Assessment of Online ACCESS

The world of education has shifted sharply once we began our societal response to the COVID-19 pandemic. Yet, we remain responsible for offering an equal educational opportunity to students with hearing loss. To do so we must identify and address access issues in online learning situations. Some current issues for our students who are DHH are:

• Concerns about equal access in distance learning
• Teaching practices to enhance or limit access
• Ways to gather information that shows a student’s level of access

Equal access was already a challenge! The Title II ADA requirement that schools are required to ensure that communication for students who are deaf and hard of hearing are as effective as communication for others [ADA Title II 28 C.F.R. 35.160 (a)(1)] was already a tall order for students who are hard of hearing since it is a fact that no hearing devices in current existence restore normal hearing ability. Even in a classroom setting the provision of hearing assistance technology, interpreter services, and captioning still are often not sufficient to close the access gap.

Encouragement is not the same as effective solutions. A 3/21/20 Supplemental Fact Sheet¹ from the US Department of Education clarified that special education and related services can be provided through distance instruction and that many disability-related modifications and services, like captioning and sign language interpreting, may be effectively provided online. The Fact Sheet encouraged parents and educators to collaborate creatively to use high-and low-tech strategies to meet the needs of students with disabilities. This encouragement resulted in a steep learning curve by all teachers, and especially those who work with students who have access issues due to hearing or vision limitations.

All instruction must be fully accessible to students who are deaf and hard of hearing.

Access Concerns:

1. a. When teachers provide online instruction during which only a PowerPoint presentation or documents are visible, the student is not able to speechread. Once we go back to meeting face-to-face in schools it is likely that many school staff will wear masks. How much is the student’s access impacted without speechreading?

1. b. When teachers instruct over an internet streaming service without using a microphone (standard mic that plugs-in to the computer or FM/DM microphone) the speech signal is degraded and adds to comprehension issues. How much is the student’s access to distance learning is impacted without the use of a microphone?

For students with hearing loss to experience equal access, we need to identify barriers first.

Perform a modified Functional Listening Evaluation procedure in an online teaching situation

We know that students with typical hearing respond with 90+% accuracy when listening in noise, even when the noise level is equal to the speech presentation level. It is reasonable to assume that the degradation in sound that occurs when a teacher’s voice is presented over an internet streaming service (like Zoom) will not significantly decrease the speech perception and auditory comprehension ability of students with typical hearing.

For equal access students with hearing loss should be able to perform with at least 90% accuracy during online learning presentations. Ideally, you will have performed the FLE under classroom conditions and have the percent scores under different listening conditions that can be compared to the following.

Suggestions on how to perform this functional check of listening accuracy during online learning:

1. a. Download and print out the Common Children’s Phrases.

1. b. Prepare to present Children’s Nonsense Phrases within the Common Children’s Phrases There are 8 lists of 20 items. You can place a + or o next to each sentence to record responses.

1. c. LIST 1: Use a microphone plugged into your computer as you present and encourage the student to watch your face. Even a standard SmartPhone headset will work with most media devices to improve speech signal clarity. This simulates the best listening condition.

1. d. LIST 2: Turn off your webcam or do not allow the student to watch your face. Continue to use your microphone. This simulates listening when the teacher is presenting a PowerPoint presentation while livestreaming and her face is not visible.

1. e. LIST 3: Unplug your microphone and present the list of words in the speechreading condition. These results will indicate how important it is for the student to have the teacher always use a microphone during online learning.

1. f. LIST 4: Present the nonsense phrases without using the microphone or allowing speechreading. Too many students are currently expected to learn in this situation. With the data you’ve now obtained you can demonstrate the level of barrier to understanding posed by not using a microphone and/or not allowing speechreading.

1. g. LIST 5 and 6: If you have a mask with a transparent inset available, repeat the conditions with and without using the microphone. This will provide you with some data as to just how important it is for a teacher to use a transparent mask once we return to school, and the potential barrier posed to having the teacher’s face viewed in this manner.

Check comprehension of what the student can hear (or see)

Schools have not been excused from conducting assessment or gathering progress monitoring data. Norm-referenced tests have strict administration protocols. That said, modifications can be made as long as they are referenced in the test report with the caveat that use of the norms may not be as accurate as if the original administration protocol was used.

For the purposes of students who are deaf or hard of hearing we really want to know how students perform on auditory (or sign interpreted) comprehension tasks relative to their typical class peers. Results will reflect (1) the degree to which hearing loss is posing as a barrier to comprehension along with (2) the impact of any language issues the student may experience. This is true whether the student is face-to-face in a quiet room, or in an online learning situation.

Suggestions for performing assessment of comprehension of spoken information

1. a. Gather comprehension data using the Oral Passage Understanding Scale (OPUS) for grades K-12. This test only takes 10-15 minutes to complete. It identifies how well a person can integrate and apply knowledge of use of words and word combinations, grammar and inferential meaning.

1. b. Gather comprehension data using the Listening Comprehension Test 2 for grades 1-6 or the Listening Comprehension Test Adolescent for grades 7-12. This test assesses comprehension of main idea, listening for details, vocabulary, reasoning and understanding messages. It takes about 30 minutes to administer.

1. c. Conduct an Informal Evaluation of Auditory Comprehension of Information with and without Accommodations. This functional assessment procedure refers to how to conduct comparison testing in a typical classroom environment (or simulated classroom noise vs. quiet). Adapt the procedure to online learning by reading a story and answering comprehension questions with and without a microphone, with and without speechreading, speechreading through a mask, with and without captioning, etc.

1. d. For hard of hearing students DO NOT ALLOW SPEECHREADING as this is an inconsistent listening condition.

1. e. If a HAT (FM/DM system) is typically used with the student be sure to use it while performing comprehension assessments.

1. f. If captioning is typically used during instruction it can be used while performing the assessments.

1. g. For students who are Deaf and use an interpreter, if at all possible have what you say when administering the test be presented by the interpreter the student uses in the classroom setting. Allow the student to view your face and the interpreter so the student’s ‘triangle of communication’ is as typical as possible.

LIST OF RECOMMENDED ASSESSMENTS: The list includes recommendations for both functional and formal assessments for ages 3-5 years and school-age students. In evaluations, it is appropriate to look closely at social/emotional, self-advocacy, and the possibly subtle phonological/morphological awareness and ‘Swiss cheese’ language skills that impact comprehension and reading fluency.

Read more information on tailoring assessment procedures to the needs of students with hearing loss.

