Bi-Monthly Update: Tailoring Assessment for Eligibility for Specialized Instruction

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Supporting Success
for Children with Hearing Loss

Late October Bimonthly Update
Welcome if you are new to Bimonthly Updates! Topics vary with each issue. Feel free to forward!


Tailoring Assessment for Eligibility for Specialized Instruction

Description: C:\Users\Karen L Anderson\AppData\Local\Microsoft\Windows\INetCache\Content.Word\Depositphotos_127559380_m-2015.jpgThe great news is that early identification of hearing loss, improvements in hearing technology, and parent involvement in high quality early intervention services REALLY WORK to improve developmental outcomes by age three. Even so at least 40% of children have the cognitive capacity for higher language levels. All too often transition teams who are evaluating students for eligibility upon school age to deem that they are ‘fine’ and need no extra services or supports.

Can he qualify? Yes! This is possible IF there is someone on the multidisciplinary team who truly understands the impact of hearing loss on development AND knows appropriate assessments to use to tailor the evaluation process to the risk areas of students with hearing loss.

Read more about appropriate assessment for students with hearing loss

 


 

Steps to Assessment
Guide to Identifying Educational Needs for Students with Hearing Loss

Description: C:\Users\Karen L Anderson\AppData\Local\Microsoft\Windows\INetCache\Content.Word\Steps to Assess 4.jpgTeachers who use this guide will have a much better understanding of the vulnerable areas of development due to hearing loss, how the areas interconnect, and ultimately how they are the experts in using the ‘deaf lens’ to contribute to their evaluation teams and service planning. The focus of this 290-page guide is appropriate assessment practices for children from transition to school at age 3 through high school. Categories of assessment are presented, as are ways to tease out information from assessment results to illustrate how to identify needs to support eligibility.

Download this Informational handout describing
Steps to Assessment to share with your Team!

Read more about Steps to Assessment

 


 

What’s New? National Microtia Awareness Day is November 9th!

Last year’s first national awareness day was amazing! Families and deaf educators raised awareness with their children at school and helped educate about hearing loss, hearing devices, and Microtia and Atresia.  Supporting Success was one of a number of websites that spread the word about National Microtia Awareness Day. If you would like to purchase an official National Microtia Awareness Day t-shirt or any awareness accessories, you can do so by going to the front page on Ear Community’s website at:  www.EarCommunity.org  Order deadline is October 20th, 2017. 

Read more about Microtia/Atresia on the SSCHL website

 


 

Tons of functional performance checklists ready to use or email

If you know and love the Building Skills for Success in the Fast-Paced Classroom book you know that there are many functional assessments throughout the book. Documenting Skills for Success: Data-Gathering Resources was developed following many requests that e-versions of the tools be provided so that they could easily be shared with and completed by classroom teachers and/or the teacher of the deaf/hard of hearing during assessment or progress monitoring. It is intended as an electronic supplement for individuals who have already purchased Building Skills for Success in the Fast-Paced Classroom. Unless someone is purposely monitoring classroom performance over time, emerging gaps can and will be missed!

Documenting Skills for Success has more than 57 tools from Building Skills for Success. There are 10 additional data-gathering tools that included in this e-publication. Of the 67 files, 42 are computer-fillable pdfs.

Read more about Documenting Skills for Success: Data-Gathering Resources

 


 

Haven’t seen the new Teacher Tools flippable e-Magazine format yet?    See the FREE Promotional Issue!

Description: C:\Users\Karen L Anderson\AppData\Local\Microsoft\Windows\INetCache\Content.Word\KKV logo with STRONG.JPGDescription: C:\Users\Karen L Anderson\AppData\Local\Microsoft\Windows\INetCache\Content.Word\Teacher Tools box logo.jpgThe new format allows members to quickly page through ALL of the materials. A good fit for busy, on the go teachers! The October e-Magazine was packed with over 50 pages of information and teaching tools to have at your fingertips! The November issue will be posted in one more week!
JOIN NOW!     We already have almost 1000 members!     LOGIN NOW

We need more Kool Kidz Vidz! You will receive a $50 coupon for Supporting Success products as our Thank You to you. If you have a student grade K-12 that you would think would be great at stating who they are, challenges, and what they do to help themselves, then consider submitting a Kool Kidz Vid!  A terrific culmination activity for self-advocacy, self-determination, and transition skill goals.

 


 

More about Evaluation and Eligibility:
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Find more information on the Supporting Success website:

Download an eye-catching evaluation results summary form you can customize HERE.

 


 

The big 5 – Can you guess???

Description: C:\Users\Karen L Anderson\AppData\Local\Microsoft\Windows\INetCache\Content.Word\Depositphotos_13884242_m-2015.jpgI am often asked, if I had to choose, which would be the most important assessments for teachers of the deaf/hard of hearing to routinely use during eligibility and 3-year evaluations.

  • We need to consider the vulnerabilities specific to our students with hearing loss.
  • We need to gather information that will reflect educational performance issues common to our students who may be doing ‘okay’ academically.
  • We need to have assessments appropriate for students using all communication modalities.
  • We also need to be able to speak strongly about the need for teachers of the deaf/hard of hearing and educational audiologists to be important members of the evaluation team who perform assessments specifically tailored to the vulnerable areas of our students.

See if you guessed right!!!

 


 

Steps to Assessment Workshop – Experience this 9-hour workshop with your DHH team!  

Description: C:\Users\Karen L Anderson\AppData\Local\Microsoft\Windows\INetCache\Content.Word\TNL-2.jpgNever before has it been as important for teachers of the deaf/hard of hearing to be directly involved in assessing student skills and needs. With increasing numbers of students entering school with low average language skills and ‘pretty good speech’ school teams are more resistant to finding them eligible for services. And yet the access issues related to hearing loss cause many subtle areas of need in our students that the standard assessment practices often do not address. This Workshop will inform you of which areas are most critical to assess, why this is so, how to assess, and provide some recommendations on appropriate assessments that can be used. You have 300 days to view the 9.25 hour webcast and can view the 7 modules of 60-90 minutes each in whatever order you prefer. Purchase it for individual view or discounted group rates for your whole DHH team.

