Advocacy Notes: Special Education Meetings for Necessary Communication

TOPIC: We seem to have so many different meetings that we are asked to attend with the school district. What is the purpose for are all of the different special education meetings? What is a Transition meeting?

Special Education Meetings for Necessary Communication

Many families know that they have an IEP meeting once a year. However, the variety of IEP meetings that and are held, when they can be held, and who can request an IEP is not always clear to families or teachers. One type of IEP meeting that can be confusing to many families is the Transition IEP, and the confusion is heightened by the fact that some school districts will use the transition IEP to change the Triennial IEP date. 

Following are the various types of IEP meetings:

Initial IEP

Annual IEP

Triennial IEP

Amendment IEP which is any IEP meeting held between the annual IEP meetings and can be requested by either the district or the family at any time. One amendment meeting is the Transition IEP.

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An Often Unknown Cause of Hearing Loss in Children

An Often Unknown Cause of Hearing Loss in Children

Understanding and Preventing CMV in the Educational Setting

Author: Brenda Balch, M.D., AAP EHDI Chapter Champion for CT

 

The leading cause of sensorineural hearing loss is heredity, but many people don’t realize that the second most common cause of SNHL in children is due to Congenital Cytomegalovirus or cCMV. It is also the most common congenital viral infection in the United States and resulting hearing loss may be preventable. CMV can cause wide variation in hearing loss, including progressive loss.  

What is CMV?

Cytomegalovirus is a herpes virus that causes minimal to no symptoms in most people. In the U.S, by age 40, most of us have evidence of a past infection. CMV becomes a concern in primarily two scenarios – in a pregnant woman or in a severely immunocompromised individual. Most women are unaware of CMV and the risk of infection during pregnancy.

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Advocacy Notes: Special Education Meetings for Necessary Communication

TOPIC: We seem to have so many different meetings that we are asked to attend with the school district. What is the purpose for are all of the different special education meetings? What is a Transition meeting?

Special Education Meetings for Necessary Communication

Many families know that they have an IEP meeting once a year. However, the variety of IEP meetings that and are held, when they can be held, and who can request an IEP is not always clear to families or teachers. One type of IEP meeting that can be confusing to many families is the Transition IEP, and the confusion is heightened by the fact that some school districts will use the transition IEP to change the Triennial IEP date. 

Following are the various types of IEP meetings:

Initial IEP

Annual IEP

Triennial IEP

Amendment IEP which is any IEP meeting held between the annual IEP meetings and can be requested by either the district or the family at any time. One amendment meeting is the Transition IEP.

Transition meetings can be very confusing. IEP teams meet for a variety of transitions throughout the educational process, and these meetings are all typically scheduled in the Spring. Following is a discussion and overview of the various types of transition meetings:

