Month: November 2019

If the family wants an ASL interpreter is the school required to provide one?

Question from the field: We have two students who were raised by Deaf families in ASL environments. Both have moderate to severe hearing loss with access to speech via amplification. The students are preschool and in grade 1. Neither are fluent in listening and spoken language (LSL). The district doesn’t want to provide interpreters because the students can ‘hear’. One student is not fluent enough in LSL to access verbal instruction. The other student has significant LSL skills but still reports frequent frustrations with access and comprehension.

Academic learning is driven by communication access.

This statement needs to be restated repeatedly and remembered constantly! The premise of providing a free and appropriate public education (FAPE) begins with the assumption that the student will be exposed to – and be able to perceive – school instruction. Job #1 in FAPE, especially for students with hearing loss, is to ensure access to instruction. As clarified by the US Supreme Court in 2017, schools need to provide instructional services and supports necessary for the student to make meaningful progress in the regular curriculum in light of the child’s circumstances. Minimal achievement gains are not enough. For students with hearing loss who have no other learning issues, the child’s primary circumstance is a lack of full communication access as the cause of past and present learning issues.

iv) Consider the communication needs of the child, and in the case of the child who is deaf or hard of hearing, consider the language and communication needs, opportunities for direct communication with peers and professional personnel in the child’s language and communication mode, academic level, and full range of needs, including opportunities for direct instruction in the child’s language and communication mode, and (v) Consider whether the child requires assistive communication devices and services. 34 CFR 303.324(2)

Special education law has specifically recognized the critical nature of communication access for students who are deaf or hard of hearing via the Special Considerations Section of IDEA. This provides a communication driven, child-centered appropriate in creating an education program that is driven by the child’s right to fully and effectively access communication that makes benefitting from education possible. This emphasis on equal access to communication is also specified within the Americans with Disabilities Act in which schools must ensure that communication is as effective for students with hearing loss as it is for peers.

The decision about the appropriateness and necessity of providing classroom ASL interpreters needs to be guided by the discussions of the IDEA Special Considerations. The following questions should be some of those that are answered by the student’s IEP team as the special consideration factors are discussed:

1. How effectively is the student able to access/comprehend using his or her communication mode(s)?

2. What appears to be the level of comprehension in different situations (i.e., quiet vs noisy class)?

3. If the child uses both sign and spoken language the team needs to understand how, when, where, why and who the child communicates with each language modality. Spoken language may be adequate for routine activities but not sufficient for the student to (fully) comprehend teacher instruction.

4. How will the student access the inferential learning opportunities that hearing children are exposed to daily? What about peer-to-peer interactions, such as group work or class discussion?

5. What hearing technology does the student use and the level of benefit? Do the hearing aids plus an FM/DM device allow the student to close their comprehension gap fully? What is his ‘listening gap’?

6. What is the student’s language level in comparison to the teacher’s instructional language level? Does comprehension of instruction increase from one communication modality over another?

7. What is the student’s ASL vocabulary development level in comparison to their spoken language development level? (Refer to the White Paper on Estimating Access for more information)

8. What level of facilitation will be needed for the student to be able to meaningfully communicate with peers and adults?

When a child can be observed to ‘hear’ it is logical – but incorrect – to assume that they can understand.

Data must be collected to determine how and when either ASL or LSL is the most effective means of communication for a student who has some skills in both. Data drives informed decision-making.

Learning a new language takes exposure and TEACHING when there are delays due to access issues.

There are two important pieces of knowledge that have been gained from research on language learning by children who receive cochlear implants that are applicable to question from the field.

a. Children who develop language via signing and then are implanted will more quickly learn listening and spoken language. As they are exposed and taught LSL, their previous language experience works as a scaffold to support verbal language learning. The better the ASL language level, the faster the rate of spoken language development once consistent hearing and appropriate LSL instruction are provided.

b. It takes time! Access to sound does not magically result in knowledge of spoken language. Knowledge must be learned. A child who is 5 years old or older who is implanted and heavily reliant on signs takes a minimum of 12 months of appropriate, knowledgeable, and intensive instruction in listening and spoken language before a major improvement in language can be expected. Not age equivalent comprehension – but beginning to rely on spoken language in some situations for understanding.

