High School Student Sample – High Visual-High Receptive Interpreter Input Form for Florida’s Communication Plan Student name: Student Interpreters’ Names & Credentials: Interpreter 1: RID CI, CT Interpreter 2: RID NIC Interpreter 3: RID NIC Interpreter 4: RID NIC Interpreter 5: Level Pending Interpreter 6: Level Pending Grade: School Name: Forest High School Days & Periods Interpreter is with Student: Interpreter 1: 5th Interpreter 2: 1st Interpreter 3: 3rd, 6th Interpreter 4: 2nd, 4th Interpreter 5: Study Period Interpreter 6: Study Period All interpreters are contracted by the district and placed at the school Receptive X X X X Auditory/oral American Sign Language (ASL) Sign Supported Speech Bilingual/Bimodal (fluency in both ASL and English) English Sign System (CASE, SEE, PSE, etc.) Gestures or Home Signs Tactile Sign Language Cued Speech Reading and Writing (print or braille) Assistive Technology/use of a communication device or augmentative communication Emerging language or no formal language established (minimum language) Created by Sheri Arthur, Deborah Flagg, Margie Tyner, Linda Feliciano, Ann Cournoyer and Kayla Surdam 2016 Page Expressive 1 Section I: Consider the Student’s Language and Communication High School Student Sample – High Visual-High Receptive Tangible Symbol System Please describe your observations of the student’s communication skills: Student, “Student”, appears to understand each interpreter’s signing styles and various geographically influenced signing vocabulary. He is able to effectively joke around and communicate with his deaf and hard-of-hearing peers. He is able to adapt his language expression based upon his peers’ language and cognitive levels. Student is aware of his need for an interpreter for academic discourse and teacher lecture. He also prefers to have an interpreter to communicate with his hearing peers for meaningful discourse connected to academics. He is proficient at gesturing and communicating on a superficial and joking/silly manner with hearing peers, and is also attempting to socialize independently. Student has a strong understanding of American Sign Language grammar, vocabulary, and structure. He is able to express the depths of his thoughts, wants, and future aspirations. 2. Instructional Communication Access Checklist General Skills- The student demonstrates the ability to: Learn abstract and/or decontextualized material with minimal expansion? Learn new vocabulary from typical classroom exposure? Comprehend class content and instructions? Understand what to do without the interpreter directing? Make age-appropriate progress without excessive assistance? Complete classwork and assignments without interpreter assistance? Self-advocate for communication and learning needs? Receptive Language- Does the student: In American Sign Language Rarely Some Frequently 10-39% 40-69% 70-89% X Always >90% X X X X X X Never < 10% In American Sign Language Rarely Some Frequently 10-39% 40-69% 70-89% Always >90% X X X Page 2 Understand connected discourse used by adults in the current education setting? Comprehend and follow directions related to the curriculum? Understand the language of instructional activities? Never < 10% Created by Sheri Arthur, Deborah Flagg, Margie Tyner, Linda Feliciano, Ann Cournoyer and Kayla Surdam 2016 High School Student Sample – High Visual-High Receptive Demonstrates a language base strong enough to learn topics in depth with minimal simplification or restructuring of language? Attend to group conversations? Demonstrate incidental learning? Exhibit relative speed in processing new information comparable to classroom peers? Demonstrate the above receptive skills for language in the following settings: One-on-one Small Group Large Group Expressive Skills- The student demonstrates the ability to: Express himself in a manner that is easily understood by familiar adults Express himself in a manner that is easily understood by less familiar adults Peers in academic and social conversations? Use no more than 2 to 3 repairs/rephrases per conversation with an adult? Carry on a conversation with one peer independently? Carry on a conversation with one (hearing, nonsigning) peer with assistance? Participate in group conversation independently (NOTE: group number should be comparable to the typical size in the current or proposed educational setting) Participate in group conversation with facilitation with an adult (NOTE: group number should be comparable to the typical size in the current or proposed educational setting) Express ideas and convey a meaningful message using connected language? Adjust expressive style (pragmatics) to match environmental conditions? X X X X X X X Never < 10% In American Sign Language Rarely Some Frequently 10-39% 40-69% 70-89% X Always >90% X X X X X X X X X Created by Sheri Arthur, Deborah Flagg, Margie Tyner, Linda Feliciano, Ann Cournoyer and Kayla Surdam 2016 Page Student