Supporting Deaf Students With Multiple Disabilities
Mar 27, 2026
Practical Strategies That Lead to Real Progress
Students who are deaf or hard of hearing with multiple additional disabilities require a level of support that extends beyond traditional instructional approaches.
These students present with complex, interrelated needs—including communication, sensory access, motor function, and medical considerations which cannot be effectively addressed in isolation. When services are fragmented, progress is often limited. When support is aligned and integrated, meaningful outcomes become possible.
Many educators and specialists find themselves asking the same question:
Where do I begin?
In my experience, the answer is not found in a single strategy or intervention. It is found in how we approach the work—particularly how we collaborate as a team.
I came to this realization through experience.
Early in my career, I worked with a student—whom I will refer to as Angel—whose needs fundamentally reshaped my understanding of effective practice.
A Shift in Perspective
At the time, I had several years of experience working with deaf and hard of hearing students. I approached my sessions with intention and consistency.
Angel presented with significant needs. She was profoundly deaf, nonverbal, did not demonstrate sound awareness, and was not using formal language. She also had complex medical and physical challenges.
I worked with Angel one time a week for thirty minutes. Angel's mom typically did not put her hearing aids in but would send them to school with her. Each week, I would enter the classroom and find her hearing aids still in her medical pouch, not yet in her ears. I would check her hearing aids to ensure they were working, put them in her ears, and reinforce the importance of consistent use with the team. From there, I would sit next to her and focus on sound awareness—using instruments, environmental sounds, and different items in an effort to elicit a response.
Despite these efforts, she did not respond in ways I expected.
I also attempted to engage her through toys and familiar objects, looking for signs of interest or enjoyment.
There was little observable response.
I reached a point where I was unsure how to proceed.
Reframing the Challenge
At the time, I believed the primary challenge was the complexity of the student.
In hindsight, the challenge was not Angel—it was my approach. And the approach of the team.
Each specialist was working independently, intentionally avoiding overlap to preserve individual service time.
- DHH services
- Speech and Language
- OT
- PT
- Vision
While each professional contributed valuable expertise, we were not working cohesively.
As a result, we were missing critical connections.
The Turning Point
The shift occurred during a session when multiple team members were unintentionally present at the same time.
Angel had been home for two weeks due to health concerns. When she returned, several specialists came in to make up required IEP service minutes. By chance, four of us arrived within the same window.
I walked into the classroom and saw the SLP in the middle of her session. She was reading a book to Angel.
I immediately noticed that Angel’s hearing aids were not in. Without them, she had no auditory access to the story. The activity, while well-intended, was not accessible or meaningful to her in that moment.
I gently pointed this out, and the SLP asked if she could stay and observe what I was doing so she could learn more about how to support Angel.
I placed Angel’s hearing aids in and explained that I was working on sound awareness—specifically, encouraging her to respond to sound.
Together, we positioned ourselves on either side of Angel and began presenting sound through instruments, clapping, and light-up toys, attempting to condition her to turn toward the source.
At that point, the vision specialist entered the room.
After observing for a moment, she provided critical insight: the materials we were using were outside of Angel’s visual field. She could not see them at all.
With that information, we adjusted. We repositioned ourselves within her visual field and modified the materials so they were visually accessible.
Shortly after, the occupational therapist joined us.
She immediately noted another important factor—Angel’s positioning. At the time, Angel was reclined in a specialized seat. The OT explained that in order for Angel to turn her head, she needed to be positioned more upright so she could engage her core.
She repositioned Angel, and we continued the activity.
And then, Angel responded.
And we celebrated.
In that moment, a critical realization emerged between us:
Each of us held essential information—but we had not been integrating it.
Within a single, shared activity:
- I was addressing auditory response
- The vision specialist was supporting visual access and tracking
- The OT was facilitating motor control and positioning
- The SLP was observing emerging communication, including a slight change in facial expression that suggested engagement
We needed all of it together to make progress.
That realization marked a turning point in our work.
Understanding the Complexity
When working with students who are deaf and have multiple additional disabilities, it is not possible to address areas of need in isolation.
Communication, sensory access, motor function, and engagement are deeply interconnected and continuously influence one another. Progress in one domain is often contingent upon access and support in another.
As a result, approaches that target a single area without considering the whole child are inherently limited.
These students must be understood as integrated learners, with each developmental domain functioning as part of a unified system.
Recognizing this interdependence required us to fundamentally shift our approach—and it changed both our practice and our outcomes.
Six Strategies That Changed Our Practice
The following strategies emerged from that shift. While each is important individually, their effectiveness lies in how they work together.