Read more about the webcasts


Advocacy Notes – Children with Disabilities in Virtual Schools

Description: C:\Users\Karen L Anderson\AppData\Local\Microsoft\Windows\INetCache\Content.Word\Depositphotos_129509528_m-2015.jpgSuccess in mainstream classrooms when you have a hearing loss is often a substantial challenge for our students. Increasingly, parents are exploring the option of enrolling their student in virtual school learning programs.  In August, 2016, the US Department of Education Office of Special Education and Rehabilitative Services issued a ‘Dear Colleague’ letter defining school’s responsibilities to students with disabilities enrolled in virtual learning settings. The letter affirmed that virtual schools must carry out the requirements of IDEA as must physical schools.

Read more for specifics for virtual schools


Do any of your students need captioning for equal access? Consider Interact-AS!

Description: C:\Users\Karen L Anderson\AppData\Local\Microsoft\Windows\INetCache\Content.Word\screenshot of InteractAS.JPGDo any of your students need captioning for equal access? Consider Interact-AS!

Interact-AS has been used successfully across the US and Canada, especially for secondary students who are hard of hearing. Do you have a student with good reading skills who just can’t quite keep up with the instructional content presented in the classroom? Interact-AS also now has options for captioning of small group discussions.
Read more for the new developments in this speech-to-text captioning software.

The next FREE webinar demonstrating and describing the use of Interact-AS captioning will be on October 24th at 1:30 PM CT. One clock-hour CEU is offered for any interested participants.

Register for the free October webinar HERE


Upcoming Presentations

Description: C:\Users\Karen L Anderson\AppData\Local\Microsoft\Windows\INetCache\Content.Word\Depositphotos_4757785_s-2015.jpgby Karen Anderson, PhD, Director of Supporting Success
October 19-20 – MA (Marlborough)
November 2 – MB (Winnipeg)
March 29 – TX (Houston)
April 10 – IL (Tinley Park)

Now booking for Summer 2018 Presentations!

Read here for more detail

Upcoming Presentations

by Karen Anderson, PhD, Director of Supporting Success

October 19-20 – MA (Marlborough)
November 2 – MB (Winnipeg)
March 29 – TX (Houston)
April 10 – IL (Tinley Park)
February 26 – March 1:  Denmark (pending)

 

 

Now booking for Summer 2018 Presentations!                                                                            

Contact info@successforkidswithhearingloss.com for more information on specific speaking engagements.   Refer here for more information on presentation services.

October 19-20, Marlborough, MA. Presentations at the Clarke Annual Mainstream Conference.

November 2, Winnipeg, MB. Conference for educators and other related professionals who work with students with hearing loss. 1 full day.

February 26 – March 1: Denmark presentations – pending.

March 29, Houston, TX. Region 4 ESC Workshop. Supporting Full-Participation of Students with Hearing Loss in the Mainstream Classroom. Outreach via TETN to other ESCs across Texas.

April 10, Tinley Park, IL. ISRC Behavior Team Training. Self-Advocacy. Holiday Inn Conference Center, Tinley Park, IL.

October 18-19, 2018, Vermont, Speech Language, Hearing Association and DHH Outreach Staff Training.

 

The big 5 – Can you guess???

I am often asked, if I had to choose, which would be the most important assessments for teachers of the deaf/hard of hearing to routinely use during eligibility and 3-year evaluations.

  • We need to consider the vulnerabilities specific to our students with hearing loss.
  • We need to gather information that will reflect educational performance issues common to our students who may be doing ‘okay’ academically.
  • We need to have assessments appropriate for students using all communication modalities.
  • We also need to be able to speak strongly about the need for teachers of the deaf/hard of hearing and educational audiologists to be important members of the evaluation team who perform assessments specifically tailored to the vulnerable areas of our students.

Biggest areas of vulnerability are: speech perception, listening comprehension, syntax, morphology, phonological awareness, conversational use of language, pragmatic language, ‘Swiss cheese’ language.

Collaborate with your IEP team SLP: Tests need to be chosen that will evaluate syntax, morphology along with receptive and expressive language. Some tests are: CASL, CASLS, TOLD, TACL, CELF-V. Using test combinations to also identify issues with phonemic awareness and pragmatics/social language is important.

 

1. Determine level of communication access in the classroom – a necessity!

Ages 6-18
15 minutes to administer

Digital audio files – Use from CD or copy to your computer or phone    

Perform all 8 conditions: Close/Far, Auditory only/ Auditory + Speechreading, Quiet/Noise (in +5 S/N classroom noise)

Continuous recording allows you to finish an 8 condition FLE in 10-15 minutes. Uses 5-word HINT sentences. Comes with computer fillable response form and auto calculating summary.

Can be adapted for SimCom/TC users. EVERY student with hearing loss who has useable residual hearing should have an FLE at least triennially.

 

2. What does s/he comprehend? – typical classroom language

Ages 6-11, Grades 1-6 or Ages 12-18, Grades 6-12
35-40 minutes to administer

  • Subtest A: Main Idea
  • Subtest B: Details
  • Subtest C: Reasoning
  • Subtest D: Vocabulary
  • Subtest E: Understanding Messages
    Focuses on:
  • Summarizing and Sequencing
  • Participating in Discussions
  • Following Directions
  • Understanding Language Concepts
  • Problem Solving and Predicting
  • Listening for Meaning 

RESULTS ARE PREDICTIVE OF HOW WELL A STUDENT WILL BE ABLE TO FUNCTION IN THE CLASSROOM.

Can be administered through amplification (no speechreading) and/or via visual communication/ASL

 

 

 

3. What does s/he comprehend? – deeper language

For ages 5 to 21 years                                                                                        
10 to 20 minutes to administer

OPUS identifies how well a person can integrate and apply knowledge in three structural categories of language:

  • Lexical/Semantic: knowledge and use of words and word combinations
  • Syntactic: knowledge and use of grammar
  • Supralinguistic: knowledge and use of language in which meaning is not directly available from the surface lexical and syntactic information.

SENSITIVE TO FUNCTIONAL COMPREHENSION AND SYNTAX ISSUES. Can be administered auditorilly and/or via visual communication/ASL.

Results of OPUS and the Listening Comprehension Test provide a clear reflection of daily comprehension ability and needs for planning. 

Listening comprehension is a higher order auditory development skill. Evaluation must occur to determine each student’s specific abilities and needs along the hierarchy of auditory skill development (such as evaluating with the SPICE)

 

4. How well does s/he interact with others? – social language use

 A. If the student was found to have language within average

For ages 4 to 16 years                                                                                          
 15 to 20 minutes to administer

Test of Narrative Language 2 identifies our student’s issues carrying on conversations, relating experiences.

No transcription required.