is able to understand language variances and different vocabulary. He has no problem asking for clarification. He struggles with acknowledging when he does not have knowledge of particular subjects. He naturally will provide interpretation for other deaf students whom have minimal or limited 3 3. Other observations related to language or communication: High School Student Sample – High Visual-High Receptive communication skills; but he needs to work on not appearing overconfident and boastful when aiding his peers. Student is naturally a fast signer in American Sign Language. While Student has an expansive vocabulary and understanding of ASL grammar, he still needs to work on his expressive communication skills. Student needs to be able to provide sequential information that is related to a specified topic that has been identified. We are also working on his ability to slow down his expressive signs so that all those around him can understand him with more ease. Section II- Considerations for Accommodations & Assistive Technology: 1. Please describe your observations of the student’s monitoring, maintenance, and use their amplification: N/A N/A N/A The student has an amplification device (hearing aid, cochlear implant, FM system, etc.) The student uses the device(s) consistently The student monitors their own device(s) Page The student will….. N/A Be responsible to put own hearing devices on and report when problems occur N/A Be encouraged to ask for repetition when it is evident that s/he did not hear message N/A Recognize effect of distance re: easier ability to listen to close speech versus far speech (Early Listening Function item demonstrations, discussion via My World Tool) N/A Self-select or move to an appropriate seat in proximity to the teacher or desired class peers N/A Appropriately ask for repetition of messages missed (i.e., more slowly, clearly. louder) N/A Recognize effect of interfering noise that occurs in learning environment ; demonstrate by closing classroom door, moving away from noise or requesting reduction in noise N/A Use pre-determined signal with teacher to indicate challenges listening/understanding N/A Request that FM microphone be passed, remind teacher to turn on FM microphone N/A Report simple names and purposes of hearing device parts and what can go wrong (no sound, intermittent, distorted (Hearing Aid Tic-Tac-Toe Bingo, FM Bingo) N/A Describe purpose and use of FM in simple terms to classroom teacher, with assistance N/A Increase awareness of recognizing when she has missed information (“When do you know that you didn’t hear or hear everything? ) N/A Be able to report “When is it hard to listen/hear/understand?” N/A Recognize when a question/direction is nonsensical N/A Appropriately use simple addition communication repair strategies N/A Improve in listening-in-noise skills Created by Sheri Arthur, Deborah Flagg, Margie Tyner, Linda Feliciano, Ann Cournoyer and Kayla Surdam 2016 4 2. Please complete the “Guide to Self-Advocacy Skill Development and check off the skills you have observed the student using consistently: High School Student Sample – High Visual-High Receptive N/A N/A N/A N/A N/A X N/A N/A X N/A Demonstrate ability to perform basic troubleshooting when hearing device malfunctions Describe purpose and appropriate use of FM with classroom teacher, with oversight Identify challenging listening situations in school Identify if the source of the listening difficulty was due to speaker, listener or environment issues Describe self-advocacy strategies to address challenging listening situations. Prioritize and implement use of strategies in some situations Improve ability to describe appropriate use of self-advocacy activities Discussion with classroom teacher to describe purpose and appropriate use of FM, set up signal system and request preferred accommodations, with assistance Identify challenging listening situations and improvements in self-advocacy strategies used Appropriately uses advanced communication repair strategies when requesting clarification in school or social situations Match appropriate self-advocacy strategies to identified listening challenges in school and social settings; meet expectations for use when priority listening challenges occur 3. Do you believe the student does or would benefit from any of these visual access considerations: DOES X X WOULD X X X X Preferential/flexible seating Line of sight considerations Copies of assignments/lessons/reading materials provided in advance Captioned media Alternate or Assistive Technology Device(s) Considerations for Visual Fatigue Lighting Considerations (ensuring the students can see the interpreter and other visual aids) Other Page A note-taker or advanced notes provided in all classes would be most advantageous for Student’s optimum learning needs. Created by Sheri Arthur, Deborah Flagg, Margie Tyner, Linda Feliciano, Ann Cournoyer and Kayla Surdam 2016 