Tip Sheet for the Teacher of Auditorily Impaired
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Sample Letter to the Audiologist
This tip sheet is intended to guide the Teacher of Auditorily Impaired in their part of determining the extent to which a student’s vision and hearing loss impacts his/her ability to move and travel with purpose and safety in the environment of home, school and community.
Access to Information
For a student with deafblindness, the combined effects of the vision and hearing loss create a barrier that significantly impedes the ability to gather information from the environment. This causes chronic difficulties with incidental learning and concept development. Students cannot learn what they do not detect,
and they may be unaware of what they are missing. Similarly, developing auditory skills is critical in order for a student who is blind to be safe in and able to navigate and learn from his environment. Determining the best approach for maximizing audition for students with deafblindness will require a team approach and possibly even looking at these skills from a new perspective. Access to information is a primary issue for all students with deafblindness, and should be addressed in each IEP. The effects of deafblindness should be taken into account in assessments, evaluations and delivery of all related services provided to the student.
Skill, patience and teamwork are all required to meaningfully assess students with deafblindness. Two areas with which the AI teacher is very familiar show this concept clearly. The audiological report not only includes a description of the implications of hearing loss in a variety of settings with or without amplification, but also addresses the student’s vision loss in the following areas:
- Ability to speech read at near and distance in all types of lighting
- Identification of speaker or sound source at both near and distance in all types of lighting
- Localization of sound with or without amplification for orientation and mobility at both near and distance in all types of lighting
- Ability to see a referent under discussion at both near and distance in all types of lighting
- Interpret facial expressions and body language at both near and distance in all types of lighting
- When determining the child’s potential for communication through a variety of means including oral, aural, fingerspelling or sign language, the impact of the child’s vision loss needs to be evaluated to determine the following:
- Appropriate distance and placement for receptive fingerspelling and signing.
- Appropriate pacing for receptive fingerspelling and signing
- Appropriate access to tactile signing and fingerspelling, hand tracking, and co-active signing if necessary
Due to the complexity of needs of students who are deafblind continuous input from a core group is often needed to guide daily programming. The function of the core team is to review, refine, and direct on-going educational programming and may include those who daily and weekly interact with the student (e.g. parent, intervener, classroom teacher, teacher of the deafblind, VI teacher, AI teacher). The core team should meet regularly (weekly, bi-weekly, monthly or quarterly) based on the student’s needs. An extended team may meet with the core team when expertise is needed in specialized therapy areas (e.g. PT, OT, O&M).
A combined vision and hearing loss can profoundly impact the development of both receptive and expressive communication. A lack of informal and/or formal communication creates a barrier affecting all areas of learning. Many students with deafblindness have difficulty finding and engaging potential communication partners without support from someone (e.g. intervener, interpreter, DB teacher) who can bridge between the student’s unique communication system and typical speakers. Without this support the student is cut off from accessing both instruction and conversational interactions that are key to learning.
There are a number of syndromes that result in both a vision and hearing loss and may have bearing on the best educational approaches to use with the student. For example, a student with CHARGE Syndrome may be behind in experiential development due to numerous early hospitalizations.
For students with deafblindness, issues of challenging behavior are usually closely tied to sensory access and communication. Behavior is often the result of coping with situations that seem confusing or threatening due to lack of information available from others or from the environment. It can also be the result of frustration about being ineffective in communicating about important topics in more socially acceptable ways. The student’s difficulty in recognizing, trusting, and bonding with others can have an impact on behavior. Additionally, behaviors may result from the student’s need to stimulate or regulate sensory input, or they may be in response to pain associated with medical conditions like glaucoma or ear infections.
Deafblindness impacts the ability to form relationships and respond to interactions with others in typical ways. For example, a lack of environmental information makes it difficult to identify people, locate them, know what they are doing, or understand what they want. Many ordinary interactions may seem threatening, negative, or confusing to the student. In turn, the student’s need to gather information by close viewing and/or touch can offend others. It is not unusual to see withdrawal and problems with bonding. It is important to consider that social problems for a student with deafblindness are often the result of an on-going lack of essential information. The psychological impact of changes in vision and hearing experienced by a student with deafblindness may need to be addressed in the IEP.
Orientation and Mobility (O&M)
Deafblindness affects the ability of students to know where they are, and how to go from place to place. Certified O&M Specialists (COMS) will find that working with this population may require some changes in instructional approaches. Students with deafblindness get less information from the environment, and have a lower motivation to explore. Deafblindness affects the identification and use of sound cues. Students need more orientation to environments, and strategies to gather information about their surroundings.
The need for experientially based vocational assessment and instruction in real-world environments is heightened when sensory issues affect access to environmental information and practical experience. The ability to initiate and sustain meaningful leisure activities is impacted by the capacity to learn through modeling and gather environmental cues. Being an effective self- advocate about communication and access to information is essential for success in higher education, employment, and other community settings. Additionally, referrals to community services designed for people with deafblindness lead to better adult outcomes (e.g. community intervener, support service provider, interpreter, specialized residential & vocational support).