  • a functional assessment of narrative comprehension and narrative production;
  • a measure of the ability to comprehend and produce three types of stories: a script, a personal narrative, and a fictional narrative;
  • a system for scoring oral narratives that does not require clinicians to transcribe the stories;
  • a normative test with clear, well-organized norms tables and administration procedures, as well as an easy-to-use record form; and
  • a fair and equitable assessment of narrative discourse for all children.

 

B. If pragmatic language was not evaluated (thoroughly) by the SLP

Obtain information from the classroom teacher about how well the student uses social language.

Both the PLSI and the PLOS are teacher checklists that take 5-10 minutes to complete.

PLSI for ages 5 to 13 years                                                                                                                                        

Students with hearing loss often have a 3+ delay in pragmatic language!

PLSI has 3 subscales:

  • Personal Interaction Skills
  • Social Interaction Skills
  • Classroom Interaction Skills
  • Clear cut-off scores
  • Guidelines for interpretation
  • Useful diagnostic instrument

 PLOS for ages 8 to 19 years                          

PLOS reflects communication behaviors that are part of the natural ebb and flow of the school setting and not related directly to spoken language instruction.

The PLOS measures what the student DOES, not what the student knows, which is often the case with normed pragmatics tests.              

Need something more in depth? Use the Social Language Development Test – Elementary

 

5. How does his/her precision listening impact knowledge of phonological awareness?

A phonological awareness ‘screener’ is not enough! Precision listening issues cause different issues than other students without hearing loss experience when they are found to have delays.

Ages 3 to 6 years                                                                                           
25 to 30 minutes to administer

The TOPEL has three subtests. All the results of which are then combined to determine the “Composite Score” that ultimately best represents a child’s emergent literacy skills:

  • Subtest 1: Print Knowledge— 36 items; measures alphabet knowledge and early knowledge about written language conventions and form
  • Subtest 2: Definitional Vocabulary— 35 items; measures single-word oral vocabulary and definitional vocabulary (assesses both surface and deep vocabulary knowledge)
  • Subtest 3: Phonological Awareness— 27 items; measures word elision and blending abilities

Results from the TOPEL subtests are useful for documenting a child’s print, oral vocabulary, and phonological awareness ability

Students with cochlear implants have been found to have phonological awareness skills typical of a student with severe hearing loss! Don’t let good speech fool you!

Even students who are deaf visual communication users (ASL) need to have fluency with phonological awareness in order to have adequate reading fluency to keep up with secondary school demands.

 

Phonological awareness, memory, and the impact of precision listening issues also can be identified by using the Test of Auditory Processing Skills (TAPS-3).

Steps to Assessment

The focus of this guide is assessment from transition to school at age 3 through high school. Categories of assessment are presented, as are ways to tease out information from assessment results to illustrate how to identify needs to support eligibility. A variety of assessments are described for each assessment area. Case examples show how the teacher can choose appropriate test instruments and interpret the results, including determining possible goal areas. Self-learning application activities help readers to integrate the information into daily practice.

Teachers who use this 290-page guide will have a much better understanding of the vulnerable areas of development due to hearing loss, how the areas interconnect, and ultimately how they are the experts in using the ‘deaf lens’ to contribute to their evaluation teams and service planning.

 


Hearing loss is an access issue that often causes listening, language, attention and social challenges for children learning in a typical classroom environment. Only 1% of children who have IEPs are qualified under a primary disability category of hard of hearing or deaf. Because of this, the learning challenges they experience in school are often overlooked or mistaken by school staff as being due to other issues. It is critical for the teacher of the deaf and hard of hearing to be able to collect the data needed to identify access to verbal instruction and student needs in the areas vulnerable due to hearing loss and use this information to develop appropriate programs.

$50 per copy or $212 for 5 copies shipped to one address


 

Introduction

  • Why this guide is needed
  • Clarification of Title II of the ADA – a ‘game changer’
  •  Using the “deaf lens” to interpret assessment information
  •  Format of the Steps to Assessment guide

Chapter 1: The Assessment Process

  • What is assessment?
  • Qualifications of evaluators
  •  Analysis of student behavior and response
  •  Steps in an effective evaluation
  •  Process of data collection

Chapter 2: Speech Perception and Device Use

  • History of Device Use
  • Interpreting the audiogram meaningfully
  • Planning speech perception assessment                                        
  • Assessment of precision listening: Preschool and School-age          
  • Assessment of functional listening: Preschool and School-age
  • Case examples
  • Chapter appendices
    – 10 Questions about Your Child’s Hearing Aids – parents and students
    – Cumulative Hearing Device Monitoring Results
     – Functional Interpretation of Hearing Thresholds on the Audiogram
    – ELFLING: Ling Sound Listening Bubble Checklist for Young Children
    – AB Short Word List
    – Lexical Neighborhood Test / Multisyllabic Lexical Neighborhood Test
    – Suggested Tools to Assess Speech Perception and Hearing Device Use

Chapter 3: Performance Review

  •  Why do a performance review?
  • Parent involvement
  • Determining eligibility for specialized instruction and related services
  • Documenting the performance review process for eligibility
  • Functional performance data-gathering tools
    – Classroom observation
    – Parent or Teacher Checklists/Interviews

Chapter 4: Auditory Skills Development

  • What are auditory skills?
  • Why assess auditory skills?
  • Auditory skills assessment: Preschool and School-age
  • Case examples
  • Chapter appendices
    –  Listening Skills Develop Early – A Hierarchy of Auditory Skills Learned by Age 4 Years
    – Checklist of Auditory Skills for Classroom Success: Hierarchy of Auditory Skill Development
    – Suggested Materials to Use with Young Children
    – Mr. Potato Head Task
    – Suggested Tools to Assess Early Auditory Skill Development

Chapter 5: Prosody, Phonologic Awareness, and Morphology

  • Prosody: Prosody skills assessment
  • Phonology: Phonological awareness assessment
  • Morphology
  • Case examples
  •  Chapter appendices
    – Formant (Frequency Band) Characteristics of Vowel and Consonant Sounds (Hz)
    – Pre-Feature Identification Contrasts (PreFICs)
    – Technical Adequacy of Phonological Screening and Monitoring Measures

Chapter 6: Language Processing and Use

  • Components of language development
  • Assessment of language processing and use: early childhood and age 3 and above
  • Chapter appendices
  • Tools Described to Assess Language Development/Processing

