Teacher Tips

Teacher Tips for Usher

Behavior Indicators for Usher:

  • Possible difficulty maintaining balance
  • Tripping or bumping while walking in changes in lighting (e.g., entering and leaving building on sunny day, etc.), in dim light, or at night; may be accompanied by heightened fear in darkness
  • Sensitivity to bright light or sun or snow; sensitivity to glare (e.g., windows, etc.)
  • Hesitating or stumbling on curbs, steps or unfamiliar terrain
  • Unresponsive to people’s nonverbal or verbal language (e.g., waving “Hello”, etc.) from the left or right or in front

Physical Manifestations of Usher (no way to predict the timing or progression of the vision loss, and progression and visual acuity/visual fields vary from student to student):

  • Deaf, hard-of-hearing or initially hearing
  • Loss of night vision
  • Progressive loss of peripheral vision to the left, right, above and/or below (“tunnel vision”); may still be able to see clearly within the small area of remaining vision
  • May be some loss of central vision

* Above involve continual readjustment to a progressive visual condition for individual and significant others

Possible Emotional Adjustment to Usher For Individuals (may experience few, some or most feelings; with support and training there is a bright future <smile>! :

  • Tripping and bumping into objects and people (startled [surprised, scared], angry, embarrassed ) and missing nonverbal and/or verbal information such as greeting (perplexed, embarrassed)
    • teasing by peers (hurt, angry, sad, lonely)
    • withdrawing and isolating self so other not witness clumsiness/feeling not belong to peer group (sad, lonely), shunning by peers because seemingly “contagious” and/or different (confused, hurt, lonely) and/or struggling to fit in with and be accepted by dominant identity group (anxious, tired)
  • Learning Usher diagnosis (relieved about difficulty being explained, shocked at the news, denied deafblindness exist because reality of Usher so painful, devastated about shattered dreams [e.g., driving], grieved the loss of vision [communication, travel, social, leisure, identity], angry at the injustice [not fair], bargained for a cure, sad about being different, scared about the unknown future [how to communicate and travel with diminished vision; how to maintain relationships; how to be independent and not be burden on family])
  • With approaching graduation thinking about leaving familiar environments and moving to the new and unknown and living independently, going to college and/or work, keeping old friends and forming new ones and/or future marriage and family (scared, overwhelmed, excited)
  • More tripping and bumping and missing information with world seeming to be smaller and smaller (e.g., going from banging head to bumping eye; going from visual sign to tracking sign) and possible temporary loss of (partner, parent, friend, worker) role and dependency on others (demoralized, frustrated, scared, guilt, sad, lonely, tired)

*person needs love, respect, dignity, sense of belonging, and knowledge during continual readjustment to progressive visual (and hearing) condition

Diverse Communication Styles (students may use one or more of these styles, and depend on skill and comfort level; may vary according to settings, changing vision, health, stress, fatigue, etc.):

  • Speechreading unaided or aided (e.g., hearing aids, cochlear implant, etc.) in well lit areas; good speechreader understand 30% -40% of spoken words
  • Hearing (e.g., assistive listening systems, etc.) in relatively quiet settings
  • Signing
  • No adaptations
  • At appropriate distance, position and within smaller central space (e.g., mouth to chest area, etc.)
  • Tracking with hand on signer’s wrist and visually following signs
  • Tactile with hand(s) on signer’s hand(s) and tactually following signs (if welcomed in dim or dark settings)
  • Other (e.g., total fingerspelling, large print TTY, tellebraille, etc.)

Possible Suggestions upon Initial Diagnosis of Usher:

  • Watch for emotional/behavioral changes (e.g., grief, anger, isolation, decreased self-image, etc.); may receive counseling-related services (have periodic psychological evaluations with attention to adjustment to Usher)
  • If student is willing, may provide in-service on symptoms and needs of Usher to classroom or school to foster understanding
  • If clumsy walking, may learn confident, safe travel through Orientation and Mobility (O & M: e.g., sighted guide, self-protective techniques, scanning, trailing, cane, etc.) (Have periodic O & M evaluations to address changing travel needs)
  • If difficulty accessing information, may use adapted communication techniques (e.g., scanning, signing confined to small window, visual tracking, tactile sign language, etc.), adapted devices (e.g., hearing aids/FM listening systems, magnifiers, monoculars, etc.), as well as other helpful items (e.g., sunglasses, caps with bibs, etc.) (Have periodic language evaluations to address changing communication needs)
  • ASL (if hard-of-hearing/initially hearing)? Easier to learn visually and with better vision, augment with speechreading/hearing
  • Braille (if adequate reading vision)? Exposure at young age as fun activity at time of stability and strength provide foundation and sense of control about future, take time to be comfortable and to master skill; if choose not to learn Braille, important to learn about possible future modifications/accommodations and adaptive equipment
  • Transition age? Explore preferred career choices; may remain in first occupation for many years with modifications/accommodations and adaptive equipment later on; may be need for career change
  • May maintain contact with service providers to support generalization of newly learned skills
  • May give resources for contact with other children, teenagers and adults with Usher and families so as to ask questions, to share feelings and experiences, to discuss concerns, to shape positive self-image, to feel socially accepted, to be receptive to adaptive techniques and to learn future options, such as post-secondary education, employment and living independently (e.g., deafblind family weekends, deafblind consumer organizations, DB Link, etc.)