  • Transition from preschool to Kindergarten: While compulsory education does not start at preschool, special education placement does. When it comes time to transition from preschool to Kindergarten, the IEP team will schedule the “Kindergarten Transition IEP.” Some school districts do not serve their students during preschool as they may use regionalized special education preschool programs. Therefore districts may do formal/informal observations in the preschool setting and gather data about how the child is doing, while other districts choose to conduct a full re-evaluation and make the Transition to Kindergarten the new triennial IEP meeting. Either way, the full IEP team would be expected to attend along with a general education Kindergarten teacher. The transition meeting is a wonderful way to reduce the stress and anxiety that both the family and the educators in the receiving school may have. It also allows for the district to share the various program options with the family and for the IEP team to identify any additional supports that will be needed. The district can then conduct staff training, order low incidence equipment, and make any necessary acoustic accommodations over the summer.
  • Transition from elementary school to middle school (junior high) and from middle school to high school: Elementary school is typically a time when our students have a single classroom teacher who is nurturing, safe, and responsible for teaching all academic subjects. The transition to middle school is stressful for all students as it occurs at the same time as the onset of adolescence. Our students with hearing loss may have even more anxiety as they move from one teacher to potentially 6-7 separate subject matter teachers who all need to understand their unique needs. Depending on mode of communication there will typically be additional staff training, discussion of interpreters, captioning, note-taking, and other unique supports. In the early Spring of the last year of elementary school the IEP team will begin to schedule a Transition IEP meetings which will include the current providers as well as special education representatives from the receiving middle school. This meeting is not a time to review progress on previous goals, develop new goals, or make a new offer of FAPE. The purpose of this meeting is to share the child’s eligibility, explain their unique needs, review the accommodations, and current services with the receiving team. This is when the middle school team will explain their programs and class options which may include a DHH placement, a variety of supported classes for ELA and Math, or a supported Study Skills class. The transition from middle school to high school is basically the same process and an opportunity for the receiving school to explain their programs and class options while the IEP team shares how the student is doing as well as all of their unique needs and support services as a student with hearing loss.
  • IEP Transition Planning: The IDEA (Individuals with Disabilities Education Act) requires that IEP teams begin planning with all students who have an IEP by the time they turn 16. The Individual Transition Plan (ITP) is included in the IEP document. It is typically created with a combination of student interview and interest surveys completed by the student with their IEP case carrier. The purpose of the ITP is to help students prepare to be as independent as possible following high school. The ITP includes planning and goals in the areas of Post-Secondary Education, Post-Secondary Employment, and Independent Living. As with all other portions of the IEP document, the ITP is revisited every year as a part of the annual IEP.
  • Transition from high school to adult education (18-22): Unless our students with hearing loss have another eligibility, the goal is that they will graduate from high school after their senior year. There are, however, occasions when students do not complete the high school graduation requirements and are eligible for IEP services until age 22. In these cases, the IEP team at the high school will call a Transition IEP in the Spring of the Sr. Year. The team should include a representative from the adult education program. While students continue to have academic support from age 18-22, much of the focus is on supporting students in accessing the community and independent living.
  • Transition out of high school, also known as the Exit IEP: The IEP and Special Education services end for the following reasons: the student no longer meets eligibility requirements, the student graduates from high school, or the student turns 22 years old. Each state decides the level of supports that they have available for individuals with disabilities post-high school. At this time the Americans with Disabilities Act (ADA) governs supports in college, career training, employment, and independent living. If there is a state agency that supports students with their college education, the IEP should invite a representative of the agency to the Exit IEP to facilitate the transition. I typically ensure that the students and IEP teams with whom I work begin to educate students (via IEP goals) during their junior and senior year regarding their IEP accommodations and the differences between the IDEA and the ADA so that they are knowledgeable and ready to successfully advocate for themselves in all areas of their lives.

 

Melinda Gillinger, M. A
Special Education Consultant
www.melindagillinger.com

 

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An Often Unknown Cause of Hearing Loss in Children

An Often Unknown Cause of Hearing Loss in Children

Understanding and Preventing CMV in the Educational Setting

Author: Brenda Balch, M.D., AAP EHDI Chapter Champion for CT

 

The leading cause of sensorineural hearing loss is heredity, but many people don’t realize that the second most common cause of SNHL in children is due to Congenital Cytomegalovirus or cCMV. It is also the most common congenital viral infection in the United States and resulting hearing loss may be preventable. CMV can cause wide variation in hearing loss, including progressive loss.  

What is CMV?

  Cytomegalovirus is a herpes virus that causes minimal to no symptoms in most people. In the U.S, by age 40, most of us have evidence of a past infection. CMV becomes a concern in primarily two scenarios – in a pregnant woman or in a severely immunocompromised individual. Most women are unaware of CMV and the risk of infection during pregnancy.  

What is the size of the CMV problem?

  cCMV is the most common congenital viral infection in the United States. Approximately 1 out of every 200 infants are infected with CMV prior to birth. With 3.8 million births in the US in 2018 we can assume that 19,000 children were infected with CMV.

Of those who are infected, how many children end up with hearing loss?