Chapter 7: Social Interaction: Pragmatic Language Use and Social Skills

  • Definitions of issues
  • Evidence of issues in these areas for children with hearing loss
  • Preschool, E
    – Elementary and Secondary – social interaction skills assessment
    Pragmatic language
    – Theory of Mind conceptualization
    – Self-concept / social-emotional development
    – Social skills
  • Case examples
  • Chapter appendices
    – Suggested Tools to Assess Social Interaction Skills and Abilities

Chapter 8: Self-Advocacy, Self-Determination and Independence with Amplification Devices

  • Context for self-advocacy skill development
  • Self-advocacy as a means to improve functional achievement
  • How is self-advocacy relevant to school achievement?
  • What is self-advocacy?
  • Self-advocacy assessment
    – Knowledge of hearing loss
    – Independence with hearing devices
    – Communication repair skills
    – Self-advocacy skills
    – Self-determination
  • Case examples
  • Chapter appendices
    – SEAM – Student Expectations for Advocacy & Monitoring Hearing Technology
    – Hearing Aid Independence & Self-Advocacy Skill Expectations Checklist
    – Functional Assessment of Hearing Device Independence Skills
    – What Can YOU Do to Help Yourself? Self-Advocacy Strategy Checklist
    – Self-Advocacy Quiz
    – Suggested Tools to Assess Self-Advocacy Skills

Chapter 9: Students with Additional Challenges

  • The Visual Language Learner – Use of Manual Communication Systems
  • Other disabilities
  • Culturally and Linguistically Diverse Learners

Self-Learning Application Activities for Individual and Professional Learning Communities

  • Self-Learning Application Activities – Part 1: Vocabulary
  • Self-Learning Application Activities – Part 2: Engagement & Practical Application
  • Appendices
    – Steps to Assessment: Vocabulary
    – Assessments Currently Used in Our Schools
    – Assessments to Consider Adding in Our Schools
    – Evaluation Practices – Who Assesses with What Tool? NOW
    – Evaluation Practices – Who Assesses with What Tool? FUTURE
    – Assessment Practices Improvement Plan
    – Assessment Time Study

Functional Skills Summary For Students With Hearing Loss

This form assists professionals and school teams in considering the communication access and other needs of a student with hearing loss. The measures below all relate to communication access or communication interaction issues for which these students are most vulnerable. Reviewing the results of measures in these areas will assist the school team in determining if unmet needs in educational performance, including skill development, self-advocacy, and access accommodations that require classroom intervention, special instruction, or specialized support services are evident.

AREAS OF NEED FOR FURTHER CONSIDERATION (RED/YELLOW) INDICATED BY REVIEW OF ASSESSMENTS:

  • Speech perception/precision listening deficits as compared to class peers (impact on access to communication)
  • Listening Comprehension
  • Functional classroom performance
  • Language – receptive       expressive   syntax       morphology
  • Language –       pragmatics/social language use
  • Reading –         Phonological awareness       fluency   comprehension
  • Self-advocacy/ self-determination / independence with hearing devices
  • Auditory development skill assessment
  • ASL skill development
  • Academics
  • Behavior
  • Social-emotional   self-concept
  • ­___________________________________
  • ___________________________________

 

2017 © Supporting Success for Children with Hearing Loss. http://successforkidswithhearingloss.com Permission granted to adapt for specific team use.

Can he qualify? Assessment for Eligibility for Specialized Instruction

Download this Article

The great news is that early identification of hearing loss, improvements in hearing technology, and parent involvement in high quality early intervention services REALLY WORK to improve developmental outcomes by age three. This all too often results in transition teams who are evaluating the student for eligibility upon school age to deem that the student is ‘fine’ and needs no extra services or supports.

Can he qualify? Yes! This is possible IF there is someone on the multidisciplinary team who truly understands the impact of hearing loss on development AND knows appropriate assessments to use to tailor the evaluation process to the risk areas of students with hearing loss.

The IDEA law is consistent about looking at educational performance needs when considering a student’s eligibility for specialized instruction and support.  Educational performance is not equivalent to academic performance. If the creators of IDEA wanted to make it clear that good grades = no IEP they would have clearly done so – but they did not. There is no question that academic performance needs to be considered, but it is no more important to consider than the other areas specified by IDEA which are functional, behavioral, social performance and any other performance considerations relevant to the specific child. If a school team only considers grades for eligibility then they are using a sole criterion, which goes against the IDEA requirement that eligibility determinations be made using academic, functional, and developmental information with consideration of at-risk areas as determined by the suspected area of disability.

Our students with hearing loss may ‘look fine’ in the classroom yet we realize that there are usually subtle differences/needs that, added together, cause academic performance to erode over time. Thus, in evaluations, it is appropriate to look closely at social/emotional, self-advocacy, and the possibly subtle phonological/morphological awareness and ‘swiss cheese’ language skills that impact reading fluency and comprehension. It comes down to: “Will this student develop the skills he or she needs to truly be able to successfully get a job or enter higher education after high school?”  Download Resources for Identifying DHH Student Needs: Eligibility Assessment and Beyond that reflects some of the information discussed in Steps to Assessment. Discussion of the impact of hearing loss on these different eligibility areas, including assessment, will be the topic of future Updates.

Low average language results reflect the impact of hearing loss, not capability. So often for our students, qualification for specialized instructional services hinges on the results of language assessment as that is the most highly recognized area of deficit secondary to hearing loss. Ideally, hearing aid fitting for children who are hard of hearing would be completed no later than 3 months of age, but this is not the norm for most students with hearing loss. Delays in amplification fitting, and inconsistent use of hearing aids until school age is more the norm in many places. One study1 found that each month lag in amplification fitting attributes to 0.17 months in receptive and 0.30 months in expressive language. Additionally, each 10 dB of hearing loss accounts for an average of 5+ months of delay in receptive and expressive language. A very recent study2 found that 40% of students with hearing loss have a capacity for higher language levels beyond what test scores indicate. Further3, language learning for students with hearing loss occurs on average at 70%, or about 2/3, of the rate of children with normal hearing.