5 4. Do you believe the student does or would benefit from any of the following service provider accommodations: DOES WOULD X Note-taker or notes provided (to allow students to watch the interpreter) X Sign Language Interpreter/Cued Speech Transliterator Intervener (for duel-sensory impaired/deaf-blind students) Real Time Speech-to-Text Captioning Services (CART, C-Print, Typewell) Other High School Student Sample – High Visual-High Receptive 5. Do you believe the student does or would benefit from any of the following tactile access considerations: DOES WOULD Tactile Access to Sign Language Other 6. Describe the student’s skill in utilizing support and any actions needed (such as monitoring or training) for the staff of the student to ensure the student’s effective use of their accommodation you identified above: Student does have preferential seating in each of his classes to maximize his line of sight for the interpreter and visual aids. Most teachers do provide visual aides to maximize comprehension and provide notes in advance; not all teachers do this. While Student does well with lecture, he benefits greatly from lesson plans including visual aids, examples, and hands on learning experiences. 7. Using the "Informal Inventory of Independence and Self-Advocacy Skills for Deaf/Hard of Hearing Students" and “The Checklist of Student Use of Interpreter Services” rate your student's ability to use an Interpreter This inventory is intended to aid collaboration among students, parents, and educational team members in order to determine educational services and appropriate goals for the student’s Individual Education Plan. It is very important to include the student’s input and to recognize that even very young children should be building skills related to independence and selfadvocacy. Discussion should include what would be considered appropriate for the child’s age, cognitive abilities, and mode of communication when determining the items that may or may not be applicable. 0-1.5 Lacks independence and self advocacy skills 1.5-3.0 Some independence and self advocacy skills 3.0-4.0 Growing advocacy and independence 4.5-5.0 Substantial advocacy and independence Student Independence 4.0 4.0 3.0 4.5 3.875 Page Average of Response N/A 6 Takes responsibility for own amplification needs (uses consistently; indicates when it is not working; charges equipment or changes batteries independently). Takes responsibility for completing daily assignments and projects. Keeps track of assignments and materials and completes assignments on time. Follows schedule and manages time independently. Attempts to follow directions without assistance. Created by Sheri Arthur, Deborah Flagg, Margie Tyner, Linda Feliciano, Ann Cournoyer and Kayla Surdam 2016 High School Student Sample – High Visual-High Receptive 0-1.5 Lacks independence and self advocacy skills 1.5-3.0 Some independence and self advocacy skills 3.0-4.0 Growing advocacy and independence 4.5-5.0 Substantial advocacy and independence Services and Accommodations Understands technology (cochlear implants, hearing aids, FM) and can explain its benefit. Expresses personal opinions concerning current educational program / services. Notifies the appropriate person to request additional explanation or tutoring. Assists with training staff in relation to communication access and needed support services. Advocates for communication accessibility and accommodations. (i.e. captioning, preferential seating. lighting, note-taker, FM use) Explain his needs to a new teacher, interpreter or staff member. Explain type and degree of hearing loss and implication to the educational setting. Attends and participates in IEP meetings and transition planning. Average of Response 0-1.5 Lacks independence and self advocacy skills 1.5-3.0 Some independence and self advocacy skills 3.0-4.0 Growing advocacy and independence 2.0 4.0 N/A 4.0 4.5 4.0 2.0 4.5 3.57 4.5-5.0 Substantial advocacy and independence Independence: Peer Interaction Participates in class discussions, making comments relevant to topic. Takes a role in cooperative learning activities and self-advocates for communication needs. Uses communication strategies to interact with peers (requests interpreter, writes notes, gestures) Average of Response 0-1.5 Lacks independence and self advocacy skills 1.5-3.0 Some independence and self advocacy skills 3.0-4.0 Growing advocacy and independence 4.5 4.5 4.5 4.5 4.5-5.0 Substantial advocacy and independence Independence: Community 4.5 2.5 1.5 Created by Sheri Arthur, Deborah Flagg, Margie Tyner, Linda Feliciano, Ann Cournoyer and Kayla Surdam 2016 7 2.0 Page Makes telephone calls using technology (amplification, CapTel, Videophone), following expected procedures and etiquette. Accesses community services for the deaf and knows how to request specific services (i.e., interpreter, CART). Aware of community events for the deaf and hard of hearing Knows