Determining Support Needs for Children with Both Vision and Hearing Loss
In an Educational Setting
Adapted by the Georgia Sensory Assistance Project from a form developed by the National Center on
Deaf-Blindness
Determining Support Needs for Children with Both Vision and Hearing Loss
In an Educational Setting
Adapted by the Georgia Sensory Assistance Project from a form developed by the
National Center on Deaf-Blindness
Purpose of the Guide: The purpose of this discussion guide is to help IEP teams make informed decisions about the
supports that are appropriate for a particular student who has combined vision and hearing loss and is on the state deafblind registry. Enrollment on the deaf-blind state registry does not require that a student have IEP eligibility of deafblindness- only that a vision AND hearing loss exist.
Individuals who have dual sensory loss have absent, partial, or distorted vision and hearing which severely limits access to
visual and auditory information that is needed for learning and communication. They require special support services to
meet the challenge of providing access to information and communication in an educational setting. These supports
include a way to access information that others receive through vision and hearing, ways to communicate in a manner
others understand and can respond to, and opportunities to bond and form relationships with others in their school
environment.
Decisions on appropriate supports must be made based on an understanding of how a student learns, communicates,
and accesses information given the profound limitations on the receipt of sensory input that occurs with combined
vision and hearing loss.
BEFORE YOU BEGIN!
Prior to discussing what level of services are appropriate for your student, the IEP Team should:
 Ensure that the team has a member with expertise in the education of students who have dual sensory loss
 Review existing evaluation data.
If teams have questions about best-practice services for students with combined vision and hearing loss, or lack
expertise in the education of students who have dual sensory loss they should contact GSAP, DOE, or resources listed
below.
Step 1: Review Assessment
Before the decision about supports can be made, the team should review assessment information in the following areas:
 Vision and hearing
 Orientation and Mobility
 Communication
 Concept Development
 Self-help and Daily Living Skills
 Adaptive Technology
 Behavior
 Social/Emotional Needs
Have all Critical Student Assessments Been Completed and Reviewed?


Yes - Proceed to Step 2
No- Complete and review assessments before making decisions about an appropriate services
The Georgia Sensory Assistance Project is a federally funded OSEP grant to provide technical assistance to schools and families
supporting children who are deaf-blind. http://gsap.coe.uga.edu
Georgia Sensory Assistance Project at the University of Georgia – COE/CSSE- 570 Aderhold Hall, Athens, GA 30602
mveto@uga.edu -478-751-4459 or cdarrah@uga.edu 706-542-2433
Step 2. Assure that the student’s IEP team has a member with expertise in educating children who have dual sensory
loss.
Due to the low incidence of combined vision and hearing loss, many teachers and related service providers have little
experience with students who have dual sensory loss and a limited understanding of their unique needs. If the team
does not currently include an individual with this specific knowledge or training, GSAP, your state deaf-blind project may
be able to provide or assist you in finding one.
If teams need more information about supports for students who have dual sensory loss, the following articles may be
useful:
 Deafblindness: Educational Service Guidelines- You may request a bound copy from GSAP or find it on-line athttp://www.spannj.org/resources/Deaf_Blindness_Ed_Service_Guidelines.pdf
 Documenting Instructional Considerations for the Student with Combined vision and hearing loss by Robbie
Blaha, Education Specialist and Kate Moss, Education Specialist, Texas Deafblind Outreach https://www.tsbvi.edu/attachments/1746_AppIDBInstructional-Modifications.doc
 IEP Quality Indicators for Students with Deafblindness developed by Texas Deafblind Outreach https://www.tsbvi.edu/attachments/other/IEP_Indicators.pdf
 10 Issues to Always Consider When Intervening for Students with Deafblindness by David Wiley, Texas Deafblind
Outreach - http://www.tsbvi.edu/outreach-staff/3114-10-issues-to-always-consider-when-intervening-forstudents-with-deafblindness
 Assessment of Deafblind Access to Manual Language Systems (ADAMLS) by Robbie Blaha & Brad Carlson http://www.dblink.org/pdf/adamls.pdf
Step 3: Complete the discussion topics which follow:
1.
2.
3.
4.
5.
6.
7.
Use of Vision
Use of Hearing
Access to Information
Access to Communication
Access to Trusting Relationships and Social Interaction
Access to Conceptual Learning
Questions about the Educational Team
Topic 1: Use of Residual Vision
1. Does the student have residual vision?
 Yes
 No
2. How do you know this?
(If you answered “no” for Question 1, continue to Table 2 after describing how you know that the student does not
have residual vision.)
3. Describe how he or she uses vision to access information (e.g., must be very close to objects and people, relies
on particular visual fields) and how you know this.
4. List supports and adaptations the student requires to maximize the use of vision (e.g., personnel, vision devices,
alternative materials).
