RE:view, volume 29, Number 1, pages 34-45, Spring 97.
Reprinted with permission of the Helen Dwight Reid Educational Foundation.
Published by Heldref Publications, 1319 Eighteenth St., NW, Washington, DC 20036-1802.
Copyright © 1997.

RE:view - Spring 1997

Corner to Corner: How Can Deaf-Blind Travelers Solicit Aid Effectively?

Dona Sauerburger and Susanne Jones

A man approached a corner with his white cane. Because he was deaf and blind, he needed assistance to cross the street. When he reached the curb he held up a card that asked for help to cross the street. A dozen people went by, some glancing his way; some even waited near him before they crossed the street, but did not offer to help. One woman stopped to say, "Can I help you?" but when the man did not answer, she left.

Why did so many people fail to help the man cross the street? Were the people too busy, or did they not realize he needed assistance? How could he have gotten assistance more efficiently? Those questions have intrigued deaf-blind travelers and those who teach them for many years. Some have concluded their problems with communicating and soliciting aid limit where deaf-blind people can travel independently, safely, and easily (Gervasoni, 1996).

Several people have conducted experiments to determine the most effective method of soliciting aid. DeFiore and Silver (1988) experimented to see if a card with the important words in the message enlarged was more effective than a card with the same message written with letters of uniform size. They found that, on average, a blindfolded person was offered assistance in a shorter time when the important words were enlarged. Florence and LaGrow (1989) tested the effectiveness of using a tape-recorded message to solicit aid. Their deaf-blind participant was helped by 36 of 60 passers-by when she used the recorded message, but when she tried to hand them a card with the same message written on it, only 4 out of 60 helped her.

Several years ago, we also conducted several experiments to compare the effectiveness of two different cards in soliciting aid to cross a street. One card, which we called the HKNC Card, had been developed at the Helen Keller National Center and was at that time being used by deaf-blind trainees to solicit aid to cross streets. The other card we called the Experimental Card. Both cards are pictured in Figure 1.

Figure 1. HKNC Card (below, left) and Experimental Card (below, right)

Photo shows a yellow laminated card with braille along the bottom and the left upper corner cut off. The 1st line says 'I AM DEAF & BLIND.' 2nd line says 'COULD YOU PLEASE HELP' 3rd line says 'ME CROSS THIS STREET.' 4th line says 'Thank you!'

Photo shows a yellow laminated card with braille along the bottom and the left upper corner cut off. The 1st line says 'I AM DEAF & BLIND.' 2nd line says 'COULD YOU PLEASE HELP' 3rd line says 'ME CROSS THIS STREET.' 4th line says 'Thank you!'

Photo shows a yellow card of the same shape and color with braille. 1st line says 'Please help me to' 2nd line in very large print says 'CROSS STREET' 3rd line says 'I am both DEAF and BLIND' 4th line says 'so TAP ME if you can help.' Last line says 'Thank you.'

We conducted a total of 40 trials, 10 with each card at two different intersections that were heavily traveled by pedestrians. One of us (the participant) wore sunglasses, used a cane to approach a curb, and held up a card while the other one recorded how many people walked by and how much time passed before someone touched the participant to offer assistance.

Our results showed no significant difference between the two cards, but the experience piqued our curiosity further. For example, assistance was sometimes offered by the first person who walked by, but at other times dozens of people passed and the participant waited as long as 6 minutes before help was offered. Some people who did not help were obviously in a hurry or not going in the same direction as the participant, but others leisurely looked at the card and then crossed the street that the participant wanted to cross. We wondered why they did not help.

We concluded that discovering effective ways of soliciting aid required more data than a record of the time and a count of passersby. We needed to talk with the people to find out how the card and the person affected them. We therefore conducted two surveys to interview passersby.

Survey Design

For these surveys, two deaf-blind participants each stood at different intersections and solicited aid to cross. We are very grateful to our two participants, Caryn Spall and David Carrigan, each of whom endured many hours in the hot sun while we interviewed passersby.

Caryn Spall solicited aid to cross the street 6 times using the HKNC card and 6 times with the experimental card. She stood near the curb, facing the street she wanted to cross, held the card above her shoulder so that it could be seen from the front or back, and did not use her voice. David Carrigan solicited aid to cross the street 7 times using the HKNC card and 10 times using the experimental card. He usually stood a few feet from the curb, sometimes with his side toward the street so that he would be facing people as they walked by. He did not use his voice to solicit aid, but after people offered help he sometimes talked with them, signing while he talked.