rights related to communication access (IDEA, ADA, etc.). High School Student Sample – High Visual-High Receptive Uses assistive technology in non-school settings (flashing/vibrating alarms, captioned media). Independently communicates in community. (orders in restaurants, makes purchases). Aware of deaf culture/community and self-identification options (D/deaf, hard of hearing) Average of Response TOTAL POINTS EARNED There are a total of 23 items. Subtract the number of NA responses from 23 then average the student’s responses. Compare to the continuum below to monitor growth over time. 0-1.5 Lacks 1.5-3.0 Some 3.0-4.0 Growing independence and independence and advocacy and self advocacy skills self advocacy skills independence Average Of Response 4.5 Unknown 3.5 3.08 3.63 4.5-5.0 Substantial advocacy and independence INFORMAL INVENTORY OF INDEPENDENCE AND SELF-ADVOCACY SKILLS FOR DEAF/HARD OF HEARING STUDENTS (©2005) Developed by: George Clark, MS. Ed, CI, NAD-IV & Laura Scheele, MS Ed, NICAdvanced The authors grant permission for use in K-12 educational settings. 0-1.5 Lacks independence and self advocacy skills 1.5-3.0 Some independence and self advocacy skills 3.0-4.0 Growing advocacy and independence 4.5-5.0 Substantial advocacy and independence For Students who use an Interpreter 5.0 4.5 3.5 4.0 4.0 4.0 3.5 8 4.0 5.0 1.5 1.5 1.5 Created by Sheri Arthur, Deborah Flagg, Margie Tyner, Linda Feliciano, Ann Cournoyer and Kayla Surdam 2016 Page Recognizes the need for interpreting services and respects their role as professionals. Explains the role of the interpreter versus the role of the teacher. Attends to the interpreter according to age expectations and student needs. Asks interpreter for clarification when interpretation is unclear and notifies interpreter of unclear signs/concepts. Uses interpreter effectively during testing situations. Gives appropriate feedback during interpretation to indicate comprehension of interpreted message. Articulates specific needs regarding interpretation (transliterating versus interpreting). Requests interpreting services, as needed, for printed English materials. Works with interpreter to prepare for presentations. Limits personal conversations with interpreter during instruction times. Generally understands RID/NAD Code of Professional Conduct in relation to educational and community interpreting. Knows grievance procedures for solving problems/conflicts with interpreter. High School Student Sample – High Visual-High Receptive Requests interpreting services for extra-curricular activities. 5.0 Average of Response 3.5 Based on the findings of the above inventory, the identified skill sets, and knowledge of deficits need to be addressed collaboratively. List the action steps that the following people will make to ensure progress on goals. Student: Classroom Teacher(s): Deaf/Hard-of-Hearing Itinerant Teacher (Teacher names here) Interpreters (List of interpreters’ names): We will continue to educate Student about how and when he can utilize an interpreter. We will continue to expose him to diverse interpreting styles and vocabulary so that he can begin to advocate for his interpreting preference. We are empowering Student to communicate with staff and peers to express his needs independently, while in a safe and supportive environment, to support his continued development of self-advocacy skills. We have a Deaf community liaison working with Student to educate him on the resources available in the Marion County and surrounding areas, resources available nationwide, and laws applicable to the Deaf community. His Deaf/Hard-of-Hearing Itinerant teacher and interpreters are also educating him on his rights as a Deaf individual, the laws that support equal access, and resources available to him within the community. Speech Language Pathologists (Speech Pathologist’s name here): Family Members: Other: Vocational Rehabilitation has been contacted and will also be working with Student. The Center for Independent Living has been working with Student as well 8. Does the student have access to any of the following safety considerations: N/A Other (Personal Electronic Devices) Cellular Phone Student does not have a cellular phone. He expresses the desire to have one to communicate with both hearing and Deaf peers and work on his independence skills Page Tactile Alerts 9 Videophones Visual Alert/Alarms Student has access at school. It is recommended that he also gets one at home as well He has access to strobe fire alarms at school Created by Sheri Arthur, Deborah Flagg, Margie Tyner, Linda Feliciano, Ann Cournoyer and Kayla Surdam 2016 High School Student Sample – High Visual-High Receptive Section III- Consider Academic Level and & Readiness to Engage in the Curriculum Complete the Checklist of “Socio-Pragmatic Language Behaviors” and please indicate the your observations of the student’s language skills 3 2 1 0 Uses language for this