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Push-In Services for Students in the Mainstream

Push-In Services for Students with Hearing Loss in Mainstream Settings: The role of the DHH teacher

By Martie Martin, M.S.

Expectations in a nutshell

As itinerant teachers, we are asked to solve every problem that the deaf or hard of hearing student encounters. Not only are we supposed to be knowledgeable about any of the academic subject matter the student encounters in school, but we’re also supposed to know about every form of technology, the latest in CI processors and “please fix this, by-the-way”. Fix the equipment or fix the student, it doesn’t matter as long as its accomplished within the 15 minutes block we have in our schedule to see the student and then get to the next school site. We’ll stop back in a month, if our schedule hasn’t been comprised by an IEP meeting or quite simply, a flat tire on our car. Does this sound like you?

The Basis of Success

consultation - generic clip art photo
I count on clever students and smart teachers to help me with my work. That’s why I lay the groundwork early in the school year for the teacher who tolerates interruptions and the student who takes control of his/her hearing loss. At the beginning of the school year I am focused on the teacher. What is needed to make the year successful? Meeting with me, meeting with last year’s teacher, all staff in-service, equipment monitoring, academic monitoring, seating, consulting about the other student who has an IEP? To make the year successful, the needs can change, but meeting the teacher where s/he has concerns is the most supportive action I can take. The average classroom teacher has never had a student with a hearing loss, and s/he is expected to accommodate that student along with the 5 other IEP identified students and the 5 unidentified students in the classroom.

Elementary School Push-In

At the elementary level, when I walk into the classroom and there are management issues, I stand or sit next to the noisiest kids and watch the teacher. I model the behavior that I want to see from them while in close proximity. Those students may not have a hearing loss, but they impact my student. Or, maybe I help the table of students struggling with the assignment—I’m a teacher, I can teach general education students and my student benefits from seeing that I don’t isolate him/her from his/her peers and that other students need help, too. The teacher will notice and usually appreciate my help. This makes it easier when I briefly raise any academic concern, such as, “I noticed my student wasn’t understanding the direction about writing, but the other students seemed to be following the instruction. I’m certain that my student didn’t hear the part about using —.” While I want to support my student, the best support I can give is to be sure the teacher knows what I see specifically, not in general terms. “My student’s not hearing the instruction” is not nearly as helpful as “my student missed the instruction about… It would be really helpful if you wrote an example on the board while you’re explaining it.”

Fitting in Technology Checks

woman looking through hearing aids
And yes, I check the hearing aids and whatever hearing assistive technology is used in the classroom. I work with the student to check his/her equipment in the classroom. We are usually off to the side, but if another student has a question, I encourage my student to answer it. “What’s that?” becomes a dual opportunity to build advocacy and build a friendship.

By the end of elementary school, my student can trouble shoot whatever equipment s/he is using and report to me or the teacher any problems. I email the parents updates as I see them. Not every parent is responsive to my request for new earmolds, but everyone involved with the child, including the student, knows I made the request—in writing. With the bilingual student, I use an interpreter to call the parent when possible, and I call the clinical audiologist about the concern. In one school district, the audiologist had a form that she filled out about the status of the hearing aid, and gave this to the student or sent it home to the parent. The form was on NCR paper, so the audiologist had a copy. It was also translated into Spanish.

Middle School Push-In

Teacher Pointing
In middle school, the push in model looks a little different. I start with the same approach with the teachers, provide a checklist of information, limited to one page, and a more personal cover sheet about the student’s strengths and preferences. In the first month, I make multiple visits to the core subjects of that student, observing the teaching style and the student’s access to instruction. I’ll catch up with the student in a brief conversation in the hall. “I noticed xyz, do you think that is the best position for you in the classroom? Where would be a better seat? Do you want to tell the teacher, or do you want me to mention it?” Here’s the dilemma, while I want the students to advocate for themselves and we’ve talked about it, the reality is that they are shy about approaching a new teacher at the beginning of the school year. If I can assist initially, with the understanding that the teacher will check in with the student and s/he provide honest feedback, then the communication will be easier in the future.

The other support I rely on is the student’s ability to text me as soon as any equipment or access is problematic. I get permission from the parent, usually during the IEP or 504 meeting, exchange phone numbers and then the texts start to come in. It’s so empowering to the student to manage his/her own needs in these areas. Does it work all the time? No, but if I’m contacted some of the time, that’s better than not-at-all.

High School Push-In

teacher high school
At the high school, I provide the initial introduction letters to the teachers, I might sit in on a class or two briefly, but basically, I am relying heavily on the text messages and my occasional drop in visits with the student. If the IEP indicates that I am supposed to work directly with the student on specific academics or advocacy, then I schedule the student during his/her homework lab or library. I follow up with teachers when there are concerns, student confusion or access issues that aren’t being addressed.

Appreciating the Working Relationship

At the end of the school year, I always write a personal note to the teacher thanking him/her for being patient with my interruptions and providing support for the student. I might give a small gift card or other appreciation, depending on how disruptive the equipment/situation had been during the school year. One year we never could remove the intermittent personal FM hum while patched into the installed soundfield system. I had people traipsing in and out of the room on a weekly basis for months and ultimately the teacher ended up wearing two transmitters—that was over-and-above for my student.

Push-In by the SLP to Support Students with Hearing Loss in a Center-Based Setting

Experienced SLPs can provide auditory and speech therapy in the DHH classroom very successfully. They can have their own FM “channel” and can see what was happening in the classroom then carry over the activity to therapy weaving in the goals. They could choose to do a small group activity with students when the opportunity arises.Daily speech “aerobics” can be done with the class. And yes, even when focusing on listening skills, the presence of distraction and background noise can be an effective tool for determining the child’s proficiency. All of the students can be actively involved in not only their speech/listening goals, but also each others’, and best of all, the teacher can be actively involved, so carry over is fabulous. This approach is counter-intuitive, but with the right staff it can be effective, so it’s worth exploring. One year, the primary DHH classroom was studying about Christopher Columbus. The speech therapy “area” became a ship, idioms derived from sailing or fishing terminology became the lessons and articulation goals spun off of that. The teacher used the idioms regularly in the language arts curriculum. One of the teachers brought her sailing dinghy to school for the day and everyone was “on board” or they would have to “walk the plank”.

Substitute Teacher Pitfalls

My greatest frustrations are the substitute teachers who are not informed or choose not to provide access, and the students who say nothing to those teachers! I consider that issue to be a breakdown in the communication link between the classroom teacher and/or principal, case manager and the substitute, so I’ll send reminder emails to each of them. The teacher usually wants to know and is appreciative.

More information:

Pull-Out or Push-In Service Delivery Model: Conducive to Students or Teachers?

About the author:At her core, Martie Martin is an educator who is fascinated by the learning process. She started out in the mid-70’s as a teacher for the deaf/hard of hearing, teaching high school students reading at Mystic Oral School, Mystic, CT. After teaching in special day classes, she “graduated” to itinerant teaching (her passion), started a private practice, later obtained a degree in audiology, and has been contracting with school districts in the San Francisco Bay Area for nearly 30 years. She is a graduate of Purdue University (Speech Pathology), University of Oklahoma (Deaf Education) and San Francisco State University (Audiology).

Posted November 2014