In the case of a child who was raised in an ASL environment that did not include an emphasis and consistent work to develop LSL skills it can be assumed that just having hearing aids on did not allow the child to develop spoken language at an adequate rate to allow him or her to be able to comprehend and compete with age peers within a typical classroom setting without an ASL interpreter.

Based on language levels in ASL and LSLS, key decisions would likely be:

• What intensity of direct intervention in listening skills is necessary to result in LSL fluency within one (Two? Three?) academic year? Daily intensive intervention by a skilled LSL provider may be likely as the child will not be exposed many hours to good spoken language models outside of school. The sooner the student can rely on listening as the primary access to classroom learning the sooner the expense of having an interpreter can be eliminated.
• What is the plan for the interpreter, classroom teacher, and classroom aide (if any) to work together to facilitate the student’s communication during instruction, incidental language exposure, and peer-to-peer communication? When would LSL be used? When would ASL be used?
• What are the communication benchmarks to look for during progress monitoring that will signal a switch from full interpretation of all class communication to using ASL to scaffold what the child does not understand when presented information by spoken language only? This is an incremental stepwise process.

 

Ultimately, what educational program will allow the child to access communication at a level that there will be meaningful academic progress?

 

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Many students who are hard of hearing or deaf enter school with limited vocabularies and language experience, whether their communication modality is spoken or signed.  Given these constraints, vocabulary instruction is an essential and ongoing component of our work with students.  The sheer breadth and depth of information presented in a general education setting is often overwhelming, however, pre-teaching vocabulary can be an effective strategy in helping students integrate new words and concepts into their “bank of knowledge”.

Various factors come into play when pre-teaching vocabulary is identified as an accommodation and/or specialized instruction.  Pre-teaching vocabulary requires close collaboration with classroom teachers. Lesson plans may be difficult to obtain, finding signs for many specialized topics can be a challenge, and time limitations make deciding which vocabulary is the most important to teach is equally challenging.

Free resource provides invaluable information for teachers working with multiple grade levels: https://www.lead4ward.com

Teachers of the Deaf and Hard of Hearing must have curriculum expertise for multiple grade levels, including staying abreast of the words and concepts being taught. One resource created by Texas educators is https://www.lead4ward.com. Concepts and vocabulary introduced in each grade, along with previous concepts to be mastered are included for all core subject areas from kindergarten to high school. This academic vocabulary can be extremely helpful in planning your pre-instruction.

Tips for vocabulary instruction:

1. Scaffolding– Learning the meaning of a new word may be more effectively taught when students can relate new words to prior knowledge. Effective teachers relate new vocabulary to what a child is likely to already know rather than to a dictionary or glossary definition. For example, when teaching the word ‘severe,’ the student may learn it better when it is related to a personal experience (e.g. a severe injury) than to a story about the weather. For some students with hearing loss, teaching the word injury will be required while learning the word severe.

2. Explicit Instruction – Put away your assumptions about what you think the student knows and teach to be sure the student can say/sign the word, recognize it in print and in visual representation, discuss the word’s multiple meanings, and use it in its various contexts.

3. Discussion – For deeper understanding, discussion is paramount. The term “discussion” is not to be confused with “questioning.” Discussion, in a group setting, involves questions or comments going from student-to-student with the teacher acting as a facilitator where questioning usually goes from teacher-to-student, back to teacher, and then to another student, with content being more strictly controlled by the teacher. Discuss:

a. the definition
b. multiple meanings
c. produce synonyms and antonyms
d. practice using the word in reading and writing, and
e. provide examples and non-examples of appropriate use of the word.

4. Visual/graphic organizers– Visual/graphic organizers show relationships between words and make information easier to manage. Our students need to be able to identify attributes and categorize words in various ways.

The ability to organize words and information makes word retrieval easier.