Possible Suggestions for Helpful Environmental Accommodations (to provide an environment that is safe, predictable, accessible, and interesting):

  • Use appropriate lighting across rooms (e.g., classrooms, cafeteria, extra-curricular events, etc.) for access and safety; when traveling in areas of changing lighting (e.g., bright sun to dim entrance, etc.); allow time for vision to adjust
  • Teacher not stand where bright light or direct light (e.g., from window, etc.) shine in student’s eyes to minimize fingerspelling or speechreading difficulties & fatigue, & enhance concentration & academic performance; if possible, close curtains or shades to minimize glare
  • Avoid clutter of walls and floor
  • Furniture should be arranged to provide easy movement in open space; limit furniture rearrangement as much as possible and when necessary inform student privately beforehand; keep drawers and doors closed
  • Allow student to sit where comfortable if maximize seeing/hearing or suggest front side in horseshoe shaped seating arrangement for access to teacher, chalkboard and students (depending on situation); students raise hands and identify themselves before signing/speaking and/or teacher assist student by directing him to the next student to speak/sign; if welcomed and as necessary, convey additional visual information, such as physical description of people, body language and facial expressions, physical description of room (e.g., location of doors, etc.), seating arrangements, when someone leaves or enters room, etc.; if student not respond visually or auditorily, touch shoulder/arm/hand to indicate presence and/or redirection
  • Teacher try to remain in one area of the room when presenting (minimize pacing); keep desired distance and position for speechreading/signing according to student’s needs (e.g., stand 5’ away facing student and confine signs and facial expressions to small window space of face and chest area, etc. ); provide tracking and tactile sign if student give prior (private) consent
  • Teacher wear solid color clothing that contrast with skin tone (light skin tone: black, charcoal, navy, dark green; dark skin tone: white, cream, buff); if wearing appropriately colored clothing is not possible, use a smock to use in the classroom when working with student; no jewelry
  • Use contrasting solid color backdrop behind teacher
  • Keep chalkboard clean when possible; use high contrast chalkboard and chalk (e.g., blackboard with white chalk); privately ask student preferred chalkboard print mode (e.g., letters be 3" - 4" in height, in regular print [not all caps, etc.])
  • Use slower, clear signs and/or speech; allow extra time for group discussions and activities
  • If student experiences difficulty following teacher while taking notes, see if student welcomes notes taken by another student or copies of teacher’s class notes to limit missed information
  • Use appropriate size and contrast of printed classroom materials based on student’s needs (e.g., bold black pen in 16 – 24 font with spacing between lines on non-glare paper, etc.)
  • Allow extra time for completing assignments and tests if needed (time and half)
  • With repetitive academic work, consider limiting questions/problems (e.g., to half, etc.) their peers have to equalize length of time spent in homework or academic drills with peers
  • Allow student to examine wall hung charts, graphs and other similar materials close up beforehand or provide individual copies
  • Use computer adaptations, such as screen color contrasts (e.g., white on black, etc.), large icons, large print, speech, Braille
  • Minimize interactions in dimly lit room or noisy rooms

Possible Suggestions for Assisting Families:

  • Important to form alliance with parents by letting them know school has child’s best interest at heart; parents more likely to work collaboratively with school by letting them know their input is crucial
  • Indicate it is parent’s role to inform student about Usher and school will not disclose information without parental permission; Tell parents that school want to hear their reasons for not informing their child and it is important to ask what the parents think staff ought to tell child
  • If want to discuss impact of Usher in school environment, first ask how child is functioning at home


  • Bagley, M., Mascia, J. and Rothstein, R. (1996). Blind and Severely Profoundly Hard-of-Hearing. Proceedings of the Fifth Canadian Conference on Deaf-Blindness. Living & Learning: A Lifelong Adventure, May 8-11, Vancouver, B.C., Canada, 43-53.
  • Baumgartner, J. Tips for Students with Usher Syndrome. Pennsylvania Deafblind Project.
  • Jordan, B. (2000). Functional Implication & Environmental Modifications with Students Who Have Usher Syndrome. Helen Keller National Center, Sands Point, NY.
  • McInnes, J.M. (1999). Guide to Planning and Support for Individuals Who Are Deafblind. University of Toronto Press, Toronto, ON, Canada.
  • Miles, B. and Riggio, M. (1999). Understanding Deafblindness. Remarkable Conversations. Perkins School for the Blind, Watertown, MA, 22-30.
  • Miner, I. (1997). People with Usher Syndrome, Type II: Issues and Adaptations. Journal of Visual Impairment & Blindness, November-December. American Foundation for the Blind. New York, NY, 579-589.
  • Miner, I. (1995). PsychoSocial Implications of Usher Syndrome, Type I, Throughout the Life Cycle. Journal of Visual Impairment and Blindness, May-June. American Foundation for the Blind. New York, NY, 287-296.
  • Miner, I. (1996). The Impact of usher Syndrome, Type I, on Adolescent Development. Journal of Vocational Rehabilitation, 6, 159-166.
  • Miner, I. and Cioffi, J. (1997). Usher Syndrome in the School Setting. Helen Keller National Center, Sands Point, NY.
  • Romer, L.T., Faus, L.L., Fredericks, B., Reiman, J.W., Neal, J.D. and White, J.L. (1998) Supporting Deaf-Blind Students to Develop Social Relationships. In L.H. Meyer, H.-S. Park, M. Grenot-Schwartz, I.S. Schwartz, and B. Harry (Eds.). Making Friends: The Influence of Culture and Development. Baltimore, Paul H. Brookes.