References:

1. 1. March 21, 2020 Supplemental Fact Sheet Addressing the Risk of COVID-19 in Preschool, Elementary, and Secondary Schools While Serving Children with Disabilities
2. 2. The Effect of IQ on spoken language and speech perception development in children with impaired hearing. Cochlear Implants International, (11)1, June, 370-74.

A Connecticut mom of a student with hearing loss shares her journey into establishing greater awareness for the need for emergency preparedness when children are hard of hearing or deaf. Read more for: – Key issues regarding students who are DHH and school safety – When planning should occur – Possible emergencies and appropriate responses

In 2018, I read a Clarke School article titled “Keeping our Students Safe.” It asked the question, How are you keeping deaf/hard of hearing students safe during school lockdowns and emergencies?  I immediately asked my son if he had a safety plan in school that addressed his hearing loss. His response was a no. I researched the Connecticut school safety guideline that is required by the Department of Homeland Security. The only proactive suggestion was that students with functional disabilities should have a buddy system in place. Did the school consider hearing loss a functional disability? Did my son ever have a buddy in place? No.  Now he was in high school making the buddy system was unrealistic.

We cannot ever forget that deafness is an invisible disability.

Safety must be in layers

Not every safety recommendation will fit every student or a school’s current capability. Technology doesn’t always work in an emergency. If you have multiple layers of communication, then the likelihood of your student being safe in an emergency increases exponentially. In the IEP/504 Plan you can request a school in-service communication needs and safety training BEFORE the school year begins. This can be done through the teacher of the deaf or deaf services agency. Often emergency drills are done the first week of school, not on the first day. This year on the first day of school, the high school cafeteria caught on fire. Confused freshmen were late exiting the building, not knowing where to go or what to do in their new surroundings. The pre-school year meeting is often held in August and can also make sure all technology is in good working condition. Often schools forget to set up these in-services, even when they are in the IEP/504 plan. Be proactive in early August to identify when this in-service training will be taking place.

A good rule of thumb

Questions to answer for ALL POSSIBLE EMERGENCIES, fire, weather, water, active shooter/threat.

1. 1. Can students access the current alerting system based on their individual communications needs identified in their IEP/504/LCP plan?

• Consider bus, bathroom, hallways, extracurriculars, playgrounds/fields, field trips, classrooms?
• Are you including the student in these discussions? Has the emergency plan been shared with the student? Have they tried it? Do they have suggestions?
• Have staff members been informed of the students’ specific needs in the event of an emergency?
  • Staff means teachers, substitute teachers, administrators, resource officers, and support staff such as secretaries, lunch aides, and maintenance personnel.
• Are students able to advocate for their communication needs in the event of an emergency?
  Example: During a 504 meeting my son told the guidance staff that announcements are very quiet in the classroom and very loud and unintelligible in the hallways-something they didn’t know.

2. 2. Can the student verbalize? Are they too young? Do they have another disability that prevents them from speaking up? *see Lanyard in Go-Bags/Kits below

• For students who use educational interpreters, transliterators, or captionists, what is the backup?
• The ENTIRE school could learn basic American Sign Language:
  • Quiet, Get Down, Run, Wait, Fire
  • Identify staff who know ASL
  • Universal safety ASL means a student can transfer in and already know safety signs

3. 3. Has your Local Education Agency (LEA) notified local emergency responders of the students who are Deaf, Hard of Hearing?

• Where the students might be sheltering?
• How to look for small hearing aids and cochlear implants?
  *if an officer tells a child to stand down and they don’t hear him-he WILL take the child down in an active shooter situation.
• Fire, Police, EMT-do they know and can they use the appropriate emergency ASL signs?

4. 4. Has the school/school district identified how emergency information will be communicated to parents with hearing loss, such as reunification plans?
5. What technology should be upgraded in the school to enable effective emergency responses?

• Televisions, laptops, with scrolling messages enabling ASL and closed caption announcements
• Allow students to have their own phones available so they can receive emergency texts
• Flashing lights, repeating announcements

Go Bags or Kits

These are classroom safety bags that can be easily put together with donated items from community organizations. This can be projects sponsored by PTA’s, boy or girl scouts, Exchange or Rotary clubs. The bags can be the inexpensive string bags that companies give out. Reach out to local companies and hearing technology companies for donations.

Items to include:

• Extra batteries for hearing aids and cochlear implants
• Chargers for hearing technology devices
• Waterproof container for technology/batteries
• Flashlight with extra batteries for to enable communication via signing/lip reading
• Pen/pencil/paper/dry erase board for writing important communications that the student cannot hear.
  *teachers need to whisper during active shooter scenarios or cannot be heard over a loud alarm.
• Communication Cards with appropriate ASL signs, words, or pictures.
  *My school is using colored cards that signal different emergencies.
• Emergency Lanyards for young students and/or those who are nonverbal
  • include name, communication mode, and parents contact information.
• Copy of School Emergency Form

Use these guidelines as tools. Parents of deaf and hard of hearing students are often at odds with school district over services. Cooperation is necessary so the whole team can thoughtfully create safety plans.

Making change through Legislation.

The situation of the unpreparedness of protecting our students with hearing loss in emergency situations spurred me on to help introduce and fight for CT legislation through the Governor’s Advisory Board for the Deaf and Hard of Hearing. On the last day of the CT Legislative session, June 2019, at 2 minutes to midnight, the State of Connecticut Public Act 19-184 was passed. It states “Every student identified as Deaf, Hard of Hearing or Deaf-Blind will have an Emergency Communication Plan as part of their Language and Communication Plan”

The Language and Communication Plan is filled out at the beginning of a Connecticut IEP or 504 meeting. It is a checklist and guide that addresses the special language and communication needs of deaf and hard of hearing students. https://portal.ct.gov/-/media/SDE/Special-Education/Language_and_Communication_Plan.pdf?la=en

The guidelines in this article were made possible through thoughtful work sessions with the Connecticut Coalition on Education of Deaf and Hard of Hearing Students and my son’s incredible teacher of the deaf, Rebecca Rabinsky-Ankrom and her teacher network. The Pennsylvania Department of Education guidelines were referenced.

Susan Yankee, is a member of the CT Governor’s Advisory Board for the Deaf and Hard of Hearing, the Coalition on Education of Deaf and Hard of Hearing Students, Disability Rights CT Partners in Policymaking graduate, and a mom to a hard of hearing high school student.