It is appropriate to anticipate that most children with hearing loss upon school entry will have some delay in expressive and/or receptive language, with greater degrees of hearing loss predicting greater levels of language delay. Also, the nature of hearing loss causes incidental language to be missed whenever a child is further away from about 3-6 feet of the speaker. This typically results in ‘spotty’ or ‘Swiss cheese’ language rather than solid overarching language delays. A student may therefore score higher than his or her actual functional language ability, based on the actual questions asked during the assessment and the individual’s particular vocabulary or conceptual knowledge. One strong finding from the robust 2015 Outcomes of Children with Hearing Loss Study4 was that when children who are hard of hearing are compared specifically to others their same age and socioeconomic status, the size of the effect of hearing loss on language averages 2/3 of a standard deviation. The study concluded that normative test scores overestimate the abilities of children who are hard of hearing as they are unlikely to reflect the level of effort that students are expending to maintain competitiveness with peers. In regard to the language development of children who are audiometrically deaf, 96%5 are currently born to hearing parents with no fluency in visual communication that would readily create an environment of rich visual language learning in early childhood. Although 80%5 of children born deaf in the developed world receive cochlear implants, the success rate with cochlear implants is highly variable and cannot be assumed to ever ‘fix’ all language development issues, even for children with the best outcomes. We must consistently communicate with our school teams that students with hearing loss are not language disordered. Delays occur secondary to lifelong access to communication issues.

It is important for DHH professionals to share with school teams the finding that at least 40% of students with hearing loss have a capacity for higher language levels beyond what test scores indicate. With this in mind, it is critical for DHH professionals to make the case that EVERY student with hearing loss who is going through initial assessment needs to have IQ testing. It is likely not that we think the student has low in cognitive skills. We need the IQ in order to accurately and appropriately estimate if/how much the hearing loss has impacted development based on the student’s ability compared to peers who do not have hearing loss. Students with hearing loss (DHH-only) experience delays secondary to access issues. Title II of the American’s with Disabilities Act requires that schools ensure that communication for students who are deaf and hard of hearing “are as effective as communication for others through the provision of appropriate aids and services, thus affording an equal opportunity to obtain the same result, to gain the same benefit, or to reach the same level of achievement as that provided to others. It is important to know the cognitive ability of each student with hearing loss as their communication access needs must be accommodated so that they reach the same level of achievement as their cognitive peers.

Although testing is performed in a few weeks’ time, evaluation isn’t just about a snap shot, it is about performance over time. Case in point, we received a call from a parent of a 5th grader who is hard of hearing. The child had an IEP in kindergarten and grade 1 and was then dismissed. By the end of grade 4 the reading scores had decreased. The school team wasn’t concerned because the student ‘wasn’t very bad yet.’  Time should be taken to consider the percentile scores on reading across time to see if there has been a decline. When looking at eligibility, dig into prior testing and see if you can make the case with declining percentile ranking in test results over time. For example, in grade 2 did the child score at the 48th percentile in reading as compared to the 26th percentile in grade 4? A public agency must provide a child with a disability special education and related services to enable him or her to progress in the general curriculum. The fact that there is a decline indicates that there are special needs that have not been addressed for the student. Access needs and/or deficits in specific skills foundational to reading comprehension would then need to be identified.

Finally, we need to step back and consider the 2004 IDEA Commentary. The Commentary provides an overall ‘setting the stage’ for the IDEA law. Section by section the Commentary responds to the comments submitted during the 2004 reauthorization process and provides explanations. The commentary is broken into sections on this webpage.   The defined purpose of IDEA: To ensure that all children with disabilities have available to them a free and appropriate education that emphasizes special education and related services designed to meet their unique needs and prepare them for further education, employment and independent living.  Therefore, the purpose of IDEA is not to support students so that they can make progress commensurate with age/grade expectations. IDEA services were envisioned as being about preparation for the future. Thus, performance on the expanded core skills needed for full participation (self-advocacy, communication repair, knowledge about hearing loss, amplification independence, etc.) are truly necessary for a student to be fully prepared to function as an adult. These are NOT standard areas of evaluation for other students with special needs but they must be considered as part of a tailored assessment for students who are deaf or hard of hearing.

Sometimes administrators make the point that schools must provide educational benefit for students but do not have to guarantee that the student reaches his or her potential. While this was established by a court cast (Bd. Ed. Hendrick Hudson Sch. Dist v. Amy Rowley, 1982), Commentary from the 2004 reauthorization specific to preparation for the future needs and the relationship of expanded core skills for the future success of students with hearing loss needs to be taken into account when ‘educational benefit’ is determined. Indeed, per the March 2017 decision of the US Supreme Court, schools may not settle for minimal educational progress by disabled students. Educational programs must be reasonably calculated to enable a child to make progress appropriate in light of the child’s circumstances. In the case of students with hearing loss, the expectation would be to provide full access to school communication and specialized instruction to fill in learning gaps PLUS support typical/expected levels of progress in the classroom. Therefore, evaluation must be tailored to identify the access, learning, and functional performance needs of every student with hearing loss so that they can progress equal to their cognitive peers.

 

References

1. Auditory development in early amplified children: Factors influencing auditory-based communication outcomes in children with hearing loss. Ear and Hearing, 31(2), 166-185
Another 2010 study1 looked at the level of hearing loss and age of amplification fitting impact on language development. Each 10 dB of hearing loss accounted for 5. 9 months decrease in receptive language performance and 5.2 months of performance lag in expressive language performance. Age at fitting was predictive of both language measures with each month of lag in amplification fitting attributing to a language lag of 0.17 months in receptive and 0.30 months in expressive language. Not surprisingly, children with the earliest access to the speech signal through amplification have the best outcomes on auditory-based communication measures. Holding the age at fitting or degree of hearing loss constant, children using a cochlear implant can expect an improvement of 12 months in receptive language and 18 months in expressive language.

2. Language underperformance in young children who are deaf or hard-of-hearing: are the expectations too low? Journal of Developmental & Behavioral Pediatrics. September 19, 2017.
Research released at the end of this September2 shared results focused on children with hearing loss who have language levels within the average range on standardized measures. The researchers identified a mismatch between the cognitive level children test at and the expectations for their language skills. In examining the abilities of their 152 young child subjects they found that at least 40 percent have a capacity for higher language levels – beyond what their language test scores indicate.

3. The Effect of IQ on spoken language and speech perception development in children with impaired hearing. Cochlear Implants International, (11)1, June, 370-74.
A 2010 study3 found that children were learning language at approximately 2/3 of the rate (or 70% of the rate) of their normally hearing peers. Subjects were 62 children ages 5-12 years who used oral communication and attended oral early intervention or school settings. Children in preschool learned language at a faster rate than children attending primary school. On average, children attending preschool were learning at 0.78 of the rate for normal hearing children as compared to a rate of 0.67 for students in primary school. Speech perception scores did not plateau until children had, on average, the language ability of a typically hearing 7-year-old.

