WVSenseAbilities Serving children with combined vision and hearing loss in West Virginia Fall 2012 The West Virginia SenseAbilities Project The West Virginia Department of Education implements a statewide project to provide services to children who have a combined vision and hearing loss. The objectives of the Deafblind Project focus on the provision of technical assistance and training to create appropriate educational opportunities for children who have a dual sensory loss and their families. The Office of Special Programs in the West Virginia Department of Education is located in Building 6 in the Capitol Complex. Pat Homberg Executive Director of Special Programs Annette Carey WVSenseAbilities Project Director acarey@access.k12.wv.us Ruth Ann King WVSenseAbilities Project Coordinator raking@access.k12.wv.us Jim Smiley Conference Coordinator West Virginia Department of Education Office of Special Programs Building 6, Room 304 1900 Kanawha Blvd. E. Charleston, WV 25305-0330 Phone: 1.800.642.8541 1.304.558.2696 Web site: http://wvde.state.wv.us/osp/ deafblindresources.html Jorea M. Marple, Ed.D., State Superintendent of Schools Sensory Simulation Try It! One of the most effective ways of training people about the impact of vision and hearing loss is to have them participate in a simulation. Ten or twelve years later a teacher or parent may say things like this: “I will never forget when you made me put on those goggles and put in earplugs. Then you told us to fix a peanut butter cracker and we ate it!” “Walking down the steps blindfolded made me so scared! “ “I never really thought about how my child/student was having to access information. I should realize that I must make his materials easier to understand.” “It made me tired because I was trying so hard to understand what was going on.” “It made me depressed.” and things to that effect. It is true that much learning can come from listening to presentations, stories from others, watching video, etc. but nothing quite hits home better than “putting yourself in someone else’s shoes”. As the parent or team member of a child with vision and hearing loss it is important that you take the time to understand what your child or student sees and hears. You must have updated reports from the audiologist and ophthalmologist to find current information about the vision and hearing. With that you can begin to figure out as a team how the child needs to access information. We have tools for better understanding the impact of the vision and hearing loss that can help you. Sensory Perspectives is an excellent interactive 2-disk DVD set that addresses sensory loss related to deafness, blindness, and deafblindness. The program includes information on sensory loss and simulations of different types of hearing, vision, and combined vision and hearing losses. Using the technology you can put in what the child is seeing and what the child is hearing and it will take you through simulations of a child with those sensory losses on the playground, in a music class, listening to a teacher and being outside on a busy street. Another tool we have to share is called the Unfair Spelling test. Using this tool you can take a test that simulates a spelling test being given to students with varying hearing impairments. What you will find is that your grade does not reflect your actual knowledge but that your hearing loss impairs your ability to take the test. Modifications must be made to ensure that you are able to understand the word. With this information specific to the child you will be better able to think through tasks and the meaning of some of those everyday routines from the world of the child. Often times as care providers and teachers we only have the child participate in the actual task. Remembering that much of our learning comes from seeing and doing the entire task from start to finish provides us with the contextual basis of understanding the why. Teachers and parents will, years later, say that though they did not LIKE doing this simulation activity, they sure remembered it and they used that information to the benefit of the child. Try it! And let us know if you would like to borrow some of our simulation tools. - Ruth Ann King From a Parent’s Perspective PARTNERS IN POLICYMAKING As the mother of three children with developmental disabilities I was thrilled to be a part of the 2011-2012 Partners in Policymaking training. I was a little concerned about having to leave my family for 2 days a month for 9 months but the knowledge I have gained was well worth it. For the last 16 years my husband and I have been the biggest advocates for our children, and we have attended more than 30 IEP’s. One might think that we would be experts by now, hardly. I was astonished by all the information and resources “I feel much better that I was not aware of. Not only did Partners in Policymaking provide me prepared to help guide with the knowledge I need to advocate for my children in the school system my children through but they also empowered me with the knowledge and resources that I need to advocate for my children in our community. I currently serve as a board many challenges...” member for The Arc of the Mid-Ohio Valley and my husband and I have been attending disability advocacy day at the capital with them for the last few years to meet with our legislatures to