Success in mainstream classrooms when you have a hearing loss is often a substantial challenge for our students. Even in 2016 the option of meeting the needs of students with disabilities in virtual school learning programs was considered.  A letter from the US Department of Education defined a school’s responsibilities to students with disabilities enrolled in virtual learning settings. The letter affirmed that virtual schools must carry out the requirements of IDEA just as they must in physical schools.

Link to the August 5, 2016, Office of Special Education Dear Colleague Letter: See the new video from the Office of Civil Rights on online learning accessibility.

Summary:

300. 1. The requirements of IDEA apply to State Education Agencies (SEAs) and Local Education Agencies (LEAs), regardless of whether a child is enrolled in a virtual school that is a public school of the LEA or a public school that is constituted as an LEA by the State.
301. 2. Accordingly, the SEA is responsible for ensuring that all LEAs, including virtual schools that operate as LEAs, implement the requirements of IDEA. If a virtual school is a public school of an LEA, the LEA is the entity that would generally be responsible for ensuring that the requirements of Part B are met by that virtual school for children with disabilities participating in the virtual school’s program.
302. 3. Each SEA also must have policies and procedures that ensure that children with disabilities who attend virtual school LEAs and virtual schools that are part of LEAs are included in all general State and district-wide assessment programs, including assessments described in section 1111 of the Elementary and Secondary Education Act of 1965, with appropriate accommodations and alternate assessments, where necessary and as indicated in their respective individualized education programs (IEPs). 34 CFR-§300.160.
303. 4. Where a virtual school is a public school operated by the LEA in which the parent resides, that LEA generally would be responsible for making FAPE available to an eligible child with a disability. LEAs retain this responsibility even if they choose to contract with virtual schools to provide educational services to children with disabilities.
304. 5. In addition to the requirements discussed above, we highlight below some particular requirements under IDEA that responsible LEAs must meet in order to ensure the provision of FAPE to children with disabilities in virtual schools. These LEA responsibilities include, but are not limited to:
305. 6. ensuring that each eligible child with a disability has FAPE available to him or her in accordance with 34 CFR-§§300.101 and 300.17
306. 7. implementing the evaluation and eligibility requirements in 34 CFR-§§300.300-300.311;
307. 8. carrying out the IEP requirements in 34 CFR-§§300.320 through 300.324, including those governing IEP content, IEP Team participants, parent participation, when IEPs must be in effect, consideration of special factors, the development, review, and revision of IEPs, secondary transition services and participation in State and districtwide assessment programs; and
308. 9. implementing the requirements in 34 CFR-§§300.114 through 300.117, regarding education in the least restrictive environment, including ensuring the availability of a continuum of alternative placements to provide special education and related services.

The educational rights and protections afforded to children with disabilities and their parents under IDEA must not be diminished or compromised when children with disabilities attend virtual schools that are constituted as LEAs or are public schools of an LEA

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Advocacy Notes: Legal Requirements for Providing Services to Children with Disabilities During the Coronavirus Disease Outbreak

The CDC has issued guidance to help administrators of public and private childcare programs and K–12 schools plan for and prevent the spread of COVID-19 among students and staff. Many decisions have been made by governments and school districts to close school campuses.  The US Department of Education has provided an FAQ document to assist in understanding the legal responsibilities of schools to provide services under IDEA during this health crisis.

Preparing for a school closure due to COVID-19

IEP teams may, include distance learning plans in a child’s IEP that could be triggered and implemented during a closure due to a COVID-19 outbreak. Such contingent provisions may include the provision of special education and related services at an alternate location or the provision of online or virtual instruction, instructional telephone calls, and other curriculum-based instructional activities, and may identify which special education and related services, if any, could be provided at the child’s home. Creating a contingency plan before a COVID-19 outbreak occurs gives the child’s service providers and the child’s parents an opportunity to reach agreement as to what circumstances would trigger the use of the child’s distance learning plan and the services that would be provided during the dismissal.

Schools closing and not providing any educational services to students

If the school does not provide educational services to general education students, then it is not obligated to provide services to students with disabilities during the same period of time. Once school resumes, the school must make every effort to provide the services specified on the IEP.

• Decisions must be made about how teachers of the deaf/hard of hearing and educational audiologists will be able to increase the service time spent with students once school resumes, to make up for the time lost during school closure, as the service time specified on the IEP remains a responsibility that the school must make every effort to provide.

Schools closing campuses but continuing to provide educational services to students

If the school is providing educational opportunities to the general student population during school closure, the school must ensure that students with disabilities also have equal access to the same opportunities. Schools must ensure that each student with an IEP or 504 Plan is provided special education and related services specified on the IEP or 504 Plan, to the greatest extent possible.

• Schools must determine how access accommodations will be provided to ensure that students with hearing loss can receive the same opportunity to instruction as their hearing peers. Schools must decide how they would provide access via interpreters and captioning to online education.
  • Note: Teacher Tools membership materials provide a wealth of digital instructional materials.
• Teaching staff (DHHTs, SLPs, Educational Audiologists) must decide what materials they can readily use in online or virtual education methods as they continue work on IEP goals.
  • Note: Streamer captioning is an option for secure captioning services.

If a child is sick with COVID-19 while schools remain open

Students with IEPs who must stay home for more than 10 school days due to a medical problem need homebound services. A placement change would need to be made on the IEP. The IEP goals would remain the same. The IEP Team would determine the method of instruction most applicable for the student to benefit. If the child does not receive homebound services, the school must determine if compensatory services may be needed to make up for any skills that may have been lost. For children with disabilities protected by Section 504 who are dismissed from school during an outbreak of COVID-19 because they are at high risk for health complications, the decision to dismiss must be based on his or her individual risk for medical complications and not on perceptions of the child’s needs based merely on stereotypes or generalizations regarding his or her disability.

If a School for the Deaf is closed

The school must determine whether each child could benefit from online or virtual instruction, instructional telephone calls, and other curriculum-based instructional activities to the extent available. If the child does not receive services during the school closure, the school must determine if compensatory services may be needed to make up for any skills that may have been lost.

Note: This information is not to be construed as legal advice. Bulleted points represent information added by the author. Refer to the full Department of Education document for more information.

E-Learning & Coronavirus (COVID-19)

Due to concerns with the rapid spread of Coronavirus, also known as COVID-19, schools and universities across the country are shutting down their campuses and moving to e-learning or virtual learning.  In light of this, the following resource information  could be helpful as you consider how to provide instruction to your students who are deaf or hard of hearing. 