4. Epilogue: Conclusions and Implications for Research and Practice. Ear and Hearing, 36, 92S-98S.
Sole reliance on norm-referenced scores may overestimate the outcomes of CHH. The findings from this study provide consistent evidence that limitations in hearing sensitivity have an impact on children’s development of language. It could be argued, however, that this effect is not sufficient to lead to a disabling condition for the majority of these children. When the CHH are compared with the norm-referenced group on various measures, the differences are small. However, when we compared the CHH to our sample of CNH who were matched on age and SES, the size of the effect of HL on language doubled to two thirds of a standard deviation. These results lead us to question the sole reliance on comparison to norm-referenced test scores for judging the adequacy of the developmental outcomes of CHH. It is likely that CHH will compete in school settings with children from similar home backgrounds, who may serve as a more realistic comparison group. Furthermore, an anonymous reviewer pointed out another way that test scores may overestimate CHH: standardized tests scores are unlikely to reflect the level of effort that students are expending (cognitive and perceptual resources) to maintain competitiveness with peers in secondary and postsecondary schooling, where the cognitive demands increase. This suggests a need to closely monitor the outcomes of CHH including comparing their performance relative to neighborhood grade-mates.In interpreting this study, it should be kept in mind that many CHH in the OCHL study represent the best case scenario; their caregivers are fairly well resourced and most had the advantage of early access to interventions. We might expect that a sample with greater diversity on these dimensions would not perform as well as the OCHL cohort.

5. Language acquisition for deaf children: Reducing the harms of zero tolerance to the use of alternative approaches. Harm Reduction Journal, 2012, 9-16.
Today, 80% of children born deaf in the developed world are implanted with cochlear devices that allow some of them access to sound in their early years, which helps them to develop speech. However, because of brain plasticity changes during early childhood, children who have not acquired a first language in the early years might never be completely fluent in any language. If they miss this critical period for exposure to a natural language, their subsequent development of the cognitive activities that rely on a solid first language might be underdeveloped, such as literacy, memory organization, and number manipulation. An alternative to speech-exclusive approaches to language acquisition exists in the use of sign languages such as American Sign Language (ASL), where acquiring a sign language is subject to the same time constraints of spoken language development. The success rate with cochlear implants is highly variable due to a variety of child, family, device function, and habilitation treatment variables. The vast majority of deaf infants (approximately 96%) are born to hearing parents, who often know very little about sign language or Deaf communities. These parents are in a state of vulnerability, grieving the loss of a normally hearing child and fearing what the future may hold (or not hold) if their child cannot speak like a hearing child. They might view sign as an inferior choice or a last resort and not fully understand that sign language is a human language with the linguistic complexity and expressiveness of spoken language. They might also fear their child will be stigmatized if they use a sign language. Furthermore, they might be afraid of trying to learn a new language at their age. In the absence of relevant information, many parents opt for the speech-only route because, without appropriate advice and information, they do not understand the risks of linguistic deprivation.

Karen L. Anderson, PhD, Director, Supporting Success for Children with Hearing Loss; Late October Update. This information is not intended as legal advice. http://successforkidswithhearingloss.com Sign up to receive Bimonthly Updates from Supporting Success.

Advocacy Notes Children with Disabilities in Virtual Schools

Success in mainstream classrooms when you have a hearing loss is often a substantial challenge for our students. Increasingly, parents are exploring the option of enrolling their student in virtual school learning programs. In August, 2016, the US Department of Education Office of Special Education and Rehabilitative Services issued a ‘Dear Colleague’ letter defining school’s responsibilities to students with disabilities enrolled i­n virtual learning settings.

 

The letter affirmed that virtual schools must carry out the requirements of IDEA as must physical schools, including:

  • establishing and maintaining qualifications to ensure that personnel necessary to carry out the purposes of IDEA, including personnel serving children with disabilities in virtual schools, are appropriately and adequately prepared and trained, and that those personnel have the content knowledge and skills to serve children with disabilities (34 CFR-§300.156(a));
  • appropriate accommodations and alternate assessments, where necessary and as indicated in their respective individualized education programs (IEPs). 34 CFR-§300.160
  • For children who have IEPs and have been determined eligible for special education and related services prior to their enrollment in the virtual school, child find responsibilities also include ensuring that periodic reevaluations are conducted
  • reliance on referrals by parents should not be the primary vehicle for meeting IDEA’s child find requirements; screenings to identify children who might need to be referred for an evaluation and questionnaires filled out by virtual school teachers and staff and children’s parents are ways in which this IDEA child find responsibility can be met
  • ensuring that each eligible child with a disability has FAPE available to him or her in accordance with 34 CFR-§§300.101 and 300.17
  • implementing the evaluation and eligibility requirements in 34 CFR-§§300.300-300.311;
  • carrying out the IEP requirements in 34 CFR-§§300.320 through 300.324, including those governing IEP content, IEP Team participants, parent participation, when IEPs must be in effect, consideration of special factors, the development, review, and revision of IEPs, secondary transition services and participation in State and districtwide assessment programs;
  • implementing the requirements in 34 CFR-§§300.114 through 300.117, regarding education in the least restrictive environment, including ensuring the availability of a continuum of alternative placements to provide special education and related services.

With these points in mind, students with hearing loss should:

1. be receiving appropriate services from the itinerant DHH teacher.

2. be accommodated with fully captioned materials (contact Interact-AS for captioning flipped classrooms), and/or access to ASL interpretation of class materials.

3. receive appropriate testing accommodations, including orally read information, ASL, more time, etc.

4. receive meaningful monitoring of functional progress, including ability to keep up with vocabulary in classes, level of comprehension of presented information (listening comprehension, reading captions/listening, comprehension via sign, any combination of communication access accommodations).

5. include effective two-way communication. Consideration of special factors includes the need for communication with native language users for effective communication. This could mean involving an interpreter in chats/discussions rather than having the student type out messages where deficits in writing, language, syntax could impact evaluation of student knowledge.

6. include transition services, and more broadly, self-advocacy skill development to specifically allow the student to become independent in all communication situations and environments.

7. have access to the intensity of specially designed instruction needed for the student to be able to make meaningful progress considering their individual circumstances. If a student is 2 years delayed in reading comprehension, then direct instruction in reading by a knowledgeable teacher (DHH teacher) would be appropriate to allow progress in foundation skills along with supporting an expected rate of curricular progress.

