The impairment can have a variety of causes some of which are genetic. Rubella (German Measles) was a major cause in days before the development of the preventive vaccine. People with this disability are not necessarily totally without sight or hearing. Some people will have additional physical and/or learning disabilities. Others with this handicap are of high intelligence.

Everyone needs recreational activities.This is especially important for people with sight and hearing problems as it helps to take away feelings of isolation and dependence. Left to themselves young children with this disability are apt to remain passively in one position due to the lack of external stimuli.

On no account should a dance program be started without consulting the participants medical advisor. The dance teacher can safely assume that all the participants will have tension in the eye area, hands, neck, shoulders and legs.

For a blind, deaf and dumb person the most important receptive organ is the hand which has to try and function as both eyes and ears for that person. Methods of communication have to be uppermost in any teacher's mind. Some children will only need to be spoken to clearly face to face. A variety of communication methods exist.

Block is one such method where words are spelled out on to the palm of the person with the sensory problem.

The Deaf Blind Manual Alphabet (also known as finger spelling) is a system where words are spelled out onto the deafblind person's hand. Each letter has a particular sign or place on the hand.

British Sign Language and American Sign Language are fully developed languages in their own right, with their own word order and grammar. Both languages incorporate hand signs and facial expressions.

Visual Frame Signing is where signing is done within the person's remaining field of vision.

Hands on Signing is based on British Sign Language. Here the person with the sensory impairment places his hands over those of the signer and feels the signs being formed.

Makaton uses some of the principal BSL signs but has no grammatical structure and is generally easier to learn.

Tadoma is a rare method of communication for the deaf blind. The person using Tadoma places their hands on the speaker's lips or throat to feel the vibrations.

Braille and Moon are ways of producing texts readable by touch. Braille uses a series of raised dots while Moon is similar to raised letters. Neither can be used for conversation.

Objects of Reference. Some people with dual-sensory impairment learn to use objects to symbolize certain activities, for example a towel may indicate swimming. This method enables people to choose activities, as well as allowing others to let them know what is scheduled.

Many people might wonder how children or adults who cannot see the movements of the dance or hear the music could possibly enjoy dancing.There may be some participants with total hearing loss who although they would not be able to appreciate the music can still pick up its vibrations. A wooden floor produces vibrations and sensations which can be felt by the dancers. Strobe lights may be set to reflect the beat of the music. If dancers hold a balloon it will also pick up the vibrations. Music needs to be played very loud with the bass turned up high.

In 1994 Palmer made the observation that "In music vibrations producing Low Tones can be felt by body senses in the feet, legs and hips. The Middle Tones can be felt in the stomach, chest and arms, similarly the High Tones can be felt in the fingers, head and hair."

At the start of a session it is essential for all those taking part to explore and become familiar with the equipment, other people in the room and their surroundings in general. The duration of the class should not exceed the attention span of those taking part, this applies particularly to children.

If appropriate the teacher can place the deaf blind person's body and/or limbs in the correct position and help him or her to perform the movement. The teacher should use only the amount of assistance that will lead to success. The level of assistance should be reduced as soon as possible. It is important that the teacher gives immediate feedback. He or she should work towards a touch clue which is associated with a particular movement.

Both Fundamental and Interpretive Movement needs to be incorporated into the activities. Fundamental movement combines gross and fine motor skills. Examples of this are walking, running, jumping and climbing. Fine Movements involve different parts of the body such as bending, clapping and flexing the fingers.

Movements have to be planned to assist the deaf blind child or adult to understand the size of movements, their direction, level, shape, force and tempo. Steps involving walking, running and hopping ,jumping, leaping etc also need to be taught.

Nancy Pieters Mayfield of the Indiana Deafblind Services Project in "Creative Expression: Opportunities for Persons who are Deafblind" has many excellent suggestions.To help those with dual sensory impairment to learn about Fundamental Movement she makes a number of suggestions such as getting the participants to move wearing different types of footwear such as tap shoes, wooden clogs and soft-soled shoes. This should help the deaf blind person to experience how movement changes according to what they are wearing.

Interpretive Movement involves a personal emotional response. The dancer can move heavily, jerkily, smoothly or in numerous other ways expressing different moods. Children can be helped to move like animals, the elements, objects or plants.

Dance for the deaf blind extends and deepens their interaction with other people, their sense of place and encourages socializing and self-confidence. In addition, there are the undoubted health benefits for participants which show themselves in greater strength, flexibility, aerobic capacity and increased concentration levels.