Characteristics of CMV SNHL Hearing loss in infants/children with cCMV can be unilateral, bilateral, present at birth, late onset, fluctuating or progressive. ANY child with hearing loss could potentially have had it caused by cCMV!
Of the 1 in 200 infants infected with cCMV, approximately 10% will be “symptomatic” and have serious symptoms at birth that may include microcephaly, enlarged liver/spleen, cerebral palsy, cognitive impairment, vision loss and sensorineural hearing loss(SNHL). Another 10% – 20% of the 200 infected infants are “asymptomatic” will have or go on to develop SNHL. Using the 3.8 million births in the US in 2018 as an example again, 1900 would have had symptomatic CMV and 950-1900 would have had asymptomatic CMV that caused hearing loss. Audiological follow-up data for 860 children with congenital CMV. Dahle et al 2000, extrapolated by Walter 2017
Asymptomatic at birth, n=651 Symptomatic at birth n=209
Hearing loss 7.4% 40.7%
Unilateral 52% 33%
Bilateral 48% 67%
High frequency only 37.5% 12.9%
Delayed onset 37.5% 27%
Median age of delayed onset 44 months range (24-182) 33 months range (6-197)
Progressive 54% 54%
Fluctuating 54% 29%
 

CMV is so common! Can’t we test for it before it causes hearing loss and other problems?

 
If an infant is known to have passed the newborn hearing screen but has tested positive for CMV, the most recent JCIH statement recommends a full pediatric audiology evaluation by 3 months of age and then future monitoring “every 12 months to age 3 or at shorter intervals based on parent/provider concerns”.
Presently, most infants are not tested for cCMV at birth. Infants with obvious symptoms of cCMV are being tested, and in a few states with recent legislation, those infants who fail their newborn hearing screen are tested. If an infant is not tested for cCMV by 3 weeks of age, any positive test after 3 weeks of age may indicate an acquired infection rather than a congenital infection. It is therefore difficult to estimate what proportion of SNHL is due to congenital CMV in children outside of the newborn period.  

How is CMV spread?

  Cytomegalovirus is primarily spread through saliva, mucous and urine. Infants and young children are commonly shedding the virus. Small children have behaviors that are more likely to lead to the transmission of CMV. Women of child bearing age should be aware of the risks of congenital CMV and methods of prevention. Women who are pregnant or planning on becoming pregnant can take precautions that may reduce their risk of exposure to CMV. Clinical studies with antivirals for CMV and trials for a CMV vaccine are ongoing.  

How can we prevent CMV?

  Educators who work with young children are at greater risk of contracting CMV and can help to prevent transmission of CMV by treating all body fluids as if they are infectious. This includes:
  • Wash hands frequently with soap and water, lathering for at least 15 seconds
  • Avoid kissing a child near the nose or mouth
  • Do not put things in your mouth that have been in a child’s mouth such as a pacifier, cups, utensils or food
  • Wear gloves for all contact with body fluids, and always wash hands after removing gloves
  • Use EPA approved disinfectants to frequently clean workplace surfaces that may be contaminated with body fluids
  • Do not use diaper wipes to clean potentially contaminated workplace surfaces
  • Disinfect small toys or objects that may have been contaminated with body fluids
  Any and all children, both in the classroom and in the home, or extended family setting, may potentially transmit CMV to a woman of childbearing age or a pregnant woman. It is prudent to use good hygiene precautions in all of these settings.   Resources Click Here to download this article
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Missing Bits Results in Syntax Deficits

Missing Bits Results in Syntax Deficits

Students with hearing loss, whether hard of hearing or deaf, are at high risk for deficits in syntax due to their imperfect perception of the English language. Word endings, tense, and other grammatical features are often lost when these ‘bits and pieces’ are not perceived. Extra direct instruction in grammar and syntax is usually necessary for students with hearing loss, as their missing bits often result in poorer comprehension – whether of conversation or the written word. These deficits can be glaring when a student turns in a written assignment.

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Advocacy Notes: Captioning in the Classroom

Captioning in the Classroom

 

 

My child can’t keep up with what is said, but the school said that they wouldn’t provide captioning…

Why would captioning be needed? Hearing loss decreases the amount of speech that is perceived, especially in large group listening environments like classrooms. Even with the most up to date hearing technology, normal hearing – or 20:20 hearing – is not restored. This puts students who are hard of hearing at high risk for increasing gaps in vocabulary and challenges keeping up with what their abilities would predict them to be able to perform in school.