purpose occasiona lly Use of language for this purpose is emerging Never uses language for this purpose No opportunity to observe this behavior/ unknown X X X X X X X X X X X X X X X X X X X X X Created by Sheri Arthur, Deborah Flagg, Margie Tyner, Linda Feliciano, Ann Cournoyer and Kayla Surdam 2016 10 Visually attends to the speaker or interpreter (directed gaze or nodding to show attending) States, signs, or writes identifying information when asked: Name States, signs, or writes identifying information when asked: Birth Date States, signs, or writes identifying information when asked: Phone Number States, signs, or writes identifying information when asked: Address States, signs, or writes identifying information when asked: Family (#, who) Respects personal space of others (maintains 12” to 18” between self and others) Appropriate body postures; smiling Uses appropriate gestures Maintains physical appearance (age appropriate) Requests attention or assistance Responds to simple directions (whether response is correct or not) Requests objects or permission Makes a response to questions Uses appropriate vocal loudness and intonation for differing situations, i.e.: classroom vs. library vs. playground Asks questions to gain information Gives commands Gives simple directions (minimum of two steps) Opens a conversation appropriately Takes turns speaking in a conversation Closes a conversation appropriately 4 Uses language for this purpose easily and often Page 1. High School Student Sample – High Visual-High Receptive Maintains topic in a conversation Changes topic appropriately in a conversation Can clarify an idea when asked Can give reasons when asked Demonstrates polite interaction with peers Demonstrates polite interaction with authority figure Shows awareness of needs of and empathy toward others Responds appropriately to humor X X X X X X X X 2. Please describe the student’s typical behaviors during a teacher-lead read-aloud: Does not watch interpreter and follows text appropriately and independently Does not watch interpreter and cannot follow text appropriately and independently Watches interpreter and does not look at text Watches interpreter and text simultaneously (such as with an interpreter next to a document camera or interactive white board) Does not watch the interpreter or look at text Student switches back and forth from watching the interpreter to looking at the text, but is not able to see both at the same time X Section IV- Consider Opportunities for Direct Communication with Peers and Professional Personal and Opportunities for Instruction in the Student’s Language and Communication Modes: How do you observe student communicating with: X X (Prefers) ADULTS (Librarian, Principal, Counselor) Does not communicate with adults Communicates directly with adults using speaking/listening sign language, gestures, a communication device, etc.. Communicates with peers through an additional source, such as an interpreter or captioner TEACHERS (Signing and Non-signing) Created by Sheri Arthur, Deborah Flagg, Margie Tyner, Linda Feliciano, Ann Cournoyer and Kayla Surdam 2016 11 X (Prefers) X PEERS (Hearing and Deaf/Hard-of-Hearing Does not communicate with peers Communicates directly with peers using speaking/listening sign language, gestures, a communication device, etc.. Communicates with peers through an additional source, such as an interpreter or captioner Page 1. High School Student Sample – High Visual-High Receptive X X (Prefers) Does not communicate with teachers Communicates directly with teacher using speaking/listening sign language, gestures, a communication device, etc.. Communicates with peers through an additional source, such as an interpreter or captioner 2. Describe how instructional content is delivered to the student in various settings, such as with a classroom teacher, DHH itinerant teacher, Occupational Therapist, coach, speech-language pathologist, etc.. The student communicates directly with these teachers: Student prefers most of his academic instruction via American Sign Language. He is able to comprehend various signing styles and vocabulary easily. He appears to receptively comprehend instructions better when it is explained in American Sign Language grammar/syntax structure evidenced by his ability to accurately complete academics. When instruction is provided in a more English based sentence structure he typically needs additional clarification and expansion techniques. He has a broad vocabulary when expressing himself via ASL. Student is able to independently communicate directly to his teachers for simple needs, such as “water” or “bathroom” and while he still prefers to use an interpreter, he enjoys the ability of communicating independently. Expressively, Student is proficient communicating his own ideas, creative stories, answering academic and personal questions, and summarizing academic materials learned. He is able to