If you have a question from the field, send it to karen@successforkidswithhearingloss.com!

NOTE: The information represents the opinion of Karen Anderson, PhD who is not an attorney. The information presented is not legal advice, may not be the most current, and is subject to change without notice.

Bi-Monthly Update: Is Inclusion Good for Students with Hearing Loss?

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Supporting Success
for Children with Hearing Loss

Early October Bimonthly Update
Welcome if you are new to Bimonthly Updates! Topics vary with each issue. Feel free to forward!

Is the Inclusion Model Good for Students with Hearing Loss?

Description: C:\Users\Karen L Anderson\AppData\Local\Microsoft\Windows\INetCache\Content.Word\Depositphotos_5826642_XL.JPGSpecial education students are first and foremost general education students. Many, if not most, school districts in the US are actively embracing the inclusion model of education, in which virtually all students are educated in the mainstream classroom, regardless of the diversity of their needs.

Students with hearing loss have special needs but not they are not due to learning disorders like most other special education populations. The primary difference between students with hearing loss and their classmates is that they do not access speech as fully. Students with hearing loss who are DHH-only have learning gaps and special needs secondary to access to communication issues, not learning disorders.

Read more about the detriments and benefits of inclusion for students who are DHH.

 


 

6 YEAR ANNIVERSARY – Building Skills for Success in the Fast-Paced Classroom

Description: C:\Users\Karen L Anderson\AppData\Local\Microsoft\Windows\INetCache\Content.Word\Building Skills 1.jpgThe book that defines expanded core DHH services!
The Building Skills for Success book has been lauded by hundreds of DHH professionals as the ‘itinerant bible.’  Many DHH teachers across the US and Canada refer to ‘The Book’ most teaching days. The introduction to each chapter provides you with language you can use when you are challenged by administrators about why your student needs these services. With the book comes 50 downloadable files for you to use with your caseload. The Building Skills book now comes in a 3-ring binder with plenty of room to add your own teaching materials or to integrate those that come with Building Skills for Independence, Steps to Success, Advocacy in Action, and other resources you can readily find on the Supporting Success website.                  

Don’t have Building Skills for Success yet? Read more here

 


 

What’s New? Authoritative Resource to Support the Need for DHH Teachers

Description: C:\Users\Karen L Anderson\AppData\Local\Microsoft\Windows\INetCache\Content.Word\Depositphotos_58808099_s-2015.jpgLast May, representatives of the Council for Exceptional Children – Division of Communication Disorders and Deafness released Teachers of Students who are Deaf or Hard of Hearing:  A Critical Resource Needed for Legal Compliance. This document reviews the foundations for why credentialed teachers of students who are deaf/hard of hearing are critical to providing appropriate evaluation, programming, planning, and student-centered instruction.

Download it from the Important Resources at the bottom of the SSCHL Home Page

 


 

NEW to SSCHL – Evidence-Based Practice in Educating Deaf and Hard-of-Hearing Students 

Description: C:\Users\Karen L Anderson\AppData\Local\Microsoft\Windows\INetCache\Content.Word\Evidence-Based Practice in Educating DHH Students.jpg The new buzz phrase in education seems to be evidence-based practices. Yet what ARE the EBP for deaf education? Two famous researchers in our field, Mark Marshark and Pat Spencer, teamed together to critically review the literature and summarize the findings. The research base has been boiled down into very understandable nuggets that teachers can share with administrators and use to guide their practice.  Included is a 5-page Key Findings Index that is in the front of the book that provides ‘sound bite’ summaries of the research findings.

This book is a MUST for every DHH program and should be on the shelf of every administrator who oversees programmatic and individual decisions for students with hearing loss.

With so many questions about appropriate programs and necessary services (such as: is it REALLY necessary to have the DHH teacher on the IEP???) it makes sense for all professionals involved in education of students with hearing loss to own, or have ready access to this book!

Read more about Evidence-Based Practice in Educating DHH Students

 


 

Teacher Tools flippable e-Magazine – The OCTOBER issue is now posted!
Description: C:\Users\Karen L Anderson\AppData\Local\Microsoft\Windows\INetCache\Content.Word\Teacher Tools box logo.jpg

View the Table of Contents

The new format allows members to quickly page through ALL of the materials. A good fit for busy, on the go teachers! We now have over 800 members!
Join NOW!  | LOGIN NOW

Thanks to those of you who have struggled to get into your Teacher Tools account. Our beautiful new website came with some issues we have slowly been working through. Please let us know if you need help!  Contact teachertools.successforkidswithhearingloss.com

 


 

Description: C:\Users\Karen L Anderson\AppData\Local\Microsoft\Windows\INetCache\Content.Word\Conference Logo.jpgDescription: C:\Users\Karen L Anderson\Dropbox (SSCHL)\Constant Contact\Photos - High Quality\Depositphotos_42286955_m-2015.jpgWhat should be the format of the Supporting Success Conference?

Please answer this survey to help determine the format of the February 2019 Supporting Success Conference. Onsite, face-to-face conferences are expense and fewer districts are allowing release time for teachers. Please weigh-in on what you think about a face-to-face versus an online, virtual conference. Your input is very important!!!!  GO TO THE 1-QUESTION SURVEY NOW.

 


 

Resources from SSCHL – More about appropriate services for students with hearing loss
Description: C:\Users\Karen L Anderson\AppData\Local\Microsoft\Windows\INetCache\Content.Word\Depositphotos_28179053_s-2015.jpgFind more information on the Supporting Success website:

 


 

Promoting Language & Literacy in Children who are Deaf or Hard of Hearing – evidence-based practices for assessment and intervention with children, birth through school-age

Description: C:\Users\Karen L Anderson\AppData\Local\Microsoft\Windows\INetCache\Content.Word\Promoting Language and Literacy in Children Who Are Deaf or Hard of Hearing 2.jpgResearch results have been used as the basis for practice recommendations throughout the book. It is cutting edge! About half of the book is devoted to birth-3. There is a chapter on visual communication modalities followed by a chapter on auditory verbal therapy so there isn’t a single-sided viewpoint presented on communication. The chapters on phonological development, supportive early childhood practices, theory of mind, literacy development and teaching writing would be rich reading for any teacher of school-aged children. The chapters include wonderful case studies and what is especially beneficial is the CD that is filled with video clips of assessment and teaching strategies. There are tons of inspiring clips, each associated with specific information from a chapter. This book is valuable for any professional who works with children or students with hearing loss and their families.