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Advocacy Notes: Captioning in the Classroom

Captioning in the Classroom

 

 

My child can’t keep up with what is said, but the school said that they wouldn’t provide captioning…

Why would captioning be needed? Hearing loss decreases the amount of speech that is perceived, especially in large group listening environments like classrooms. Even with the most up to date hearing technology, normal hearing – or 20:20 hearing – is not restored. This puts students who are hard of hearing at high risk for increasing gaps in vocabulary and challenges keeping up with what their abilities would predict them to be able to perform in school.

Legal Case: Providing captioning of verbal communication that occurs in school is one way that we can use to close the typical ‘listening gap’ of students who are hard of hearing who have sufficient language and reading fluency skills to benefit from captioning services.  In 2013, two high school students who with hearing loss brought a suit against the Tustin Unified School District. The students had IEPs under IDEA but were not provided captioning services as part of their educational plans. The findings of the case were that, while IDEA and ADA are similar statutes, “the ADA requirements regarding students who are deaf or hard-of-hearing are different than those imposed by the IDEA.” Under ADA the district had an obligation to provide effective communication under Title II of the ADA.

Digging Deeper into this Case: The two high school students wanted a word-for-word transcription so that they could fully understand the teacher and fellow students without undue strain and consequent stress. In both of these cases, the school district denied the student requests but offered other accommodations. In the case of student K.M., even though the teachers felt that the student participated in classroom discussions comparably to peers, she emphasized that she could only follow along in the classroom with intense concentration, leaving her exhausted at the end of each day. The other student, D.H. felt that she needed captioning in order to have equal access in the classroom, even though she was making good academic progress. The school’s finding that “D.H. hears enough of what her teacher and fellow pupils say in class to allow her to access the general education curriculum” and “did not need CART services to gain educational benefit” was sufficient to meet their obligations under IDEA as the IDEA does not require that services be provided to maximize achievement, but this finding was insufficient for fulfilling the effective communication obligation under ADA. Public entities must furnish appropriate auxiliary aids and services where necessary to afford an individual with a disability an equal opportunity to participate in, enjoy the benefits of, as service, program, or activity conducted by a public entity. Furthermore, in determining what type of auxiliary aid and service is necessary, a public entity shall give primary consideration to the requests of the individual with disabilities.

Considerations – Will the student be able to benefit? Just as with other accommodations, captioning will not necessarily meet the communication needs of every student with hearing loss. Families and school teams should consider whether a student has the skills necessary to benefit from word-for-word captioning. Information and a checklist to help guide these considerations can be found here. The Placement and Readiness Checklists (PARC) includes within the suite a Captioning/Transcribing Readiness Checklist.

Some of the considerations are:

  • Reading fluency rate of 100-130 words per minute, which is the average speaking rate. This is typical of an average rate for a 4th grade student.
  • Language ability and/or language processing ability to comprehend text that appears at a rate of 100-130 words per minute.
  • Tolerance for delay. CART transcription by a captionists has a 2-3 second delay. Automated captioning systems have a delay of about 1 second.
  • Tolerance for error. An accuracy rate of 98% has been found to be adequate for captioning services. Whether automated captioning or CART services, there will be some inaccuracies due to difficulty to transcribe words that are not said loudly enough, or clearly enough, for fully accurate captioning.
  • Ability to split attention from 2-way communication to 3-way. Attention and focus in needed by the hard of hearing listener to be aware of when a comprehension issue occurs, access the captioning, and revert back to listening and speechreading.
  • Student motivation to utilize captioning if it is provided.
  • In the case of remote CART or automated captioning, teacher willingness to use the microphone appropriately, and ensure use of the microphone in student discussions, so that accurate captioning can be provided.

