1.1 Nordic material for the functional assessment of deafblindness
The Nordic material for the functional assessment of deafblindness has been developed through collaboration between professional environments in the Nordic countries. The material is based on the Nordic definition of deafblindness and is a revised and updated continuation of earlier assessment material. The aim has been to facilitate a more shared and recognisable practice for functional assessment in the Nordic countries.
The material is based on a functional understanding of deafblindness and may be used in cases of both congenital and acquired deafblindness. It is based on the ICF (International Classification of Functioning) and provides support for assessing how vision, hearing and the bodily-tactile sense are used in everyday life. The assessment is built on several elements, including a common professional framework, relevant medical and personal information, indicators from observation and interview guides. Together, these provide a basis for a holistic assessment of sensory functioning.
1.2 Background
The Nordic countries have a long tradition of collaboration concerning knowledge, services and assessment related to deafblindness. Since the 1980s, there has been both a common Nordic definition of deafblindness and common assessment material. The definition has been revised several times, most recently in 2024, and emphasises function rather than medical factors alone.
The earlier assessment material has only to a limited extent been updated in line with changes in the definition and new knowledge in the field. At the same time, practice regarding functional assessment of deafblindness has developed differently across the Nordic countries. This has created a need for updated material that may contribute to a greater degree of shared understanding and more similar practice across the region.
1.2.1 The Nordic definition
The Nordic definition describes deafblindness as a combined vision and hearing impairment of such severity that it is hard for the impaired senses to compensate for each other. Thus, deafblindness is a distinct disability. The consequences may vary, but often affect communication, access to information, and orientation and mobility. The definition emphasises that the degree of severity and the consequences are influenced by several factors, including when the sensory loss occurred, whether it is stable or progressive, and whether there are additional disabilities. When vision and hearing cannot compensate for one another, other senses, particularly the tactile sense, become especially important.
1.2.2 The importance of the environment in the functional assessment
The functional understanding of deafblindness is based on the ICF and emphasises the interaction between the individual and the environment. Functioning is understood as something influenced both by individual prerequisites and by the way in which the environment is adapted. This means that deafblindness is assessed not only on the basis of the degree of sensory loss, but also on the basis of how the environment may either intensify or reduce functional challenges.
In the functional assessment, it is therefore important to examine how the person uses the senses in concrete situations and how people and surroundings can support this. The assessment cannot be carried out in isolation from the social and practical context in which the person lives.
1.3 Purpose
The purpose of the material is to support the functional assessment of deafblindness. Deafblindness is understood here as a functional condition, not a diagnosis. Through the assessment, relevant medical, educational and other professional information is gathered to form the basis for an overall evaluation.
The assessment should help to clarify whether functional deafblindness is present. The outcome may subsequently be used as a basis for planning interventions and adaptations. The process presupposes interdisciplinary collaboration, professional judgement and awareness of ethical considerations in relation to the individual.