Some types of visual organizers include Venn diagrams, flow charts, KWL charts, sequential organizers, semantic maps, and graphs.  Without word organization, students end up with a “laundry basket” of new words rather than a file cabinet. And isn’t it easier to retrieve something from a file cabinet than a laundry basket?

5. Repetition, repetition, repetition – Repetition is necessary for students to master vocabulary words. Along with repeated exposure, seeing and using a new word or phrase across content areas and activities will help deepen word knowledge. Up to 12 exposures may be necessary to develop deep understanding of a new word, and students who struggle with reading may need additional opportunities (Easterbrooks & Beal Alvarez, 2013).

Which vocabulary words?

• Tier 1 words are words students are likely to know (happy, mom)
• Tier 2 words appear in many contexts and across content areas (equal, state)
• Tier 3 words are content-specific (chromosome, biosphere)

While some of our students may have to be taught Tier 1 words before moving on, targeting vocabulary instruction for Tier 2 words may be the best use of your time for students in the general education setting.   These are words that will be seen and heard frequently and across subjects. Taking advantage of pre-teaching these words in multiple contexts and forms (with applicable prefixes and suffixes) will address higher order thinking skills as well. There are many sources for Tier 2 word-lists, such as this free resource that appears on  Teachers Pay Teachers:  https://www.teacherspayteachers.com/FreeDownload/FREEBIE-Vocabulary-Targets-Word-List-K-5-Tier-2-Words-2095007

Other sources for vocabulary instruction include Cracking the Grammar Code 4 Book set with a Vocabulary Enhancement Simple Picture Glossary Supplement (Homelvig & Rugg); Latin and Greek Roots: Teaching Vocabulary Using Hands-On Activities and Common Objects (Stokes); 100% Curriculum Vocabulary-Primary and Secondary Editions (Eggleston & Larson). See complete catalog.

Pre-teaching vocabulary is NOT tutoring – it is specialized instruction.

Systematic vocabulary instruction including pre-teaching is essential not only for increased knowledge of the world around  our students, but also for increased confidence in reading, writing, and comprehension.

 

Sources:

• Price, L. (2014). Visualizing vocabulary: Improving word association & retrieval skills [.pdf]. Retrieved from https://successforkidswithhearingloss.com/ Webcast available from The Online Itinerant.
• Knoors, H. & Marschark, M. (2014). Teaching deaf learners. New York: Oxford University Press.
• Easterbrooks, S.R. & Beal-Alvarez, J. (2013). Literacy instruction for students who are deaf and hard of hearing. New York: Oxford University Press.
• Gambrell, L.B. & Morrow, L.M. (2013). Best practices in literacy instruction (5^th). New York: Guilford Press.
• Schirmer, B.R. (1994). Language and literacy development in children who are deaf. New York: Macmillan.
• Hart, B.O. (1963). Teaching reading to deaf children. Washington, D.C.: Alexander Graham Bell Association for The Deaf, Inc.

 

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What program is most appropriate for
a preschooler with cochlear implants?

 

While this question needs to be answered on an individual basis, a 2004 court case provides important insights into what an appropriate program is – and is not.

The many factors that influence a child’s success with a cochlear implant include¹:

Age of onset of deafness Age at time of implantation Consistency of device use

Bilateral/bimodal device use Educational environment Family support & follow up

Residual hearing Etiology of hearing loss Additional special needs

Before a school can provide an appropriate educational program, it must be established the level to which the child has made auditory progress since the time of implantation. With appropriate early intervention, including work with the family and child to develop auditory skills, the following progress is expected²:

Lack of appropriate intervention, follow through by families, other health/development issues, and problems with equipment function will all slow down expected development. For a performance checklist for development of complex listening skills, see Activities for Listening and Learning.

In general, an educational environment that supports good use and continued auditory development using cochlear implants will have someone who knows how to support and maintain the CI, educators with a knowledge base about the impact of hearing loss on learning and how to best support performance, an optimal auditory environment via appropriate classroom acoustics and use of remote microphone technology (FM/DM system), and intervention to continue auditory development.

