as a backup for phone numbers.
Rule of thumb: ask what the task demands and what the person's senses and hands can deliver.