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The SKI*HI Institute developed a system of coactive signing to help alleviate communication and instructional barriers for children who are dual-sensory impaired (deaf and blind). The system also can be used to help children who are severely multihandicapped learn how to communicate. The system includes optimized coactive signs that are functional, easy to feel, easy to relate to the referent, and easy to make, and it also includes techniques related to effective coactive sign use. The coactive sign system is illustrated on a series of video tapes that has been field tested and produced and is being disseminated throughout the United States and Canada.

A federally-funded consortium, Project RITCH (Research In Total Communication in the Home), developed a model videotape program to teach total communication to the families of young hearing-impaired children in their homes. The model program resulted from two years of research on issues related to sign selection, presentation and filming, such as use of optimal sign descriptors and use of appropriate camera angles. The research findings lead to the development of a prototype videotape which was field tested nationwide. Information from the field test was used to develop a series of 60 lessons on 20 videotapes. To make the videotapes easily accessible to families of hearing-impaired children throughout the country, the consortium developed and field tested procedures to house the tapes in local video stores and have them distributed to the families at no cost.

This study focused on the hearing-screening procedures used to identify children who have hearing losses who were later enrolled in SKI*HI parent/infant programs throughout the country. Responses to a questionnaire for 1,404 children indicated that although auditory brainstem response (ABR) technology provided the lowest mean identification age, informal hearing-screening procedures (parental suspicion and referral) were the procedure of identification for 80% of the children. The data suggest that formal screening programs are not presently locating the vast majority of infants who have hearing losses. Recommendations for professional and parental education in the area of hearing-loss screening are provided.