Author: Caroline Melberg

The abilities of children with hearing loss, whether they are exiting from early intervention or are already school-aged, are typically evaluated to identify overall delays or learning disorders. Since children with hearing loss have access issues learning language due to barriers caused by the hearing loss, they often score ‘low-average’ on norm-referenced language tests. Rather than having overall delays, the access issues caused by hearing loss often result in ‘spotty skills’ or learning gaps that are not identified by typically used evaluation instruments. Because these needs are not identified by typical measures, our students are often denied eligibility for specialized instruction and supports. The specialist in education of students with hearing loss needs to be a member of the evaluation team to help tailor the assessment process to identify the unique needs of these children.

Research has consistently revealed that a ‘good’ result of early intervention for children with hearing loss is a standard score of -1 SD to -1.5 SD on norm-referenced language tests (standard score 78-88 range). All too often teachers of the deaf/hard of hearing have sat in meetings where the evaluation team has described these results as ‘normal’ and ‘he will be okay.’ After all, special education is not preventative, it is for children who have identifiable disabilities. ‘Low-normal’ does not equal a disability. Yet professionals who work with these students realize that there ARE language issues, including ‘Swiss cheese language’ which influences comprehension, delays in syntax learning, and in early literacy skills.

Using Norm-Referenced Tests to Determine Eligibility

The purpose of the testing is to identify an educational disability or adverse educational effect on educational performance. For children with hearing loss, assessment needs to be sufficient in scope and intensity to identify gaps in auditory (or sign language development), language, narrative discourse, academic, literacy, and social language skills. Information needs to be collected that reflects the student’s ability to function in situations similar to the school setting, including typical use of amplification.

Norm-referenced tests typically have various subtests, each of which assesses one type of ability area. These subtest scores are rolled together into an overall or total score for the norm-referenced test. It is often claimed that only the overall score from the norm-referenced test can be used to determine eligibility. This is frustrating to persons who work with students with hearing loss as there are often one or more subtests that show areas of need, but the overall score average is within the acceptable range.  Section 300.304(b)(2) of IDEA states that a single measure or assessment cannot be used as a sole criterion for eligibility. So yes, a single subtest score cannot be used to determine a child as eligible. This is misleading. If the area of need identified by the low performing subtest(s) was also demonstrated by other norm-referenced and/or functional measures, then the child’s area of need would have been demonstrated with more than one measure. If there is a substantial need identified, go the extra step to verify it. This can make the difference between eligibility for supports and services or no specialized help for the child. For more discussion on using subtest results to determine the need for further testing, read here.

Another aspect of norm-referenced testing is that the measures are designed to identify areas of delay or disorder. To use an analogy, we can compare the knowledge and skills learned each year to a row of 12 bricks to build a wall. Every year there would be a row built up, starting from infancy. Think of each brick as collectively representing vocabulary and concepts learned during one month of exposure. Consider our students who did not consistently use amplification, or were not consistently exposed to fluent sign, during early childhood and how that would impact their ‘row of bricks development’ as compared to typically developing hearing peers. Norm-referenced tests, specifically the overall scores, consider development as ‘How high is the wall?’ as compared to typical learners. Children who have cognitive delays or learning disorders would have shorter walls. Children with hearing loss are typically found to have walls almost as high as their age peers (low average) but what is NOT identified is the gaps in learning that are typical of children with hearing loss due to communication access limitations that vary over time.

To combat this, the person specializing in the education of children with hearing loss needs to be part of the evaluation team (IDEA Section 300.321(4)(i)(5)). We need to press for evaluation in the areas that we know are at highest risk for issues due to the impact of hearing loss. In looking at the list below, it is clear that the test battery typically used by the school team to evaluate children suspected of learning disorders will not capture the most likely areas of need for students with hearing loss. Moreover, we need to work with the team to discuss evaluation measures that can provide the norm-referenced results of the specific skills needed to tailor the assessment to specific areas of educational need, as required by IDEA (Section 300.304(c)(2)). Refer to Steps to Assessment for information on specific measures.

Areas of learning most likely to be impacted by hearing loss:

• Understanding group discussions or participating in small group work due to distance/noise in class and socially
• Vocabulary:  Gaps due to decreased ability to overhear incidental language (‘Swiss cheese language’)
• Syntax: Incomplete understanding of rules (i.e., cannot hear /s/ or /ed/; do not understand plurals, possessives, past tense)
• Working Memory: ability to retain fragmented parts of words heard and new spoken/signed vocabulary
• Listening skills:  Can be challenges with simple discrimination of sounds, phrases or comprehension of conversation or verbal instruction in class (they may hear but not process the full meaning)
• Attention: Periodic inattention due to listening fatigue and gaps in understanding; ‘tuning out’ when it is challenging
• Early reading: Phonology/phonemic awareness issues related to not distinctly hearing speech sounds
• Language processing: due to fragmented hearing, vocabulary gaps, syntax and morphology gaps, slower listening rate, reduced understanding words in context
• Viewing information from different perspectives, understanding emotions of others, critical thinking
• Social language: Socially awkward, delays in pragmatic language, nonverbal social cues, and appropriate peer interactions
• Passive or immature skills in responding when they do not understand what was said; lack of self-advocacy

Influence of CONSISTENT use of hearing devices on language outcomes: Consider our students who did not consistently use amplification, or were not consistently exposed to fluent sign, during early childhood and how that would impact their ‘row of bricks development’ as compared to typically developing hearing peers. Children with more consistent DAILY hearing aid use have better language and auditory outcomes than children with less consistent use, averaging 2/3 of 1 standard deviation difference². This is especially true for children with hearing loss of 41-70 dB. If children with hearing loss already perform in the low average range for language, an additional 2/3 of 1SD delay can make a lifelong difference in school outcomes. Consistent hearing use is a big key to protecting against language delay and catching up or keeping up with language/learning.

A Predictable Downslide in School Performance: With exposure to a dynamic language environment in a structured classroom setting, many typically hearing children who have low-average language ability can begin to catch up to their more average peers. This assumption cannot be applied to children with hearing loss. A dynamic classroom language environment typically provides less access to communication than what the child experienced in early childhood. It is typical for our students to have their learning trajectory decrease once they enter school, meaning their rate of learning actually declines due to increased issues clearly accessing communication. If a child was not made eligible for specialized instruction, be sure that a 504 Plan is developed and include periodic monitoring by a DHH specialist as part of the necessary auxiliary aids and services (education in regular classes with supplementary services, read FAQ 4).

An evaluation team has the responsibility to appropriate assess students to identify areas of need that will interfere with educational performance. To this end, IDEA Section 300.304 requires that teams gather relevant functional, developmental, and academic information about the child. Academic information is only one part of educational performance. This is especially important for students with hearing loss who often have functional performance issues related to decreased access, such as challenges following directions, participating in group work, listening comprehension, and fatigue. These are all relevant functional performance issues that must be considered when evaluating a student’s need for specialized instruction and support.

References

1. Spencer, P., & Marschark, M. (2010). Evidence-Based Practice in Educating Deaf and Hard-of-Hearing Students. “Children who are identified early and receive early intervention have been found to demonstrate language development in the “low average” level compared to hearing children.” (pg 42) Read more about book.

2. McCreery R. W., Walker E. A., Spratford M., et al. (2015). Longitudinal predictors of aided speech audibility in infants and children. Ear Hear. 36:24S–37S Go to article.

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Grade Retention

Question from the field:

I was wondering if there was any research or insight on retaining kids who are Deaf/HH for one school year. There have been a few small cases where student who were able to repeat one grade level helped to close that wide gap that they had and eventually (with DHH support) catch up to those of their peers. However, I think the first reaction is – do not retain kids with special needs. Any insight pro or con?

In looking up research on this topic, I found a study of Portuguese students comparing 24 with typical hearing to a group of 20 who were Deaf and implanted and 24 who were Deaf without cochlear implants, in grades 4, 7, 9, 12. In my international travels I have found that many countries have no formalized special education services and all cognitively able students are in the general education setting. Where in the US we do not usually ‘fail’ students with disabilities, this is not necessarily true in other countries. In the case of this Portuguese study, the students who were implanted had a higher failure rate than the typically hearing students, and the students who were considered Deaf but not implanted had a higher rate of repeated school years than the implanted students. See Figure.

While this research finding answers the question of whether students who are deaf would be retained at a higher rate if there is a practice of grade retention for lack of performance (yes), it does not answer the question from the field in terms of pros or cons to retention for students with hearing loss. A 2015 study of predictive factors for academic achievement of this population analyzed data of about 500 DHH secondary students. The authors found that having attended regular secondary schools (vs a deaf school or deaf ed program) and having better spoken language were associated with higher test scores. Predictors of poorer academic achievement test scores included having an additional diagnosis of learning disability, having a mild degree of hearing loss, and being African American or Hispanic.

A really fascinating, but old (1999) study looked at the academic achievement of 75 third grade students who failed first grade screening tests, comparing those who did seek medical attention for the hearing issue to those who did not. The author concluded that more children who had not sought medical attention after failing hearing screening, failed either the first or second grade. The typical retention rate between grade 1 and grade 2 was 9% whereas the students who did not seek medical follow up for hearing issues had a retention rate of 28%. It must be noted that in 1999, the field of education had not embraced the ‘do not retain’ policy held by most school districts today.

Thus, the research reinforces that hearing loss can have a very significant adverse effect on academic achievement, but the studies are very limited. Looking more broadly at the practice of retention of students with disabilities has a bigger research base that has been consolidated nicely into an article by the National Association of School Psychologists. In essence, retention in any grade level is associated with later high school dropout, as well as other deleterious long-term effects. Typically, test scores of retained students in the primary grades increase for a couple of years and then decline below those of their equally low-achieving students who had not been retained. NASP declared that retention is a failed intervention which was partly due to a lack of specific remedial strategies to help enhance student social or cognitive competence.

Summary and Karen Anderson’s reply to the field:
In general, we don’t retain kids anymore. I agree that there are exceptions for students with hearing loss.

Example:

Tommy attended kindergarten. He was an inconsistent hearing aid user and upon entry, the school did not see it necessary to provide DHHT support or the specialized instruction/support provided was not appropriately intensive. Now a year has gone by with only a couple of months of progress made during the year. There were just too many access issues that interfered with Tommy’s instructional progress, too little support for the teacher to understand the behaviors she observed were related to hearing loss, too little support with the parents to recognize the 1:1 correlation between lack of hearing aid use and lack of school progress/behavior/social issues. Now it is spring and people have finally gotten around the table to discuss this Tommy’s lack of educational progress and future needs. He is NOT ready to go on to gr 1 as he really never had access to instruction during Kindergarten. The team agrees that Tommy should repeat Kindergarten but only if he has the intensive support he needs along with consistent hearing aid use. They decided that Tommy will receive strong support (i.e. 1 hour/day) from the DHHT, with 1x/week in the classroom and the rest pull out 1:1 services. This time will be devoted to 1) language development 2) social skills 3) self-advocacy/understanding of hearing loss impact/hearing aid use. At the end of the year the school team expects to see the expected annual yearly progress for a student in the class (hearing) and readiness for grade 1.  If this student were to be retained without the intensity of service and consistent hearing aid use, it would be another wasted year from his education.

Note: The Advocacy section does not constitute legal advice and provides information for thoughtful consideration only.

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The U.S. Department of Education gives each State the right to determine what constitutes adequate yearly progress (AYP) based on that State’s final assessment system. Instruction must be rigorous enough to demonstrate “continuous and substantial” yearly progress. High-stakes standardized testing is one measure of school achievement and competency. At the least, the results of this testing can determine whether accommodations have been successful, and services have been effective in preventing a widening achievement gap. At most, results can determine whether a student is promoted to the next grade or graduates. Though high-stakes testing is one measure of academic achievement, it cannot be the only source of data used to determine whether a student has made substantial gains toward AYP. With the weight of these considerations at stake, it is no wonder parents, students, and teachers may feel pressured by the impact of these tests.

The number of students who are deaf and hard of hearing (DHH) served in the general education setting continues to grow. However, these students still lag behind their hearing peers, specifically in language and reading, secondary to the impact of hearing loss. This has made the need for appropriate supports and services by personnel with highly specialized skills and knowledge a critical factor for success. Under IDEA, states must use information about the performance of children with disabilities in state and district-wide assessment programs to revise their State Improvement Plans, as needed, to improve their performance.

Educators cannot wait until the end of year to determine if teaching practices, accommodations, and services have been effective. Progress monitoring is critical.

Disadvantages of High-Stakes Testing for Students with Hearing Loss

• Results of high-stakes testing may underestimate a student’s actual skill and abilities. Students who are DHH, especially those included in a general education setting, are often at a disadvantage during high-stakes testing due to their limited knowledge of the language style and structure of the tests. Tests use phrasing, grammar, and syntax that differs from everyday English, often including idioms, multiple meaning words, and complex grammar that is unnecessary to comprehension of text. For a student with an interpreter, the interpreter may account for the student’s language ability and modify communication to assist comprehension. If familiar presentation of the language is not used during high-stakes testing, the consequence is an unfair disadvantage when the testing is presented in written form.
• For students who use sign language to communicate, some schools allow only a verbatim interpretation of the test. For a student who receives the accommodation of signed translation for test items and/or questions, the ASL interpreter must now change the communication system to present the test items as they are written.
• Students who are DHH being educated in the general education setting are typically the only student in that classroom with hearing loss. The student’s teacher is likely to be unfamiliar with the effects that hearing loss can have on equity of test results in comparison to typically hearing peers.

Is RTI the Same as Progress Monitoring?

Progress monitoring includes forming a baseline for present levels of performance and completing weekly or monthly assessments with a number of tools to verify small incremental gains in student progress. Response to Intervention (RTI) techniques are often used to monitor progress of students who are DHH included in the general education classroom. RTI was originally intended to identify hearing students who have learning disabilities. This type of monitoring includes selection and implementation of “evidence-based tools, with consideration for cultural and linguistic responsiveness and recognition of student strengths.”  According to the National Center on Response to Intervention, RTI is a framework for providing comprehensive support to students. It is not an instructional practice. RTI is a prevention-oriented approach linking assessment and instruction that can inform educators’ decisions about how best to teach their students. A goal of RTI is to minimize the risk for long-term negative learning outcomes by responding quickly and efficiently to documented learning or behavioral problems and ensuring appropriate identification of students with disabilities.” Though this type of formative assessment is used by districts, it is not intensive enough, tailored to DHH unique needs, nor can it be applied appropriately, as our students have education issues secondary to access barriers and not learning disorders.

Challenges in Collecting Valid Data on Students with Hearing Loss

Collecting accurate and valid data on students who are deaf or hard of hearing is an ongoing challenge. Educators in the field have struggled with finding, modifying, and “reinventing the wheel” when it comes to assessments that can provide parents, school teams, and administrators with valid information reflecting present levels of performance. Part of the difficulty for educators is that there is no one progress monitoring tool or assessment that is appropriate for all students with hearing loss. Student’s variability in type and degree of hearing loss, age of onset, language exposure, and modes of communication are a few of the variables that can complicate the process of choosing the correct monitoring instrument. In addition, assessment for students with hearing loss is largely misunderstood and assumed to be covered by the typical tests and data collection used with students who have common disability conditions. The type of assessment that is needed is often overlooked in favor of the type of assessment that schools require.  Many educators of the deaf and hard of hearing providing itinerant services, are forced to rely on the general education teacher, who is unfamiliar with the unique needs of a student with hearing loss, to collect informal data on a daily or weekly basis.

Common Progress Monitoring Procedures

To intervene with school teams appropriately, educators of the DHH must be attentive to the curriculum being presented to our students in order to plan, accommodate, modify and collaborate to provide tailored instruction prior to valid progress data collection. It is also essential that educators of DHH have a working knowledge of the progress monitoring tools used to assess students’ skills.

• Students in early elementary grades are often given formative assessments that test their ability to use phonological knowledge and apply it to the written word. Due to auditory access issues, phonological awareness is frequently delayed. Students who cannot access sound and whose teachers and interpreters are unfamiliar with Visual Phonics as a strategy may make little progress. Even if they are familiar, this strategy may not be implemented intensely or consistently enough to result in true progress. In this case, training may need to be offered to the educational team, a more appropriate monitoring instrument may need to be used. For some students, progress monitoring may need to be overseen by the Teacher of the Deaf. Equally, students who use ASL may not be assessed appropriately with data gathering that includes the phonological aspects of ASL.
• Concurrently, many schools use computer-based progress monitoring which depends upon auditory skills to access the information. This may not be appropriate for students who have delays in auditory skill development or minimal auditory access as well as those who use ASL or other manual communication systems. Measuring these skills equitably may (again) require alternate presentation methods such as the use of Visual Phonics. For a student who uses ASL, Gallaudet University has developed ASL Assessment Toolkits that measure ASL phonological awareness and receptive skills (insert link here).

Are Standardized Test Scores Enough as a Measure of Achievement?

No, high-stakes test results are an insufficient measure of achievement. Without additional data, standardized testing results have limited meaning, and provide little insight for planning instruction. When preparing for end of the year meetings with other teachers, parents, and professionals, it is essential to use data from additional sources as well as the data retrieved from high-stakes testing. IDEA mandates that other sources as well as high-stakes testing be considered when evaluating yearly student progress.

What Additional Data Should be Gathered?

• Progress data on standards-based goals and objectives (criterion)
• Progress data on curriculum-based measures (CBM) that have been administered equitably
• Comparison to age-anchored hierarchies of skill development (i.e., listening skill development, self-advocacy, independence with hearing aids, etc.)
• Observation data – this can be qualitative as well as quantitative.
• Teacher reports that include present levels of functional, behavioral, developmental, and academic performance.
• Parent information (i.e., Parent language survey)
• Language samples – spoken and/or signed, and written communication. This can be done with a voice recorder, video, and by collecting samples of written language throughout the year.
• Student interviews (when appropriate) – how does the student feel about his/her educational experience?
• Student-completed checklists (i.e., LIFE-R and After LIFE, CHILD)
• Social-emotional measures
• Daily records of hearing technology use.

With the amount of collaboration necessary among a child’s educational team, collecting data on students who are DHH is no small task. Teachers who provide services via the itinerant model and classroom teachers of the deaf and hard of hearing rarely have the time in their schedules required to do all that is needed to support good student outcomes (e.g., teach to the unique needs of students, consult enough with the school staff to accommodate or modify to meet student needs, and gather relevant and valid progress monitoring data). Therefore, relationships with school staff are a critical component of this data gathering process. It is often the responsibility of the teacher of the deaf/hard of hearing to establish relationships with campus administrators, general education teachers, and other service providers to effectively collaboration in data gathering.

The challenges presented touch only the surface of the issues with high-stakes testing and continuous monitoring of our students who are DHH. As long as high-stakes test results continue to be used as a primary gauge of adequate yearly progress, educators must be cognizant of the demands it places on students with hearing loss. It is critical to ensure that the progress monitoring tools being used are the most valid (appropriately matched) and accurate measure of student skill.