After people either passed a participant without helping or guided him or her across the street, they were approached and interviewed by one of us or Mary Ann Heddleson, who helped us with the interviews. The questions we asked are listed in the Appendix. After getting assistance to cross, the participants would enter a nearby store, wait a few minutes while we completed the interviews and the sidewalk cleared, then approach the corner to solicit aid to cross back again.

Because we chose intersections where the pedestrian traffic was moderate to light, we were able to approach all of those who passed by--a total of 72 people. All but 3 were willing to answer our questions.

For several reasons, we were unable to collect reliable, consistent data to compare the two cards. One reason was that each participant used a different technique to solicit aid, which we believe affected the responses and behavior of the passersby. Another was that, as a result of our curiosity about the responses of those who passed Caryn Spall, we changed our questions for people who passed David Carrigan. Finally, we did not strictly follow the listed questions during the interviews. Sometimes there was not time to do so, and sometimes people revealed unsolicited information that we wanted to follow up during the brief time we were able to talk with them.

The following information is therefore based on our observations and on statements made to us by passersby during our surveys.

Results

Why Did Some People Not Help?

Of the 72 people who passed the participants, 41 did not offer assistance. See Table I for their reasons for not helping. Some of the people who reported that they had not noticed the deaf-blind participant and the card had walked near enough to have seen him or her. Although some of these people may have been fabricating an excuse for not helping, in many instances they seemed sincerely surprised to notice the card when it was pointed out to them and reported that they would have helped if they had realized that the person needed assistance. It seems quite possible that this is the case, because 2 people who had guided the participant across said that at first they had not planned to stop because they had not realized the participant needed help. In both of these cases, as soon as a driver or another passerby told them that the participant needed help, they willingly approached and offered assistance.

Table 1. Reasons Given by Passersby for Not Helping the Deaf-Blind Participant Cross the Street

Number of passersby (N=41)	Reasons
11	Did not see or notice person and card. (Of these, 3 noticed the participant but not the card.)
9	Not paying attention, engrossed in conversation, or seemed not to care.
7	Saw the participant and the card but concluded that he or she did not need help. Almost all reported that they would have helped had they known.
4	Could not understand English.
3	Unsure what to do. (These people appeared to be very concerned while passing the participant, but were hesitant to approach, unsure whether assistance was needed.)
1	In a hurry.
1	Not going the same way as the participant (This person asked someone to help the participant across.)
1	Other people were there who could help.
4	Reason not recorded, or the passerby refused to speak to the interviewer.

Seven people had seen the deaf-blind participant and the card but still did not realize that he or she wanted help. Some of these people thought the participant was holding up a card to advertise for local stores, to get a ride from drivers, or to practice crossing the street. Because David held his card in front of his chest, at least one person thought he was holding it up to read it.

It was interesting that no one reported thinking the deaf-blind participant were proselytizing or asking for charity. Toward the end of the surveys, we even specifically asked a few people if they thought the participant was doing so, and they said no. That finding was surprising because it is often said that when people see someone holding up a note or card, they make that inference. These surveys took place near the campus of the University of Maryland and in the business district of a prosperous suburban Maryland community; perhaps people in these communities did not expect panhandlers there. It would be helpful if future researchers could investigate this phenomenon further, perhaps in inner-city as well as suburban settings, so that the assumption can be verified or disproved that people think that anyone who displays a card is panhandling.

How Was the Need for Assistance Conveyed?

Of 16 passersby who thought that David Carrigan needed help, 13 said it was because of the card, and 3 said it was because he had a white cane. We asked 14 of the people who helped him if they would have done so if he had not been holding the card. Four said yes, 9 said no. One person said she would be hesitant to approach if he had not used a card, but that she would help if he stood a certain way (presumably, as if needing help). Reasons given for not helping if he had not held up a card were not wanting to intrude (they know that blind people often want their independence), and surmising that because David used a cane, he could get around and cross the street without help.

How Should the Card Be Worded?

Some of those who guided the deaf-blind participants across the street said that at first they were flustered and did not know how to approach and help, even though they had read the card's instructions to tap the deaf-blind person (the experimental card). To find out why they still did not know how to help, we asked 11 of the people who said they had read the experimental card how much of it they had read. Five said they had read the entire card, and 6 had read part of it. However, of those who had read the entire card, at least 2 said they had read only part of it at first, and then they offered help verbally. After getting no response, they read the rest of the card, then tapped the participant.

That finding may explain why some of the would-be helpers were bewildered even when the experimental card was used. No more than 3 of the 11 people who saw and read that card had read the entire card before offering to help.

