People who have acquired deafblindness will often have previously learned formal language, but may need to adapt their means of communication or learn new methods.

For example, someone with Usher syndrome may retain sufficient vision to continue with sign language but within a reduced visual field, and this should be considered by the person they are conversing with.

Further visual deterioration may need hands-on signing. This means the deafblind person places their hands over the hands of their conversation partner so they can feel the signs being made.

Similarly, somebody who loses all of their vision may adopt the deafblind manual alphabet. This is a form of tactile communication that involves the conversation partner spelling out letters individually onto the deafblind person’s hand.

Whichever method is used, the individual will have reduced access to communication clues. This means:

• No longer being able to see body language, preventing them from gauging emotions or tone, such as joy, anger, disappointment, or sarcasm
• Loss of incidental information, such as who is present, hearing conversations, or sensing a mood
• Uncertainty that an interpreter understands and is conveying the 'full picture'

A deafblind person facing these new problems may become frustrated or distrusting if they feel excluded.