References

Test equity for individuals who are deaf or hard of hearing. (2008). PePNet Test Equity Summit. Retrieved from http://resources.pepnet.org/files/356_2010_2_1_16_35_PM.pdf.; Cawton, S., & Leppo, R. (2013). Assessment accommodations on tests of academic achievement for students who are deaf or hard of hearing: A qualitative meta-analysis of the research literature. American Annals of the Deaf, 158(3), 363-376.

U.S. Department of Education. Adequate Yearly Progress. Retrieved from https://www2.ed.gov/policy/elsec/guid/standardsassessment/guidance_pg5.html

Retrieved from http://www.wrightslaw.com/law/osep/faqs.idea.assessment.htm

Anderson, K.  (2018). Is the inclusion model good for students with hearing loss. Retrieved from http://successforkidswithhearingloss.com/2017/10/01/is-the-inclusion-model-good-for-students-with-hearing-loss/. Antia, S.D., Jones, P.B., Reed, S., & Kreimeyer, K.H.. (2009). Academic status and progress of deaf and hard of hearing students in general education classrooms. Journal of Deaf Education and Deaf Studies 14(3), pp. 311. Doi 10.1093/deafed/enp 009

PePNet Test Equity Summit Highlights. (2008).

PePNet Test Equity Summit Highlights. (2008).

Center on Response to Intervention. Retrieved from https://www.rti4success.org/essential-components-rti/progress-monitoring

About the Author: Brenda Wellen has been a teacher of the deaf/hard of hearing in center-based and itinerant settings for 28 years. She recently completed a graduate degree in Deaf Education and Reading Specialist certification.

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The Power of an Appropriate Program of Special Education Support

The special education pendulum has swung away from segregated settings where students with special needs minimally mixed with ‘regular’ students in the 1980s to the current full inclusion model, where direct 1:1 instructional services are becoming rare. Students with hearing loss are already at high risk for ‘academic slippage’ due to their inability to completely access classroom communication without appropriate accommodations and supports. The move from pull-out services to provide intensive teaching in reading, language, and self-advocacy, places our students at even higher risk for developing increasing academic delays over time.

In light of this, I found a court case from 2002 that gave me pause, and hope. In Kevin T. V. Elmhurst Comm. School District No. 205 Kevin, who had a learning disability and ADHD, had received twelve years of special education (age 6-18). Kevin had average intellectual potential but his reading, math and writing skills were at the 3rd to 5th grade levels despite receiving special education services. Triennial assessments over 9 years showed that his IQ dropped nearly 20 points. Scores on academic achievement tests also decreased significantly over a 6-year period. The school was aware of his poor reading scores but did not make IEP changes to address his reading difficulties. It was stated multiple times that he should have been assessed for, and given, assistive technology (AT), but the district did not consider, let alone provide Kevin, with AT. Modifications or accommodations during state testing procedures were not included on his IEP. Although Kevin’s skills were deficient, at the end of his 12^th grade year while receiving all Fs, he graduated with a high school diploma. Per this court decision, “Automatic grade promotion does not necessarily mean that the disabled child received a FAPE or is required to be graduated.”    

At the urging of the parents, the district transferred Kevin to a specialized day school where he received intensive instruction. In one year, Kevin made about 3 years of progress in reading, math, and writing. His parents then decided to bring the case to court. The court ruled that Kevin receive compensatory education. The school district was required to reimburse the parents for tuition paid to the specialized school and for his continued education at the school.

Where is the Silver Lining in this Case?

First, schools can and should be held accountable when students with disabilities are not making sufficient progress. Indeed, the March 22, 2017 US Supreme Court decision rejected the standard of minimal progress. For children fully integrated in the regular classroom, the IEP should be reasonably calculated to enable a child to make progress appropriate in light of the child’s circumstances.

Second, a free and appropriate public education (FAPE) for students with disabilities includes specially designed instruction to meet the unique needs of the child. Present levels of performance and continuous performance monitoring are critical elements for determining student needs, and also identifying if the specially designed instruction is truly meeting the needs of the child. Children who display hearing loss as their only disability do not have a learning disorder. Issues in education are related directly to the access barriers caused by the hearing loss. These barriers must be accommodated per ADA and an IEP be suitably designed to close the existing gaps in learning and support the student’s ability to keep pace in the classroom.

Third, intensive instruction by persons who truly understand the unique learning needs of the specific disability is likely to result in substantial progress to close achievement gaps. If our students are 1+ years delayed in their achievement, it is unlikely that they will close this gap nor keep up with the current pace of learning UNLESS an appropriately intense program of specialized instruction – by a teacher of the deaf/hard of hearing – supports this progress.

Services need to be appropriate if a child with hearing loss is to receive FAPE.

Appropriate:

• Accommodations to optimize access to school communication
• Assessment to identify the learning needs unique to students with hearing loss
• Intensity of specialized instruction tailored to meet these unique needs by a knowledgeable teacher with specialty in working with students with hearing loss
• Continuous progress monitoring to measure progress in closing learning gaps
• Revising IEP services and accommodations/supports to support GROWTH.

Note: the views expressed are those of Karen Anderson, PhD, and do not constitute legal advice.

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Transition services are required for students who are receiving specialized services under IEPs, starting no later than age 14. Unfortunately, Transition is often thought to be satisfied by a check off form with little true instruction. Effective and timely instruction during Transition is necessary for the future success of students who are Deaf or hard of hearing.

For more than 45 years, researchers have demonstrated how transition from school to postschool environments can be affected. The keys to success in transition are not many, and they are not complex. Nonetheless, few schools “do” transition successfully. The National Deaf Center has links to Postsecondary Outcomes of persons who are deaf or hard of hearing in each state. Nationally, only 48% of persons who are deaf or hard of hearing are employed and employment rates increase with education and training. Good Teen Transition services mean better readiness for post-secondary success. How did students in your state do in postsecondary achievement?

Transition services means a coordinated set of activities that are outcome oriented, based on the student’s individual needs and preferences, to prepare them to face life as an adult. In 2007, the Office of Special Education Programs required states to develop a comprehensive state plan on 20 specific indicators; Indicator 13 dealt with Transition. The questions that the IEP team should ask of each student’s education program at Transition are:

1. Are there appropriate measurable postsecondary goals in the areas of training, education, employment, and, where appropriate, independent living skills?

2. Are the postsecondary goals updated annually?

3. Is there evidence that the measurable postsecondary goals were based on age appropriate transition assessment(s)?

4. Are there transition services in the IEP that will reasonably enable the student to meet his or her postsecondary goals?

5. Do the transition services include courses of study that will reasonably enable the student to meet his or her postsecondary goals?

6. Is (are) there annual IEP goal(s) related to the student’s transition service needs?

7. Is there evidence that the student was invited to the IEP team meeting where transition services were discussed?

8. If appropriate, is there evidence that a representative of any participating agency was invited to the IEP team meeting?

From the National Deaf Center, a 2-page transition guide specifies Essential Transition Questions:

• What kinds of extracurricular experiences will provide opportunities to learn social and problem-solving skills?
• What kind of classes will prepare the student for postsecondary programs and/or employment?
• Will the student work in high school?
• Will the student participate in general education classes or will they need more intense training to achieve their postsecondary goals?
• What types of accommodations are needed in different situations?

Per the Minnesota Transition Guide for Teachers of the Deaf/Hard of Hearing (see Goodies below), throughout transition planning students should continue to increase their self-advocacy skills:

• Ability to describe their own skills and needs
• Ability to set their own goals and create a plan to reach them
• Knowing the how, who, and when to ask for assistance
• Ability to make decisions and take responsibility for the consequences of those decisions

Teaching Transition Skills

1. Refer to C.O.A.C.H. for specifics on how to work with tweens and teens to teach these skills! Self-advocacy skills are taught beginning in preschool through grade 4, switching to problem-solving for self-determination by age 12. If you only teach self-advocacy without teaching problem-solving for self-determination you are doing only half the job! See the self-advocacy webpage for more information on skills and age expectations.

2. The Ida Institute has free Transition Management resources to enhance teaching tweens and teens

a. Telecare for Teens and Tweens assist students in formulating questions for their audiologist, describing their hearing loss to others, getting family members involved in supporting communication needs, learning communication strategies, and learning how to self-manage their hearing loss.

b. Transitions Management is a suite of materials, including nice videos, that relate to different transition periods in the life of the child with hearing loss. Check out the Being a Tween and Being a Teenager videos and the other well-designed materials this extensive website has to offer. Although the videos feature British children, they are captioned and provide a rich resource for discussion and learning.

c. 12 free lessons for teens on legal rights, self-advocacy, personal and interpersonal skills. Thanks to Dr. Kris English for making her e-book, Self-Advocacy for Students who are Deaf or Hard of Hearing freely available on the SSCHL website. Scroll to the bottom of the self-advocacy webpage to access each of these lessons

Communication skills and access to communication are critical to success in employment settings. Being well versed in communication strategies to support successful interactions is an important skill that needs to be further honed during the transition years. Transition-aged students should have a good understanding of their hearing loss and have practiced explaining its impact in preparation to do so with an employer or coworkers. Other communication skills include:

• sharing communication strategies that were previously successful in other settings,
• showing employer inexpensive options for making environmental cues visible,
• asking available resources to offer deaf awareness training for employers, and
• knowing about and communicating workplace accommodations.

In addition to meeting academic requirements, students need to have strong self-advocacy, time-management, money management, and independent living skills to be successful in postsecondary settings. By using the Postsecondary Competency Skills Checklist (see Goodies below), IEP teams can help the students evaluate their readiness for postsecondary settings.

Transition for Students Who are “Low Functioning Deaf”

In 1999, an estimated 2000 students in the US who were deaf or hard of hearing were identified by state vocational counselors as “low functioning deaf.” This term is defined as having reading levels under second grade, low math, reading and other subjects (second to fourth grade), and/or have a secondary disability. These students drop out of school at a higher rate than other students with hearing loss. They require a much greater emphasis on vocational and independent-living skills than is now provided in most secondary schools. Read the article by Bowe, below, for more information. With many similarities to programs for higher functioning students, transition programs for lower functioning students with hearing loss should include:

• training students in job-specific skills, preferably on site
• prepare them to make good decisions and advocate for themselves
• emphasize the “unwritten rules” of the workplace and key skills of good team members
• introduce students to available vocational rehabilitation resource to support career transitions
• develop an understanding of civil rights (Americans with Disabilities Act) on the job and in the community
• help students appreciate the opportunities and limitations of government supports (i.e., Supplemental Security Income)

A Step Toward Post-High School Readiness

The Rochester Institute of Technology (RIT) Communication Studies and Services Department provides a broad range of support to expand post high-school student’s communication skills. Contact RIT to receive a $65 voucher your students can use toward one of RIT’s summer camps for middle or high school students who are deaf or hard of hearing (grades 5-12).

References

• National Deaf Center on Postsecondary Outcomes (2017). Transition Planning. https://www.nationaldeafcenter.org/sites/default/files/asset/document/Transition%20Planning.pdf
• Bowe, F. G. (2003). Transition for deaf and hard of hearing students: A blueprint for change. Journal of Deaf Studies and Deaf Education, 8(4), 485493.
• Minnesota Transition Guide for Teachers of the Deaf/Hard of Hearing (2012)
• Ida Institute: https://idainstitute.com/toolbox/
• Supporting Success for Children with Hearing Loss, Self-Advocacy: 12 free lessons for tweens and teens
• Rochester Institute of Technology Summer Camp Program http://www.rit.edu/academicaffairs/koc/

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Who is Responsible for Providing FAPE?

I enjoy receiving e-newsletters from WrightsLaw and found their information on a free and appropriate public education (FAPE) in the least restrictive environment (LRE) to be very interesting. Although it is written for the parent’s perspective, the responses may be equally appropriate when professionals are advocating for access and reframing the concept of LRE in terms of students who are deaf or hard of hearing.

The purpose of the IDEA 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…” 20 U.S.C. 1400(d). Is the IEP designed to meet the child’s unique needs? Will the goals in the IEP prepare the child “for further education, employment and independent living?” The answers to these questions will help to determine if the IEP is appropriate and provides the child with a free, appropriate public education.

Educational Benefit

Courts have held that to receive a free appropriate public education, the child must receive meaningful educational benefit. How will you know if the child is receiving “meaningful educational benefit”? As this issue of the Bimonthly Updates discusses, you use objective information from tests that measure the child’s knowledge and skills.

The legal landscape is changing. The No Child Left Behind Act of 2001 requires states to adopt high academic standards for all children. The law also requires schools to test all children to determine if they are mastering these standards. When Congress reauthorized IDEA in 2004, the focus shifted from access to the schoolhouse and compliance with procedures to improved outcomes for children who receive special education services.

In Endrew F. v Douglas County (March 22, 2017), Chief Justice Roberts explains that SCOTUS is not reversing the old Rowley standard, but – if a child is not fully integrated in the regular classroom, the focus on FAPE shifts even more to the “unique circumstances of the child.” Read the analysis.

Who is Responsible for Providing Free Appropriate Education (FAPE)?

The school is responsible for providing the child with a free appropriate education (FAPE). The child’s Individualized Education Program (IEP) is the roadmap that describes how the school will provide your child with a FAPE.

“The IEP provisions [of IDEA] reflect Rowley’s expectation that, for most children, a FAPE will involve integration in the regular classroom and individualized special education calculated to achieve advancement from grade to grade.” (Page 11)

“When a child is fully integrated in the regular classroom, as the Act prefers, what that typically means is providing a level of instruction reasonably calculated to permit advancement through the general curriculum.” (Page 13)

The decision is clear. Being “fully integrated” and “making progress in the general education curriculum” are the keys. If a child is not fully integrated, the focus shifts even more to the “unique circumstances of the child.”

The “IEP Must Enable Child to Make Progress: A Plan for Academic and Functional Advancement”

Resources

Wrightslaw article: Who is responsible for providing FAPE?

Wrightslaw analysis of Endrew v. Douglas County: IDEA demands more: Inclusion & Progress in Regular Curriculum: IEP Tailored to Unique Needs.

Note: the views expressed are those of Karen Anderson, PhD, and do not constitute legal advice.

We Can Only Provide Self-Advocacy Skills If There Is An Academic Need – NOT!

It isn’t unusual for school teams to focus on student’s academic deficiencies. Yet a child with an adverse effect on educational performance can be found to be eligible for specialized instruction. If the authors of IDEA had intended to say ‘adverse effect on academic performance’ then they would have done so. Educational performance includes the ability to function appropriately and be fully included in the general education setting.

Analogy

If there was a low vision student that was constantly bumping into walls, desks, and people, would the school team refuse to consider eligibility for orientation/mobility skills because of a lack of academic impact? Would they let the child collide and fall down frequently without any skill development in how to manage mobility with low sight? Very unlikely. Yet children with hearing loss mishear, miscommunicate, and are often totally left out of discussions. Despite not knowing what they didn’t hear, because they didn’t hear it, students who are hard of hearing are constantly held accountable for knowing information they never perceived. Self-advocacy skills are to a child with hearing loss what orientation mobility is to a child with low vision – necessary for full participation and social inclusion in the classroom.

The disability must adversely affect educational performance per the legal definition of a child with a disability in IDEA 2004 at 20 USC 1401(3). Educational performance is not limited to academic performance. A student with a disability cannot be denied service even if there are no concomitant academic problems. The adverse effect of a communication disorder must be considered on a case by case basis in order to meet the individual needs of each student. Also, each state must ensure that a free and appropriate public education (FAPE) is available to any student with a disability even though they are advancing from grade to grade.

Note: the views expressed are those of Karen Anderson, PhD, and do not constitute legal advice.

Schools and teachers have recently been held accountable for the progress made by each and every student. Many state departments of education and districts have defined the accommodations that can be provided to students with special needs so that fair access, but no unfair advantage is provided.

With only 1:100 IEPs for students eligible for specialized instruction due to hearing loss, the access issues secondary to being deaf or hard of hearing are often unrecognized or minimized.  The unique needs of students with hearing loss may not be thoroughly recognized in the administrative testing policies, requiring us to advocate so that students who are DHH are tested fairly for their knowledge, and not their inability to fully perceive the test items.

Test accommodations are changes made in the test presentation or response method so that students can demonstrate what they know about the content without changing the content of what is intended to be measured. Valid accommodations produce scores for students with disabilities that measure the same attributes as standard assessments measured in non-disabled students.

The purpose of accommodations is to ‘level the playing field’, thereby improving access to the material presented in instruction and to ensure accurate assessment of student knowledge of the test material. Many students use accommodations that are commonly used by other students with special needs, such as extended time, and also use accommodations that fit the unique communication and learning needs of this population. Standardized, high-stakes testing presumes a certain level of English proficiency that is not necessarily appropriate for students who are deaf or hard of hearing. High-stakes tests have a highly verbal aspect, therefore, students with restricted language skills are at a distinct disadvantage. When expressive and receptive language levels and modalities used by students with hearing loss are considered, and how these may differ significantly from those of English-based hearing students, the need for accommodations becomes even more apparent. Reading is auditorilly based and learning to read at the same rate and to the same level of peers is often challenging. Students who are deaf/hard of hearing may be one or more years delayed in reading as compared to their typically hearing classmates. Often, decisions about what accommodations are necessary are made by IEP team members without an adequate understanding of, or training in, the impact of hearing loss on interaction and performance.

Access to instruction is much more than identifying if your students can hear/see what the teacher is presenting. The instructional language level used by teachers is often 1.5 grades above the student grade level, making it especially difficult for students with hearing loss who have a 6 month or more delay to fully comprehend what the teacher is saying. Access to instruction also includes thinking about the language used in the environmental print in the classroom, use of figurative language, and the language level used in textbooks. The language that the student must understand to be able to complete assignments is also a factor.

Questions to answer about student access during test taking when planning for appropriate accommodations:

1. Is the student able to access the test materials as effectively as peers without hearing loss?

2. Is the student able to demonstrate content knowledge via a variety of test formats?

3. Is the student able to respond accurately to a variety of test questions (wh-questions, compare/contrast, summarize, etc.)?

4. Can the student organize thoughts and use appropriate grammar, spelling and mechanics to clearly communicate ideas via essay-type questions?

5. Does the student budget time to allow completion of all test items?

In response to issues identified when answering the questions above, IEP teams should determine changes necessary to ‘level the playing field’ for each student who is deaf or hard of hearing.

Timing/Scheduling Changes to when the assessment is given

Setting Changes to where the assessment is given

Administration Changes to how the assessment is given

Presentation Format Changes to how the assessment is given

Response Format Changes to how a student responds to the assessment

Other Use of dictionaries/word lists/glossaries

Assessment accommodations uniquely relevant to students who are deaf or hard of hearing may include the following. Accommodations should be used in classroom instruction prior to testing to ensure that the construct measured is the content area rather than the student’s ability to use the accommodation.