5. Describe how each support is currently delivered.
Topic 2: Use of Residual Hearing
1. Does the student have residual hearing?
 Yes
 No
2. How do you know this?
(If you answered “no” for Question 1, continue to Table 3 after describing how you know that the student does not have residual
hearing.)
3. Describe how he or she uses hearing to access information (e.g., must be very close to people) and how you
know this.
4. List supports and adaptations the student requires to maximize the use of hearing (e.g., personnel, hearing
devices, alternative materials).
5. Describe how each support is currently delivered.
Topic 3: Access to Information
For items checked “Yes,” describe the supports and adaptations the student requires and who will deliver them.
Examples of supports include, but are not limited to:






Close-up instruction
Tactile learning
Prior access to information presented during group
instruction
Assistance anticipating upcoming activities
Assistance transitioning from one activity to another
Orientation to and exploration of the environment
Supports (Including Personnel) and
Accommodations
Student Characteristics
As a result of combined vision and hearing loss, the student:
Relies on close vision and/or hearing to obtain
information (Describe)
Yes
No
Relies on touch to obtain information (Describe)
Yes
No
Requires support to participate in group instruction
(Describe)
Yes
No
Yes
No
Requires support when moving within environments
(Describe)
Yes
No
Requires support to know what will happen next
(Describe)
Yes
No
Requires support to transition between activities (this
refers to the cognitive and emotional aspects of
transitions as well as physical support) (Describe)
Yes
No
Yes
No
Yes
No
Requires support to locate items (Describe)
Requires support to explore surroundings (Describe)
Requires support to use assistive technology equipment
(Describe)
Summarize Your Responses- With responses to the above questions in mind, discuss whether current supports are
meeting the student’s needs for appropriate access to information. Do current personnel have the specialized skills
needed to provide supports that the student requires? A plan to provide appropriate access to information should be
specified.
Documentation- List the sources of information that helped you respond to the questions above (e.g., specific
evaluation reports; staff or family knowledge).
Topic 4: Access to Communication
For items checked “Yes,” describe the supports and adaptations the student requires and who will deliver them.
Examples of supports include, but are not limited to:










Instruction in the student’s primary modes of
communication
Facilitation of direct communication between the
student and others (including peers)
Ensuring that supplemental communication aids are
functioning and being used
Hand under hand instructional techniques
Consistent use of communication systems
Calendar systems
Consistent use of supplemental communication aids
Altered pacing of instructional and other activities
Providing extended time for the student to respond
Multiple communication partners proficient in primary
communication mode
Student Characteristics
Supports Including Personnel /Accommodations
As a result of combined hearing and vision loss, the student:
Communicates using sign language (Describe)
Yes
No
Uses tactile sign language, specifically
Yes
No
Uses other tactile communication methods (e.g., informal Yes
touch systems, touch cues, object cues) (Describe)
No
Requires a slow pace of communication (Describe)
Yes
No
Requires support to get someone's attention (Describe)
Yes
No
Requires support to express knowledge and interests Yes
(Describe)
No
Requires support to express needs (Describe)
Yes
No
Requires support to make requests (Describe)
Yes
No
Requires support to understand what others are
Yes
communicating (Describe)
No
Requires support to understand curricular content
(Describe)
Yes
No
Requires others to be in close proximity to communicate
Yes
(Describe)
No
Summarize Your Responses- With responses to the above questions in mind, discuss whether current supports are meeting
the student’s needs for appropriate access to communication. In particular, consider whether current personnel have the
specialized skills needed to provide supports that the student requires. A plan to provide appropriate access to information
should be specified.
Documentation- List the sources of information that helped you respond to the questions above (e.g., specific evaluation
reports, staff or family knowledge).
Topic 5: Access to Trusting Relationships and Social Interactions
For items checked “Yes,” describe the supports the student requires and who will deliver them.
Examples of these supports may include, but are not limited to:
 Functional analysis of communicative intent and perceived inappropriate behavior
 Formal or informal social skills training
 Teaching initiation and interaction strategies to peers and staff
 Facilitating social interactions with staff and peers using students primary modes of communication
 Assistance locating and identifying staff members and peers
 Assistance orienting to new people
 Provision of additional information when transitioning between individuals and activities
Student Characteristics
Supports Including Personnel / Accommodations
As a result of combined hearing and vision loss, the student:
Needs support to interact with peers (Describe)
Yes
No
Often expresses emotions in socially inappropriate ways
(Describe)
Yes
No
Has difficulty establishing trusting relationships with
educators and peers (Describe)
Yes
No
Becomes frustrated or confused when interacting with
educators and peers (Describe)
Yes
No
Summarize Your Responses- With responses to the above questions in mind, discuss whether current supports are meeting
the student’s needs for appropriate access to relationships. In particular, consider whether current personnel have the
specialized skills needed to provide supports that the student requires. A plan to provide appropriate access to information
should be specified.