Students who do not have the language ability or reading fluency to benefit from captioning at the typical speaking rate could benefit from captioning that is not word-for-word, such as TypeWell or C-Print

Is the student really benefitting from having captioning available? A communication accommodation is only effective if it truly allows the user better comprehension during communication. No one communication accommodation is a perfect fit for all communication situations. This page has some ideas for gathering pre-test and post-test information to assist in determining the degree the student is benefitting from captioning. The page includes Assessing Auditory Comprehension with and without Accommodations which provides a process for gathering this data.

 

Summary: Due to typical gaps in listening comprehension, students who are hard of hearing often can benefit from having captioning available to them in the secondary grades. Families and school teams should consider if the student has the ability to benefit from captioning. If it appears this is possible or likely, a trial period to gather data supporting level of benefit should occur. Successful use of captioning relies on student ability and motivation, teacher compliance, and appropriate use of transcript and/or transcription technology. High quality automated captioning systems, such as StreamerTM, allow students and families to trial use of captioning in home communication environments and are a good way to prepare a student for eventual use of captioning in the school setting.

 

Relevant References:

https://onlinelibrary.wiley.com/doi/abs/10.1002/dei.262

https://www.ncbi.nlm.nih.gov/pubmed/21941878

 

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Missing Bits Results in Syntax Deficits

Missing Bits Results in Syntax Deficits

Students with hearing loss, whether hard of hearing or deaf, are at high risk for deficits in syntax due to their imperfect perception of the English language. Word endings, tense, and other grammatical features are often lost when these ‘bits and pieces’ are not perceived. Extra direct instruction in grammar and syntax is usually necessary for students with hearing loss, as their missing bits often result in poorer comprehension – whether of conversation or the written word. These deficits can be glaring when a student turns in a written assignment.

The challenge: Effectively teaching grammar and syntax is a daunting task. Hearing peers largely absorb correct syntax through listening alone and have a good handle on it as they begin to develop reading skills. As early as kindergarten, typical students following the general education curriculum should be able to (with adult assistance) speak/sign, read, and write a grammatically correct sentence as simple as “I like pizza.” to as complex as “My brother rides his red bike around the park after school.” By the fourth grade, typical students should be able to speak, read, and write sentences as simple as “I like pepperoni pizza from Pizza Hut.” to as complex as “Jason, Kim and I rode in my mother’s dark blue Suburban to the movies on Friday night where we saw three of the most popular students in our school.”  By middle school, typical students are responsible for the intricate content of novels. They are often given a prompt or topic as a writing assignment and a few ideas at which point they are on their own to generate the rest. Where typically hearing and developing students gradually absorb syntax with minimal extra instruction, students with hearing loss often have to work hard to keep up with this rate and complexity of typical development.

What we need to know about syntax skills whether students use spoken language or a sign system:

  • Can the student speak/sign a sentence with a subject and a verb?
  • Use tense markers?
  • Use singular and plural forms? Many times, the /s/ on the end of plural words is not heard. The same can hold true for the possessive ‘s. If the student uses ASL, plural is shown by repeating the sign, such as CHAIR-CHAIR-CHAIR for “chairs”
  • Use articles and determiners? (the, a, that, this, etc.).
  • Are there any descriptive words being used? Prepositions?
  • For ASL users, is the student using classifiers? Nonmanual markers?

Assessment: As with other areas of instruction, it always helps to start with the basics – identifying the student’s challenges. As part of a functional assessment for syntax, taking language samples is a great way to take inventory of what a student knows. Use a smart phone to record a student as you read a book together or discuss a topic. Try to obtain about 50 utterances, which may take more than one session with some students. After doing recorded language samples several times, you will begin to feel adept at listening and looking for patterns in the student’s language. Other assessment methods are provided as follows.

Does the language make sense? (Is it sequential?)

When language samples have been analyzed, gaps can be determined as can targets for instruction.  Whatever your method for obtaining data whether it is language sampling, formal tests, or functional assessments suggested below, syntax is an important piece of the reading and  comprehension puzzle and must be assessed!