• Repeating directions (including with or without a proficient ASL interpreter)
• Simplifying directions (including with or without a proficient ASL interpreter)
• DVD with video or without video
• Amplified audio recordings/auditory presentations
• Video or streaming video of visual communication (i.e., ASL)
• Response in sign language with a scribe
• Augmentative, assistive, or adaptive technology
• Computer-based, or computer-assisted testing

Accommodations are not mutually exclusive; students may use only one accommodation, or they may use many, depending upon their unique educational context and preferences. Additional factors influence accommodation patterns and effects including the student’s age, written English proficiency, and accommodation quality (i.e., interpreter proficiency or appropriateness of hearing assistance technology). Take time to review the extensive handout from NICHCY on Assessment & Accommodation found on the Accommodations webpage under Planning to Meet Student Needs in the Professional Resources section. It provides information on the big picture, deciding which accommodations a student needs, types of accommodations and more. Accommodations for Students with Hearing Loss.

Increasingly, high stakes testing requires listening to content presented on a computer. What do you need to do to make this type of testing accessible to the student with hearing loss? The webpage Connecting Hearing Devices to Computers or iPads provides extensive suggestions for ways that a student can listen effectively through a computer or iPad, including through streaming or Bluetooth systems, headphones or the use of silhouettes. Be sure to look through this information to be sure that you have really addressed all your student’s computer access needs!

It is a tremendous challenge to make peer discussion fully accessible to students with hearing loss due to the distance, noise and multiple talker issues. No technology at this point handles access to peers well. Although there are pass around microphone available to use with FM systems, these options are often under-used by most teachers. Access to instruction, including peer discussion, still relies on the classroom teacher keeping in mind that special consideration is needed by the student with hearing loss.

The Access to Instruction Checklist in the Teacher Tools Materials Just for Members Library is useful for discussing the different aspects of instructional access with teachers, and results in a score that can be interpreted to mean the level of necessity for accommodations and adaptations. This checklist is also in Chapter 7 of Building Skills for Success in the Fast-Paced Classroom, which deals with Instructional Access throughout the chapter.

Resources

• Leppo, R., Cawthon, S.W, & M.P. Bond (2013). Including Deaf and Hard-of-Hearing Students with Co-occurring Disabilities in the Accommodations Discussion. Journal of Deaf Studies and Deaf Education, 19: 2, 189-202.

• Case, B.J. (2005). Accommodations to Improve Instruction and Assessment of Students Who are Deaf or Hard of Hearing. Pearson Policy Report.

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Providing communication access to students often includes auxiliary aids and services, like hearing aids, FM/DM hearing assistance technology, and/or sign language interpreters. Yet we cannot assume that students are using these accommodations as well as they need to if they are to access information optimally.

Although students who are hard of hearing now receive hearing aids at much younger ages than they did in decades past, they still will not learn all of the auditory skills hierarchy (by age 4 as their hearing peers do) – unless direct teaching occurs.

A student may have been raised with ASL as his primary language, or he may be in a ‘learn as you go’ situation with this communication modality added later in early childhood. Understanding what the interpreter is signing is a prerequisite for this accommodation to truly provide communication access.

Just because we provide hearing devices and/or an interpreter, does not mean the student can use this input effectively.

This fact may come as an ‘aha’ to administrators and educators who ‘see that the child can hear’ or ‘see that the child watches the interpreter.’ Optimizing how well the student is able to benefit from the communication that they perceive only makes sense if we are to truly ‘level the playing field’ and provide an appropriate education to students who are deaf or hard of hearing.

The PARC: Placement and Readiness Checklists for Students who are Deaf and Hard of Hearing include a General Inclusion Checklist and an Instructional Communication Access Checklist that are useful in identifying the level of access and readiness of students, regardless of their communication modalities. There are specific Placement and Readiness Checklists for Preschool/Kindergarten, Elementary, and Secondary grade students. Finally, there is the Interpreted/ Transliterated Education Readiness Checklist that iterates many factors that go into a student being able to fully benefit from a sign language interpreter or cued speech transliterator.

Development of Auditory Skills

It is true that the earlier a child begins consistently using amplification devices, the more naturally he or she will develop auditory skills. The terrific advantage of early identification of hearing loss, early amplification, and early intervention to develop communication skills still cannot be assumed to develop all of the listening skills on the auditory hierarchy in time for school. The handout Listening Skills Develop Early provides listening skill expectations from birth to age 4. The ALL – Activities for Listening and Learning is a performance checklist for development of complex listening skills. Even those of us who have worked with students who are hard of hearing for many years may still be surprised at just how much auditory skill development occurs, without effort, by children with typical hearing.

A child with hearing loss may use hearing devices that provide the potential for to perceive enough of the speech that surrounds him to learn language. In order to meaningfully interpret what is heard, he or she must specifically learn the necessary precursor auditory skills. Poor listening skills can cause maladaptive strategies to develop (per David Sindrey) such as:

• watching what others do instead of listening to directions
• looking for eye gaze/gestures from the speaker instead of trying to process their words
• guessing at meaning from context rather than listening to the whole sentence
• choosing to isolate themselves from others during play opportunities
• becoming dependent on a few people who act as ‘human hearing aids’
• faking comprehension
• monopolizing conversations

It is important to gather data on the presence and frequency of these maladaptive strategies through observation by individuals trained to recognize them or through comments in interviews of parents and school staff. These observations, along with formal assessment data, should provide a road map for auditory intervention.

Assessment is Necessary

Just as you would not develop reading skills without first knowing the child’s abilities, we must assess the student’s abilities to determine where they have developed along the auditory hierarchy.

The SPICE – Speech Perception Instructional Curriculum & Evaluation remains the best means to assess auditory development.  The SPICE for LIFE curriculum is excellent for developing the more complex auditory skills that our more language-appropriate students may still need to master. The Early Speech Perception test is excellent for basic evaluation of speech perception for young children or those new to consistent listening.  Central Institute for the Deaf, developer of these materials, has FREE WEBINARS on how to assess and develop auditory skills. There is a charge if you desire CEUs.

• SPICE Overview and Detection
• Suprasegmental Perception
• Vowel and Consonant Perception
• Connected Speech
• Auditory Memory (SPICE for Life)

Development of Sign Language Skills

To people who do not sign, even a student with spotty or low sign language development appears very skilled. A strong foundation in one language is needed to meet the communication and comprehension needs in school. If a student has not been raised in families where American Sign Language (ASL) is fluently used, it is very unlikely that the child has learned to become fluent in ASL by school age.

Too often when students are ‘one and onlies’ it is assumed that the interpreter will ‘fill in’ all of the student’s communication needs. Keeping pace with the surrounding communication and delivering it at an appropriate language level is part of the role of the educational interpreter. Assessing a student’s level of sign language knowledge and systematically teaching to fill in gaps in language knowledge is the role of the teacher of the deaf/hard of hearing.

Assessment is Necessary

The White Paper: Estimating the Level of Communication Effectiveness/Access includes recommendations for how to assess the level of student knowledge of ASL. Refer to this resource for more information about determining the of communication effectiveness for students who use sign language, including the:

• Student Language and Communication Profile Summary
• Standardized Visual Communication Sign Language Checklist
• American Sign Language Receptive Skills Test

Knowing where the student is on the hierarchy of sign language development will provide specific areas of need to address through direct intervention.

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504/IEP Accommodations: Is Extra Time REALLY Needed?

Question from the Field:

“I have a student who is in middle school general education with resource for math, co-taught courses for the other subjects, and added support in the classroom for anyone who may need it.  He has 2 cochlear implants and is typically an A and B student able to keep pace with his peers; however, this year is more demanding.  He is receiving so much homework that he is working from the time he gets home to the time he goes to bed around 11:30 pm. I believe he needs the modification to have reduced homework.  It takes him longer than peers to get it done and he is exhausted every day due to his extensive task of listening all day as well as all the homework.  The school team is going to fight me on this and I was wondering if you have anything that explains how this is a reasonable accommodation for a deaf student in the general education?  I am going to need a lot of support!”

Karen’s Answer:

Clearly with a history of getting As and Bs in his classes, this is not a young man who has slower cognitive abilities. Logically then, if he has the same level of access as classmates, he should be able to follow through with the homework in the same time frame. It all comes down to why it is taking him so long to do his homework.

For example:

• Did he lack access to instruction in the classroom so that he has to try to glean from the text books what he missed in class?
• Is it due to language issues, meaning he has so many missing words/concepts/general knowledge that he is spending a lot of time trying to use context in the readings to figure out what is being talked about?
• Is it because of poorer writing skills, which reflect language and syntax issues?

If it is just a matter of so much more homework, then every student in those classes is facing the same thing. There IS more homework. It WILL take more time. It comes back to why he is slower in getting it done. Are there missing skills or reasons related to his deafness that cause him to work more slowly than class peers, thereby necessitating homework modifications? Do the observations, student/family interviews, functional assessment, or formal assessment as appropriate to gather the data needed to support the accommodation.

Yes, hearing loss can result in conditions, such as those bulleted above, that cause slower working times. That said, every student is unique and there is no blanket statement or body of research that will provide a justification for the accommodation, without the data that determines what the actual problem is attributable to.

Once you understand the why you can advocate for one or more of:

a) better access to instruction in the classroom

b) homework accommodations (some of everything, but fewer problems)

c) direct instruction to build the skills that are now interfering with her full participation and ability to keep pace.

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.

Sharing the Basics: Impact of Hearing Loss

There are some basic facts about students who are hard of hearing, trying to learn in a classroom setting, whether the hearing loss is permanent or fluctuating.

From the field: I see a lot of kids with conductive hearing loss caused by middle ear effusion.  I found evidence that if they are young and the conductive loss is going on for a while, they will not develop their listening skills (auditory figure-ground skill, selective attention) like their peers.  I found evidence that they are going to expend more effort to listen, therefore leaving less cognitive resources to other tasks.  Is there any evidence that a mild conductive hearing loss will lead to poorer performance in noise compared to a quiet environment?

A decrease in hearing will cause some issues – hearing in noise and at a distance being the most universal. The greater the effort needed to pay attention to listen and understand the words that are said, the fewer the cognitive resources available to comprehend meaning fully, and integrate the information into memory. The degree of loss and the time the loss has been experienced will impact specific areas of learning language, social interaction, pre-reading skills, etc. The Cascading Impact of Hearing Loss handout steps the reader through this chain of events.

During the times when hearing loss is experienced, children with fluctuating hearing loss will experience these same listening in noise/distance and attention effects as children with sensorineural hearing loss. It is a decreased input issue. What is also noticed is that children with a history of fluctuating hearing loss develop poorer attention during class discussion, even during times of normal hearing. Their experience base has taught them that hearing is a sense that cannot be relied upon. They tend to give up easier than peers (lack perseverance in problem solving). ALL of this can also be said for typically hearing children being educated in excessively noisy classroom environments. Even in these challenging listening situations, children’s cortisol levels (stress hormone) are not elevated. Inattention and listening fatigue can be viewed as their daily norm.

Download the Cascading Impact of Hearing Loss

Reading is foundational to school success. It takes approximately 20,000 hours of listening to speech before a child’s brain has clear mental referents for each of the speech sounds¹. This ability is necessary to enjoy rhyming and to develop phonological awareness skills. Reading is parasitic on listening. Listening can be thought of as applying meaning to sound, allowing the brain to organize, establish vocabulary, develop receptive and expressive language, learn, internalize, and indeed listening is where hearing meets brain². As we read we ‘listen to ourselves read aloud in our heads’ as a precursor for gaining meaning. Anything that slows down reading fluency will interfere with reading comprehension and overall success. Even students who are visual learners must develop adequate phonological awareness using visual, rather than auditory, techniques. A whole-word approach to reading will never allow students to keep up or prepare for the content comprehension demands of secondary school and beyond. The One World Literacy Foundation has found that 2/3 of students who cannot read proficiently by the end of 4th grade will end up in jail or on welfare. Over 70% of inmates in America’s prisons cannot read above a 4^th grade level. We can predict that if a child is not reading proficiently in the 4th grade, he or she will have approximately a 78% chance of not catching up³.

It has been said that reading is parasitic on language, but more fundamentally, verbal language learning is reliant on hearing the sounds of speech throughout everyday activities and environments. Therefore, phonological skills reflect a child’s fine-tuned auditory perception ability. The 2000 National Reading Panel, in their report: Teaching children to read: An evidence-based assessment of the scientific research literature on reading and its implications for reading instruction, stated that “the best predictor of reading difficulty in kindergarten or first grade is the inability to segment words and syllables into constituent sound units (phonemic awareness).” Whether a child has the residual hearing for this fine auditory discrimination or teaching/learning is via cued speech or visual phonics, it is clear that children with hearing loss must hone their phonemic awareness skills if they are ever to achieve the reading fluency needed to keep up in secondary school.

Phonologic Awareness

Based on this necessary foundation, it is critical that we (1) assess the phonological awareness ability of all young children with hearing loss (see recommended assessments below), and (2) teach to the phonemic awareness weaknesses identified^{4, 5, 6}. Reading Reflex provides a sound teaching methodology that will enhance the learning of students who are deaf or hard of hearing. Yes, this teaching may take 30-60 minutes PER DAY during most of one school year for 4, 5, or 6-year-olds and NO, we cannot assume that they will learn it ‘through the air’ at the same rate or to the necessary proficiency as their hearing classmates. Chipper Chat provides a means functionally assess the 12 areas of phonological awareness, teach to very specific skills, and to continually monitor progress. It can be used for honing PA skills even into secondary school.

Comprehension

“Vocabulary knowledge is knowledge; the knowledge of a word not only implies a definition, but also implies how that word fits into the world⁷“.  Students who learn vocabulary through multiple and varied activities have an increased likelihood of retaining and comprehending word meanings and their proper applications⁸. Using materials that provide meaning of words visually, simple definitions, and sentences, such as the Vocabulary Enhancement Glossary can be very beneficial to students with hearing loss. Reading fluency cannot be achieved by working on phonemic awareness alone. A student must also be able to quickly identify and understand the words spoken. With the typical ‘Swiss cheese language’ of children with hearing loss, lack of comprehension due to missing vocabulary is more of a norm, than an exception. Quick functional assessment of comprehension through use of the cloze procedure can be very revealing.

Syntax/Grammar

Poor syntactical development will result in weak reading and writing development. By the time most typically hearing students are age 5-6 they understand and can use basic grammar and syntax in their speech, writing, and to help understand meaning. Due to decreased exposure to verbal language, it is likely that the student with hearing loss will not learn these rules at the same rate, or as completely as their age peers. Poor syntax hampers students in their effort to access and apply their known vocabulary to the reading process. As with phonological awareness, functional assessment of syntax/grammar knowledge is necessary so that pinpointed instruction can occur. Cracking the Grammar Code provides free functional assessments and workbooks with activities to build skills at the point at which the deficit is identified on the assessment. We cannot assume that there is ‘no problem’ nor that the student will ‘catch up’ with exposure in the classroom.

Summary

The tried and true methods of meaningfully reviewing vocabulary before reading a story or new content unit is important for almost all student IEPs. This does not mean simply having the student spit back the new words and brief meanings of each. Simple vocabulary review is tutoring. While some review at home and by a paraprofessional at school will be of benefit, there is intensive work (usually 1:1) to be done to build the web of understanding based on what the student already knows. Strengthening the attributes of each word will further build the web of understanding.

Truly exploring the word in relation to building the overall knowledge base is teaching. Vocabulary instruction, with focus on phonological awareness and syntax/grammar, is the ‘bread and butter’ of teaching students with hearing loss.

Resources

1. Dehaene S. (2009). Reading in the Brain: The Science and Evolution of a Human Invention. New York: Penguin.

2. Beck DL, Flexer C. Listening is where hearing meets brain…in children and adults. Hearing Review. 2011;18(2):30-35. http://www.hearingreview.com/2011/02/listening-is-where-hearing-meets-brain-in-children-and-adults/

3. One World Literacy Foundation: http://www.oneworldliteracyfoundation.org/index.php/why-support-owl/iliteracy-statisctics.html

4. TOPEL – Test of Preschool Early Literacy (norm-referenced ages 3-6 years)

5. PAT-2 – Phonological Awareness Test 2 (norm-referenced ages 5-9 years, gr K-4)

6. Phonological Awareness Chipper Chat (functional assessments for each of the 12 areas of PA to foster focused instruction)

7. Stahl, S. (2005): https://www.readnaturally.com/research/5-components-of-reading/vocabulary

8. Pressley, M. & Woloshyn, V. (1995). Cognitive strategy instruction that really improves children’s academic performance. Cambridge, MA: Brookline Books.

Karen Anderson, PhD, Director of Supporting Success

• April 20 – WA (Shoreline)
• June 15 – TX (Region 1)
• June 25, 26, 28 – PA (3 Sites; Early Intervention)
• August 3-4 – IL
• October 18-19 – VT (VSHA – Vermont Speech, Language, Hearing Association + Outreach Consultants)

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Contact info@successforkidswithhearingloss.com for more information on specific speaking engagements.

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Assistive Technology and Student Access

Strategies for Assistive Technology Negotiations is written for the parent’s perspective however, the responses may be equally appropriate when professionals are advocating for necessary captioning, Hearing Assistance Technology, interpreter services, etc. for their students. It may also be useful to share this information with school teams in preparation for responses parents may have in discussions about needed assistive technology.

Strategies for Assistive Technology Negotiations
Adapted from and Advocacy Institute presentation
by Dave Edyburn, PhD, University of Wisconsin – Milwaukee

*“With the advent of cost-effective and efficient digital scanning technology, local districts have significantly increased their capabilities to digitize books directly into more accessible digital formats. … in the absence of accessible materials from publishers, scanning a book may be the most effective method of providing instructional materials to print-disabled students, at least for the immediate future.”