code-switch contingent on who he is communicating with and understands that some of his peers have different cognitive and language abilities. He has the ability to express himself based on their sign language vocabulary, grammar needs, and cognitive needs. He is still learning that cognition is not directly related to a peers’ maturity level and that this also impacts conversation content and reactions. Student has exhibited an improved attention span and maturity while in classes, evident by completing assignments, completing his homework, and being attentive to lecture. He is able to finish challenging academics without shutting down. He is adept at using resources available to him, in his environment, to aid in his comprehension and completion of academics. Student has a playful inclination that he is able to moderate when needed to complete tasks. He has a very strong understanding of how to use an interpreter, and when to use the interpreter, versus when to ask the teacher for help. Student is able to communicate directly with his DHH Itinerant Teacher and his Speech-language Pathologist due to their signing capabilities. He is able to ask them for clarification or ask an interpreter to help clarify when the occasional need arises. We are working on his ability to become gentler and less supercilious in expressing his needs and language preferences. The student communicates through an additional source with these teachers: Page 3. In your opinion, do you feel that additional training could benefit you or any other staff involved with this student to provide an environment most conducive for language development and educational success? Please explain. Created by Sheri Arthur, Deborah Flagg, Margie Tyner, Linda Feliciano, Ann Cournoyer and Kayla Surdam 2016 12 NA High School Student Sample – High Visual-High Receptive Yes, we believe an in-service for teachers that specifically work with Student would benefit from an hour training to: Provide a typical history of deaf students entering the school system Explain more about the process of interpreting Discuss how to plan with an interpreter to effectively meet the daily classroom objectives while simultaneously meeting Student’s annual individualized educational goals Explain diverse methodologies of teaching a deaf student so that lessons can be more visual and more accessible Discuss why completing academic assignments while the teacher is lecturing is not accessible for the Deaf student Discuss the difference between ASL and English and how this may impact lessons, specifically in vocabulary, reading comprehension, and grammar based subjects/topics Explain facial expressions and body language and how that is vital to communication (and easily misconstrued by both hearing to deaf and deaf to hearing cultures. Ie: Student’s signs many creative ASL stories that are often comedic and overdramatic; staff can misinterpret his signing as anger or threatening when it is often his witty personality and ASL creative expression being exhibited) Section V- Considerations Regarding the Full Range of Needs 1. Describe any accommodations needed to provide communication access to non-classroom components of the school day, such as recess, lunch, assemblies, extracurricular activities, school plays, sports, field trips, etc... Page 2. Describe any other areas of need or concern you have for this student that is not yet been addressed (Social-emotional, cultural, etc.) Student would greatly benefit from more exposure to Deaf professionals within the community. He also needs to have more information about the alerting and notification systems available to create a more inclusive environment upon graduation (ie: strobe fire alarms, door bell, carbon dioxide, and crying alarms, etc.). He needs to know and understand and quote the laws that are in place to prevent discrimination and to provide a sign language interpreter for his needs. We would also like to teach more coping skills on how to interact with the hearing community. Student needs to be exposed to college, technical, and trade schools opportunities available to him specifically as a Deaf individual (National Institute for the Deaf or Gallaudet University). We would like to see him work closely with Vocational Rehabilitation and the Center for Independent Living to get him ready for living independently. Both of these entities will aid in preparation for independence and college/tech school readiness. 13 Student should always have interpreter available to him during assemblies, school plays, joining an after school sports team, and off campus field trips. He should be empowered to make the choice to attempt these activities without an interpreter, if he so chooses. Student does not require an interpreter during lunch, but has access to one if a need were to arise. Created by Sheri Arthur, Deborah Flagg, Margie Tyner, Linda Feliciano, Ann Cournoyer and Kayla Surdam 2016