discuss disability issues. The knowledge that I have gained from Partners in Policymaking has given me more confidence to speak with people in positions of power and to speak in front of small groups. I feel much better prepared to help guide my children through many of the challenges they have to face and I feel much better prepared to help other individuals who have disabilities find resources that could be beneficial for them. - By Jill Fox, mother of three children listed on the WV SenseAbilities Census 2 “Look, there are people here that look just like us”....were the words that came from our 4 year old daughter Emma as we walked into a room full of persons with albinism. “This is awesome”....were the words that came from our 8 year old son Alex while my husband and I looked at each other in silence. While our hearts warmed, we also felt nervousness, excitement, anxiousness and many other emotions. We were finally getting the opportunity to mingle among people, that to us, were “our normal”..... people with albinism! It was on July 11th that our family got to experience this life changing event. We walked into a hotel in Saint Louis, Missouri not knowing what to expect and left the hotel as part of a family, the N.O.A.H (The National Organization for Albinism and Hypopigmentation) family. The conference became a place of comfort for us...rooms filled with people like our children, people that know what our everyday lives are like. During the conference we attended many sessions and learned many interesting things. For example, we learned about what the albino eye sees. Not only do persons with albinism have low vision, but they also lack the ability to see details within their environment such as blades of grass, or the words on a street sign. We learned what sports are good for them and how to maintain self esteem. There were also classes on genetics and current along with future research for albinism and its effects on the eyes. While we attended grown up sessions, the kids had classes of their own, they got to spend each day with new friends that they made and do exciting things adapted just for them. We can’t say “Thank You” enough to those that helped us financially with our trip and to N.O.A.H. We were truly blessed to have so many people that wanted to help us make our trip to the conference possible. We also plan to attend the next N.O.A.H conference which will be in San Diego, California in 2014. We are very proud of our children, both of which have albinism, and we are proud to be part of the albinism community. When out in public, our children are often asked, “where did you get that white hair”.... it warms our hearts to know that their answer has always been “I’M ALBINO AND GOD MADE ME THIS WAY!”. We anticipate the next conference to be reunited with new friends and our albinism family! Sincerely and God bless, The Huddleston Family 3 Check out this new website!!!! Designed specifically for students and children with combined vision and hearing loss, you will get so many ideas for teaching literacy. http://literacy.nationaldb.org This past year we used the website in conjunction with offering some Make It Take It workshops. I have included some of the simple literacy materials that teachers made for their students. Try it! A set of numbers flashcards made from a poster from a dollar store. Poker chips are put on with Velcro to use as manipulatives. Braille dots have been added and on the back is the number in sign language for the teacher and others to use as a reminder. Some pre-Braille books were designed to help students who are blind and visually impaired begin to have books in their hands, learn to go left to right, turn pages, begin to understand the concept of reading. A teacher made a picture schedule with visually bright symbols for a child with low vision. 4 The Flipped Classroom and Other Options for Learning This portion of the newsletter is dedicated to technology. Many teachers are beginning to get iPads, smartboards, flip cameras, and other technology equipment to use in their classrooms. There has been a lot of training provided to keep teachers up to date with the technology. Our colleague, Lyn Ayer, from the Oregon Deafblind Project had this great article in her recent newsletter and she has given us permission to copy the information and pass along to you. Enjoy! Since this issue of the newsletter is about technology, I thought this term might be a good thing to think about, especially the aspects of what happens IN the classroom. What is it? Take a look at the “infographic” at www.brainmeld.org that explains the concept and how it functions, and its “history”. The creator of this site was a video game producer before he began creating games to liven up classroom lessons. At the same site, look for the “Video Game Teaching Guides”. Here’s what a teacher says:http://tiny.cc/hw0pjw Here’s a news report: http://tiny.cc/vq0pjw: Another teacher explains “Why I flipped my classroom”: http://tiny.cc/ wz0pjw While you watch, think about what this idea can do for inclusive education. Another person reminds us that flipping is not about technology and videos — and that it does not replace good teaching: http://tiny.cc/x60pjw And here is a listing of 10 reasons to use technology in education: http://tiny.cc/wh1pjw The author quotes Cheryl Nusbaum-Beach as saying, “Teachers