An Educator’s Guide to the Acquisition of Alternate Format Core Learning Materials for Pre-K-12 Students with Print Disabilities

Resources

1. Remediation vs. Compensation  http://anzatresearch.wikispaces.com/file/view/Edyburn+2002RemediationvsCompensation.pdf

2. WATI Assessing Student Needs for AT – 5th Edition  https://dpi.wi.gov/sped/educators/consultation/assistive-technology/wisconsin-assistive-technology-initiative/asnat-manual

3. Chapter 1 – Consideration Guide  https://dpi.wi.gov/sites/default/files/imce/sped/doc/at-wati-asnat5-chapter1.doc

4. WATI Assessment Package  https://dpi.wi.gov/sites/default/files/imce/sped/pdf/at-wati-assessment.pdf

5. Assessing AT Student Need  http://atto.buffalo.edu/registered/ATBasics/oundation/Assessment/printmodule.php

6. Funding AT  http://www.wati.org/content/supports/free/pdf/Ch16-FundingAT.pdf

7. Texas AT Training Modules  http://www.texasat.net/training-modules/training-modules-home

8. AT Parent Guide – AT Tools  http://www.greatschools.org/pdfs/e_guide_at.pdf?date=3-13-06&status=new

9. How do you know?  https://dpi.wi.gov/sites/default/files/imce/sped/pdf/at-know-it-show-it.pdf

10. Decision-Making  http://atto.buffalo.edu/registered/DecisionMaking/

11. Learning from Text  http://www.qiat.org/docs/resourcebank/LearningfromText.pdf

12. Teaching Every Student  http://www.ascd.org/publications/books/101042.aspx

13. Fairness

14. Documenting AT Needs in the IEP  http://www.gpat.org/Georgia-Project-for-Assistive-Technology/Pages/Documenting-Need-for-Assistive-Technology.aspx

15. Scan to Speak Programs  http://atto.buffalo.edu/registered/ATBasics/Curriculum/Reading/scantoSpeak.php

16. Ensuring Access for Students with Print Disabilities
http://www.cleweb.org/sites/cleweb.org/files/assets/NCLD_AIM.pdf

17. Legal Issues Associated with the Provision of AIM to Students with print Disabilities

18. Legal Issues: Laws, Regulations, Guidelines  http://aem.cast.org/policies/laws-regulations-guidelines.html

19. Accessible Textbooks in the Classroom: An Educator’s Guide… (2010 Revision)  http://www.wrightslaw.com/info/AccessibleTextbooksClassroom8.10.10.doc

20. 34 C.F.R. §300.172(b)(4) Access to instructional materials. (IDEA Regulations, Subpart B, p.18)

21. OSEP Q and A In order to meet its responsibility under paragraphs (b)(2), (b)(3), and (c) of this section to ensure that children with disabilities who need instructional  materials in accessible formats are provided those materials in a timely manner, the SEA must ensure that all public agencies take all reasonable steps to provide instructional materials in accessible formats to children with disabilities who need those instructional materials at the same time as other children receive instructional materials.

22. While comprehensive assistive technology evaluations are important and needed, a 60 day wait to establish the need for Accessible Instructional Materials is not necessary.  IEP teams have sufficient existing data – test scores, grades – to establish a student’s need for text-to-speech software and accessible instructional materials without an assistive technology evaluation.

SOURCE OF THIS INFORMATION:  WrightsLaw.com  http://www.wrightslaw.com/info/at.strat.edyburn.htm 11/21/2017

2018 © Compiled by Karen L. Anderson, PhD. Supporting Success for Children with Hearing Loss. http://successforkidswithhearingloss.com

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There is no more effective way to estimate a student’s level of auditory access in the classroom! This functional assessment is easy to perform and can take only 15 minutes. Find the size of your student’s listening bubble and compare speech perception accuracy at 3 feet in quiet/noise to 10-15 feet in quiet/noise.  Examine the results to identify phonemes that are commonly missed or misunderstood. 

Using the Recorded Functional Listening Evaluation Using Sentences

This 1:15 minute webcast is only $24.00. Purchase the digital FLE audio files and pdfs for only an additional $13.00 ($37.00 for webcast and the digital FLE). Load it onto your SmartPhone, computer, or DropBox/GoogleDocs.  Purchased separately, the FLE on CD is $20.00. Pricing also available for licensing use for your whole district.

2-minute video – very brief demonstration of using the Recorded FLE Using Sentences or on YouTube.

IDEA FROM THE FIELD: I have used the Recorded FLE Using Sentences with a number of our HH kids and they seem to have real speech perception challenges.  I tried the FLE with my 7 year old grandson, whose hearing is fine, and he got almost all the items right. The couple that he missed were corrected by his 4 year old brother who told him what the sentence actually was! I notice that my two CI kids, whose CI team feel they are hearing at 20 dB or better, tend to omit is, past tense markers and present progressives as they repeat the sentences. They tend to get the key words correct but due to missing so much they really don’t understand what is presented. Even when I question them they can’t explain what the idea of a sentence was with clarity. The Recorded FLE has really helped to identify issues beyond simple audibility.         

– Teacher of the Deaf/Hard of Hearing

 IDEA FROM THE FIELD:  It is important to note not only the errors the student makes in repeating the sentences, but HOW the student repeats. For example, I had to pause several times throughout the testing to remind one student to repeat any words of the sentences she heard even if she didn’t catch the whole sentence. That wasn’t easy for her to do…it was either repeating the whole sentence or nothing…she was usually able to repeat 2 of the 5 words of a sentence when I paused to ask if there were any of the words she heard.  Another observation of the HOW was that most of the responses she gave at the far distances were as if she was repeating it as a question (e.g., The fruit came in a box???). The few that she clearly repeated as a statement showed her confidence that she was sure of what she heard.  I think these observations are also very important to share when we discuss results of the FLE with the school team. There was much more of a lack of confidence at the far distance.  Plus, it demonstrates the added effort a student has to make to listen.     

– Teacher of the Deaf/Hard of Hearing

So often our students test out ‘normal’ on receptive/expressive vocabulary or other language tests but you KNOW that he cannot carry on a typical conversation or relate a story of an event like age peers. The Test of Narrative Language is a fast, easy to use test that provides insights to a student’s ability to interact, that are not identified by standard language tests.

Ages: 4-0 through 15-11; testing time: 15 to 20 minutes; individual administration $192.00

The Test of Narrative Language–Second Edition (TNL-2) is a norm-referenced test that measures children’s narrative language abilities (i.e., children’s ability to understand and tell stories). Narration is an important aspect of spoken language, not usually measured by oral-language tests, that provides a critical foundation for literacy.

The TNL-2 enables clinicians and teachers to assess important aspects of narrative language without having to transcribe children’s stories. This saves hours of transcription time, and provides a valid and reliable metric of narrative language development.

Features of the TNL-2
The TNL-2 is:

• a functional assessment of narrative comprehension and narrative production;
• a dynamic assessment in which comprehension and production tasks are alternated so children have the opportunity to profit from adult narrative models;
• 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.

Story Topics

• 2 children going to eat at McDonalds with their mother
• school art project
• boy late for school
• finding treasure at a park
• aliens

On SALE through September! The NEW Teacher Inservice Combo

The new Impact of Hearing Loss on Listening, Learning, and Social Interactions included in the Teacher Inservice Combo provides a visual example of how various levels of hearing loss fragments speech and describes the impact of a smaller listening bubble. The Impact of Hearing Loss handouts are part of the 12 downloadable handouts and checklists (including fillable SIFTERs!). A great deal of information at a great price – especially through September!  30 pages of resources not found on the website!

What makes this new Impact of Hearing Loss on Listening, Learning, and Social Interactions handout different from the old/free Relationship of Hearing Loss to Listening and Learning?

1. The sections of possible impact on understanding, possible social/emotional impact, and potential educational accommodations have been thoroughly revised.

2. Audibility of speech sounds for soft speech (35 dB), conversational speech (45 dB), and teacher speech (50 dB) have been included. A percent audibility is specified as are missing or audible speech sounds.

3. An example of fragmented listening is provided via a paragraph of instructions with parts of speech eliminated based on decreased audibility.

4. Possible listening challenges in school have been included, derived from the LIFE-R Student Appraisal. You can either check off the items that the student has identified as challenges, or leave them as is to raise awareness of difficult listening situations.

5. The footnote contains a check off of important teacher accommodations that you can review to reinforce the necessary accommodations specified in the student’s IEP or 504 Plan.

6. An instruction sheet has been included with suggestions for use with TODAY’S STUDENTS WITH HEARING LOSS!

What else comes in the Teacher Inservice Combo along with the newly revised Impact of Hearing Loss handout?

The Teacher Inservice Combo is fully digital and includes the following pdf handouts:

1. Impact of Hearing Loss on Listening, Learning, and Social Interactions (5 pages)

2. Emailable, computer fillable SIFTERs (Preschool, Elementary, Secondary) (6 pages)

3. Emailable, computer fillable LIFE-R Teacher Appraisal (2 pages)

4. Emailable, computer fillable Access to Curriculum Inventory (ATCI) for General Education Teacher (3 pages)

5. Children with Hearing Loss Miss More Than You Think (1 page)

6. Listening Comprehension Exercise – Mother’s Aprons (1 page)

7. Barriers to Listening – Visual analogies of listening in noise, reverberation, and distance (5 pages)

8. Student Listening Challenges – Understanding the Missing Pieces (1 page)

9. Attitude is Caught, Not Taught (teacher version) (1 page)

10. Hearing Aid/Cochlear Implant Monitoring and the Law (1 page)

11. Hearing Aid Monitoring – An Important Daily Activity (4 pages)

12. Emailable Tips for Teachers (Early Childhood + K-12) Word version (15 pages)

All 12 Inservice-related Materials in DIGITAL DOWNLOAD Format for only $39.00

So many of our student cannot hear the insalient parts of speech (cannot perceive the high frequencies and/or the quiet parts of speech) – EVERY TEACHER needs to have easy to use syntax-building materials! Cracking the Grammar Code is a perfect fit for your needs whether you are an itinerant, or provide center-based, resource room, or push-in services. Keep the CGC materials on your media device to present the items to your students or copy the pages you need as you go.

Within the 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 diagnosis specific skills in the broader category.

When you are ready to dive into the full curriculum, there are four comprehensive downloadable books for purchase. The books provide a year’s-worth of teaching materials at your fingertips! Each book contains assessment and teaching materials. The books are available as a complete package as well as separately. Books can be taught in any order depending on the students’ skill levels; however, for a complete year’s-worth of lessons, present the books in the following order:
(1) Nouns, Articles & Conjunctions (173 pages for $27) and its companion Vocabulary Enhancement – Simple Picture Glossary (128 pages for $20 digital or $28 printed)
(2) Verbs (143 pages for $18)
(3) Pronouns, Adjectives, Adverbs, & Prepositional Phrases (94 pages for $13), and
(4) Finding the Subject & Subject-Verb Agreement (141 pages for $14).
Each book contains individual subject pretests and teaches concepts in incremental steps.

All 4 Books (Nouns, Verbs, Pronouns, Finding the Subject)
Digital downloads for individuals only $62.00
Digital downloads for groups of up to 8 users only $248.00
All 4 Books (Nouns, Verbs, Pronouns, Finding the Subject) + Vocabulary Enhancement Glossary
Digital downloads for individuals only $79.00
Digital downloads for groups of up to 8 users only $315.00
Digital downloads of all 4 books + 1 Printed Vocabulary Enhancement Glossary $86  individuals only
(no group  pricing)

Regardless of the move to full inclusion and the shortage of teachers of the deaf/hard of hearing, school teams remain obligated to the student to identify areas of educational need, appropriate IEP goals, amount of service time needed, by whom, and in what setting.

In the March 22, 2017 US Supreme Court decision, Chief Justice Roberts wrote, “…IDEA demands more. It requires an educational program reasonably calculated to enable a child to make progress appropriate in light of the child’s circumstances.”  If a child is not fully included, school officials must look at the child’s unique needs and required level of specialized instruction before developing an IEP that is “pursuing academic and functional advancement.” If a child is 6 months behind expected achievement levels, an itinerant DHH teacher cannot maintain a year’s growth and also make up the level of delay with only twice per week 30-minute sessions of service. Providing an inappropriate amount of educational support will not result in the needed level of student outcomes nor will it make teachers of the DHH appear effectual.

“Kids in the middle” refers to students who may not be served in delivery models that consist of direct services from a teacher of the deaf and hard of hearing. Therefore, the resulting services may, or may not, adequately address the communication, social, and academic needs of these students. Central to the concept of special education is the idea that the Individual Education Planning Team will collaboratively determine the special and general education services a student needs, based on the goals and objectives developed for him or her. This process is meant to ensure that each student will receive services tailored specifically to his or her unique set of needs. With the recent clarification by the US Supreme Court it is anticipated that school teams will once again consider the amount and intensiveness of services necessary to allow students with hearing loss to progress at a rate typical of hearing peers. Our goals should focus on helping students become effective communicators, competent readers, and knowledgeable consumers of goods and services.

One result of the Supporting Success survey last April to identify the roles and responsibilities of itinerant teachers of the deaf/hard of hearing indicated that 25% of respondents used matrices to guide their discussions in the determination of the level of service delivery. With increased pressure to ‘serve less, more remotely’ under the assumption that the student will learn as well when teacher of the DHH services are minimized, many teachers and districts are exploring or implementing the use of service delivery matrices.

It is important to preface this discussion recognizing that a service delivery matrix can only be a guide to decision making, assisting in team discussions and not the final word in appropriate levels of service. The focus needs to remain on “what the student needs to catch up and keep pace.”

Hearing loss results in learning needs that are unique, including some areas of need that cannot be effectively addressed in a mainstream classroom (refer to Early October Bimonthly Update). For the teacher(s) of the DHH who would like to begin the conversation of using a service delivery matrix, the following handouts may be a helpful addition to discussions with administration:

• Why Involve the Teacher of the Deaf/Hard of Hearing on the Assessment Team and the IEP?
• Role Comparisons: Supporting Students Who are Deaf or Hard of Hearing
• Considerations for Assessment & Service Provision for Children with Hearing Loss

Below are examples of matrices that are already in use. Some are DHH specific while others are not. Some take into account the social, technology, accommodations, and self-advocacy needs of students and others do not.

Use of a service delivery matrix may provide the evidence basis needed for justification of appropriate levels of service to meet student needs – academic, class participation and expanded core skill development. 

Example Matrices for Determination of Level of Service Delivery

• Educational Impact for Students who are Deaf or Hard of Hearing The Michigan Department of Education – Low Incidence Outreach has produced an exceptionally helpful tool that has recently been made computer fillable. It is suggested that persons interested monitor their website for the new fully accessible version to be released.
• Hearing Itinerant Services Rubric Many varying factors are considered within the 3-page matrix. Individual child issues or circumstances need to be carefully considered as well as the rubric recommendations. Thanks much to SEDOL in Illinois for sharing this 2014 resource.
• Service Delivery Guide for Educating Students Who are Deaf and Low Functioning was developed by Region 4, Houston Texas in 2016. As the title indicates, this matrix is different from the others as it is specific to students who are Deaf-plus.
• Matrix of Services was developed by the Florida Department of Education Bureau of Exceptional Education and Student Services in 2017 as guidance to indicate the intensity of support required to meet the needs of students identified as exceptional. It is not DHH specific. Be sure to download the large Matrix of Services Handbook that provides detailed explanations of all domains for appropriate use. Note: this large file may take extra time to access.

2018 © Karen L. Anderson, PhD, Late November Update, Supporting Success for Children with Hearing Loss http://successforkidswithhearingloss.com This information is not intended as legal advice.

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Addressing Children with Hearing Loss:
Appropriate Use of Norm-Referenced Test Instruments

The purpose of this document is to explore information available regarding use of normative tests with children who are deaf or hard of hearing. Very few tests have specific norms for this population. In comparison to pre-newborn hearing screening, the population of children with hearing loss has become increasingly heterogeneous, affecting the relevance of averaged, normative responses. Also, increasingly, students are fully included in their neighborhood schools, often as the only student with hearing loss/hearing devices/sign language interpreter in their grade or school. The expectations are that they have the capability to compete in their classroom settings. Thus, it is now being strongly suggested that students be evaluated with test instruments that may not include the deaf/hard of hearing population in the norming group; with the caveat that communication during testing be maximized, and the purpose of the testing is to assess the student’s skills in comparison to the performance of classroom peers.

The following information has been identified as being pertinent to this topic. Highlighting has been added for emphasis. Readers are encouraged to refer to original source information.

1. 2015 Guidance about the WPPSI-IV. Normative data section, page 3. This same paragraph is provided in 2015 guidance about the WISC-V.

“Examiners must determine whether the general normative sample is an appropriate comparison group for the child. While normative information for the general population is provided on the WPPSI-IV/WISC-V to assist with interpretation of scores, the WPPSI-IV/WISC-V normative sample did not include individuals with uncorrected hearing loss. Thus, comparison of standard scores for some deaf and hard of hearing children with the normative population may be limited, particularly for those without corrected hearing loss and/or whose primary language is some form of signed communication. In contrast, for deaf and hard of hearing children who use assistive technology, such as cochlear implants or hearing aids, and who are primarily spoken language users, a comparison with the normative sample may be appropriate.”

Comment: Most students are hard of hearing and are included in the mainstream with expectations that, with necessary supports and services, they perform at the same rate and to the same level as their class peers who are typically hearing. Comparison of their skills to this normative sample would therefore, usually be appropriate assuming communication optimization at testing occurs.

2. 2011 http://www.isrc.us/sites/default/files/pdf/psychguidelines2011.pdf Page 4, number 3.

“The use of standardized tests to determine the cognitive abilities, academic achievement, and mental status of people who are deaf or hard of hearing may result in inaccurate or misleading results. Few tests have been normed on deaf and hard of hearing populations. Comparison norms are made to English-speaking, same-age students without a hearing loss. Assessment results need to be considered and interpreted in this light. Misdiagnosis can follow an individual throughout his/her lifetime. Scores from standardized tests should be interpreted in conjunction with other assessment information.”

Comment: The evaluator must always take the impact of the hearing loss on communication and attention into account during the assessment process. Most students designated as hard of hearing may be the only one in their grade or school to have hearing loss and use hearing devices. Comparison of their skills to the averaged responses of the very heterogeneous population of students who are deaf or hard of hearing can arguably be seen as less relevant for educational planning than comparison to their typically hearing peer group.

3. 2011 http://www.isrc.us/sites/default/files/pdf/psychguidelines2011.pdf  Page 9

“VI. Guidelines for Selecting Tests

1. General Considerations

a. Few standardized tests include specific norms for comparisons with people who are deaf or hard of hearing.

b. Some standardized tests provide guidelines for administration of test items to people who are deaf or hard of hearing.

c. Due to the problems encountered with standardized instruments, the inclusion of informal assessments is suggested. The use of informal assessments (such as interviews, observations, and work samples) can provide additional information on the student’s skills.

d. A word-for-word transliteration of standardized administration procedures may not adequately convey test instructions or student responses.

2. Achievement Testing

a. There are many facets to consider when selecting standardized, norm-referenced achievement tests for students with hearing loss, considering the student’s communication modality, difficulty translating questions into sign language, and the lack of validity studies of such techniques.

b. Achievement testing is beneficial to establish baseline levels of an individual’s educational performance and to monitor their academic progress over time.

c. Consider the use of hearing impaired norms (if available). This approach is valid when the desire is to compare the student with other hearing-impaired children.

d. It is suggested that academic achievement testing be conducted along with a communication assessment (expressive and receptive language skills) to identify the student’s strengths and needs.

e. Curriculum-based measurements (CBM) and criterion-referenced tests may also be used to monitor academic progress over time. With these measures, a student’s performance is compared to his/her own baseline rather than same age peers without hearing loss.

f. Oral reading CBM measures should not be used with students who are deaf except in highly specialized circumstances.

g. Classroom observations and portfolios are additional sources of educational data.”