Of the 6 people who said they had never read the entire card, 5 had read only the words "CROSS STREET" (enlarged and near the top of the card), and 1 had read only "I am DEAF & BLIND" (also enlarged but on the next line). None of them had seen the words "TAP ME," (enlarged but near the bottom of the card). It seems words that are near the top of the card may more likely be seen, whether or not they are enlarged.

Thus we inferred that because many people read only the first or second line of the card, the first line of the card should have the most important information--what the deaf-blind person wants ("CROSS STREET")--and the next line should explain specifically how to approach or help the deaf-blind person ("TAP ME"). The information about the person's visual and hearing impairment should probably be last, because this is the least important of the information the public needs to help appropriately. It would be interesting to see if correcting the word order on the experimental card would decrease the number of people who are disconcerted.

What Is the Most Effective Way to Use a Card to Solicit Aid to Cross the Street?

During the surveys, we began to realize that the manner in which the deaf-blind person stands and holds the card may be at least as important as what the card says. For example, some people perhaps did not realize that David Carrigan was trying to cross the street, because he stood with his body facing the direction of the traffic flow instead of facing the street itself. One person who helped him even commented that it was only by reading the card that she knew he needed help, because he did not appear as if he wanted to cross the street.

We concluded that the most effective method for deaf-blind travelers to get help to cross the street would be for them to stand in such a way that it is clear they want to cross the street (i.e., near the curb and facing the street to be crossed) while holding up a card. Figure 2 illustrates that approach. However, several people who realized that the participants wanted to cross did not realize that they needed assistance to do so, even though the participants held up a card. If the participants had also used gestures or body language to convey their need for assistance, the response might have been better.

We also concluded that a card should be held to the side, up near the shoulder (see Figure 2). This way, the card can be seen more easily from behind the deaf-blind travelers, and he or she avoids giving the impression of holding the card up to read it. Periodically turning the card 90 degrees degrees helps make it more visible to people who may be waiting to cross or approaching the deaf-blind traveler's side.

Our observations and conclusions may explain the unusual finding reported by Florence and LaGrow (1989). Of 72 people who passed the deaf-blind participants in the present study, 31 people helped. In the Florence and Lagrow study, when the participant used a card to solicit aid, only 4 of 60 people who passed their deaf-blind participant stopped to help her. She apparently solicited aid by trying to hand passersby her card. On the basis of what we learned in our interviews, it seems quite likely that most of those 60 passersby did not realize that she was trying to cross the street, or that she wanted their assistance to do so. Had she held up the card while facing the street instead of trying to hand the card to people, the response might have been quite different. Also the wording of her card was the same as that on the HKNC card. Because many of the people in our study did not read past the first line, it seems logical that many of the passersby in the Florence and Lagrow study probably also did not read past the line "I am deaf and blind," if they looked at the card at all.

Do the People Realize That the Person Is Deaf?

Of 29 people who helped a participant cross the street, 9 did not realize that the participant was deaf. In many cases this was because they had not read the entire card. However, several respondents had read the entire card and still did not realize the participant was deaf. One person even said that he had carefully read the whole card because he was curious but was still unaware that the participant was deaf. When asked about that phenomenon, he thought carefully, then explained, "I did not expect that a person who is both deaf and blind would be out walking by himself!" Another person who had read the whole card but failed to realize the participant was deaf seemed to be oblivious to the world in general. She crossed the street during the red light twice (once while guiding a deaf-blind person!), holding her hand out to stop traffic.

The fact that passersby often comprehend only the first part of a card is illustrated by our observation that when the words "DEAF & BLIND" are written at the top of the card (as on the HKNC card), people are more likely to see it than when the words are enlarged and located in the middle of the card (as in the experimental card). Most of the people who reported that they knew a participant was deaf said they had read all of the experimental card. We know that 2 of these people at first had read just the top line and presumably had not realized the participant was deaf because they offered help verbally; they read the rest of the card when they got no response from the participant, and only then realized that the participant was deaf. Other people may have done the same, but we did not investigate and document that matter. We also did not ask people who passed Caryn Spall how much of the card they had read; we recorded that only 1 of the 6 people who helped her when she held the experimental card realized she was deaf. (The word "DEAF" appears in the second line of that card; 2 of these people volunteered that they had read only the first line.) By contrast, 4 of the 6 people who helped when she used the HKNC card realized that she was deaf. (The word "DEAF" is in the first line of the HKNC card.) Three of these people reported that they had seen the word "DEAF" on the card, and 1 reported that he knew because she did not respond to questions.