will not be replaced by technology, but teachers who don’t use technology will be replaced by those who do”. So what might some of the implications be for our classrooms? It is interesting that you will hear about things that we already do in special education as something that technology will enhance for ALL children. For example: • Allow students to work at their own pace • Pay attention to different learning styles • Drill and practice (this is easy when it is “fun”) • Classroom amplification systems There are tons of ideas “out there” - some that you would have to buy and some that you could actually create. Here are some - directly associated with the equipment; and some that are presented via YouTube or other formats. DIGITAL SOUND: Let’s talk about MUSIC - which many of our youngsters love:VMI or Virtual music instrument which uses motion-detection technology: http://www.youtube.com/watch?v=OI5Iax8I58&feature=related How cool is this!!! http://tiny.cc/3eppjw “Virtual piano, guitar/banjo/mandolin etc, hammered dulcimer simulatorand note mapper lets you write & play back songs thru midi and see the notes animated on a musical staff and scale, piano keyboard, guitar/banjo/ mandolin, and hammered ... “ Table for simulation: http://www.youtube.com/watch?v=r4lGwDnuWUw Non-digital — still fun! A “hang drum”? Take a look: http://www.youtube.com/ watch?feature=endscreen&v=mS8eipuXYWg&NR=1 OR http://tiny.cc/bd79jw With a little ingenuity, you can create a hang drum. Search for ‘propane tank hang drums’ on YouTube! 5 DIGITAL TOUCH: The sense TOUCH - which has implications for our kids: Watch and listen to this news from Disney on Disney touch-based Touche Technology: http://tiny.cc/7h4pjw Wow! Some more sites to look at that give you a “window” into advances in touch technology: http://www.elotouch.com/technologies/ This site gives us clues as to what might be possible in the future for our children who are deafblind. If you would like to know more about Touch Screen Technology, here’s an article you can read — “Who Invented Touch Screen Technology?” Not only does it cover a history of this technology, but it also gives us a brief outline of HOW it works: http://inventors.about.com/od/ tstartinventions/a/Touch-Screen.htm . You can see how far we’ve come! You can learn more about how they work from another article, “How do touch-screen monitors know where you’re touching?” http://tiny.cc/tvhrjw DIGITAL PAINTING is becoming more advanced every day — from finger-painting to drawing and painting with precise tools. For example, Corel Painter not only allows you to do all sorts of interesting things — just with your hands. For example, with the Autodesk Sketchbook, you can not only sketch with your fingers, but you can turn the page any way you want, and then you can also color in what you sketch: http://tiny.cc/tairjw There are even adjustable stands which allow someone to work in a comfortable and ergonomic position, a “pen” (Nibs) that works its magic on the screen, and is set up for ambidexterity. You can rotate the screen and adjust the tilt as needed: http://tiny.cc/9lirjw Use an iPod Touch to fingerpaint. Watch this person: http://www.youtube.com/watch?v=54QGt3e9xkk Watch this person (“Tablet tips and tricks”) and how he uses drawing paper over his tablet — to stop the “slipping” with a pen-like device: http://tiny.cc/svirjw Here’s a really great YouTube video on the “Best art and drawing apps on the iPad”: http://tiny.cc/7pkrjw Design, produce symmetrical/mirror images, moving objects, fluorescent images - endless possibilities for fun! You can even try your hand at virtual pottery. Watch this person fingerpaint Spiderman on his iPod Touch: http://tiny.cc/z9irjw Did you know that you can even use an Amazon Kindle Fire to paint? Here’s a sample using a specific type of stylus. Watch while the person uses the Kindle like you would a notebook: http://tiny.cc/wwkrjw And then - something like this may be fun too - and all it needs is water in a tray of sorts! Painting ON WATER?? No kidding! http://tiny.cc/jgjrjw I think I could have a lot of fun with this - and so would kids! FRANGRANCES AND THE SENSE OF SMELL - DIGITAL TOO? This one is difficult to do “digitally” - YET - but it is not so far off in the future because some “digital wizards” out there are already thinking about this and working on how to make it happen: http://tiny.cc/ixlrjw . They talk about “teleofaction” that would allow a viewer to watch TV and smell what is being viewed. And they also talk about the “Scentsory” phone that will allow you to see, hear, feel and smell the caller’s environment. Or there’s a chip card that, used with a compatible mobile phone, can send scented text and picture messages, as well as smelly ringtones and games! Read more about “How Internet Odors will Work”. Learn about the iSmell — a personal scent synthesizer. SENX Scent Device goes one step further. Believe it or not — they are planning to have users not only download scents, but to print out flavors that can be tasted! Unbelievable! Movies will use eSmells — and you will be able to smell gunpowder when a canon fires. Keep reading….there are several other interesting links at the end: http://www.howstuffworks.com/internet-odor1.htm 6 However — for now — there are activities that could be fun and teach a variety of educational concepts. For example: Here’s something that might be fun to do as a group project — it will involve not just the senses of smell and sight — but, also, using the pulser will provide vibration — and you can actually hold and feel the end product — AND use it. A lot of concepts in there! http://tiny.cc/0vjrjw . This is just one example, but it includes a broad variety of concepts: • Color • Shape (swirls), cups, bowl, spatula etc. • Smell • The functional “process” of soap making, • Health and the value of washing hands etc • Taste (ugh!!) • Vibration and tools that might create it The concept of a flipped classroom is to, ultimately, make learning more attractive to young people, to do this on their own “techie” terms, and to draw them into educating themselves. We may not have to look too far to determine what children who are deafblind may find fun — while they are learning concepts, functional skills, about their everyday world — all the while communicating with people around them. The flipped classroom emphasizes dialog and discussion as a core of the “in-classroom” experience. FLIP THAT IEP and all those goals/ objectives — so that the whole plan becomes more meaningful! The National Association for Parents of Children with Visual Impairments hosted an International Family Conference July 27 – 29, 2012 at the Boston Marriott Newton. Through funding from The Greater Kanawha Valley Foundation, Charles and Sigal Kuhl and their three sons were able to attend. One of their sons has combined vision and hearing impairment. While the parents gained valuable information and resources related to their son’s needs, the boys had fun with other children from throughout the world with vision impairment and their siblings! 7 Strategies for Creating Communication-Rich Environments for Children who are Deaf-Blind By Maurice Belote This information is from an original article found in the California Deaf-Blind reSource Spring 2008 • Volume 13, Number 2 Page 5 CORE BELIEFS Everyone communicates Children who are deaf-blind are communicating all the time. Some children communicate in very obvious ways: speech, signed communication, sign language, pictures and drawings, voice output boards, etc. Other children may communicate in more subtle ways moving you to an object, standing near a desired object, eye gaze, withdrawal, change in muscle tone, self-injurious behaviors, etc. In many cases, the challenge to service providers and family members is to give the child a more socially appropriate way to communicate. The new system, however, must work as well for the child as the way she or he has communicated in the past or the child will have little motivation to use the new system. Everyone has the right to a formal communication system. A communication system is formalized when it is documented so that it follows the child who is deaf-blind from program to program. The system must be accessible to the child at all times, so it must be portable, and it must be appropriate to the child’s wants and needs. A communication system isn’t something that happens when the right person is hired, adequate funding is secured, or the next IEP is convened. Once a child’s team has developed the system, some parts of the new system can probably be implemented almost immediately. True communication is dependent on trust. Many children who are deaf-blind live in a world of surprise, contradiction, and confusion. One of the ways that service providers and family members can help a child to organize her or his world is to establish a relationship built on and respectful of trust, and to be mindful of the need for relationship repair if the trust is at risk. KEY POINTS Does the child have a way to communicate about the abstract, e.g. the past, the future, people who are not present, etc.? An important benefit of a well designed communication system is that it allows the child to share past experiences, future plans, and his or her feelings. Non-symbolic forms of communication do not typically allow for this. They are effective mainly for communicating about the present, such as immediate wants and needs. Does the child have opportunities to be a passive observer of other people communicating using the same system that the child uses? Children with sensory impairments may not realize that those around them are also effectively communicating, and communication is not always directed to/from the child. The child might not only find amazement in this discovery, but it may be an important component to her or his learning. Has the child experienced success and found joy in the ability to be clearly understood by others? Communicating effectively should be a wonderful experience and should not be stressful, at least at the start. Think about the way you communicate under stress: a job interview, an awkward social situation, a foreign language in which you are just marginally proficient. Choose a system that doesn’t require too much learning – at the beginning – in order to be successful. As much as you can, build in success. 