Comment: Again, as most students with hearing loss are educated in the inclusive mainstream education environment, there is limited utility in assessing their performance in comparison to group norms of students who are deaf or hard of hearing. Informal assessment of the student’s functional performance in the classroom, including social interactions, participation in group settings, pace of learning over time and fatigue can be very valuable in determining the adverse effect hearing loss has on educational performance.

3. NASDSE http://www.nasdse.org/Portals/0/Documents/AssessmentTools.pdf

“Recommended Assessment Tools: The specific tests listed under each area represent possibilities from which to choose. Many tests are usable only in part, such as the use of only visual or performance subtests from a more comprehensive standardized evaluation. Almost all evaluation tools require some form of modification which the evaluator must note in the student’s record.”

Comment: For students who are hard of hearing with educational performance close or on par with classmates the modifications to testing may be to reduce background noise, ensure good lighting in the test space, ensure that hearing devices are functioning properly, and to control distance between the evaluator and student so that it is no more than 3-6 feet (unless an FM/DM hearing assistance technology system is in use). Note should be made of atypical number of requests for repetition, length of pauses between the question and response (processing time), and evidence of listening fatigue. These test considerations must be included in the description of test results.

4. NASP Position Statement file:///C:/Users/Karen%20L%20Anderson/Downloads/ServingStudentsWhoAreDeaf%20(2).pdf

“Assessments and other educational support services need to address all domains in the life of the students who is deaf or hard of hearing, including social, emotional, physical, and cognitive development, and should use multiple sources of information for decision making. Due to etiological, neurobiological, and social factors, some students who are deaf or hard of hearing may be at risk for academic, social, or emotional difficulties. A successful educational program should proactively address the needs of these at-risk students and provide school psychological assistance to educators and support personnel working with these populations.”

“For students who use cochlear implants or hearing aids, the school pshychologist, in conjunction with other professionals, should determine how well the student can understand and communicate with these assistive devices and whether an interpreter (e.g., sign language, oral, or cued speech) may also be needed to access the curriculum.”

“School psychologists should collaborate with specialists knowledgeable in working with students who are deaf or hard of hearing (e.g., certified teachers of the deaf, speech and langauge pathologists, audiologists, ASL/deaf studies teachers) to assess how the student can communicate in a variety of settings. A mechanism should be in place to provide ongoing progress monitoring and, when progress is deemed less than adequate, additional assessment and intervention should be provided.”

“A certified teacher of the deaf should always be part of the team.”

Summary:

The assessment process should include professionals knowledgeable about the educational impact of hearing loss, specifically teachers of the deaf/hard of hearing and educational audiologists. The purpose of the assessment, and the group with whom it makes the most sense to compare the abilities of students who are deaf or hard of hearing, must be considered. This initial decision must be made if the results are to be most useful for eligibility and individual educational planning purposes. Administration of norm-referenced tests that do not include deaf/hard of hearing students in the norming group can be very appropriate if the student is primarily educated in the inclusive mainstream setting with few or no peers with hearing loss. The test administrator must provide an environment for optimal communication for the student who is hard of hearing, with special attention to the student’s attention, processing time, and level of listening fatigue. Students who use sign language must be tested with the involvement of their sign language interpreter, or if equally skilled, the teacher of the deaf/hard of hearing. All results must be reported specifying any significant alterations to test procedures.

Comments by experienced school psychologists with specialization in assessing students who are deaf/hard of hearing:

As a Licensed Psychologist and Teacher of the Deaf and Hard of Hearing, I have been conducting psychological and psycho-educational evaluations with students with hearing loss, as well as combined vision and hearing loss, for the past 12 years. In that time, I have seen numerous heart-wrenching situations where children’s cognitive skills have been tragically mislabeled because they were evaluated by a psychologist that either did not communicate with the student directly in the student in the student’s primary language OR the psychologist did not have training, education or experience working with children with hearing loss or combined hearing and vision loss. These professionals were well-intentioned. They read the manuals for intelligence tests such as the widely used Wechsler Intelligence Scale for Children (WISC) and the manual suggests giving just the “non-verbal” scales to children with hearing loss. Many respected sources also recommend that the “verbal” scales of intelligence tests NOT be given to students with hearing loss due to their limited exposure to language. Students with hearing loss have less access to language than their hearing counterparts and, as the “verbal” scales of intelligence tests are based on English, it puts children with hearing loss at a disadvantage.  I do not agree, however, that Deaf/Hard of Hearing students should not be given the verbal scales – even students who are profoundly Deaf and/or whose primary language is ASL. The following provides a very brief summary of why I believe it is usually necessary to give both the verbal and nonverbal scales of intelligence tests:

1. If you only give the nonverbal half of a standardized test, such as an intelligence or “IQ” test, then you remove half of the student’s opportunity to succeed. The assumption is that a child with hearing loss will not perform well on the verbal scales, but that is not always true.

2. Some students with hearing loss, even a profound hearing loss, perform better on the verbal scales of an intelligence test. I personally have tested numerous students who performed significantly higher on the verbal scales than the non-verbal scales. For example, I assessed a profoundly Deaf student who lived in a third world country until age 7, with no exposure to any type of signed or visual language (and therefore virtually no exposure to language as he had no access to spoken language). This student moved to the United States at age 7 and received exposure to ASL. At age 9, he was given the non-verbal scales of an intelligence test and those results suggested his intelligence fell in the Low Average to Below Average range. When I tested him at age 11, I gave him both the verbal and non-verbal scales and he earned scores in the Superior range on the verbal subtests and in the Low Average range on the non-verbal subtests, but his overall IQ score came out in the Superior range due to his extremely high verbal scores. If I had followed the guidelines printed in the manual or the guidelines provided by many respected resources for Deaf/Hard of Hearing students, then this student’s intelligence would have been estimated to fall within the Low Average range, instead of the Superior range. This student was struggling at school therefore his school performance did not reflect his Superior level of intelligence, either.  After this testing was performed, his academic program was adjusted to include teaching strategies that focused on language (ASL, as that was his primary language) and within 18 months he was earning A’s. Previously, his teachers had focused on visual teaching strategies because they assumed he would be a “visual” learner due to his lack of exposure to language and hearing loss, but he actually struggled with visual skills. This student eventually took Advanced Placement classes in high school and earned A’s. The student would be considered the “prime example” of a student that should NOT be given the verbal scales due to his extreme lack of exposure to language. Had I followed that logic, this student might still be struggling with “visual” teaching strategies. Note: Identifying details were changed to protect the identity of the student.

3. It is true that some students with hearing loss do not perform well on the verbal scales, most likely due to a lack of exposure to language. If the evaluator is trained and experienced working with students with hearing loss, then he/she will know which aspects of their social/educational/medical/audiological history should be considered as part of the interpretation of scores and will provide an effective discussion of the student’s scores, as well as strategies that are likely to be effective for improving the student’s language skills. In order for a psychologist to provide appropriate recommendations regarding a student’s cognitive skills, they need adequate information, which includes the student’s verbal/language-based cognitive skills. A trained/experienced psychologist will base their estimate of the child’s overall cognitive skills on a wide variety of factors, not just an IQ score. If there are lower verbal scores, a trained psychologist will interpret those in a way that includes the student’s hearing loss as well as their history.  That interpretation should result in specific recommendations aimed at improving their areas of need to help the student succeed. A trained evaluator should not underestimate the student’s overall cognitive abilities based on a small subset of verbal scores.

4. Verbal subtest scores are very highly correlated with an individual’s performance at school and work. If a student with hearing loss earns low scores on the verbal subtests (as well as any other measures of language), it is our responsibility as professionals to collect as much data about those challenges as needed to develop effective teaching strategies to improve language skills. Language skills, whether we like it or not, are highly correlated with both academic and vocational success. Refusing to test a student’s “verbal” cognitive skills because the scores might be low is very unfair to students with hearing loss. Professionals need to be trained to effectively evaluate a student with hearing loss so that their overall cognitive abilities are not “underestimated” based on lowered verbal subtest scores.   

– Dr. Nanette McDevitt, Minnesota Specialist in Assessing Students who are Deaf/Hard of Hearing

CBM/progress monitoring should be considered an important tool in tracking a student’s growth and development. Children who are D/HH may start out at or close to age/grade level expectations due to intensive intervention provided during the preschool years. These interventions often taper off as the child enters the K-12 system. Deficits in communication/listening skills in the form of a slowly increasing gap in academic skills could easily be missed, or misidentified as a learning disability.    

– Retired School Psychologist with DHH Advanced Graduate Certificate in School Psychology and Deafness

Supporting Success sincerely thanks the professionals who provided their comments on this important question.

2017 © Compiled by Karen L. Anderson, PhD. Supporting Success for Children with Hearing Loss. http://successforkidswithhearingloss.com

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Increasingly, students with hearing loss are educated in their neighborhood schools and often the only student in their grade or school to use hearing devices or sign language. They are at higher risk than peers for teasing, and often have difficulty developing a healthy identity as a person who has a hearing loss. A thorough evaluation of educational performance includes considering social/emotional issues. Only looking at grades and receptive/expressive language is NOT an in-depth assessment to identify all needs. Why are children with hearing loss prone to these issues? What ARE the concerns we should be trying to identify? What are some means to identify social/emotional issues occurring in students with hearing loss?

Social/Emotional Issues

Social interaction is complicated! It involves social cognition to be able to ‘read’ social situations, theory of mind to be able to infer the perspectives of others, pragmatic language development to be able to communicate in a way that is socially appropriate and not awkward, and finally, a positive self-concept to believe that you have something of value to contribute to the social group. When we consider assessing student needs we need to think about performance in each of these areas. As we work with students to improve outcomes and educational performance we need to be sure that development in the components of social interaction are continuously being addressed.

Children with hearing loss do not ‘overhear’ incidental language as well as peers without hearing loss. This makes them vulnerable to language issues, including social language issues. Research suggests that children with hearing loss may have a 4-year delay in pragmatic language learning by the age of 7. It is not surprising then that students with hearing loss are often considered to have immature social skills. Self-concept issues also may be significant, especially for students mainstreamed into their neighborhood schools without contact with peers who have hearing loss. Development of our identity stems from the groups we consider ourselves to be a part of and without a connection to DHH peers a student’s identity and acceptance of the hearing loss is unlikely to develop in a healthy manner. All of these together can impact self-concept at school. Students may feel lonelier in comparison to peers and/or less satisfied with their social status in school as a result.

Teasing

Teasing can be friendly or unfriendly. Everyone experiences teasing while growing up. If there is an obvious difference, a child is more likely to be teased by peers. According to a 2014 US status report*, 15% of boys and 16% of girls are verbally bullied 2-3 times per month or more. Bullying usually occurs on the playground, during lunch or in hallways, but a third of these children also experience bullying remarks in the classroom while the teacher is present. It is not a question of IF a student with hearing loss will be bullied, it is a reality that it WILL occur. A 2013 study** reported that students who are deaf and hard of hearing experience bullying rates 2-3 times higher than those reported by hearing students AND that school personnel intervened less often when this behavior occurred. Pointedly developing self-confidence and early preparation for children to be resilient to teasing or bullying situations is unfortunately necessary for children with hearing loss if they are to emotionally persevere as ‘one and onlies’ in their mainstream classroom environments.

Social/Emotional Assessment Considerations

Evaluation needs to be tailored to assess specific areas of educational need (§300.304(c)(2)). Because we recognize that social/emotional development may be an area of need for students with hearing loss, the following section of IDEA is especially relevant: Part 300/D/300.304/c/4(4) The child is assessed in all areas related to the suspected disability, including, if appropriate, health, vision, hearing, social and emotional status, general intelligence, academic performance, communicative status, and motor abilities.

The National Association of School Psychologists Position Statement states: “Assessments and other educational support services need to address all domains in the life of the students who is deaf or hard of hearing, including social, emotional, physical, and cognitive development, and should use multiple sources of information for decision making. Due to etiological, neurobiological, and social factors, some students who are deaf or hard of hearing may be at risk for academic, social, or emotional difficulties. A successful educational program should proactively address the needs of these at-risk students and provide school psychological assistance to educators and support personnel working with these populations.”

Children with hearing loss are a very diverse group. When most of the students we served were functionally Deaf and educated in center-based programs, the Meadow-Kendall Social-Emotional Inventories that were normed on this population were very appropriate to assess these areas of need. Now most of our students spend the majority of time included the mainstream classroom and it is most appropriate to compare their social/emotional needs to those of their typically hearing class peers. Thus, this long-used Meadow-Kendal assessment should no longer be the ‘go to’ for the large majority of students who are DHH.

If tests normed on students who are deaf/hard of hearing is often no longer appropriate, what can we use? When school psychologists perform a social/emotional assessment the usual areas of need they are most likely to identify are impulsivity, lack of ability to attend, depression, or non-compliant behavior. Although our students can experience these issues, the hearing loss may cause behaviors that suggest these issues, but the behavior is most often due to hearing loss and not other issues. For example, if the teacher completed the Connors Behavior Rating Scale a student with hearing loss may seem off task and inattentive when the real issue is fragmented hearing and not receiving complete information, or excessive effort to listen resulting in periods of distractibility. Likewise, the Behavior Assessment System for Children may identify a child as depressed, when instead the student may be hyper-focused on trying to get information auditorilly and visually and seems to have little affect or interaction. The key is the need to have someone on the evaluation team who can discuss the results of these measures with the team in terms of the ‘DHH Lens’. Adding observational and teacher checklist information about specific behaviors that are of most concern for students with hearing loss and discussing the results with the evaluation team in addition to other testing performed can help you to ‘make the case’ that there may be more social and emotional challenges than are easily identified by using standard measures alone.

Specific Assessment Suggestions

1) Social-Emotional Assessment/Evaluation Measure is completed by parents of infants, toddlers and preschoolers (up to 66 months). Preschool teachers can also complete the form. It is most useful if parents/teachers review skill development and identify areas of concern over time.

2) Social Language Development Test is a norm-referenced test that delves into pragmatic language use, social cognition, making inferences, peer negotiation and multiple interpretations of social information. Grades 1-6. Low performance in any of these areas is likely – in combination with hearing loss – to impact social interaction.

3) Pragmatic Language Skills Inventory is a teacher checklist that can be completed in 10-15 minutes. For children ages 5-12. It has strong psychometrics to be able to clearly identify issues, even for children as young as kindergarten in the areas of: Personal Interaction Skills; Social Interaction Skills; Classroom Interaction Skills.

4)  Pragmatic Language Observation Scale is a teacher checklist that can be completed in 10 minutes. For children ages 8-17. The test was normed on almost 1000 students, it is appropriate to identify the social interaction/emotional issues that are most likely to appear for students with hearing loss.

5) Children’s Peer Relationship Scale can provide very useful information about how isolated or integrated a child feels. Although it is not normed, this data can add insight to self-concept affecting other test measures.

6) Children’s Loneliness and Social Dissatisfaction Scale is designed to assess children in grades 3-6. Simple to administer and score, this scale has psychometric properties to identify students who are socially rejected and/or who feel lonely in regard to their school relationships. It is not DHH specific.

7) Does this student have a poor self-concept? This checklist asks the classroom teacher or the DHH teacher in discussion with the classroom teacher to consider 15 behaviors. All items are presented negatively, such as “Expresses feelings of not belonging” or “Gives up easily.” This checklist is not normed but can provide very important insights to consider in addition to other assessment information. Teacher Tools Members Library.

8) Think About It Quiz is a checklist for teens to assess self-concept. It asks the teen to judge themselves against their peers in five different domains, including peer acceptance. There is a cut off score to identify areas of concern. Teacher Tools Members

9) Social skills checklists can also be completed by the teacher, such as the Social Skills Checklist (Pre-K/Elementary), Social Skills Checklist (Secondary) and The Social Attributes Checklist. Some in Teacher Tools.

If we truly tailor assessment so that the vulnerable areas of development specific to the access issues of hearing loss are considered AND we examine functional performance in a classroom setting (or predictive measures) the likelihood is that most children with hearing loss can be found to be eligible for specialized instruction and related services. Refer to Steps to Assessment for case examples and specifics on assessment.

Online Game to Assess and Improve Social/Emotional Skills

Created by a team of researchers, artists, and game developers, Zoo U is the only research-proven online game that assesses and improves children’s social and emotional skills. These skills include:

• impulse control and self-management
• emotion regulation
• communicating effectively
• showing empathy
• social initiation
• cooperating with others

Developed with funding from the US Department of Education. Zoo U is geared toward students in grades K through 5 and can be administered to one child or to many children at once. Because the assessment is a game, children stay engaged and motivated. In Zoo U, players are students in a school for future zookeepers, where Principal Wild and a host of friendly animals help them learn social and emotional skills as they navigate common school-based social scenarios. Find out more about the Zoo U games. Released November 2014.

*Bullying in U.S. Schools: 2014 Status Report. Downloadable PDF.                                            http://www.violencepreventionworks.org/public/document/bullying_2015_statusreport.pdf

**Weiner, M. T., Day, S. J., & Galvan, D. (2013). Deaf and hard of hearing students’ perspectives on bullyin

2017 © Karen L. Anderson, PhD, Late November Update, Supporting Success for Children with Hearing Loss http://successforkidswithhearingloss.com This information is not intended as legal advice.

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Supporting Success is proud to be the sole source to offer Interact-AS captioning technology to schools!  The new products described below will soon be added to those offered by Supporting Success.

Welcome to the new school year. We’ve got some good news for you. Two of the requests that we received from teachers during the 2016-2017 school year was a way to better support team teaching situations and also student discussion groups. Plus, there were several other suggestions we received. Thanks for forwarding those ideas to us. By partnering together we can help ensure every student has equal access to classroom discussions. Here is a quick summary of how over the summer we took your suggestions and came up with solutions.

Voice Training is No Longer Needed:  With Interact-AS™ Version 6 you no longer need to train voice profiles. You still can train a voice profile, and it is recommended that each teacher do this, but training is no longer required. Having the ability to recognize speech without having pre-trained voice profiles means students can now pass a microphone around their group and whatever they are saying will be captioned. Also, a substitute teacher no longer needs to train a voice profile. Instead you can just create a User Account called “Substitute Teacher” and use the default “English Speech” option. Also, training a voice profile is now much faster. Instead of taking about 8 minutes to do this, with Version 6 it only takes about a minute. That was step one in our summer efforts. Next, we worked on microphones…

Team Teaching:  To support team teaching situations Auditory Sciences is now offering a new dual-channel wireless receiver. This new Dual Receiver includes a second audio channel, so now two wireless microphones can be simultaneously connected to the student’s computer. You still need to take turns speaking, but two teachers can now easily be part of the same captioned conversation. There’s no longer a need to switch user profiles, or hand over a microphone, or to turn off and on a transmitter. Just turn on your microphone and it automatically connects to the student’s computer. The new Dual Receiver includes a built-in audio output jack. This makes it easier to connect an earbud, headset, hearing aid or CI to the wireless microphone. All you do is plug the device into the receiver, that’s it. Plus, this new receiver includes a built-in digitizer, meaning you no longer need a USB adapter to connect the receiver to the computer. Fewer parts, not as many connections, and more functionality, all built in to a receiver that can still fit in a student’s pocket.