MEETING LEGAL RESPONSIBILITIES:

The Center for Deaf and Hard of Hearing Education has some #DeafEdTips on E-Learning Accessibility.  It has lots of good reminders and additional resources for both deaf educators and general education teachers.

While more focused on post-secondary access, the National Deaf Center (NDC) has some helpful tips for educators as they switch to online learning.

RESOURCES:

Some ASL resources can be found at ASL Teaching Resources. ASL videos are available on various YouTube channels: Educational Resource Center on Deafness, Rocky Mountain Deaf School, ASLized!, and Aunt Alice’s ASL TV. Check out additional virtual activities through this LiveBinder.  And lastly, have students create books at Book Creator!

Described and Captioned Media Program (DCMP) is a great resource too. Teachers can assign videos for students to watch and then do follow up assignments. All content is captioned, and audio described and FREE.

Supporting Success Teacher Tools e-magazines are full of ready-to-use materials with your students. Members can download pages to use immediately that can be shared and discussed in an e-format with students.

The Ability Challenge has created a Slack community forum for educators to discuss the provision of special education services and supporting learners with diverse needs during online instruction. 

Snapplify offers a library of 50 000+ free e-books. Teachers can sign up for free and also claim exclusive teacher benefits. Excellent to send free e-books to your kids and get them to read while they are at home! You can also share your resources on the platform. Easily integrates with Microsoft and Google for education.

Did you know that Zoom has the capability to add captions during live video sessions that can be recorded?  You can type the closed captions directly via Zoom or you can integrate a third-party service, like Streamer^TM automated captioning that is available from Supporting Success for Children with Hearing Loss that can add captions in real-time. Streamer is typically 98+% accurate (with the speaker using a microphone) for only $9.97/month (email questions to streamer-support@success4kidswhl.com). Other videoconferencing resources and their caption abilities are available from See Hear Communication Matters (they also have a lot of e-learning resources, including virtual field trip sites on their Facebook page!)  

EXPLAINING CORONAVIRUS TO CHILDREN: When trying to explain coronavirus to children, it can be difficult to know what to say.  Two resources to share with families:

• A kid friendly video explaining coronavirus, with captions and a transcript, can be found at Brain Pop.
• A FREE, downloadable coronavirus social story can be found at The Autism Educator.

In addition to Supporting Success for Children with Hearing Loss Facebook page, there are MANY deaf educator Facebook groups that are discussing these topics and sharing resources. MANY resources and ideas are being shared on these pages. If you are a Facebook user, search for them and join the discussion!  While not education specific, The Daily Moth has a Facebook page that provides frequent updates in ASL on current events that you or your students might find helpful. 

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

Special Education Meetings for Necessary Communication

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

Following are the various types of IEP meetings:

Initial IEP

Annual IEP

Triennial IEP

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

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

• Transition from preschool to Kindergarten: While compulsory education does not start at preschool, special education placement does. When it comes time to transition from preschool to Kindergarten, the IEP team will schedule the “Kindergarten Transition IEP.” Some school districts do not serve their students during preschool as they may use regionalized special education preschool programs. Therefore districts may do formal/informal observations in the preschool setting and gather data about how the child is doing, while other districts choose to conduct a full re-evaluation and make the Transition to Kindergarten the new triennial IEP meeting. Either way, the full IEP team would be expected to attend along with a general education Kindergarten teacher. The transition meeting is a wonderful way to reduce the stress and anxiety that both the family and the educators in the receiving school may have. It also allows for the district to share the various program options with the family and for the IEP team to identify any additional supports that will be needed. The district can then conduct staff training, order low incidence equipment, and make any necessary acoustic accommodations over the summer.

• Transition from elementary school to middle school (junior high) and from middle school to high school: Elementary school is typically a time when our students have a single classroom teacher who is nurturing, safe, and responsible for teaching all academic subjects. The transition to middle school is stressful for all students as it occurs at the same time as the onset of adolescence. Our students with hearing loss may have even more anxiety as they move from one teacher to potentially 6-7 separate subject matter teachers who all need to understand their unique needs. Depending on mode of communication there will typically be additional staff training, discussion of interpreters, captioning, note-taking, and other unique supports. In the early Spring of the last year of elementary school the IEP team will begin to schedule a Transition IEP meetings which will include the current providers as well as special education representatives from the receiving middle school. This meeting is not a time to review progress on previous goals, develop new goals, or make a new offer of FAPE. The purpose of this meeting is to share the child’s eligibility, explain their unique needs, review the accommodations, and current services with the receiving team. This is when the middle school team will explain their programs and class options which may include a DHH placement, a variety of supported classes for ELA and Math, or a supported Study Skills class. The transition from middle school to high school is basically the same process and an opportunity for the receiving school to explain their programs and class options while the IEP team shares how the student is doing as well as all of their unique needs and support services as a student with hearing loss.

• IEP Transition Planning: The IDEA (Individuals with Disabilities Education Act) requires that IEP teams begin planning with all students who have an IEP by the time they turn 16. The Individual Transition Plan (ITP) is included in the IEP document. It is typically created with a combination of student interview and interest surveys completed by the student with their IEP case carrier. The purpose of the ITP is to help students prepare to be as independent as possible following high school. The ITP includes planning and goals in the areas of Post-Secondary Education, Post-Secondary Employment, and Independent Living. As with all other portions of the IEP document, the ITP is revisited every year as a part of the annual IEP.

• Transition from high school to adult education (18-22): Unless our students with hearing loss have another eligibility, the goal is that they will graduate from high school after their senior year. There are, however, occasions when students do not complete the high school graduation requirements and are eligible for IEP services until age 22. In these cases, the IEP team at the high school will call a Transition IEP in the Spring of the Sr. Year. The team should include a representative from the adult education program. While students continue to have academic support from age 18-22, much of the focus is on supporting students in accessing the community and independent living.

• Transition out of high school, also known as the Exit IEP: The IEP and Special Education services end for the following reasons: the student no longer meets eligibility requirements, the student graduates from high school, or the student turns 22 years old. Each state decides the level of supports that they have available for individuals with disabilities post-high school. At this time the Americans with Disabilities Act (ADA) governs supports in college, career training, employment, and independent living. If there is a state agency that supports students with their college education, the IEP should invite a representative of the agency to the Exit IEP to facilitate the transition. I typically ensure that the students and IEP teams with whom I work begin to educate students (via IEP goals) during their junior and senior year regarding their IEP accommodations and the differences between the IDEA and the ADA so that they are knowledgeable and ready to successfully advocate for themselves in all areas of their lives.