8 Does the child have access to the communication system at all times? A communication system must be accessible in each of a child’s environments – home, school, transit, workplace, recreation sites, etc. The system, or at least a component of the system, must therefore, be portable. A point to remember about access: the child might communicate something over and over as she or he relishes this newfound power of communication. During this time, access to the system cannot be denied simply because the system is annoying. Validate the communication even when you can’t honor the specific request. Does the communication system meet everyone’s needs? A well-rounded system must not only include what adults would like the child to communicate about. It must also allow the child to talk about his or her interests – no matter how repetitive or peculiar the topics may be. The system must also take into account what others of the same age are interested in communicating about, so that the child who is deaf-blind is seen as an interesting potential communication partner to non-disabled peers. Is the child’s communication system documented? The system can be documented with videotape, written descriptions such as a personal communication dictionary, or a combination of these and other methods. Without documentation, some children are forced to learn new ways of communicating every time they transition to a new school, agency, foster home, etc. There may be someone on the child’s educational team who is uniquely suited to maintain this documentation, such as a speech and language specialist who doesn’t feel qualified to provide direct instruction to the child. There is probably an important roll for any service provider who is written into the child’s education plan. Is the child given opportunities to make choices throughout the day? There are many ways to build in choice making, even in structured situations. In school, if the child is required to complete a number of tasks, is it possible to allow the child to choose the order of these tasks? At home, is it possible to allow the child choice in clothing, food, meal times, etc.? To help with this process, try making a mental list of all the choices you make from the time you get out of bed in the morning. You may be surprised to discover how significantly your day might be affected if opportunities to make simple choices were taken away, e.g., having to wear an uncomfortable pair of socks all day, or being forced to drink too much at breakfast knowing that a bathroom will not be available during a long commute to work. Have you given yourself credit for your interest in this subject? Never underestimate the value of helping someone learn to communicate clearly. It may be the most important gift you can give, and will improve a person’s quality of life immeasurably. Further Reading: Remarkable Conversations: A Guide to Developing Meaningful Communication with Children and Young Adults who are Deafblind, edited by Barbara Miles and Marianne Riggio. Published in 1999 by Perkins School for the Blind, Watertown, MA. 9 1 Wednesday 2 Thursday Fri 3 October 26, 2012 • Advisory Board Café Cimino, Sutton, WV 7 Each year a group of selected advisors representing families, school systems, Birth to Three, and agencies working with individuals who are deaf or hard of hearing, blind or visually impaired meets. This group guides the planning of the WV SenseAbilities grant. 8 November 29, 2012 • Cortical Visual Impairment PATH Bridgeport Conference Center 9 10 For ten years, Cortical Visual Impairment training and assessments have been being offered in West Virginia. Many changes have occurred in developing a system of services. A core group of teachers and other service providers will meet to review the status of services in the state and give recommendations for the future. November 30, 2012 • “ Accessing the Curriculum for Students with Combined Vision and Hearing Loss” Bridgeport Conference Center Teachers and other service providers often have difficulty in linking curriculum to the state standards. Teaching CAN be very rewarding when you better understand how to take the standards and modify the content and materials to meet the needs of the individual students. And the students CAN learn! We will spend a day with Peggy Lashbrook, a national consultant in deafblindness, as she walks us through various content standards and we brainstorm around individual students. Planning for methods of teaching, access to materials and information will be a creative and fun process! Please join us! To register contact Ruth Ann King at raking@access.k12.wv.us or 304-558-2696. February 21 & 22, 2013 • Celebrating Connections The 2013 Celebrating Connections Conference is designed to promote effective and positive practices when working with young children and families; provide relevant information about policies, planning and research that enhances community partnerships and quality in early care and education. For more information contact Alyson Edwards at aedwards@rvcds.org. Building Effective Student Teams (B.E.S.T.) around Transition Needs November 16, 2012 • BEST Team Training March 1, 2013 • BEST Team Training March 22, 2013 • BEST Team Training Bridgeport Conference Center Four students ages 16 and 17 have been selected to be part of the 2012-2013 BEST team trainings. We focus on older students and makes plans for their last few years of high school and their life after graduation. Using the COACH Parent Interview family values will be considered. Teams will visit places in their community where adults with disabilities have meaningful daily activities, attend skills training, have part time or volunteer work experiences, and live with supports. The three focus teams are around students from Barbour and Wood Counties and the WV Schools for the Deaf and Blind. Teams will meet twice during the year to discuss their plans and work together to make a PATH for the next few years for the focus student. Information from various systems of support will be provided. 