New Handheld Wireless Microphone:  The previous handheld wireless microphone was designed for use in adult conference rooms — the setup time was way too long for classroom use. That issue is now solved. The new handheld wireless microphone automatically connects to the new Dual Receiver.

Mix and Match Components: With the new Dual Receiver and handheld and wireless transmitters you can mix and match components to meet your needs. You can use two wireless headsets (e.g., for two teachers); or one wireless headset and one wireless handheld (e.g., for a teacher and a group of students); or two wireless handhelds (e.g., for a large auditorium assembly). Plus, there are more options…

1:1 Teaching or Meetings:  In addition to the new wireless components, we also developed a new Y-Cable (part Z.DUAL.CAB) that allows multiple microphones to be connected via cables to a student’s computer. This is an extremely low-cost team-teaching solution ($14.95). It’s a cabled versus wireless option, so this is not a solution designed for use in a classroom, but it works great for 1:1 meetings with the student, or during an IEP where multiple people may be speaking.

More Captioning Options with Multiple Speakers:  So, what about situations where you have dozens of people speaking? We’ve got an answer for that as well. We’ve added a new feature to Interact-AS that is called Streamer™. With Streamer™ you can connect as many people as you want to a student’s computer. Literally, you can have hundreds of people speaking, even speaking at the exact same time, and whatever they say is labeled with the speaker’s name, captioned, and displayed on the student’s computer. The way this works is that each person that is speaking needs to have a copy of Interact-AS running on their computer (such as the teacher’s computer). Whatever they say is captioned on that computer and then “streamed” to the student’s desk. The student can view the captioning on any device that can connect to the internet, including iPad, Chromebooks, Android Phones and iPhones. Note that student does not need to install any app on their device, all they’ll do is go to www.streamer.center and enter the name of your Streamer™ account (usually the name of your school) and that’s it.

You can have as many students as you want connect to the Streamer account. So, for example, if you have 20 students in an all-school assembly that want to see a captioning and/or translation of what is being said, with Streamer™ you’re all set. The same for enabling those students to view a captioning of the morning announcements, or an announcer at the football game. The Streamer™ module costs just $99, and like Interact-AS, this is for a permanent unlimited use license.

More Comfortable Teacher Microphone:  This past year many teachers requested that we offer a behind-the-head microphone versus the over-the-top version. So, we’ve done that as well. You now can choose the style of microphone that you would like to use with your  Interact-AS Captioning and Translation System. You can now select the traditional over-the-head option or the behind-the-head option.

A More Cosmetically Acceptable Student Receiver:  For students where “fitting in” is a priority, we’ve developed a receiver that looks like a USB thumb drive. This USB model receiver was designed to be as small as possible. It does not have dual channels (just a single channel), nor an audio output jack for a hearing aid or CI, but it is incredibly small. For some students, this may be the key to having them be excited about using a captioning system. Keep it in mind as an option when configuring a captioning system for your students.

Easier Phrase Building:  Interact-AS™ includes at no extra charge the complete set of PhraseBuilder™ features. These are used by students that are non-verbal. This past year many teachers requested an improved way to create and maintain Favorites Lists. These are lists of phrases and/or sentence constructs that students can use to easily ask questions in the class or hold conversations with others. So, we did it. You can now use basically any text editor (such as Microsoft Word or Google Docs) and with a single click convert that document into a Favorites List. Likewise, you can export a Favorites List into your preferred text editor. This new module is free, just ask, and we’ll be glad to send you a download link.

Thanks Again for your Suggestions.  Together, Interact-AS, Supporting Success and YOU are making the classroom more accessible for everyone, including students that are Deaf, Hard of Hearing and/or non-verbal. You, the teachers, are the most important members of our team. Thanks for all you do to help so many students !!!

Sincerely,

Robert Palmquist
President & CEO, SpeechGear, Inc and Auditory Sciences, LLC.

205 South Water Street, Northfield, MN . 55057 | 507.645-8924

Expectation: Most Children Will be Fully Integrated and Make Progress in the General Ed Curriculum

On March 22, 2017, the U.S. Supreme Court issued a unanimous ruling in favor of children with special needs (Endrew F. v. Douglas County Sch Dist (Opinion # 15-827, Chief Justice Roberts).

Purpose of IDEA: Congress Acted to Remedy Children Excluded from School with Tragic Pervasive Stagnation
Justice Roberts noted that “[T]the broad purpose of the IDEA, an ‘ambitious’ piece of legislation enacted ‘in response to Congress’ perception that a majority of handicapped children in the United States ‘were either totally excluded from schools or [were] sitting idly in regular classrooms awaiting the time when they were old enough to drop out.’ . . . A substantive standard not focused on student progress would do little to remedy the pervasive and tragic academic stagnation that prompted Congress to act.” (Page 11).

The Court emphasized that full inclusion is the primary standard with the “child progressing smoothly through the regular curriculum.” However, if the child is not fully included, then the school officials must look to the child’s unique needs to develop an IEP which is “pursuing academic and functional advancement.”

IDEA Demands More: Inclusion & Progress in Regular Curriculum; IEP ‘Tailored to Unique Needs’

In defining FAPE for a child who is placed in a setting that is not fully integrated or mainstreamed, the Supreme Court noted that “The ‘reasonably calculated’ qualification reflects a recognition that crafting an appropriate program of education requires a prospective judgment by school officials. . . The Act contemplates that this fact-intensive exercise will be informed not only by the expertise of school officials, but also by the input of the child’s parents or guardians.” (Page 11)

“The IEP provisions [of IDEA] reflect Rowley’s expectation that, for most children, a FAPE will involve integration in the regular classroom and individualized special education calculated to achieve advancement from grade to grade.” (Page 11)

“When a child is fully integrated in the regular classroom, as the Act prefers, what that typically means is providing a level of instruction reasonably calculated to permit advancement through the general curriculum.” (Page 13)

The decision is clear. Being “fully integrated” and “making progress in the general education curriculum” are the keys. If a child is not fully integrated, the focus shifts even more to the “unique circumstances of the child.”

“IEP Must Enable Child to Make Progress: A Plan for Academic and Functional Advancement” 

“The IEP must aim to enable the child to make progress. After all, the essential function of an IEP is to set out a plan for pursuing academic and functional advancement.” (Page 11)

In the decision, the Court opened with “A FAPE, as the Act defines it, includes both ‘special education’ and ‘related services.’ §1401(9). “Special education” is ‘specially designed instruction . . . to meet the unique needs of a child with a disability’; ‘related services’ are the support services ‘required to assist a child . . . to benefit from’ that instruction.” (Page 2)

Instruction Must be ‘Specially Designed’ to Meet ‘Child’s Unique Needs’ Through an IEP

Later, the Court returned to these concepts: “A focus on the particular child is at the core of the IDEA. The instruction offered must be ‘specially designed’ to meet a child’s ‘unique needs’ through an “[i]ndividualized education program.” §§1401(29), (14)

An IEP is not a form document. It is constructed only after careful consideration of the child’s present levels of achievement, disability, and potential for growth. §§1414(d)(1)(A)(i)(I)–(IV), (d)(3)(A)(i)–(iv)

Progress: IDEA Demands More

“When all is said and done, a student offered an educational program providing ‘merely more than de minimis’ progress from year to year can hardly be said to have been offered an education at all. For children with disabilities, receiving instruction that aims so low would be tantamount to ‘sitting idly . . . awaiting the time when they were old enough to ‘drop out.’” (Page 14)

“The IDEA demands more. It requires an educational program reasonably calculated to enable a child to make progress appropriate in light of the child’s circumstances.” (Page 14)

“We will not attempt to elaborate on what “appropriate” progress will look like from case to case. It is in the nature of the Act and the standard we adopt to resist such an effort: The adequacy of a given IEP turns on the unique circumstances of the child for whom it was created. This absence of a bright-line rule, however, should not be mistaken for “an invitation to the courts to substitute their own notions of sound educational policy for those of the school authorities which they review.” (Pages 15-16)

In closing, the Court returned to the importance of both parties being able to “fully air their respective opinions” and that school authorities should be able to offer “a cogent and responsive explanation for their decisions . . .”

Please refer to the document Is the Inclusion Model Good for Students with Hearing Loss? from Supporting Success for more information on full inclusion for students who are deaf or hard of hearing.

Supporting Success thanks the experts at Wrights Law for this important information. http://www.wrightslaw.com/law/art/endrew.douglas.scotus.analysis.htm Posted 3/23/2017

As you are probably aware, education has changed with teacher lecture becoming less prominent as an educational practice. Typically, new information is presented in a lecture format supplemented by reading material, until students build surface knowledge of the topic. Interaction activities such as classroom discussion, small group work and partner problem-solving are used to solidify surface knowledge and to move students to a deeper level of understanding¹. Therefore, how well students are able to participate in the classroom setting truly impacts their move toward deeper understanding.

This article focuses on the ‘unseen’ challenges that children with hearing loss often experience when trying to keep up in the regular education setting.v

On the way to deeper understanding: For students with hearing loss, keeping pace in moving to a deeper level of understanding can be very challenging. A favorite study was reported by Christie Yoshinaga-Itano in 2010² and considered language learning of students with hearing loss from age 4 to age 7. There were 4 categories of results: children who were delayed at age 4 and still language delayed at age 7 (45%), those who had language within the normal range and 4 and still did at 7 (35%), those who actually closed their language learning gap from age 4 to age 7 (15%), and 10% of the children had language within the normal range at age 4, but due to lack of access and/or appropriate instructional support, developed a learning gap by age 7. Clearly, it cannot be assumed that just because a student has ‘okay’ language at school entry that they will be able to keep up with class expectations across the academic years.

Background, or world knowledge is necessary to build surface level understanding of a specific topic. Prior knowledge is an excellent predictor of performance. Our students tend to have ‘Swiss cheese language’ with unpredictable knowledge gaps in vocabulary and concepts. They also are often limited in the number of attributes they use to describe objects or concepts, further contributing to their gaps and limited world knowledge. Imagine learning about the conquistadors if you lacked knowledge of geography, discoveries of early explorers, and that there are different countries and they may desire different things.

Examples of Student Misunderstanding of Teacher Instruction³ 

“The Indians were dying because of the drought and the famine.” Student asked: “Why were they dying if they had all that fish?”  Lack of discrimination between d/t and f/s. Student thought the words ‘trout’ and ‘salmon’ were said.

Book Chicka Chicka Boom Boom was being read aloud by the teacher: “A told B and B told C, I’ll meet you at the top of the coconut tree.” At the end of the lesson, when asked to retell what was said the student replied, “Today we learned about cocoon trees.”  Thereby demonstrating that the vocabulary ‘coconut tree’ needed to be pretaught and connected to knowledge of other trees before the teacher read the story.

Filling the gaps. We can expect that surface learning will take longer for students with hearing loss than their typically hearing peers. Students who have a less complete understanding of surface level information are not going to benefit to the same degree, or at the same rate, during interactive activities meant to move them to deeper understanding.  “Closing the language gaps” is not just something that is a nice extra touch to provide to our students if there is a teacher of the deaf available; it is necessary for deeper learning. Add to this the fact that reduced precision listening ability often delays literacy skill development and slows reading fluency. Just teaching vocabulary, without sufficient phonological awareness, will not develop the reading fluency the students need for comprehension at the pace of peers. Filling in the gaps in prior knowledge is necessary if a child is to be able to develop the surface learning that is prerequisite to developing deeper understanding. Without this surface learning, a deeper understanding is not possible.

Conversational inequalities. Research⁴ has indicated that during one-on-one conversations in a quiet setting, students who are hard of hearing have conversational skills equivalent to their hearing peers. This includes skills for initiating a conversation, maintaining a dialogue over several turns, shifting the topic, and terminating the conversation. In a typical mainstream classroom, there are many choices for communication partners along with background noise, reverberation, and listening at distances beyond 3 feet that interfere with speech perception of students who are hard of hearing. Students with hearing loss make fewer overall communication attempts than their hearing peers. They also often seem unaware when their peers tried to initiate conversation and did not attempt to maintain the conversation. When they attempt to maintain the conversation they generally use one-to two-word phrases to maintain the communication and do not add new information. The research found that in a 1:1 conversation, 75% of the maintenance attempts by children with hearing loss were appropriate compared to 100% for hearing peers. They frequently tried to maintain the conversation by bringing up a topic that was unrelated to the conversation. In other words, they were not aware enough of the content of the conversation to contribute information, so they brought up a new topic.

Thus, educational practices to move to deeper understanding by way of interaction with peers is often very challenging for students with hearing loss. As can be inferred by the research, in quiet settings listening by students who are hard of hearing often approaches or equals peers. Therefore, it is the acoustic access inequality in the classroom that results in conversational challenges for students with hearing loss. This provides a powerful argument for the use of hearing assistance technology (HAT) that will improve perception of peer voices in 1:1 or group settings.

Challenges repairing breakdowns. Another aspect of conversation relates to what a person does when they do not fully understand. One study⁵ found that persons with hearing loss were able to cue into changes in topic but had much more difficulty when a shift in topic was made during the conversation. The research findings can be summarized as, the more predictable the conversation, the fewer the likely breakdowns. If a student is sitting with a group who maintains their focus on the problem-solving task, the level of understanding is likely much higher than if the student was in a group who wandered off topic repeatedly.  The teacher needs to be aware of this issue when pairing the student with different partners or groups. Moving to a quieter area for discussion will not ensure full participation by the student with hearing loss, but will make participation easier and more likely. Including him or her in a group that sticks to the topic will heighten the value of the exercise for the learner with hearing loss.

Keeping up in the classroom is a challenge for children with hearing loss due to access issues that interfere with understanding conversational communication and the gaps in knowledge resulting from decreased auditory access since infancy (or sign communication with limited language models since infancy). Filling the gaps of vocabulary and phonological awareness is necessary for students to keep up with class expectations for developing surface learning. Access to classroom discussion and for all group activities is a prerequisite for deep learning to occur. Providing the appropriate access technology is a necessity to facilitate deeper learning to occur within the classroom. Selecting appropriate group partners and honing communication repair skills is also critical to students with hearing loss achieving at the same rate and to the same level as peers.

References:

1. Fisher, Frey, Hattie (2016) Visible Learning for Literacy Grades K-12: Implementing the Practices that Work Best to Accelerate Student Learning. Corwin/SAGE, Thousand Oaks, California

2. Yoshinaga-Itano (2010). The longitudinal language learning of infants and children with hearing loss. ASHA Virtual EHDI Conference, October.

3. Meyer, Kym (8/17/2017). Wait – There’s a Student with Hearing Loss Coming into My Class? Webinar viewable at https://www.youtube.com/watch?v=r3ytOawiYuI&feature=youtu.be

4. Duncan (2001). Conversational skills of children with hearing loss and children with normal hearing in an integrated setting. The Volta Review, 101(4), 193-211.

5. Caissie (2002). Conversational topic shifting and its effect on communication breakdowns for individuals with hearing loss. The Volta Review, 102(2), 45-56

2017 © Karen L. Anderson, PhD, Late November Update, Supporting Success for Children with Hearing Loss http://successforkidswithhearingloss.com This information is not intended as legal advice.

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Equal Opportunity to Participate – It’s the Law!

Quick excerpts of a few of the American’s with Disabilities FAQs related to participation.

• Public school students with disabilities are covered by Section 504 regardless of their eligibility for special education and related services under the IDEA.
• Section 504 regulations require, among other things, that public school students with disabilities have an equal opportunity to participate in school and that they receive FAPE consisting of regular or special education and related aids and services designed to meet their individual educational needs as adequately as the needs of nondisabled students are met.¹³  
• In general, auxiliary aids and services make aurally or visually delivered information available to students with hearing, vision, or speech disabilities so that they can receive information from, and convey information to, others as effectively as students without disabilities.
• Interpreters must be qualified.²⁴  This means that the interpreter must be able to interpret both receptively (having the skill needed to understand what the person with a disability is saying) and expressively (having the skill needed to convey information to the person with a disability).  For example, an interpreter must be able to sign to the person who is deaf what is being said by the hearing person, and voice to the hearing person what is being signed by the person who is deaf.  This communication must be conveyed effectively, accurately, and impartially, using any appropriate specialized vocabulary.²⁵  Thus, a teacher or other staff member who signs “pretty well” is not a qualified interpreter.
• For a deaf or hard of hearing student, a sign language interpreter or CART may be appropriate where student comments and discussions are part of the class experience for all students, i.e., to enable the student to understand comments and discussions from classmates that all students are exposed to, in addition to what is being said by the teacher, and to enable the student to express himself or herself in a manner that permits the teacher and classmates to fully understand and respond to the student.
• Once the student has indicated a need for an auxiliary aid or service or requested a particular auxiliary aid or service, the public school district must provide it or an effective alternative as soon as possible. This requirement is separate from the provision of special education and related services under the IDEA.  For example, where the student or his or her parent(s) requests auxiliary aids and services for the student under Title II, the appropriate aids and services must be provided as soon as possible, even if the IDEA’s evaluation and IEP processes are still pending.

Lecturer Dr. Carol Flexer emphasizes how hearing loss is about the brain, not the ears. Hearing devices are needed to activate the brain and to access spoken communication for learning. For children who are hard of hearing, we need to get them through the ‘doorway’ of hearing loss, so information will get to the brain. Any ‘doorway obstruction’ interferes with auditory information reaching the brain. All hearing devices are designed to break through the doorway to get information to the brain.

Being closer to the person talking will help the listener with hearing loss to hear more loudly and clearly. Hearing aids amplify all sound and make it seem louder and clearer at ear level for persons with hearing loss, but never ‘corrects’ hearing to a normal hearing level. They are designed to work best in picking up speech within 3’ to 6’ and amplifying it to an optimal level for hearing speech. Therefore, students with hearing loss have smaller ‘listening bubbles’ or shorter listening ranges than their typically hearing peers.

If a student with hearing aids has two dead batteries, then there is a substantial ‘doorway’ obstruction to him being able to perceive speech clearly enough to understand.  Imagine a child attending class each day, but instead of sitting within the classroom, the student is required to stand outside the room and look in. Is it fair to expect him to learn at the rate of class peers when he does not have the same access to instruction? Because students seem to ‘hear’ the teacher, the impact of the hearing loss significantly reducing comprehension of what is said is very often misunderstood and minimized.

Hearing aids and FM/DM systems do not restore normal hearing, but they DO provide much improved access to verbal communication that would otherwise be auditorilly impossible to the child with hearing loss. The Americans with Disabilities Act² 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 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, to participate in and enjoy the benefits of the district’s services, programs, and activities.

