Adults with congenital deafblindness and an intellectual disability are at high risk for exposure to chronic and severe stress. Sensory deprivation, separations from primary caregivers, and difficulties in communication, from birth on, make daily life stressful for them. Chronic and high stress can lead to deviancies in the cortisol curve. This, in turn, can have negative effects on mental and physical health. Nothing is known yet about the cortisol curve of adults with congenital deafblindness and an intellectual disability, but our hypothesis is that it will be deviant.In this study, the cortisol curve of six participants with congenital deafblindness was compared to the curve of 40 typical controls. Remarkably, in spite of all past and present stress factors, the cortisol curve of the participants was rather normal. Possible explanations for this finding are discussed, amongst others individual differences in experiencing stress. Implications for further research are discussed.

Interaction with people with congenital deafblindness (CDB) and an intellectual disability (ID), and recognition of their often unconventional expressions, is complex. In this study, the effects of a two-phase intervention program intended to foster harmonious interaction and the use and recognition of expressions based on a bodily emotional trace (BET) were examined. Five adults with CDB and an ID, and ten of their caregivers participated in the study. A multiple-baseline design was used. Target behaviours were attention by caregiver, attention by participant, confirmation by caregiver, mutual affective involvement, quality of interaction, participant expressions based on a BET, and participant expressions based on a BET recognised by the caregiver. Overall, the results tend to be positive. However, some of the changes were minimal and the results varied considerably among participants.The results of this study suggest that it is possible to foster harmonious interaction and the use and recognition of expressions based on a BET in adults with CDB and an ID. evident in eye-gaze, smiling, and reactions to acoustic signals similar to the human voice (Pérez-Pereira & Conti-Ramsden, 1999). Vision and hearing cannot be addressed in the same way in interactions with people with congenital deafblindness (CDB). It is therefore necessary to address other senses, like the tactile modality.People with CDB mainly experience the world through their proximal senses, often resulting in expressions that are atypical for seeing and hearing people. These expressions can be stereotypical and idiosyncratic (Bjerkan, 1996), and difficult for their communication partners to understand. Expressions made by people who have an intellectual disability (ID) in addition to CDB are often even more idiosyncratic and subtle, and are not always used consistently. This makes it very hard to notice and interpret these expressions, complicating interaction and subsequent qualitative communication. Qualitative communication is assumed to be based on harmonious interactions.Moreover, communication is facilitated by a history of shared experiences. Adults with CDB and an ID who live in residential settings meet many different communication partners, which severely limits the construction of a history of shared experiences to communicate about. In short: establishing harmonious interaction and subsequent qualitative communication with people with CDB and an ID is very difficult (Bloeming-Wolbrink, Janssen, Ruijssenaars, Menke, & Riksen-Walraven, 2015;Bruce, 2005;Dalby et al., 2009;Damen, Janssen, Huisman, Ruijssenaars, & Schuengel, 2014;Dammeyer, 2010;Hart, 2010;Janssen et al., 2003a;Martens, Janssen, Ruijssenaars, & Riksen-Walraven, 2014). Communication partners (e.g. caregivers, parents, teachers) need high levels of sensitivity, special insights, and considerable skills to establish harmonious interaction and qualitative communication with people with CDB and an ID (Janssen, Riksen-Walraven, & Van Dijk, 2003b).Several intervention studies have show...

This study examined the effects of the first 2 years of the ongoing Project CHANGE, aimed at improving interaction and communication in adults with congenital deafblindness (CDB) and an intellectual disability (ID). Six adults with no history of deafblind education participated in this study. These first 2 years of CHANGE involved an improvement in living conditions, including a transition to a new group home and interactions with specialized caregivers. Video recordings and file information were used to measure interaction and communication during baseline (T0) and two subsequent periods (T1 and T2). The results show an improvement in interaction: attention by the caregiver, confirmation by the caregiver, and affective involvement all improved. An improvement was also shown in the participants' level of expressive communication and in the variety of their communicative behaviors. The improvements over time emphasize the need for a specific approach for persons with CDB and an ID.