Relevant court case³: In 2004 the question about appropriate programming for preschoolers with cochlear implants was deliberated in Florida. The child received a cochlear implant at age 30 months and was receiving intensive services to promote listening and spoken language. At age 3 the family wanted the child to attend an auditory oral school for children who are deaf and hard of hearing so that rapid growth would continue in her listening and spoken language development. The school was offering placement in a varying exceptionalities (VE) class of students who are all developmentally delayed as there was no preschool class specially designed to teach children with hearing loss to listen and speak without using sign language. Neither the VE teacher nor the classroom aides had experience working with deaf children, nor did the available speech language pathologists. There was a special education teacher who had not worked with any oral deaf children. There was also an itinerant teacher of the deaf/hard of hearing who had some experience using sign language with students who had cochlear implants in secondary school grades, but no experience with a child who had a cochlear implant and required auditory skill development.

With close collaboration with the oral deaf school staff, an IEP was developed and the child began attending a pre-kindergarten VE class, even though she had no developmental delays unassociated with hearing loss. It was subsequently revealed that the child was receiving speech articulation services instead of intensive training to develop her ability to access and process sound through the auditory channel. The family rejected the placement and unilaterally returned the child to the oral deaf school.

Findings: The district was found to have violated provide a free and appropriate public education (FAPE) as the IEPs developed by the school did not address the student’s need to learn how to hear, comprehend, and communicate in her mode of communication, thus not providing her with FAPE. The court found that the school’s proposed placement would not provide the student with FAPE because:
(1) a VE classroom is inappropriate because the student needs an educational program in a setting designed to allow meaningfully access to the educational process through an oral mode of communication,
(2) the district professionals lack the necessary knowledge, training, and experience to implement the IEP,
(3) the VE placement does not provide for necessary parent training, ongoing audiology support and hearing device troubleshooting services,
(4) the VE placement will not adequately develop the student’s auditory brain structure, and thus her ability to hear and speak, during the narrow window of opportunity before the student is 5-6 years of age,
(5) the VE placement fails to provide the student with the opportunity to achieve the goal of being mainstreamed by kindergarten or first grade.

 

Resources

1. 1. Setting Appropriate Expectations and Communication Goals with a Cochlear Implant. https://advancedbionics.com/content/dam/advancedbionics/Documents/libraries/Tools-for-Schools/Educational_Support/presentations/Expectations_for_Cochlear_Implantation/ExpectationsforCochlearImplantation_Notes.pdf
2. 2. Tools for Toddlers: TRACKING AUDITORY PROGRESS in children with cochlear implants. https://advancedbionics.com/content/dam/advancedbionics/Documents/libraries/Tools-for-Toddlers/early-intervention-professionals-teachers-therapists/Tracking-Auditory-Progress.pdf
3. 3. N. vs St. Johns County School Board. https://successforkidswithhearingloss.com/wp-content/uploads/2019/10/Court-case-need-for-appropriate-preschool-program-for-child-with-CI.pdf

Despite the technological leaps made in Hearing Assistive Technology Systems (HATS), devices like hearing aids and cochlear implants do not “fix’ the listening challenges of students with hearing loss. Incomplete auditory access usually interferes with auditory skill development therefore, children who are hard of hearing benefit from practice with listening skills¹. It is up to the professionals who understand hearing loss to provide listening strategy intervention for students who are hard of hearing.

Too often, however, teachers who work with these students don’t feel they have enough knowledge about which auditory skills are appropriate to practice and how those skills develop. New information recently added to the Supporting Success website can answer many of your questions: Listening (Auditory Skills) Development pages.

Why practice auditory skills?

Listening is essential to communicating. Many who write about the contribution of listening skills to school success cite a study by Wilt², which analyzed how time spent communicating is broken into different activities. Wilt found that people listen 45% of the time they spend communicating, 30 % of communication time was speaking, 16%  reading, and 9 % writing.