It is a cruel reality that 50% of children’s hearing aids malfunction on any given day¹. In the US, IDEA specifies³ for children with IEPs, schools must ensure that the hearing devices worn by students with hearing loss are functioning. This requirement underscores the value of working hearing devices and their necessity if a student with hearing loss is to receive a free and appropriate public education, while the ADA focuses on the discriminatory nature of denying full access to classroom communication.  With an effective hearing aid monitoring program in place hearing aid malfunction rates can drop to less than 1%¹.

IDEA Sec. 300.113. (a) Each public agency must ensure that hearing aids worn in school by children with hearing impairments, including deafness, are functioning properly. (b) (1) Each public agency must ensure that the external components of surgically implanted medical devices are functioning properly.³

Although the law provides no specifics on who, how or how often hearing device monitoring will occur, there is clear intent that the school bears the responsibility to ensure that this monitoring occurs. This need for monitoring and data gathering was reinforced by the outcome of a 2015 court case⁴ that ruled that a school violated the IDEA record keeping clause (34 CFR 76.731 ) by not keeping a daily log of whether or not the student was provided daily access to the FM/DM system required by the IEP, and if the student used the FM/DM system each day.

In order to verify that the hearing device monitoring activity has occurred, the school needs to have a record of data that provides evidence of hearing device monitoring, including the daily presence and use of the FM/DM system if this communication access accommodation is included on the IEP.   

Checklist for Monitoring Responsibilities. Do You/Does Your School District:

1. Include teaching hearing aid independence skills to students as a goal on the IEP or as part of ADA accommodations on the 504 Plan. Hearing devices can malfunction at any time. ONLY the student – with training –  is able to immediately identify when a problem arises, and is in the best position to troubleshoot the device and/or request assistance.⁵   See SEAM skill hierarchy.

2. Have administration knowledge and support of the legal requirement to perform regular monitoring and necessary data collection. Without clear support from the principal, classroom teachers often view hearing aid monitoring as a ‘good thing to do if they have time’ rather than a required activity.

3. Require that a teacher of the deaf/hard of hearing or educational audiologist meet with classroom teachers and provide instruction in how to monitor hearing device function, including involving the student in monitoring, and delineate expectations for necessary data gathering.

4. Provide clear expectations for data collection processes/forms to be used, how often data needs to be collected (i.e., daily), where it needs to be kept, and who is ultimately responsible for ensuring that monitoring and data collection occurs.

What about students who don’t use their hearing devices?

While it may seem funny to turn to a child not wearing their hearing aids and say, “Your brain is in your pocket! Oh no!” it is true that about 25% of students do not (consistently) use their hearing aids⁶. Rejection of hearing aids can be due to lack of support from home. If the family is not supportive of the child using hearing aids, the student may feel as though they are being disloyal to what parents want by wearing their hearing aids at school. If the family does not want amplification to be used, it should not be included on the IEP and there needs to be a clear understanding of reduced academic achievement expectations and risk for social issues. Children can often reject their hearing aids when malfunction issues frequently occur as they learn they cannot rely on hearing better via the technology. Instruction in hearing aid use, monitoring, and troubleshooting is necessary for equal access to education. Finally, as students enter 3^rd grade and beyond, having no preparation for resilience to teasing by peers too often results in students rejecting amplification secondary to social rejection concerns, even if they know that the amplification is important for learning. Most students with hearing loss are in their neighborhood school with no other peers who use hearing devices. Developing an identity as a person with hearing loss is not possible without feeling a part of a group of okay kids who happen to have hearing loss and use hearing devices. The direct involvement of a teacher of the deaf/hard of hearing to instruct students in self-advocacy skills and connect them to similar peers is needed if rejection of hearing devices due to social reasons is to be minimized. Refer here for more information on this intervention.

References

1. Langan, L. & Blair, J.C. (2000). “Can You Hear Me?” A Longitudinal Study of Hearing Aid Monitoring in the Classroom. Journal of Educational Audiology (5), 34-36.

2. Summary of ADA information related to students with hearing loss.

3. IDEA Sec. 300.113. (a) Supporting hearing aid monitoring (b) (1) Supporting cochlear implant processor monitoring.

4. Detroit City School District., 115LRP 31115 (SEA MI 06/12/15). Written summary of court case findings.

5. Instructional materials for 43 separate goals for hearing device independence can be found in Building Skills for Independence in the Mainstream.

6. 2017 Supporting Success for Children with Hearing Loss Survey: Children Rejecting Hearing Devices: Who, Why, When? Findings for 88 respondents representing a combined caseload of 1863 students.

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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).

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.

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.

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.

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.

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.

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Special 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 all students are educated in the mainstream classroom, regardless of the diversity of their needs.

Students who are deaf and hard of hearing (DHH) 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. Background noise and distance have exaggerated effects on the student with hearing loss as compared to typically hearing peers. Students who are DHH-only have learning gaps and unique needs secondary to access to communication issues, not learning disorders.

Basics of inclusion:

Inclusion in education is an approach to educating students with special educational needs. Inclusion rejects the use of special schools or classrooms to separate students with disabilities from students without disabilities (source). Some inclusive classes use a collaborative team teaching (or co-teaching) model with a special education teacher in the room all day. Other inclusive classes have special education teachers ‘push in’ at specific times during the day. Both teachers are available to help all students. Studies show that inclusion is beneficial for all students – not just those who receive special education services.

Summary of the legal framework supporting appropriate 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.

Refer to the end of this article for more specifics and sources of this legal framework.

Changing face of deaf education:

Our students: While the majority of students with hearing loss (DHH-only) appear to have academic skills at the same level, or within 6 months, of age peers, we do continue to have a group that have significant delays. Although almost all students with congenital hearing loss are identified shortly after birth, we still have about 35% of parents who are unresponsive (source), choosing to not receive early childhood services, having no access to effective EI services, or not attaining consistent amplification use and/or effective use of visual communication. When performed, these actions together minimize the predictable delays observed at school entry. Students with hearing loss are not a heterogeneous population and, while their needs may appear similar to other special needs groups, they have unique needs that set them apart, such as the need to develop auditory skills, sign language expertise, awareness in how their hearing loss impacts them, skills in use/troubleshooting hearing devices, and eventually become competent in self-advocacy skills if they are to become full participants in the classroom. These skills are not extensions of the general education curriculum but are necessary for the student to access/perform in general education at the level of peers.

Changing district policies:
In the US, we are in a very challenging period for deaf education as many schools have moved toward the inclusion model, which (strongly) discourages any pull-out services by special educators. For students with hearing loss, this move to inclusion is being applied to all students, whether skills are commensurate with classmates or multiple years of delay are present. The inclusion model then means that these itinerant teachers ‘push-in’ to regular classes to try to address IEP goals rather than pulling students out for specific teaching, or only provide consultative services to school staff.

Detriments/specific issues for children with hearing loss in inclusive settings:

• Intrinsic challenges of performing with a hearing loss in a classroom: A 2014 extensive literature review (source) examined how children who are deaf or hard of hearing interact with hearing peers in inclusive settings. Children who are DHH have many barriers to communicating, initiating and/or entering into social groups, and maintaining interactions with hearing peers, even though today they are more likely to be identified in early life and fitted with advanced sensory aids from a very young age. Fewer communication interactions occur between children who are DHH and their hearing peers, even when a child has a cochlear implant. Children who are DHH can often understand their peers when in a quiet environment but have difficulty expressing complicated linguistic content. The success rate of children with DHH when initiating communication and maintaining social interactions are much lower as compared to hearing peers, complicated by vocabulary, social interaction, and acoustic challenges. They have been found to be more often rejected or ignored by their hearing peers, who are also impatient when asked to repeat themselves. In summary, children who are DHH face great difficulties in communicating, initiating/entering, and maintaining interactions with hearing peers in inclusive settings.

• Lack of meeting DHH unique needs: The inclusion model prevents all the necessary skills from being taught as these skills are designed to improve functional performance and are not an extension of academic skills. Said another way, skills necessary for the student with hearing loss to be able to appropriately access and benefit from the general education environment can only be taught outside of the mainstream classroom. Specifically, it is not possible to teach many auditory development skills because of the noise present in the typical classroom. Developing an awareness of the impact of hearing loss on listening, learning and socialization and hearing device management are specific to our students and teaching does not fit into a small group instructional model as the students are typically the only ones with hearing loss in their schools. These are just two examples of unique needs that are highly unlikely to be met in an inclusive special education model. As an analogy, how could a low vision student be taught orientation and mobility skills within an inclusion classroom? It should not be surprising that the environmental and direct teaching requirements to meet the unique needs of students with limited or no hearing would also be incompatible within the inclusion classroom. In addition, it can be presumed that the typical fragmented auditory perception plus gaps in vocabulary cause students with hearing loss results in a more limited comprehension of surface learning information when the class moves to activities to promote deeper understanding, such as problem-based or small group learning. If a student lacks sufficient surface knowledge, moving to these activities prematurely is ineffective to, and may delay, the overall learning process¹.

• Itinerant DHH model applied to the inclusion model to meet student needs: The move to provide specialized instruction at a student’s neighborhood school has necessitated the growth of the itinerant DHH teacher service model, in which itinerant teachers of the deaf/hard of hearing go to an average of 10 schools per week, and serve an average of 15-25 students². The number of DHH teachers available in many districts is often insufficient to allow them to provide the intensity of pull-out services required for students with hearing loss to (a) make up language delays missed by lack of access, (b) maintain progress at the expected rate due to decreased access to classroom communication on a daily basis, and (c) teach specifically to develop auditory or sign language skills, build self-advocacy skills, and address other skills unique to the student with hearing loss. The inclusion model presumes that supports will be provided within the classroom. In the inclusion model, the itinerant DHH teacher will be unable to spend all day or very unlikely to spend a portion of every school day in one student’s classroom.

• Lack of sufficient intensity to meet unique needs: While language delays, auditory or sign language development, building self-advocacy skills, and other skills unique to the student with hearing loss could be efficiently taught in a pull-out model of sufficient intensity, having to provide this teaching as push-in services severely decreases the time available to specifically teach the needed skills. If a student with hearing loss is 6 months behind age peers, an itinerant DHH teacher cannot maintain a year’s growth and make up the existing delay with only twice a week 30 minute 1:1 teaching sessions. If this same itinerant DHH teacher is now expected to both close the student’s 6-month delay and support keeping pace with classroom learning, it is not possible to do so in a push-in model that allows only small group or team-teaching, which rarely can be directly focused on meeting the needs of the single student with hearing loss. Some students are 1-2+ years delayed due to late identification or lack of communication access (auditory or sign) prior to school entry who are also being placed in inclusive classrooms with the unrealistic assumption that their unique needs will be able to be met through this model. The benefits of inclusion do not replace nor supercede the need for appropriate intensity to appropriately meet the unique needs of the student with hearing loss.

• Lack of peers with hearing loss: Many of our students are the only one in their school with hearing devices, have no role models, and rarely or never see another DHH student. Across all educational models (center-based, specialize resource, local groupings, one-and-only), approximately 25% of students reject their hearing devices³. Those who are ‘one-and-onlies’ are 5 times more likely to reject hearing devices as compared to students who spend time daily or weekly with a cohort of DHH peers. In many school districts it is a rarity for more than 10% of secondary students who are ‘one-and-onlies’ to consistently use FM/DM systems or even their personal hearing aids. Not using amplification severely decreases access to instruction and results in either the student working immensely harder to keep up, the student performing much more poorly, or both. This high rejection rate can be interpreted as a strong sign that the unique social-emotional needs of these students are not being met. These students require connections with other students who sign or use amplification devices to be able to develop a healthy identity as a person with a hearing loss and as a strategy for exchanging self-advocacy strategies. Teaching to achieve understanding of the impacts of hearing loss, self-advocacy skills to support full participation, and addressing significant social-emotional needs are not unimportant nor perfunctory if the expectation is meet the unique needs of students who are deaf/hard of hearing and prepare them for further education or employment. Due to the move away from center-based programs, addressing the social-emotional needs of students has often been a significant challenge for the itinerant DHH teacher providing 1:1 services. The ability to do so within the inclusion model is remotely possible, or more likely, impossible to achieve.

Benefits of the inclusion model for students with hearing loss

The 5 benefits specified in italics below were taken from this source. Comments have been added to each to relate these benefits to the unique needs of students with hearing loss.

Benefit #1: Differentiated Instruction

All students learn differently. This is a principal of inclusive education. One key teaching strategy is to break students into small groups. By using small groups, teaching can be tailored to the way each student learns best. This is known as differentiated instruction. Teachers meet everyone’s needs by presenting lessons in different ways and using Universal Design for Learning (UDL). For example, they may use multisensory instruction. In math, that may mean using visual aids and manipulatives like cubes or colored chips to help kids learn new concepts. (See more examples of multisensory math techniques.)

Differentiated instruction and UDL are very positive aspects of inclusive education. Many students with hearing loss benefit with attention to learning syntax, morphology, vocabulary, reading comprehension, etcetera, which would be amenable to differentiated instruction and small group learning. Since students with hearing loss are so low incidence, they would likely be grouped with students who are learning disabled or who have language disorders. Teaching to disorders is not necessarily the same as closing gaps due to delays, especially when the gaps can be very spotty (“Swiss cheese language”). A DHH student’s reason for not understanding is likely to be related to fragmented hearing, which would benefit from acoustic highlighting, stating information in different ways, or support via sign language, which would likely not occur in teaching a group of students. The quality of a sign language interpreter directly impacts the level of comprehension of the student who is DHH and a visual or visual plus auditory communicator. Many school districts do not hire fully qualified sign language interpreters which inadvertently undermines the outcomes of many students who are deaf (source). Teaching to the vocabulary development needs of students who are hard of hearing or deaf is not likely to be sufficient in a small group learning situation within the inclusive environment.

Benefit #2: Supportive Teaching Strategies

In an inclusive classroom, teachers weave in specially designed instruction and support that can help students make progress. Kids may be given opportunities to move around or use fidgets. And teachers often put positive behavioral interventions and supports (PBIS) in place. These strategies are helpful for all students—not only for students with learning and attention issues.

Teaching strategies that support quieter classrooms during communication would be excellent for the student with hearing loss. The fact that inclusive classrooms tends to group students to work together more often than traditional classrooms will result in an overall noisier environment. While some supportive teaching strategies may indeed be good for the student with hearing loss, it can be assumed that some will be detrimental as well. Per Title II of the American’s with Disabilities Act, the consistent use of necessary accommodations must always be kept in mind (source). Teacher accommodations during lecture are often consistently implemented. As about 1/3 of the school day is devoted to group learning activities (source), use of accommodations to reduce noise can be very problematic to consistently implement. Although there have been some technological advances, it continues to be difficult to achieve consistent and effective use of the FM/DM system in small group discussions due to the communication dynamics of active discussion.

Benefit #3: Reduced Stigma

Inclusive classrooms are filled with diverse learners. That lets kids talk about how everyone learns in their own way. They may find that they have more in common with other kids than they thought. This can go a long way in reducing stigma for kids with learning and attention issues. It can also help kids build and maintain friendships.

Diversity in the classroom is a plus for any student with ‘differences.’ Students will naturally come to see themselves as belonging to one or more groups within the classroom setting. Most classrooms will have students who have LD, ESOL, attention issues, etc. Since it is unlikely that there is another student with hearing loss in class, the result is that these students will emotionally and/or intellectually strive to join a group where they find acceptance. Therefore, the urge to reject hearing aids and ‘become LD’ or ‘become one of the kids who don’t comply’ may be even stronger in an inclusive setting than in more traditional educational models. Due to the hearing loss, the social communication issues (especially in noise) will continue to set them apart, even among their ‘chosen’ groups, which will continue to be a basis for teasing or bullying. Without the opportunity to leave the class to meet with someone knowledgeable in DHH who can help them work through identity and emotional issues related to hearing loss, the student who is deaf or hard of hearing may feel even more isolated and unsuccessful socially in an inclusive class than they would in a pull-out model of support.

Benefit #4: Effective Use of Resources

In more traditional special education settings, many kids are “pulled out” for related services, like speech therapy or for other specialized instruction. An inclusion class often brings speech therapists, reading specialists and other service providers into the classroom. These professionals can provide information and suggestions to help all students.

Increased focus on basic communication skills, vocabulary, syntax, morphology, improving comprehension – all are issues where inclusive settings would be of benefit. The itinerant DHH teacher going in to the mainstream may be able to work with a small group that includes the student with hearing loss on these issues. It is unlikely that the itinerant DHH teacher will be able to address the needs that are truly unique to students with hearing loss. DHH teachers are increasingly challenged by school administration with “What do you that is different than the SLP or LD teacher?” In the inclusive model in general, strategies specific to teach reading to DHH are not appropriate to use in a group, or self-advocacy skills that feature focusing on what was heard so the student can appropriately request clarification of information missed, or other needs unique to students with hearing loss are NOT appropriate to teach to a group of students who all do not have hearing loss. If the only skills that are applicable to teach in inclusive settings are the communication and academic supports that can also be provided by SLPs and LD teachers, then the value of having a highly trained teacher specifically for students with hearing loss is likely to be dismissed as unnecessary. With this in mind, it is projected that the greater the implementation of fully inclusive settings, the less valued and effective will be the teacher of the deaf/hard of hearing AND the students’ unique needs specific to hearing loss will go unmet, with increasing numbers of students performing more poorly academically, socially, emotionally, and/or behaviorally over time. Inclusion is beneficial to students with hearing loss, but only to the degree that the student is able to learn effectively and the appropriate level of support is provided.

 Benefit #5: High Expectations for All

Individualized Education Program (IEP) goals should be based on the academic standards for your state. Those standards lay out what all students are expected to learn in math, reading, science and other subjects by the end of the school year. Differentiated instruction and co-teaching in a general education classroom make it easier for students with standards-based IEPs to be taught the same material as their classmates. In some schools, only certain classrooms are inclusion classes. In that case, schools may assign general education students randomly to inclusive or non-inclusive classes. Other schools may choose students who benefit from the emphasis on meeting the needs of all learners at all ability levels.

Common core standards based IEPs strongly support development of skills that result in full participation in the classroom, and therefore have a positive influence on the education of students with hearing loss. Unlike students with hearing however, the unique needs that must be met for students with hearing loss to become full participants in the classroom are beyond that of their classmates, and distinctly different than other special education populations. Achieving goals to address the unique performance needs secondary to hearing loss largely requires pull-out services into environments supportive for learning these listening, social, and self-advocacy goal areas.

Summary
The inclusion model of special education has been adopted by many school districts throughout the US. The positives of having a diverse learning community, implementing differentiated learning, varied teaching strategies, and universal design for learning principles are all beneficial aspects of the inclusion model. Many students – both regular education and special education students – thrive in inclusion classrooms. The participation of all children is a purpose of inclusive practice and classroom activities. However, it cannot be assumed that social communication and interaction between children who are D/HH and hearing peers will occur naturally. It is essential that opportunities for all children to interact with each other must be appropriately designed, supported, and developed in inclusive educational practice.