 

 

Other tools for gathering functional data:

Test of Grammatical Structures (TAGS)   PRESCHOOL and ABOVE

Part of the Preschool Language Pack, the CID Teacher Assessment of Grammatical Structures (TAGS) is a series of three rating forms developed to evaluate a child’s understanding and use of the grammatical structures of English. The rating forms provide a representation of grammatical structures for children with hearing loss who develop grammatical structures in smaller increments and at slower rates compared to children who are typically developing. This starter kit is a guide to using the CID TAGS system for teaching and tracking receptive and expressive language development in oral children who are deaf and hard of hearing. It can also be used to evaluate sentence structure for children who use sign language. The TAGS rating forms enable teachers to:

FREE CID Online Course: The Art of the Structured Syntax Lesson: Assessing, Planning and Prompting
  • determine present levels of syntax skills
  • determine syntax goals for IEPs and lessons
  • track syntax development over time and
  • report syntax progress to parents and other professionals

 

Grammar Chipper Chat     GRADE K-5

These materials allow you to explore 16 of the grammatical structures found on most language assessments (i.e., CELF, TOLD). Each grammar area has 20-30 color-coded question cards with a sentence prompt on one side and images on the reverse side. The student fills in the missing word on the question side using the pictures as cues. A functional assessment can be performed using these cards. A subset of cards in each of the 16 areas (i.e 3-4 cards) can be shuffled together and presented in random order to the student. Additional cards can be presented in the areas in which there are errors to verify that there is a lack of functional use (up to 10 cards per problematic area). Refer to Brown’s Stages to assess or intervene in sequence of development. A valuable means to pinpoint issues and monitor progress in syntax learning.

Cracking the Grammar Code  GRADE 5 – ADULT
Within the 149-page FREE downloadable  Syntax Skill Pretests and Simple Skill Activities
sample book, there are pretests teachers can use to identify students’ skill levels. Each pretest has a rubric to diagnose specific skills in the broader category. The pretests and answer keys are provided for the following syntax skill areas: Nouns, Articles, Conjunctions, Verbs, Pronouns, Adjectives-Adverbs-Prepositional Phrases, Finding the Subject, and Subject-Verb agreement. A passing score is 80% on any of these functional assessments. If your student does not pass various parts of the pretest the specific lesson to start on within the Cracking the Grammar Code workbooks is provided.

Download the Free Syntax Skill Pretest book and start assessing your students ASAP!

 

 

Formal, norm-referenced testing

There are a number of test instruments typically administered by speech language pathologists that will assess a student’s level of syntax development. If a student has received an evaluation by a speech language pathologist in the previous 6 months it is often useful to review those results for insights into specific areas of syntax deficit that have already been identified.

Teachers of the deaf/hard of hearing often perform assessments related to students’ listening comprehension ability, specifically the ability to recall and understand information presented by others. Two popular assessments for this purpose also provide some information about student syntactic understanding or use. While not an extensive investigation into syntax, if a TDHH is performing one of these tests anyway, it may provide a starting place to focus additional syntax assessment, for example with the Cracking the Grammar Code free syntax skill pretest book.

Oral Passage Understanding Scale (OPUS)

For ages 5.0 to 21 years, the Oral Passage Understanding Scale is a measure of listening (auditory) comprehension. It evaluates a person’s ability to listen to passages that are read aloud and recall information about them. This ability is key to success in the classroom and social situations. It also measures memory skills, which are integral to listening comprehension. OPUS identifies how well a person can integrate and apply knowledge in three structural categories of language:

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

Measuring higher-level comprehension skills, including inference and prediction, yields more detailed information beyond simply whether or not the individual can comprehend. These skills require deeper processing abilities.

Test of Narrative Language-2 (TNL2)

For ages 4.0 – 15-11, the TNL2 provides a format that shortcuts the typical lengthy language sample analysis process. No transcription is necessary. Children’s answers to the comprehension questions and their stories can be reliably scored from audio recordings (use your Smart Phone!). The instructions are scripted and clear examples are used for scoring. The TNL should be of great benefit in identifying students who have adequate language, but issues using their language ability for ongoing interactions in an age-appropriate manner.

 

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