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Introduction: Persons with congenital deafblindness mainly communicate using the bodily tactile modality. Their expressive communication is often formulated by an authentic language that gives the persons with congenital deafblindness low readability towards the rest of the world. This can be an obstacle for the development of their communicative agency. In the present study it is investigated whether a theoretical approach to improvisation can contribute to the development of communicative agency in a person with congenital deafblindness with low readability and authentic language in a dialogical perspective.  Method: The study employs a qualitative design conducted as a dialogical single case study. Even though this research is based only on one recording of a communicative encounter between a person with deafblindness and her communication partner, it is assumed that the study can be used as a representative case study for people with low readability and authentic language.  A video of communication between a person with CDB and a sighted/hearing communication partner is transcribed and the transcription is analysed in three stages through 1) Conversational analysis (CA), 2) Improvisation analysis and 3) Subjectivity/intersubjectivity analysis.  Results: The Conversation analysis proved useful to identify complex turn-taking patterns in the communication. Through the improvisation model it was possible to define the degree of subjectivity/intersubjectivity in every utterance by each participant, as well as how each act was met by the other. With the improvisation model discriminations could be made between the different modalities, as vocal speech and bodily tactile acts.  Regarding communicative agency, the model was useful to analyze degrees of self-expression as well as the balance of subjectivity and intersubjectivity between the participants.  Conclusion and discussion: The model of improvisation contributed to specify subjectivity/intersubjectivity and multimodality in communication, though it did not contribute to the analysis of turn-taking. The model contributed to the development of communicative agency by pointing to the open-ended outcome for each utterance as the most important factor for developing and sustaining communicative agency.  Limitations: The main limitation of this study was that the analyses were performed on only one video-clip with one dyad. Due to time constraints, a consensus check could not be carried out. Recommendations for future research is that, since this is a very innovative method in the deafblind field, replications of the study should be performed on more dyads, different dialogues and more video clips.  Recommendation for practice: The combination of conversation analysis and improvisation analyses can very well be used with focus groups of care professionals in clinical practice under supervision of a trained expert in this method of communication analyses.

Introduction: In this case study, performed in a home situation in Zambia, it was assumed that the child with congenital deafblindness had too poor vision to access sign language without support by the bodily tactile modality. The aim was to explore if a theoretically based intervention on Communicative Relations with a role model who demonstrates communication in the bodily tactile modality and builds on knowledge and competence in sign language can improve bodily tactile aspects of communication between the child and her mother and brother. Method: This study has a qualitative single case study design, which enabled a close analysis of the communication between the child and her mother and brother, by a reflective team. Four members of the reflective team provided insight into the videorecorded episodes in home situations such as bathing and play. Data analysis took place before and after the intervention. The intervention was performed by the researcher as a role model, who is a mother herself, and well trained in the Diamond Model and Dialogical Model underlying the theory of Communicative Relations ( Nafstad & Rodbroe, 2015). Results: The results demonstrated that the intervention with the application of aspects of the Diamond Model was effective in face-to-face interaction, gestures and social interaction, and the application of aspects of the Dialogical Model enhanced the ability to reciprocate signs during the interaction. The findings in this study clarify how use of sign language and hand positions can benefit persons with CDB to improve their communication. The study has shown how competent mother and brother were communicating with the child after intervention using ZSL, reciprocation and imitation and hand positions. The utterances that were addressed by the child to the partners in gestural expressions were answered by the partners. Lastly, it has shown the need to focus on whole-body communication, understanding, and relating to communicative expressions. Conclusion and discussion: It can be concluded that the intervention had indeed a positive effect on a variety of bodily tactile communication aspects between the child and her family communication partners. The role model approach that was used in this study enabled mother and brother and child to learn through reciprocation of roles and imitation. It is a natural form of learning which does not necessarily require shared reference to theoretical concepts. In addition, the study showed that only sign language is not enough. There must be a connectedness between signing and adapted interaction patterns.