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

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An Often Unknown Cause of Hearing Loss in Children

What is CMV?

What is the size of the CMV problem?

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

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

How is CMV spread?

How can we prevent CMV?

• Wash hands frequently with soap and water, lathering for at least 15 seconds
• Avoid kissing a child near the nose or mouth
• Do not put things in your mouth that have been in a child’s mouth such as a pacifier, cups, utensils or food
• Wear gloves for all contact with body fluids, and always wash hands after removing gloves
• Use EPA approved disinfectants to frequently clean workplace surfaces that may be contaminated with body fluids
• Do not use diaper wipes to clean potentially contaminated workplace surfaces
• Disinfect small toys or objects that may have been contaminated with body fluids

• https://cdc.gov/cmv/index.html
• JCIH 2019 position statement

Captioning in the Classroom

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

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

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

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

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

Some of the considerations are:

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

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

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

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

Relevant References:

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

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

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Missing Bits Results in Syntax Deficits

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

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

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

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

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

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

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

Other tools for gathering functional data:

Test of Grammatical Structures (TAGS)   PRESCHOOL and ABOVE

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

• determine present levels of syntax skills
• determine syntax goals for IEPs and lessons
• track syntax development over time and
• report syntax progress to parents and other professionals

Grammar Chipper Chat     GRADE K-5

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

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

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

Formal, norm-referenced testing

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

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

Oral Passage Understanding Scale (OPUS)

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

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

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

Test of Narrative Language-2 (TNL2)

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

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TOPIC:

Documenting Daily Amplification Use is Legally REQUIRED in the U.S.

Per 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.

A court case from June 2015 has raised the bar for what educators who specialize in DHH must know and do. In this case, the school district team had included use of an FM system on a student’s IEP. The educational audiologist fitted and verified the FM for the specific student’s use and trained the teacher in its use. The FM system was then made available to the student. The court found the school district negligent in providing FAPE because there was no record that the FM/HAT devices was provided to the student daily. Read more. This finding strengthens the need for daily hearing aid monitoring and data collection.

We know that not all families want their child to gain the attention needed to perform hearing device monitoring. We also know that in the US, there needs to be documentation that the student’s hearing devices are functioning properly. Thus, we truly need to inform families of these requirements. An example of Amplification Monitoring Consent Form has been included in the Hearing Aids and FM/DM pages of the Supporting Success website.

Since hearing devices can malfunction at any time, to truly ensure that they are functioning properly we ultimately need to teach the student how to be responsible for their own hearing aid monitoring. See Building Skills for Independence and Advocacy in Action for instructional materials to strengthen hearing device independence skills for students.

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Get Free Tools to Work with Children with Hearing Loss

The Ida Institute, a nonprofit working to advance person-centered hearing care, offers free pediatric tools and resources to support educators and hearing care professionals in understanding the perspectives of children with hearing loss and give the them stronger voices as they advocate for their own needs.

Growing Up with Hearing Loss

To help manage the key transitions in a child’s life, the institute developed Growing Up with Hearing Loss. The resource offers easy-to-follow strategies for developing independence, good decision-making, and self-awareness during each developmental stage.

My World Tool

Ida’s popular My World tool resembles a game in both its digital and physical versions, making sessions more relaxed and enjoyable for kids. The free My World app is downloadable from iTunes and the Play Store. Research has shown that working with children in a play setting can ease anxiety and improve their sense of self, adaptive functioning, and family functioning.

Telecare for Teens and Tweens

The Ida Institute

References

[1]. WHO, Childhood Hearing Loss: Strategies for prevention and care https://www.who.int/docs/default-source/imported2/childhood-hearing-loss–strategies-for-prevention-and-care.pdf?sfvrsn=cbbbb3cc_0

2. [2] Ear Foundation study https://www.earfoundation.org.uk/research/research-categories/current-research/transitioning-for-european-young-people-using-telecare-tools

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Progress in Light of Circumstances – A Right for Every Student

I don’t think my child is making progress in reading…

Our question from the field: At a recent IEP meeting it seemed as though my child who has both hearing loss and other learning issues hasn’t made any progress in learning to read in the last year. I KNOW he can learn. The school didn’t seem surprised nor did they suggest any changes in the program….  

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 increasingly 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?

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 disordered learning. 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.  

A recent research study* focused on the reading performance of students who were deaf/hard of hearing and had additional learning issues. The majority of the 214 students in this study had either intellectual or multiple disabilities as their primary disability while about 10% had DHH as their primary.  Over the 6-year period the 314 students took an alternate reading assessment an average of 3.72 times between grades 3-11. When comparing the performance of the 214 DHH+ students with the performance of other students with significant disabilities taking the same alternate reading assessment, the DHH+ students had overall poorer performance and growth rates. Most of these students increased their performance on the alternate state reading standards as they progressed in grade level. The percentage of ‘proficient’ increased, while the percentage of ‘emerging’ decreased during the 6-year period. The fact that the study found students who are DHH+ had lower proficiency scores than other students with significant disabilities on their state alternate assessment underscores how the addition of hearing loss to a child with complex needs is multiplicative, not additive. The need for interdisciplinary teaming to untangle and respond to the unique and complex needs of students who are DHH+ is essential. Like all students, those who are DHH+ CAN LEARN!  

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.

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.

* Donne, V, Hansen, M.A.,  & Zigmond, N. (2019). Statewide alternate reading assessment of students who are deaf/hard of hearing with additional disabilities. Communication Disorders Quarterly, 40(2), 67-76.

For a review of this study, refer to the January 2020 Teacher Tools e-magazine Knowledge is Power article by Holly Pedersen.  

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The ‘bread and butter’ of itinerant support to students with hearing loss is often considered to be ensuring communication access, supporting language development to allow expected academic progress, and self-advocacy skills training. While access relates to ADA requirements, and supporting language is linked to academics, training in self-advocacy is too often considered to be non-academic and therefore not necessary.

Students do not know what they didn’t hear because they didn’t hear it – yet they are held accountable for receiving and fully understanding this information.

The Iowa Core Curriculum states, “students who are deaf or hard of hearing have specialized needs not covered in the general education curriculum. Hearing loss adds a dimension to learning that often requires explicit teaching, such as information gained through incidental learning. It has been estimated that for persons without hearing loss, 80% of information learned is acquired incidentally. No effort is required. Any type of hearing loss interrupts this automatic path to gain information. This incidental information must be delivered directly to students who are deaf or hard of hearing.