Specialized services, by law, are tailored to meet the student’s individual needs. In the case of DHH-only students, an appropriate inclusion/support network is needed to provide the support(s) for them to be able to make progress commensurate with their cognitive peers. Meeting all the unique needs of students with hearing loss within the inclusive classroom environment is at best unrealistic, if not highly unlikely. The student with hearing loss does not know what he does not hear because he did not hear it. Specific teaching needs to occur if the student is to be able to successfully identify and request appropriate support when faced with road blocks. If the statement “He hears just fine” continues to be made by school staff, we can assume that the unique access and learning needs of students with hearing loss are not being adequately or appropriately met within the inclusion environment.

As a continuum of services and supports are required by IDEA to allow individual needs to be met, the fully inclusive model cannot be put forth as the only model of special education support provided by a school district. Gone are the days when most student with hearing loss were educated primarily in a center-based DHH-specific program. Despite the move away from this intensive model, students with hearing loss do continue to require some pull-out services by persons specialized in the unique educational needs of students who are deaf and hard of hearing so that they can learn necessary skills to allow them equal access to, and the ability to fully participate in, the general education setting. Hearing loss is not a learning disorder. Hearing loss is a communication access issue that is predictive of listening, interaction, and learning challenges. The inclusion environment is GOOD for students with hearing loss, as long as they are receiving the specialized support they require to keep pace in the classroom AND their access and learning needs are fully supported during ALL classroom activities.

Karen L. Anderson, PhD, Director, Supporting Success for Children with Hearing Loss, Early October Bimonthly Update, 2017. http://successforkidswithhearingloss.com This information is not intended as legal advice.

References:

1. D., Frey. N., & Hattie, J. (2010). Visible Learning for Literacy: Implementing the Practices that Work Best to Accelerate Student Learning. PP 36-44.

2. Survey results: Role/Duties of an Itinerant Teacher of the Deaf/Hard of Hearing. Conducted by Supporting Success for Children with Hearing Loss, April – May 2017 (267 respondents).

3. Survey results: Children Rejecting Hearing Devices: Who, Why, When? Conducted by Supporting Success for Children with Hearing Loss, August 2016 – April 2017 (88 respondents representing a total caseload of 1863 students with hearing loss).

There is no more effective way to estimate a student’s level of auditory access in the classroom! This functional assessment is easy to perform and can take only 15 minutes. Find the size of your student’s listening bubble and compare speech perception accuracy at 3 feet in quiet/noise to 10-15 feet in quiet/noise. Examine the results to identify phonemes that are commonly missed or misunderstood.

This 1:15 minute webcast is only $24.00. Purchase the digital FLE audio files and pdfs for only an additional $13.00 ($37.00 for webcast and the digital FLE). Load it onto your SmartPhone, computer, or DropBox/GoogleDocs. Purchased separately, the FLE on CD is $20.00. Pricing also available for licensing use for your whole district.

2-minute video – very brief demonstration of using the Recorded FLE Using Sentences or on YouTube.

IDEA FROM THE FIELD: I have used the Recorded FLE Using Sentences with a number of our HH kids and they seem to have real speech perception challenges.  I tried the FLE with my 7 year old grandson, whose hearing is fine, and he got almost all the items right. The couple that he missed were corrected by his 4 year old brother who told him what the sentence actually was! I notice that my two CI kids, whose CI team feel they are hearing at 20 dB or better, tend to omit is, past tense markers and present progressives as they repeat the sentences. They tend to get the key words correct but due to missing so much they really don’t understand what is presented. Even when I question them they can’t explain what the idea of a sentence was with clarity. The Recorded FLE has really helped to identify issues beyond simple audibility.          Teacher of the Deaf/Hard of Hearing

IDEA FROM THE FIELD:  It is important to note not only the errors the student makes in repeating the sentences, but HOW the student repeats. For example, I had to pause several times throughout the testing to remind one student to repeat any words of the sentences she heard even if she didn’t catch the whole sentence. That wasn’t easy for her to do…it was either repeating the whole sentence or nothing…she was usually able to repeat 2 of the 5 words of a sentence when I paused to ask if there were any of the words she heard.  Another observation of the HOW was that most of the responses she gave at the far distances were as if she was repeating it as a question (e.g., The fruit came in a box???). The few that she clearly repeated as a statement showed her confidence that she was sure of what she heard.  I think these observations are also very important to share when we discuss results of the FLE with the school team. There was much more of a lack of confidence at the far distance.  Plus, it demonstrates the added effort a student has to make to listen.     Teacher of the Deaf/Hard of Hearing

In a November 2014 policy guidance, it was clarified that under Title II of the ADA, schools are required to 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, thereby affording an equal opportunity to obtain the same result to gain the same benefit as that provided to others and to participate in and enjoy the benefits of the district’s services, programs, and activities.

While this was a bold step reinforcing the requirement for equal access for students with hearing loss, there was no recommended means included for schools to assess the level of student access, or communication effectiveness, as compared to class peers.

In July, Supporting Success for Children with Hearing Loss released White Paper: Estimating the Level of Communication Effectiveness/Access, which is the result of almost a year-long iterative process with contributions by a variety of deaf education practitioners

White Paper: Estimating the Level of Communication Effectiveness/Access

The purpose of this White Paper was to provide recommendations to school personnel on how the level of communication effectiveness in comparison to class peers can be identified, as required per ADA, as it has been specified that student academic grades cannot be used as a measure of access.

To determine the level of communication effectiveness, appropriate assessment must occur. The teacher of the deaf/hard of hearing is typically the most qualified to be at the forefront of this assessment process. Students with hearing loss who are primarily auditory learners and those who are primarily visual learners require assessment. These assessment procedures differ. Finally, students with expressive language concerns, like Deaf visual learners, must also be assessed to ensure that their opportunity to fully participate in the classroom is equal to their class peers.

A primary goal of the White Paper was to provide practical recommendations for assessment that could be implemented by teachers of the deaf/hard of hearing, educational audiologists, and/or speech language pathologists who have specialty training and experience in working with children who are deaf/hard of hearing. It is hoped that this White Paper will become the center of discussion, inspiration, and information by individual teachers of the deaf/hard of hearing and DHH Teams across the US. Broad sharing of this document is encouraged.

How can the White Paper help YOU?

Many school administrators are still unaware of the requirements of the ADA regarding students with hearing loss. The White Paper provides you with a compact, authoritative summary of the requirements of ADA and recommendations for how these requirements can be satisfied. Keep a copy of the White Paper on your media device or in your ‘meetings folder’ so that you can easily refer to it if you are questioned about the necessity to assess the level of communication effectiveness, not just identify adverse educational affect for special education eligibility.

This document was shared with the following in July, 2017. You are encouraged to share the White Paper with your school administration and other parties who may be interested.

• Office of Civil Rights
• National Association of State Directors of Special Education
• American Speech and Hearing Association
• AG Bell
• National Association of the Deaf
• American Sign Language Teachers Association
• OPTION Schools
• American Society for Deaf Children
• Conference of Educational Administrators of Schools and Programs for the Deaf
• Association of College Educators – Deaf/Hard of Hearing
• Council for Exceptional Children – Division for Communicative Disabilities and Deafness

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.

For most classroom communication students who are hard of hearing must work harder to listen, thus having fewer resources needed to process what was said so that it can be comprehended and remembered.

Our students who are Deaf and communicate visually will only perceive what is provided via their interpreter and/or captioning, which in combination with language ability may or may not result in complete understanding.

How well a student is able to perceive speech in a classroom will impact educational performance. This Update will review how reduced speech perception is likely to impact learning. These impacts are often overlooked or misunderstood by school staff as they review whether it is necessary to evaluate a student with hearing loss to determine eligibility for specialized supports and services. Hopefully, the information mentioned below will provide the hearing loss professional with the information needed to make the case that this access issue indeed has educational ramifications.

Hard of Hearing Students – comprehension from bits and pieces

Audibility refers to how much sound, especially how much of the speech signal, can be heard. How well language can be used to ‘fill in the blanks’, level of interest and motivation to understand, and level of fatigue from extended listening all contribute to how well a student comprehends what was said.

Audibility

The Speech Audibility Audiogram for Classroom Listening, on the Speech Perception page of the website, shows the difference in audibility for ‘Teacher Speech’ versus ‘Soft Speech.’  Examples of soft speech include comments from peers spoken 6 or more feet away (class discussion) and many of the comments during social situations in school. Group learning when competing conversations are occurring also reduces audibility very significantly. A student with hearing levels in the 25-30 dB range will experience 81% audibility of the teacher’s voice and only 25% audibility of soft speech. This hearing level is not uncommon for children wearing hearing aids. The new Teacher Inservice Combo contains specific handouts describing the impact of hearing loss in speech perception, even when students are using hearing aids. Obviously, hearing aids are not enough to allow these students to fully access class communication, especially class discussions, unless an FM/DM is used and the pass around microphone is used.

Specific Speech Sounds

Decreased audibility looks different from child to child based on their hearing loss and how well their hearing aids are fit. The Speech Perception – Formant Representations for Vowels and Consonants is revealing about the challenges a child with a hearing loss that has ‘peaks and valleys’ that cause islands of hearing. In general, higher pitched consonant sounds (s, f, th, p, k, t, etc.) and brief words and endings are most easily missed, unless speech is presented within 3 feet.

Prereading

A child needs to listen for about 20,000 hours before the brain has developed a clear idea (mental referent) of what each of the discrete speech phonemes sounds like. This requires precision hearing and is a necessary step before children can develop a consistent understanding of sound/letter relationships. It is not a surprise that many students who are deaf or hard of hearing fall behind in their phonological awareness skills. Without these skills students work harder to ‘sound out’ words as they read, which interferes with comprehension. Poor reading fluency will cause even the smartest students to read more slowly and work harder than peers. Students with hearing loss need to have an in depth assessment of their phonological awareness skills.

Reading Comprehension

A recent study* explored reasons why so many students with hearing loss seem to plateau in their reading achievement at the 4th grade level. They found that (1) morphologic awareness was a prerequisite to high reading test scores, (2) speech intelligibility was not correlated with language proficiency (i.e., even if a student has ‘good speech’ this does not predict good language), and (3) language proficiency (measured by the CELF-4) predicted reading achievement. Thus, speech perception has an impact on student’s hearing and learning how to interpret morphological information, such as learning the meanings such as cosmo-, mal-, bio-.

*Nielsen, D. C, Luetke, B., McLean, M., & Stryker, D. (2016). The English-language and reading achievement of a cohort of deaf students speaking and signing Standard English: A preliminary study. American Annals of the Deaf, 161(3), 342-368.

So many of our student cannot hear the insalient parts of speech (cannot perceive the high frequencies and/or the quiet parts of speech) – EVERY TEACHER needs to have easy to use syntax-building materials! Cracking the Grammar Code is a perfect fit for your needs whether you are an itinerant, or provide center-based, resource room, or push-in services. Keep the CGC materials on your media device to present the items to your students or copy the pages you need as you go.

Within the 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 diagnosis specific skills in the broader category.

When you are ready to dive into the full curriculum, there are four comprehensive downloadable books for purchase. The books provide a year’s-worth of teaching materials at your fingertips! Each book contains assessment and teaching materials. The books are available as a complete package as well as separately. Books can be taught in any order depending on the students’ skill levels; however, for a complete year’s-worth of lessons, present the books in the following order:
(1) Nouns, Articles & Conjunctions (173 pages for $27) and its companion Vocabulary Enhancement – Simple Picture Glossary (128 pages)  – Printed Version ($28) –  Digital Version ($20)
(2) Verbs (143 pages for $18)
(3) Pronouns, Adjectives, Adverbs, & Prepositional Phrases (94 pages for $13), and
(4) Finding the Subject & Subject-Verb Agreement (141 pages for $14).
Each book contains individual subject pretests and teaches concepts in incremental steps.

All 4 Books (Nouns, Verbs, Pronouns, Finding the Subject)
Digital downloads for individuals only $62.00
Digital downloads for groups of up to 8 users only $248.00   

All 4 Books (Nouns, Verbs, Pronouns, Finding the Subject) + Vocabulary Enhancement Glossary
Digital downloads for individuals only $79.00
Digital downloads for groups of up to 8 users only $315.00  

Digital downloads of all 4 books + 1 Printed Vocabulary Enhancement Glossary $86  individuals only (no group  pricing)

What’s New? Technology Advancements for Interact-AS

Increasingly, students who are hard of hearing are requesting captioning as an accommodation in secondary school. Interact-AS is a computer program that provides realtime captioning on a media device on the student’s desk. Only the speech that is picked up from a microphone is captioned. Interact-AS now has microphone options to assist in providing access during discussion group situations.
Register for our first Interact-AS webinar on Sept 20^th at 1:30 CT.  

Download a PDF of the following information Here

A Few of the New Features for Interact-AS™

Supporting Success is proud to be the sole source to offer Interact-AS captioning technology to schools!
The new products described below will soon be added to those offered by Supporting Success.

Welcome to the new school year. We’ve got some good news for you. Two of the requests that we received from teachers during the 2016-2017 school year was a way to better support team teaching situations and also student discussion groups. Plus, there were several other suggestions we received. Thanks for forwarding those ideas to us. By partnering together we can help ensure every student has equal access to classroom discussions. Here is a quick summary of how over the summer we took your suggestions and came up with solutions.

Voice Training is No Longer Needed: With Interact-AS™ Version 6 you no longer need to train voice profiles. You still can train a voice profile, and it is recommended that each teacher do this, but training is no longer required. Having the ability to recognize speech without having pre-trained voice profiles means students can now pass a microphone around their group and whatever they are saying will be captioned. Also, a substitute teacher no longer needs to train a voice profile. Instead you can just create a User Account called “Substitute Teacher” and use the default “English Speech” option. Also, training a voice profile is now much faster. Instead of taking about 8 minutes to do this, with Version 6 it only takes about a minute. That was step one in our summer efforts. Next, we worked on microphones…

Team Teaching: To support team teaching situations Auditory Sciences is now offering a new dual-channel wireless receiver. This new Dual Receiver includes a second audio channel, so now two wireless microphones can be simultaneously connected to the student’s computer. You still need to take turns speaking, but two teachers can now easily be part of the same captioned conversation. There’s no longer a need to switch user profiles, or hand over a microphone, or to turn off and on a transmitter. Just turn on your microphone and it automatically connects to the student’s computer. The new Dual Receiver includes a built-in audio output jack. This makes it easier to connect an earbud, headset, hearing aid or CI to the wireless microphone. All you do is plug the device into the receiver, that’s it. Plus, this new receiver includes a built-in digitizer, meaning you no longer need a USB adapter to connect the receiver to the computer. Fewer parts, not as many connections, and more functionality, all built in to a receiver that can still fit in a student’s pocket.

New Handheld Wireless Microphone: The previous handheld wireless microphone was designed for use in adult conference rooms — the setup time was way too long for classroom use. That issue is now solved. The new handheld wireless microphone automatically connects to the new Dual Receiver.

Mix and Match Components: With the new Dual Receiver and handheld and wireless transmitters you can mix and match components to meet your needs. You can use two wireless headsets (e.g., for two teachers); or one wireless headset and one wireless handheld (e.g., for a teacher and a group of students); or two wireless handhelds (e.g., for a large auditorium assembly). Plus, there are more options…

1:1 Teaching or Meetings: In addition to the new wireless components, we also developed a new Y-Cable (part Z.DUAL.CAB) that allows multiple microphones to be connected via cables to a student’s computer. This is an extremely low-cost team-teaching solution ($14.95). It’s a cabled versus wireless option, so this is not a solution designed for use in a classroom, but it works great for 1:1 meetings with the student, or during an IEP where multiple people may be speaking.

More Team Teaching Options: So, what about situations where you have dozens of people speaking? We’ve got an answer for that as well. We’ve added a new feature to Interact-AS that is called Streamer™. With Streamer™ you can connect as many people as you want to a student’s computer. Literally, you can have hundreds of people speaking, even speaking at the exact same time, and whatever they say is labeled with the speaker’s name, captioned, and displayed on the student’s computer. The way this works is that each person that is speaking needs to have a copy of Interact-AS running on their computer (such as the teacher’s computer). Whatever they say is captioned on that computer and then “streamed” to the student’s desk. The student can view the captioning on any device that can connect to the internet, including iPad, Chromebooks, Android Phones and iPhones. Note that student does not need to install any app on their device, all they’ll do is go to www.streamer.center and enter the name of your Streamer™ account (usually the name of your school) and that’s it. Note also that you can have as many students as you want connect to the Streamer account. So, for example, if you have 20 students in an all-school assembly that want to see a captioning and/or translation of what is being said, with Streamer™ you’re all set. The same for enabling those students to view a captioning of the morning announcements, or an announcer at the football game. The Streamer™ module costs just $99, and like Interact-AS, this is for a permanent unlimited use license.

More Comfortable Teacher Microphone: This past year many teachers requested that we offer a behind-the-head microphone versus the over-the-top version. So, we’ve done that as well. You now can choose the style of microphone that you would like to use with your Interact-AS Captioning and Translation System. You can select the traditional over-the-head option or the behind-the-head option.

A More Cosmetically Acceptable Student Receiver: For students where “fitting in” is a priority, we’ve developed a receiver that looks like a USB thumb drive. This USB model receiver was designed to be as small as possible. It does not have dual channels (just a single channel), nor an audio output jack for a hearing aid or CI, but it is incredibly small. For some students, this may be the key to having them be excited about using a captioning system. Keep it in mind as an option when configuring a captioning system for your students.

Easier Phrase Building: Interact-AS™ includes at no extra charge the complete set of PhraseBuilder™ features. These are used by students that are non-verbal. This past year many teachers requested an improved way to create and maintain Favorites Lists. These are lists of phrases and/or sentence constructs that students can use to easily ask questions in the class or hold conversations with others. So, we did it. You can now use basically any text editor (such as Microsoft Word or Google Docs) and with a single click convert that document into a Favorites List. Likewise, you can export a Favorites List into your preferred text editor. This new module is free, just ask, and we’ll be glad to send you a download link.

Thanks Again for your Suggestions. Together, Interact-AS, Supporting Success and YOU are making the classroom more accessible for everyone, including students that are Deaf, Hard of Hearing and/or non-verbal. You, the teachers, are the most important members of our team. Thanks for all you do to help so many students !!!

by Karen Anderson, PhD, Director of Supporting Success
September 22 – ND (Minot)
October 12-13 – LA (Lafayette)
October 19-20 – MA (Marlborough)
November 2 – MB (Winnipeg)

Now booking for 2018 Presentations!                                                          

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

September 22, Minot, ND. Friday Symposium celebrating the 200^th year of deaf education in the US and the 55^th year of the DHH teacher prep program at Minot State University. Keynote + sessions.

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

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.