All but 2 of the 18 people who helped David Carrigan realized he was deaf. Because David is adventitiously deaf and spoke to some of the helpers, that finding is all the more remarkable; the public often does not realize that a person is deaf if the person speaks well (Michaud, 1990). The element that conveyed his deafness so effectively may have been the fact that he signed while he talked; one person volunteered that David's signs were what made her aware that he was deaf.

In Table 2 we show the breakdown of whether people knew a participant was deaf and, if so, how. (Two of the 31 helpers were not asked this question.)

Table 2.--Extent of Awareness Among Passersby That Deaf-Blind Participants Were Deaf

Knowledge of deafness and reasons for knowing	Experimental card	HKNC Card	Total
*Number knowing and not knowing that participant was deaf*
Didn't realize person was deaf	5	4	8
Knew person was deaf	11	9	20
TOTAL	16	13	29
Reasons for knowing the participant was deaf: Number of responses
Saw the words "deaf" or "tap me" on the card	7	4	11
Participant did not respond when spoken to	0	3	3
Participant signed while speaking	0	1	1
Participant said he is deaf*	1	0	1
Participant's voice sounded unusual*	1	1	2
Received no response to verbal offer of assistance; then they read the card further	2	0	2

Note: HKNC = Helen Keller National Center.
* The fact that the participant signed while speaking may have helped in these instances as well, because his voice is not characteristic of a deaf person.

How Did Those Who Helped Guide the Participants Feel About the Experience?

Most passersby indicated that the experience was not extraordinary, and they just felt glad to help. Several enjoyed the experience (one said it made his day), and several said they were curious. Some reported that when they realized the participant was deaf, they felt flustered because they did not know how to communicate. Several also said they were very concerned about the deaf-blind person. (One said he prayed briefly before approaching.) Several others appeared very concerned or curious, or both, after the participant left them, because they watched until he or she entered a building.

Conclusion

We concluded that to solicit aid effectively with a card, a deaf-blind traveler should stand at the curb facing the street, using body language and posture to appear as if he or she wants help to cross it. The person should hold the card up at the shoulder, where it can be seen from the front and the back, possibly turning the card briefly to face the side occasionally.

The purpose of the card should be stated at the top ("CROSS STREET"), in letters large enough to be seen easily. The card should then explain to the public how to approach or communicate with the deaf-blind person ("TAP ME") and should reveal the visual and hearing impairment last. Although this word order is the opposite of what is commonly used (Gervasoni, 1996), by conveying the information clearly in this order a deaf-blind person may be able to reduce the bewilderment and lack of cooperation that we witnessed during our survey. To be more readily recognized as deaf, a person with sign language skills might try signing.

What we learned from this survey may apply to other situations. That is, when deaf-blind people are attempting to communicate with the public to get assistance or information, it may be most effective for them to write or say, first, what is needed; second, exactly how the public is to respond; and, finally, the fact that they are deaf and blind or visually impaired. For example, when a deaf-blind traveler is trying to use a card to communicate with a busy bus driver, perhaps it would be most effective for the card to explain first that the person needs to get off at a certain place; second, exactly what the driver should do; and finally that the person is deaf and blind. ("I need to get off at Market and Fifth. Please tap my knee when the bus reaches my stop because I cannot hear you--I am deaf and blind.")

Although we did not use strict controls in this study to compare the effectiveness of different cards and techniques for soliciting aid, interviewing the public nevertheless provided a wealth of information and helped us understand which techniques may be effective for soliciting aid, and why. We believe that surveys such as this one may compare the effectiveness of techniques for communication or soliciting aid in a way that is more revealing than simply observing and timing or counting people who respond. It may also be helpful to conduct similar studies in different situations, including with people whose communication needs and strategies are different from persons who are deaf and blind.

Figure 2. Pedestrians crossing street see deaf-blind person holding card at shoulder height. They stop to read the card, and recross the street to help the deaf-blind traveler to cross.

This series of 3 photos were taken from the middle of the street. The deaf-blind woman faces the street and holds up the card with her right hand, while a man in the crosswalk, wearing a dark tank-top, white shorts and flip-flops, walks toward the curb at her right, turning his head to look at the card. Then he stands in the street next to the curb, leaning forward to look at the card while she stands and smiles. Last photo they walk into the street while she holds his arm, both smiling and looking forward.

This series of 3 photos shows a deaf-blind woman wearing short-sleeved white shirt and flowered shorts. We see her from the back as she stands at the crosswalk holding up a card in her right hand. A man with white shirt and tie, holding his business coat over his shoulder, crosses the street toward her and then stands in the street to her left, looking at her card. Last photo shows them standing at the curb waiting to cross, she is holding his left arm and he looks toward her.