Most teachers without specialized training related to hearing loss do not have the expertise to address the unique needs of students who are deaf or hard of hearing. Therefore, IFSP & IEP team collaboration with educational audiologists and teachers of students who are deaf or hard of hearing is necessary in addressing academic and social instruction and the assessment of these areas. In order to close this information gap, the Expanded Core Curriculum for Students who are Deaf or Hard of Hearing was developed.”

Legal Considerations

The American’s with Disabilities Act is a discrimination law that, in summary, requires schools to ensure that students with hearing loss have communication that is as effective as it is for others. If not, auxiliary aids and services must be provided to “level the playing field” or allow equal access. Since we KNOW that there is no amplification that fully closes the ‘listening gap’ for students in a classroom and we KNOW that incidental language will be missed, and we KNOW that classroom or group discussions are especially challenged then the FACT that students with hearing loss will not perceive information as fully as hearing peers will be one of their (full range of) needs.

Components of Self-Advocacy: Following are basic questions that students with hearing loss typically require instruction in so that they can understand their hearing needs and respond appropriately.

Self-Advocacy

1. 1. What does it mean to have a hearing loss?
2. 2. Why do I have problems understanding (relate to hearing loss and language issues)?
3. 3.  How does my hearing loss affect me (school, socially)?
4. 4. When do I have problems understanding what people say?
5. 5. How important are my hearing devices?
6. 6. How do I know when my hearing devices are not working?
7. 7. What should I do when they are not working?
8. 8. What can I do when I know I have not heard what was said (specific self-advocacy & communication repair strategies)?

Self-Determination

1. 1. How much am I willing to have the hearing loss impact how well I do in school (planning/future goals)?
2. 2. When is it critical for me to disclose my hearing loss (problem solving)?
3. 3. What are my legal rights to access, supports, and services?

From the US Office of Civil Rights:

• They need to know the functional limitations that result from their disability.
• Understand their strengths and weaknesses. Be able to explain their disability to others.
• Be able to their difficulties in the past, and what has helped them overcome such problems.
• This should include specific adjustments or strategies that might work in specific situation.
• They must practice explaining their disability, as well as why they need certain accommodations, supports, or services.

He does not know what he did not hear.

1. 1. Advocacy in Action Self-Advocacy Curriculum
2. 2. Audiology Self-Advocacy Checklist – Elementary School  Middle School  High School
3. 3. Building Skills for Success in the Fast-Paced Classroom
4. 4. ELFLing
5. 5. Monkey Talk Self-Advocacy Game
6. 6. Phonak Guide to Access Planning
7. 7. Recorded Functional Listening Evaluation Using Sentences (FLE)
8. 8. Rule the School Self-Advocacy Game
9. 9. Steps to Success Sequence of Skills for Students who are Deaf/Hard of Hearing

Teaching Hearing Device Use and Troubleshooting

1. 1. Race to the Brain Game
2. 2. Advocacy in Action Self-Advocacy Curriculum
3. 3. Building Skills for Independence in the Mainstream
4. 4. SEAM – Student Expectations for Advocacy & Monitoring Listening and Hearing Technology (PDF)
5. 5. Steps to Success Scope and Sequence of Skills for Students who are Deaf/Hard of Hearing

Teaching Self-Advocacy Strategies

1. 1. Advocacy in Action Self-Advocacy Curriculum
2. 2. Building Skills for Independence in the Mainstream
3. 3. Building Skills for Success in the Fast-Paced Classroom
4. 4. COACH: Self-Advocacy & Transition Skills for Secondary Students who are Deaf/Hard of Hearing
5. 5. Guide to Self-Advocacy Skill Development: Suggestions for Sequence of Skill Attainment (PDF)
6. 6. Monkey Talk Self-Advocacy Game
7. 7. Phonak Guide to Access Planning
8. 8. SCRIPT 2^nd Ed: Student Communication Repair Inventory & Practical Training
9. 9. Steps to Success Scope and Sequence of Skills for Students who are Deaf/Hard of Hearing
10. 10. What’s the Problem Game

Success in the general education setting requires ongoing instruction in self-advocacy skills needs, including hearing device independence for students who are hard of hearing, as part of the IEP or 504 Plan.

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Where is the silver lining in this case?

Tailored Assessment for Students with Hearing Loss: Identifying Needs to Support Eligibility for Specialized Instruction

1. 1. Ninth Circuit Court of Appeals, June 1, 2018, S.P. v. East Whittier City School District: https://successforkidswithhearingloss. com/wp-content/uploads/2019/01/Court-case-RE-need-for-thorough-assessment-highlighted.pdf
2. 2. IDEA section 300.324(2)(iv): Consider the communication needs of the child, and in the case of a child who is deaf or hard of hearing, consider the child’s language and communication needs, opportunities for direct communications with peers and professional personnel in the child’s language and communication mode, academic level, and full range of needs, including opportunities for direct instruction in the child’s language and communication mode.
3. 3. LEAD-K: Language Equality and Acquisition for Deaf Kids. https://successforkidswithhearingloss.com/wp-content/uploads/2019/01/Court-case-RE-need-for-thorough-assessment-highlighted.pdf
4. 4. The 2004 IDEA Commentary provides an overall ‘setting the stage’ for the IDEA law; on this webpage.
5. 5. Language underperformance in young children who are deaf or hard-of-hearing: are the expectations too low? Journal of Developmental & Behavioral Pediatrics. September 19, 2017. Results² focused on children with hearing loss who have language levels within the average range on standardized measures. Researchers identified a mismatch between the cognitive level children test at and the expectations for their language skills. In examining the abilities of their 152 young child subjects they found that at least 40 percent have a capacity for higher language levels – beyond what their language test scores indicate.
6. 6. The Effect of IQ on spoken language and speech perception development in children with impaired hearing. Cochlear Implants International, (11)1, June, 370-74. A 2010 study³ found that children were learning language at approximately 2/3 of the rate (or 70% of the rate) of their normally hearing peers. Subjects were 62 children ages 5-12 years who used oral communication and attended oral early intervention or school settings. Children in preschool learned language at a faster rate than children attending primary school. On average, children attending preschool were learning at 0.78 of the rate for normal hearing children as compared to a rate of 0.67 for students in primary school. Speech perception scores did not plateau until children had, on average, the language ability of a typically hearing 7-year-old.
7. 7. Epilogue: Conclusions and Implications for Research and Practice. Ear and Hearing, 36, 92S-98S. Sole reliance on norm-referenced scores may overestimate the outcomes ofCHH. When the children who are hard of hearing (CHH) were compared with the norm-referenced group on various measures, the differences were small. However, when compared the CHH to a sample of CNH who were matched on age and SES, the size of the effect of HL on language doubled to two thirds of a standard deviation. These results question the sole reliance on comparison to norm-referenced test scores for judging eligibility. Standardized test scores may overestimate CHH as they are unlikely to reflect the level of effort that students are expending (cognitive and perceptual resources) to maintain competitiveness with peers in secondary schooling, where the cognitive demands increase. We need to closely monitor the outcomes of CHH including comparing their performance relative to neighborhood grade-mates. Many CHH in the OCHL study represent the best-case scenario. We might expect that a sample with greater diversity on these dimensions would not perform as well as the OCHL cohort
8. Language acquisition for deaf children: Reducing the harms of zero tolerance to the use of alternative approaches. Harm Reduction Journal, 2012, 9-16. Today, 80% of children born deaf in the developed world are implanted with cochlear devices. Due to brain plasticity changes during early childhood, children who have not acquired a first language in the early years might never be completely fluent in any language. If they miss this critical period for exposure to a natural language, their subsequent development of the cognitive activities that rely on a solid first language might be underdeveloped, such as literacy, memory organization, and number manipulation.
9. Addressing the Need for Appropriate Use of Norm-Referenced Test Instruments. Supporting Success, December 2017.