10 1 7 8 Wednesday 2 9 Thursday Fri 3 10 December 6, 2012 • Bridgeport Milestones December 7, 2012 • Teays Valley Milestones Children’s Vision Rehabilitation Clinic for Students/Children with Cortical Visual Impairment Children diagnosed with Cortical Visual Impairment or who have characteristics of CVI may be referred for selection to attend a clinic offered by the WV SenseAbilities Project and the WVU Children’s Vision Rehabilitation Project. Twelve children will be pre-selected to be seen each day. Children must be accompanied by a parent and at least one service provider so that information can be explained and then distributed to other team members. For more information contact Ruth Ann King at raking@access.k12.wv.us or 304-558-2696. March 9, 2013 • SPARKLE Boot camp Morgantown Waterfront SPARKLE is a Learning Program for parents who have children with a combined vision and hearing loss. Patti McGowan, a parent of a son with Usher Syndrome and Clara Berg, parent of a son with multiple disabilities including deafblindness, will facilitate group activities to assist parents in learning more about their child’s disability. Areas of study will include: Impact of combined vision and hearing loss, vision, hearing, touch, concept development, intervention. April 12 - 14, 2013 • WV SenseAbilities Family Enrichment Weekend Blackwater Falls State Park Each year families of children listed on the WV SenseAbilities Census have the opportunity to spend a weekend together. Informal sessions on subjects of interest to parents are offered. Mom’s and Dad’s discussion groups are another highlight. Childcare and nursing are offered for the children. This year siblings will be able to attend special SibShop groups to participate in activities and discussions unique to their situations of being a sibling of a child with a disability. All expenses are paid and travel expenses are reimbursed. July 19 - 24, 2013 • Camp Gizmo WV Schools for the Deaf and Blind, Romney, WV Twenty “focus” children between the ages of birth and eight will be accepted and assigned a team of professionals who help families identify and apply new strategies for solving their multiple assistive technology needs. For more information contact Kathy Knighton at kknighto@access.k12.wv.us or call 304-558-2696. 11 West Virginia Assistive Technology Systems (WVATS) and West Virginia SenseAbilities are pleased to announce the establishment of iCanConnect West Virginia, a program established by the Federal Communications Commission (FCC) to distribute a wide array of assistive technology to people with combined hearing and vision loss who require special equipment to make a phone call, send an email or access the Internet. Working in conjunction with the FCC, the Perkins School for the Blind, the Helen Keller National Center for DeafBlind Youth and Adults (HKNC), WVATS will connect people in West Virginia who are deafblind with the proper agencies to obtain equipment and training on how to utilize it. iCanConnect was mandated by the 21st Century Communications and Video Accessibility Act (CVAA) and provides a wide range of hardware, software and applications to suit the varying communications technology needs of people who have hearing loss plus visual impairment. West Virginia Board of Education 2012-2013 L. Wade Linger Jr., President Gayle C. Manchin, Vice President Robert W. Dunlevy, Secretary Michael I. Green, Member Priscilla M. Haden, Member Lloyd G. Jackson II, Member Lowell E. Johnson, Member Jenny N. Phillips, Member William M. White, Member Brian E. Noland, Ex Officio Chancellor West Virginia Higher Education Policy Commission James L. Skidmore, Ex Officio Chancellor West Virginia Council for Community and Technical College Education Jorea M. Marple, Ex Officio State Superintendent of Schools Who can benefit from iCanConnect West Virginia? Here are just a few examples. • A recent college graduate who is deaf-blind and wants to use Monster.com to search for a job • A young girl with combined hearing and vision loss who wants to use Skype to connect via sign language with her grandmother • A man who has lost sight and hearing as a result of aging and wants to use email and Facebook to reconnect with friends and family Who is eligible? Any individual who meets the definition of deaf-blindness in the HKNC Act and has an income that does not exceed 400% of the federal poverty level can qualify to receive telephone, advanced communications and information services equipment. Communication is essential for staying healthy, holding a job, managing a household and participating in the community. If you know someone who might benefit from the iCanConnect program West Virginia, please contact West Virginia Assistive Technology Systems at 304-293-4692 and West Virginia SenseAbilities (Annette Carey or Ruth Ann King) at 304-558-2696. You can also visit the new website, www.iCanConnect.org or call 1-800-825-4595. WVSenseAbilities Serving children with combined vision and hearing loss in West Virginia 12