1. Establish True Team Collaboration
The most significant change we made was moving from isolated service delivery to a collaborative team model.
Rather than working independently, we:
- conducted sessions in pairs
- intentionally rotated team members
- actively included classroom staff in the process
This ensured that:
- strategies were consistently implemented
- observations were shared in real time
- support extended beyond individual sessions
Classroom staff, who were present throughout the day, began to stay for our sessions and became active contributors rather than passive participants. This allowed them to implement our strategies when we left the classroom.
This alignment significantly increased the effectiveness of our interventions.
2. Prioritize Observation Before Intervention
Prior to this shift, our approach was task-oriented—we focused on implementing strategies.
After our shift toward colloborative therapy, we began with observation.
As a team, we carefully observed:
- subtle responses to sensory input
- changes in body tension
- indicators of engagement or discomfort
- emerging communication behaviors
Each team member contributed a different perspective.
What appeared insignificant in isolation became meaningful when viewed collectively.
These observations provided the foundation for informed, responsive intervention.
3. Implement Predictable and Meaningful Routines
We identified a lack of predictability in Angel’s daily experiences.
Transitions were not clearly communicated, and activities lacked consistency.
To address this, we began to introduce tactile supports to create structure.
For example, we observed increased tension when Angel was transitioned into her stroller. In response, we introduced a tactile cue—a piece of the stroller strap—prior to the transition.
Over time, she began to anticipate the transition and demonstrated increased readiness.
Predictability reduced anxiety and supported engagement.
4. Shift from Language Demands to Accessible Experiences
Initial interventions relied heavily on traditional language-based approaches.
However, these were not accessible given Angel’s sensory and communication profile.
We shifted our focus from eliciting language to creating meaningful, accessible experiences.
This included:
- movement-based activities
- tactile interactions
- sensory-rich play
These experiences provided a foundation for engagement, which in turn supported the development of communication.
5. Conduct Collaborative Communication Assessment
Once engagement and access were established, we were able to begin meaningful assessment.
This process was collaborative and observation-based.
Together, we evaluated:
- receptive communication
- expressive communication
- interaction patterns
Angel’s communication occurred at very early developmental levels and was expressed through subtle movements and responses.
By working together, we were able to recognize these behaviors, collect meaningful data, and develop instruction aligned with her actual abilities. This information was helpful to everyone who was working with her in every environment.
6. Strengthen Home-School Collaboration
A critical component of progress was strengthening the connection between home and school.
Families provide insight that cannot be replicated in educational settings. They observe patterns, preferences, and responses that are essential to understanding the whole child.
We prioritized:
- consistent communication with the family
- sharing observations and progress
- home-to-school communication systems
We also recognized that daily variables—such as sleep, routines, and overall well-being—directly impacted Angel’s engagement at school.
By aligning home and school perspectives, we were able to provide more consistent and responsive support.
What Changed
Prior to this shift, progress had been limited.
After implementing these changes, we began to observe meaningful growth.
Angel demonstrated:
- increased engagement
- anticipation of routines
- emerging responses to interaction
- greater connection with those around her
The difference was not a single intervention. The difference was alignment—across people, strategies, and environments.
Final Thoughts
Supporting students with multiple disabilities requires more than expertise in individual domains.
It requires integration.
When teams move from isolated practice to true collaboration, when observation informs intervention, and when access is prioritized across all domains, meaningful progress becomes possible.
Often, the most significant changes in outcomes begin with a shift in perspective.
And in this case, that shift changed everything.
Want to See These Strategies in Action?
If you would like to see how these strategies are applied step-by-step, I walk through this process in a recent training.
WATCH THE FREE TRAINING ON YOUTUBE
Ready for More Support?
If you are supporting students who are deaf with additional multiple disabilities, you should not have to navigate this work alone.
Inside The Professional Academy and Friend Academy at The Online Itinerant, you will find:
- observation tools
- communication assessments
- ready-to-use activities
- IEP goals aligned to assessment data
- trainings on deafblindness, autism, and complex needs
You can learn more here:
EXPLORE THE ACADEMY
Frequently Asked Questions
Where should I start with a student who has multiple disabilities?
Start with observation and access. Ensure the student can physically, visually, and auditorily access the environment before introducing targeted instruction.
Why is collaboration essential?
Because each specialist provides critical insight. Without collaboration, important information is missed, and interventions are less effective.
What if the student is not responding?
Lack of response often indicates lack of access. Reevaluate positioning, sensory input, and engagement before adjusting instructional goals.
How do I involve families more effectively?
Build trust through consistent, respectful communication and create systems that allow for shared observations between home and school.