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

Question from the field:

Academic learning is driven by communication access.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Tips for vocabulary instruction:

3. Discussion

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

Which vocabulary words?

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

Sources:

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

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

Findings:

Resources

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

Why practice auditory skills?

Listening practice can improve listening skills.

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

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

Use the Speech Perception Lens for Error Analysis

Step One: Analyze the auditory task.

The Bottom Line: Do Something!

References:

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

Why do students with hearing loss specifically need to be observed?

Who is the professional that needs to observe?

Communication Lens

• How much instruction does the student understand?
• What is the student’s level of classroom interaction?

• What strategies or compensatory skills does the student utilize?
• What does the student do when there are learning breakdowns?
• How does the student understand and utilize social language in the integrated setting?
• Are the student’s use and understanding of social language developing appropriately?

• What strengths and gaps in access were observed when the teacher delivered the instruction?
• What strengths and gaps in access were observed when the peers contributed to the instructional delivery?
• How did the student access the general education curriculum when technology was utilized?
• Did the student demonstrate appropriate progress in the general education curriculum?

What needs to be observed?

• “Tyler turned to watch his peers offering oral responses 2/9 times or 22% of the time.”

• “During Marianne’s 45 -minute civics class on October 12, she attended to the interpreter 44% of the time. The longest interval of attending was 5 minutes.”

• “In the morning it takes William 7 minutes to follow instruction after the teacher gives a direction. In the afternoon it takes William 4 minutes to follow instruction after the teacher gives a direction.”

How can observation data be reported?

• Of the 17 questions or items reviewed, Sam was able to answer five correctly (29%). Much of this information was review, not new. Sam was surprised when told the British were from England, not France, they lost the war and that the Continental Army was made up the colonists/Americans and they/we won the war in America, not in France.
• The pace, level of complexity in relation to new concepts and vocabulary and language loaded curriculum in all areas at his current grade level highlight Sam’s difficulty to access and internalize new information at the same rate as his grade level peers. … Without a concerted effort and plan for intervention, the gap that is seen at the fifth-grade level will only continue to increase.

Identifiable adverse educational effects caused by the hearing loss

1)     Hesitate in starting work after instruction

2)     Participate less in the classroom (less often, less appropriately)

3)     Have challenges comprehending verbal instruction, class discussions, small group work, and partner projects as compared to peers.

4)     May interact less and/or more immaturely with peers

1. 1. Access to Curriculum Assessment Inventory can be found in Building Skills for Success in the Fast-Paced Classroom, page 27-58 or purchased as part of the Teacher Inservice Combo from Supporting Success.
2. 2. Anderson, K. & Arnoldi, K. (2011). Building Skills for Success in the Fast-Paced Classroom. Supporting Success for Children with Hearing Loss Publications. Pages 14-19.

My student is being bullied but the school isn’t taking it seriously!

Question from the field: 

Real-Life Examples

What can be done to reduce victimization of students with hearing loss?

• Peer in-services: Proactively, the best way to create a circle of support around our students is to do peer in-services at the beginning of each year. I like to explain how amazing their peer with hearing loss is as a person dealing with a challenge. Answer all of the peer’s questions to take the mystery out of it, and at the same time give the peers a sense of ownership in understanding that in noisy situations when there is not teacher using an FM/DM system, their friend is going to have a harder time hearing. Make the inservice age appropriate and new every year. The requirement for peer inservice can be added into the IEP as an accommodation.


• Grade level in-services: Some schools will do grade level presentations either directly related to the student with hearing loss and their unique circumstance or more of a focus on tolerance, empathy, and understanding differences. Kids are amazing!! They will almost always recognize that we all have something that makes us feel different and this helps to promote empathy for our students with hearing loss as well as for all of their peers.


• Intervention in the moment: If there is bullying in the moment, pull the 2 students together and ask the student with hearing loss what they heard. This gives you the opportunity to work on communication repair and at the same time you are able to teach the typically hearing peer about how they may have been misunderstood or not heard at all. You can respond to the cause of bullying in the moment without ever directly addressing the typical peer.


• Staff training: Talk with the school administration about the nuances of how hearing loss, listening in noise, and language issues can affect our students in social communication. You may want to ask for an opportunity to speak at a regularly scheduled staff meeting. This way you will be able to address the general education teachers as a group and get them on board with addressing bullying of students and add a focus on hearing loss specifically.


• DHH Itinerant push-in services: If the teacher of the deaf/hard of hearing is currently only providing pull-put services, adding some push-in services in order to observe in class can lead to opportunities for intervention. Observe during regular instruction, specialist instruction (ie: Art, Music, etc.), and during unstructured times (i.e., PE, recess, lunch, etc.).


• Goals for communication repair and self-advocacy: As this month’s Update topic emphasizes, about a quarter of typically hearing students are victimized whereas over half of students with hearing loss typically experience some type of bullying. While being bullied is not the fault of the student with hearing loss, you can prepare them to deal with the likelihood of being victimized by adding goals for communication repair strategies and self-advocacy. This way you can work directly with your student on how to handle situations in which they are being bullied.