Documentation- List the sources of information that helped you respond to the questions above (e.g., specific evaluation
reports, staff or family knowledge).
Topic 6: Access to Conceptual Learning
For items checked “Yes,” describe the supports and adaptations the student requires and who will deliver them.
Examples of supports include, but are not limited to:
 Pre-teaching, reviewing, and repetition
 Activity-based instruction
 Hands-on experiences to build concepts
 Meaningful and relevant activities
 Direct and incidental teaching
 Attach language to all experiences
 Generalization training
Student Characteristics
Supports Including Personnel/ Accommodations
As a result of combined hearing and vision loss, the student:
Does not understand concepts used in instruction or
conversation(e.g., up, down, over, stop) (Describe)
Yes
No
Does not understand concepts used in grade-level
standards work
Yes
No
Lacks understanding of the concepts of time. (Describe)
Yes
No
Lacks understanding of concepts associated with objects
(e.g. function, use) (Describe)
Yes
No
Does not understand concepts used in daily routines
(Describe)
Yes
No
Summarize Your Responses - With responses to the above questions in mind, discuss whether current supports are meeting
the student’s needs for appropriate access to conceptual learning. In particular, consider whether current personnel have the
specialized skills needed to provide supports that the student requires. A plan to provide appropriate access to information
should be specified.
Documentation- List the sources of information that helped you respond to the questions above (e.g., specific evaluation
reports, staff or family knowledge).
Questions about the Instructional Team
yes
no
For each question marked YES, discuss the supports
needed for the instructional team
Due to other demands in the classroom, does
the instructor find it difficult to remain in close
enough proximity so the student can maintain
visual, auditory, and or tactile access to
instruction? Describe any concerns:
Due to the needs of other children in the
classroom, does the instructor find it challenging
to adjust the pace of instruction so the deafblind student has enough time to get
understandable information through either
modified communication or tactile/close-vision
exploration? Describe concerns:
Do any instructors have difficulty or
unfamiliarity with the student’s preferred
communication modes (e.g., tactile symbols,
sign language, tactile sign)? Describe concerns:
Does existing staff find it challenging to schedule
time for deaf-blind –specific material adaptation
and equipment maintenance (e.g.,
communication aids, vision devices, hearing
aids)? Describe concerns:
Is it challenging for the team to be consistent
due to the large number of individuals working
with the student?
Describe concerns:
Is it challenging for the team to provide
necessary background and fill-in information to
help the student fully understand instruction
and conversation across all settings? Describe
concerns:
Summarize current staff ability to provide necessary supports:
Taken from: Determining the Need for an Intervener in Educational Settings. Developed by Texas Deafblind Outreach, TSBVI Outreach Programs
5/1/12
www.tsbvi.edu
Summary of Vision and Hearing Topics
Vision:
Summary of the Discussion
Summary of Access Topics
Access to Information
Access to Communication
Hearing:
Access to Social Interactions
Access to Conceptual Learning
Questions about the Instructional Team
Accommodations currently in place:
Based on the results of the team discussion, the team Based on discussion, the team identified the following
identified the following student needs for additional supports and adaptations to address the identified need
supports and adaptations. Please list specific examples
of situations where supports are not working.
One service delivery model for providing appropriate supports to students who are deaf-blind with significant needs in
the areas discussed above is through the use of an intervener. Interveners, through the provision of intervener services,
provide access to information and communication and facilitate the development of social and emotional well-being for
children who are deaf-blind. In educational environments, intervener services are provided by an individual, typically a
paraeducator, who has received specialized training in deaf-blindness and the process of intervention. An intervener
provides consistent one-to-one support to a student who is deaf-blind (age 3 through 21) throughout the instructional
day. Working under the guidance and direction of a student’s classroom teacher or another individual responsible for
ensuring the implementation of the student’s IEP, an intervener’s primary roles are to:
•
provide consistent access to instruction and environmental information that is usually gained by
typical students through vision and hearing, but that is unavailable or incomplete to an individual
who is deaf-blind2;
• provide access to and/or assist in the development and use of receptive and expressive
communication skills2;
• facilitate the development and maintenance of trusting, interactive relationships that promote
social and emotional well-being2; and,
 provide support to help a student form relationships with others and increase social connections
and participation in activities.
An intervener does not work in isolation. Instead, he or she:
•
•
•
•
•
participates as an active member of the student’s educational team,
attends and participates in IEP meetings,
attends regularly scheduled planning and feedback meetings with the teacher and other team
members,
is actively supervised and supported by the classroom teacher and other professionals responsible
for the child’s IEP, and
receives ongoing support from professional educators with expertise in deaf-blindness
For more information on the role of interveners, please contact GSAP.