Read more about Promoting Language & Literacy in Children who are DHH

 


 

WEBCASTS to Support Appropriate Student Services  

Description: C:\Users\Karen L Anderson\AppData\Local\Microsoft\Windows\INetCache\Content.Word\TNL-2.jpgThe more you know about the law and its requirements, the better you can advocate for your student and the need for YOU to provide services to address their unique needs due to hearing loss. We have just pulled together a new Trio Combo, providing reduced pricing when all three of the following webcasts are purchased together. Only $40 for all 3!


Making the Case: Legal Interpretations to Remember (45 min)
Match It! Sell It! Guarantee It! Getting Your Students the Support They Need to Achieve (60 min)
We are Zebra Experts: Recognizing the Needs of Zebras in a World of Horses (45 min)

Go to the WEBCAST CATALOG or directly to the Trio Combo page

Read more about the webcasts


Description: C:\Users\Karen L Anderson\AppData\Local\Microsoft\Windows\INetCache\Content.Word\Depositphotos_82128142_m-2015.jpgAdvocacy Notes – In a nutshell

Description: C:\Users\Karen L Anderson\AppData\Local\Microsoft\Windows\INetCache\Content.Word\Depositphotos_100383942_m-2015.jpgWe know about IDEA, ADA, FAPE and other acronyms for terms related to providing services and supports to our students with hearing loss. Below are some of the basics that underlie who, why, and how we are required to provide support for students who are deaf or hard of hearing within the US. At YOUR fingertips!

Read More for the Legal Framework in a Nutshell


Upcoming Presentations

Description: C:\Users\Karen L Anderson\AppData\Local\Microsoft\Windows\INetCache\Content.Word\Depositphotos_4757785_s-2015.jpgby Karen Anderson, PhD, Director of Supporting Success
October 12-13 – LA (Lafayette)
October 19-20 – MA (Marlborough)
November 2 – MB (Winnipeg)
November 10-11 – WI (Appleton)

It was fun as part of my keynote in Minot ND to conduct an onsite, app-enabled Roles and Responsibilities survey with the participants! Cool!   
Now booking for 2018 Presentations!

Read here for more information

Upcoming Presentations

Upcoming Presentations

by Karen Anderson, PhD, Director of Supporting Success
October 12-13 – LA (Lafayette)
October 19-20 – MA (Marlborough)
November 2 – MB (Winnipeg)
November 10-11 – WI (Appleton)

 

Now booking for 2018 Presentations!                                                          

Contact info@successforkidswithhearingloss.com for more information on specific speaking engagements.   Refer here for more information on presentation services.

October 12-13, Lafayette, LA. Speech Pathologists and Audiologists in Louisiana Schools conference. Cajun Dome. 1 full day.

C:\Users\Karen L Anderson\AppData\Local\Microsoft\Windows\INetCache\Content.Word\thumb_IMG_1371_1024.jpgOctober 19-20, Marlborough, MA. Presentations at the Clarke Annual Mainstream Conference.

November 2, Winnipeg, MB. Conference for educators and other related professionals who work with students with hearing loss. 1 full day.

November 10-11, Appleton, WI. WESP-DHH Conference for families and educators working with children who are deaf or hard of hearing. Keynote and a session each for parents and professionals that highlights free resources available on the SSCHL website.

Advocacy Notes – In a nutshell


We know about IDEA, ADA, FAPE and other acronyms for terms related to providing services and supports to our students with hearing loss. Below are some of the basics that underlie who, why, and how we are required to provide support for students who are deaf or hard of hearing within the US.

Legal frameworks defining services for students with special needs:

1. The purpose of 2004 IDEA, as specified in the Commentary, is…to ensure that all children with disabilities have available to them a free appropriate public education that emphasizes special education and related services designed to meet their unique needs and prepare them for further education, employment, and independent living. Source

2. All elementary and secondary school students who are qualified individuals with disabilities, as defined by Section 504, and who need special education and/or related aids and services are entitled to a free and appropriate education (FAPE). Under Section 504, FAPE is the provision of regular or special education and related aids and services that are designed to meet the individual educational needs of students with disabilities as adequately as the needs of non-disabled students are met and are based on adherence to procedures governing educational setting, evaluation and placement, and procedural safeguards. Source page 10.

3. A student with a disability may achieve a high level of academic success but may nevertheless be substantially limited in a major life activity due to the student’s impairment because of the additional time or effort the student must spend to read, write, or learn compared to others. A school district must evaluate a student if it has reason to believe the student has a disability and the student needs special education or related services as a result of that disability, even if the student only exhibits behavioral (and not academic) challenges. Source page 12, 14. Behavior is interpreted broadly and includes challenges in performance or keeping pace with peers, not just acting out or conduct issues.

4. The March 2017 US Supreme Court threw out the de minimis standard applied to acceptable educational benefit to special education students and concluded that … To meet its substantive obligation under IDEA, a school must offer an IEP reasonably calculated to enable a child to make progress appropriate in light of the child’s circumstances…. It must…aim to enable the child to make progress; the essential function of an IEP is to set out a plan for pursuing academic and functional advancement…..at the core of the IDEA, and the directive that States offer instruction “specially designed” to meet a child’s “unique needs” through an individualized education program. Source

To summarize in regard to education of students with hearing loss:

  • Hearing loss fills the ADA/504 criteria as a life limitation that places a student at high risk for functional and/or performance needs. All students with hearing loss are eligible for 504 Plans and appropriate accommodations.
  • Students with hearing loss should be evaluated to determine their level of unique needs including the need for auxiliary aids, related services, and specialized instruction necessary to address academic and/or functional performance issues.
  • A high level of academic success does not preclude the need for specialized services or supports. Hearing loss will cause the student to have to expend additional time and effort to comprehend and fully participate, typically with less information perceived due to fragmented hearing, which impacts the ability to function and learn as compared to others.
  • Specialized services are tailored to meet the student’s unique needs and should provide the support(s) needed for the student to be able to make progress similar to their cognitive peers, as the access issues caused by hearing loss are not learning disorders impacting the level to which a student with hearing loss can learn.

This information also appears within the body of the article on Inclusion in this Update.

 

If you have a question from the field, send it to karen@successforkidswithhearingloss.com!

NOTE: The information represents the opinion of Karen Anderson, PhD who is not an attorney. The information presented is not legal advice, may not be the most current, and is subject to change without notice.