October is National Bullying Prevention Month.

The Problem:

• verbal: name-calling, insulting, teasing, ridiculing
• emotional/indirect: ignoring or deliberately excluding, spreading rumors or nasty stories, turning friends against the child, laughing at them or talking about them behind their back, taking, hiding or damaging their personal belongings, drawing unkind pictures of the child, using a feature of the child’s disability to bully them, e.g. deliberately making loud noises near a deaf child who is known to find loud noises unpleasant, creeping up on them from behind to scare them, deliberately making a noise when the teacher is giving instructions.
• physical: any physical contact which would hurt such as hitting, kicking, pinching, pushing, shoving, tripping up, pulling out hearing aids.
• manipulation/controlling behavior: using the child’s vulnerability as a way of controlling them or making them do something the bully wants them to do.
• cyberbullying: using electronic media (internet, mobile phones) to bully someone. This includes bullying through text messages, instant messaging, email, chat forums, online games and social networking websites.

Solutions:

1. 1. Ask the child about friends. A response of “none” or “few friends” deserves additional prompting (Why do you think that is?).
2. 2. Inquire if the child avoids going to school and request more information on the assistance the child has accessed.
3. 3. Ask the child directly if he or she has experienced bullying. If the child answers “yes,” ask follow-up questions and refer the child to school and community resources.

Recognize, React, and Raise Awareness

• http://www.nea.org/tools/lessons/teaching-students-to-prevent-bullying
• https://stompoutbullying.org/get-help/about-bullying-and-cyberbullying
• https://www.lebonheur.org/blogs/practical-parenting/keeping-up-with-your-child-online
• https://www.pacer.org/bullying/classroom/planet-fitness/
• Kraizer, S. (2007). 10 Days to a Bully-Proof Child. Marlowe & Co., New York. https://www.amazon.com/10-Days-Bully-Proof-Child-Confidence/dp/1569242534

1. 1. Warner-Czyz, A. D., et. al. (2018) Effect of hearing loss on peer victimization in school-age children. Exceptional Children. https://medicalxpress.com/news/2018-04-children-loss-bullying.html . Download from: https://successforkidswithhearingloss.com/wp-content/uploads/2019/09/Children-with-hearing-loss-face-more-bullying-2018.pdf
2. 2. 2016 news: https://www.newschannel5.com/news/national/burke-high-school-investigating-bullying-incident-after-it-goes-viral
3. 3. Van den Bedem, N.P., et al, (2018). Victimization, bullying, and emotional competence: Longitudinal associations in (Pre)Adolescents with and without developmental language disorder, Journal of Speech, Language, and Hearing Research, 61, 2028-2044.
4. 4. Goberis, D., Beams, D., Daples, M., Abrisch, A., Baca, R. & Yoshinaga-Itano, C. (2012). The Missing Link in Language Development of Deaf and Hard of Hearing Children: Pragmatic language development. Seminars in Speech and Language, (2012), 33:4, 297-309.
5. 5. Bullying Advice for Parents of Deaf Children. National Deaf Children Society in the UK. Download from: https://successforkidswithhearingloss.com/wp-content/uploads/2019/09/Bullying-Advice-for-Parents-of-Deaf-Children-NDCS-UK.pdf
6. 6. Warner-Czyz, A. D. (2018). Peer victimization of children with hearing loss. The Hearing Journal, October. Download from: https://successforkidswithhearingloss.com/wp-content/uploads/2019/09/Peer_Victimization_of_Children_with_Hearing_Loss.4.pdf

What are the key things that classroom teachers need to know in order to support my students?

1. Always share the WHY behind what you are asking them to do for the student. Once teachers understand WHY they need to use the teacher transmitter or pass-mic, WHY students need strategic preferential seating, and WHY we ask for pre- and post-teaching, most begin proactively thinking about what else they can do to support the student.

2. Everyone who will influence the success of the student needs to be at the training. It is critical that all staff who will interact with our students attend the training to hear the information from the TOD, AUD, or expert conducting the training. Asking teachers who attend the training, but are not experts in this field, to pass on the information is not fair to the student, the teacher who has just learned everything about the new student, or the teacher who missed the training.

• Difference between hearing aids and cochlear implants: It is important for people outside of this field to understand that cochlear implants are not the same as hearing aids. Additionally, there are still teachers and administrators who believe that cochlear implants restore normal hearing or believe that the students are no longer deaf.

• Understanding the audiogram: I explain the audiogram not from the technical perspective that clinical and educational audiologists understand it, but rather in order for teachers, coaches, and service providers to understand the speech spectrum and where the critical features of linguistic information occur. It is also very important for everyone to understand the unique loss and history of the student they will be serving. Many general education teachers and providers who have previously served students with hearing loss are under the impression that this means they understand what all students with hearing loss will need. Knowing the individual child’s loss, the technology they use, and their history helps everyone have a better school year.

• Incidental hearing/Incidental learning: It is critical for everyone to have an understanding of how our students may have gaps in their knowledge of language and concepts that their typically hearing peers know and how that can lead to misunderstandings in both their academics and social interactions.

• Hearing Assistive Technology (HATS): Hearing assistive technology is a term that encompasses the low incidence equipment in the IEP such as the personal FM/DM system, classroom sound field system, and pass-mic for access to peer input. After explaining what a student has in his/her IEP, it is very helpful to share the Hearing Loss in the Classroom video¹.

Filling the gaps

Conversational inequalities

Keeping up in the classroom

1. 1. Fisher, Frey, Hattie (2016) Visible Learning for Literacy Grades K12: Implementing the Practices that Work Best to Accelerate Student Learning. Corwin/SAGE, Thousand Oaks, California
2. 2. Duncan (2001). Conversational skills of children with hearing loss and children with normal hearing in an integrated setting. The Volta Review, 101(4), 193211.
3. 3. Caissie (2002). Conversational topic shifting and its effect on communication breakdowns for individuals with hearing loss. TheVolta Review, 102(2), 4556

• 100% Curriculum Vocabulary
• Cracking the Grammar Code (download the free assessment guide!)
• Evidence-Based Practice in Educating Deaf and Hard-of-Hearing Students
• Latin and Greek Roots
• No Glamour- Following Directions
• Phonological Awareness Chipper Chat
• SCRIPT – Student Communication Repair Inventory & Practical Training 2^nd Ed
• Promoting Language & Literacy in Children who are Deaf or Hard of Hearing
• Language Strategies for Little Ones