Listening practice can improve listening skills.   Sweetow³ reviewed dozens of studies of auditory training and found that improvements in communication strategies—and often in sentence recognition—can be expected. When using a synthetic training approach, participants listen to spoken language, often at the sentence level, and learn to use visual cues, context and knowledge of language to understand the information.

Listening practice is underrepresented in most general education curricula. Listening can be challenging for many students, and even more difficult  for students with hearing loss.  If our students are to have improve their access to communication in the classroom, discussing listening challenges and practicing listening skills must happen during their time with professionals who understand hearing loss.

Q: How can we find time to assess and practice auditory skills?

A: Apply the Speech Perception Lens to every lesson.       

Auditory speech perception is the set of skills needed to understand spoken language through listening. Improvement of speech perception can lead to better comprehension and production of spoken language. If you wonder where to find the time in your daily schedule to add auditory practice, each month the Listening Strategies article in Teacher Tools provides new ready-to-use cross-curricular activities for auditory practice while also addressing common curriculum goals.

Four abilities⁴ comprise speech perception. Listed in order of complexity:

• Detect or hear sounds
• Discriminate, or recognize how spoken utterances (e.g., phonemes, words, sentences) are different from each other
• Identify, or attach meaning to, spoken utterances, and
• Use all that auditory information to comprehend discourse such as phrases, sentences and conversations

Incorporating auditory speech perception practice into lessons that are aligned with academic objectives can take full advantage of the time the D/HH professional spends with a student, while also targeting auditory skill sets for students with hearing loss.

If a teacher examines the task being asked of a student in a given lesson, she can determine what listening skills will be required for successful completion of the task. Taking this perspective can be likened to looking at the lesson through a “speech perception lens.”

Use the Speech Perception Lens for Error Analysis

Step One: Analyze the auditory task. To examine auditory tasks, looking at the first column of this table to find the complexity level of the spoken message to which the student will listen. For an early reader, a lesson on sound-letter matching will ask the student to listen to a phoneme. In a small group or partner discussion, the student will be listening to discourse.

Next, determine how the student will be responding. If the student is simply indicating that she heard something, a rare task in an educational setting, the task is one of detection. If the student is expected to repeat what was heard, the task is identification. Most educational tasks require the student to demonstrate comprehension by making a choice. The choice may be within a given set of possible answers, or it may be an open choice based on information learned. The student who hears the phoneme /m/ and is expected to point to the letter m or write it,  is showing comprehension of a phonemic relationship. The student who listens to a classmate’s opinion and then responds to show agreement or disagreement is showing comprehension of a sentence or discourse, depending on the length of the classmate’s statement.

Step Two: Know the essential features of vowels and consonants.  Vowels vary from one another based on the location in the vocal tract in which they resonate.  Vowels which resonate near one another sound similar. Consonants, however, vary based on the way in which they are produced – whether they are nasal (like /n/), require a stopping of breath (like /t/), or produce a sound caused by friction of air passing through a restricted space (like /s/).  Errors are more likely to happen when listening to sounds that are produced in the same way, like /s/ and /z/.  Read more here.

The Bottom Line: Do Something!

Professionals who work in a one-to-one or very small group session with students who have hearing loss can provide guided practice using materials from the student’s academic curriculum. In these sessions, the adult will be able to determine the possible reasons for an error and help the student find strategies to avoid that type of error in the classroom. New lessons and strategies for listening success can be found in the monthly Teacher Tools magazine.

References:

1. 1. Ferguson, M. A., & Henshaw, H. (2015). Frontiers in psychology, 6, 556.
2. 2. Miriam E. Wilt(1950) A Study of Teacher Awareness of Listening as a Factor in Elementary Education, The Journal of Educational Research, 43:8, 626-636, DOI: 1080/00220671.1950.10881817
3. 3. J Am Acad Audiol.2005 Jul-Aug;16(7):494-504. Efficacy of individual auditory training in adults: a systematic review of the evidence.
4. 4. Erber, N.P. (1982). Auditory training. Washington DC: AG Bell Association for the Deaf