REFERENCES

DeFiore, E. N., & Silver, R. (1988). A redesigned assistance card for the deaf-blind traveler. Journal of Visual Impairment & Blindness, 82, 175-177.

Florence, I. J., & LaGrow, S. J. (1989). The use of a recorded message for gaining assistance with street crossings for deaf-blind travelers. Journal of Visual Impairment & Blindness, 83, 471-472.

Gervasoni, E. (1996). Strategies and techniques used by a person who is totally deaf and blind to obtain assistance in crossing streets. RE:view, 28(2), 53-58.

Michaud, M. (1990). Making the difference for deaf-blind travelers in mass transit. In M. Uslan, A. Peck, W. Wiener, & A. Stern (Eds.), Access to mass transit for blind and visually impaired travelers (pp. 137-150). New York: American Foundation for the Blind.

APPENDIX
Questions Asked of Passersby

These questions were asked verbally of each person who passed by or stopped to help the participant. Some of them have follow-up questions if the person responded in certain ways.

For Those Who Encountered Caryn Spall
For Those Who Helped David Carrigan to Cross the Street
For Those Who Did Not Help David Carrigan to Cross the Street

Photo shows a woman wearing sunglasses and a white short-sleeved blouse, standing at the curb facing the street and smiling, holding a white cane in her right hand and her left hand is holding up a card in front of her shoulder. To her left is a wall that obscures her from our view from the waist down, and behind that is a telephone pole. On the other side of the pole is a man wearing a shirt and tie and sunglasses, stopping to look at her.

For Those Who Encountered Caryn Spall:

The interviewer noted which card was used, whether the person passed near the participant, whether or not the person glanced at the card or stopped to read the card, and whether the person helped the participant across, in which case questions #1 and #5 were skipped.

1. We are conducting a research project. Do you mind if I ask you why you think the woman with the cane is/was standing there?
2. In what way is she handicapped?
[If deafness is not mentioned, ask "Could she be deaf?" Y/N___]
3. Did you get a chance to read the card? Y/N____
[If yes, why do you think you didn't realize the person was deaf?]
[If they have no idea, ask if they were incredulous? Not paying attention? Not thinking?]
4. How did you feel when you saw that woman?
[If they have no idea, ask if they wanted to help? Felt cautious? Curious? Feeling pity? Angry? Afraid?]
5. Would you be reluctant to approach the woman? Y/N___ Why?
[Would you be reluctant if you had time, or if you knew she needed assistance? Why?]

Photo shows a man wearing a white short-sleeved shirt, dark pants and sunglasses. He is standing about 2 feet from the edge of the street, facing the corner. His left hand holds a white cane and his right hand holds up a card in front of his right shoulder.

For Those Who Helped David Carrigan to Cross the Street

The interviewer noted whether the person was a man or woman, which card the participant used, and comments about the person's approach to the participant (e.g. "stopped to read card," "Never looked in his direction," "Seemed in a hurry," "Talking with someone else.")

1. Did you see or read his card?
[If yes, when did you see the card, and how much of it did you read?]
2. Did you realize that he is deaf?
[If no and you read the card, how could we have made it more clear that he is deaf?]
[If yes, when did you realize, and how did you know?]
[If the person talked to the participant: Did you think he could understand you when you talked to him?]
3. How did you know that he needed help to cross the street?
Would you have helped him if he hadn't used a card?
4. Any comments about the experience?
Thank You!

photo shows two men standing at a crosswalk facing the street -- we are standing behind them. The man on the left is wearing a suit and holding a newspaper. He is looking to his left into the street. The other man is about 10 feet to his right, wearing a white short-sleeved shirt and holding up a card in his right hand. Behind and to his right are magazine boxes and a telephone pole, which makes us unable to see anything except his back and head.

For Those Who Did Not Help David Carrigan to Cross the Street:

Interviewer noted which card was used, whether the person glanced at the participant, whether or not the person could have seen the card from where he or she passed the participant and if so from what distance, and whether or not the person stopped to read the card.

1. We are conducting a research project. Do you mind if I ask you if you saw that man and the card that he is holding?
If yes:
2. How much of the card were you able to read?
3. Why did you think he was holding up the card?
[If the answer is ambiguous, ask "Did you think perhaps he was using the card for soliciting or asking for a handout, or getting help to cross the street?"]
4. Do you think that he:
A. Can cross the street independently?
[If you thought he needed help and you weren't in a hurry, would you approach him to help?]
B. Cannot cross the street independently?
[Under what circumstances would you be willing to approach him to help him cross?]
Thank You!

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