Considerations to Determine DHH Service:
Level of Service and Minutes/Wk.
After completing nearly 25 years of classroom teaching experience in a centerbased DHH classroom, I began working as an Itinerant Teacher. The most difficult
question I had to address after assessing the Itinerant student was “Does the student
qualify for direct or indirect service?”; and if so, “How much time should the DHH
teacher serve in order to meet the DHH student’s needs?” It still remains a challenge in
our field. Following is a list of things that should have been answered during the
assessment process. This information will provide the IEP Team with factual
information to accurately define the student’s present levels of performance. From these
performance levels, the student-based needs can be determined. It then becomes the IEP
team’s responsibility to weigh each piece of information, establish and prioritize the
academic needs, and agree upon the service providers and minutes the staff person should
serve. Individual school districts have different policies and procedures. Each school
within a district has their unique internal service models. There is no “cookie cutter”
recipe for determining levels of service. This is especially true when testing students
from other cultures or ethnic backgrounds. Therefore, it becomes very important to have
collected broad-based data beyond just norm-referenced, academic testing.
STUDENT’S PERSONAL HISTORY
I. Family/Student Statistics: (Cum Record Review; Family Interview; Student Interview if age 14+)
A. Basic Data: age; address; phone #; previous schools attended; grade level
B. Immigrant Data: age entered the USA; previous countries of residence;
languages spoken in countries; primary home language; primary educational
language; general attitude of family toward handicapping conditions/hearing loss;
culturally significant information from parent interview
C. Health History: (health files; cum; parent interview)
1. General Health: birth trauma or accidents; medications; vision status;
asthma; allergies; chronic infections; other handicapping conditions
2. Hearing Loss: type; age of diagnosis; degree of loss; speech
discrimination score; tinnitus or recruitment; repeated infections; medical
follow-up related to hearing issues
D. Amplification/Cochlear Implant: (health files; parent/student/staff interview)
Age first amplified/implanted; type of amplification at home/school;
student/parent support for use of amplification/implant; general success of
amplification/implant; student’s ability to manage the equipment by him/herself
such as reporting malfunctions, changing batteries, charging equipment, etc.
II. Communication Mode: (parent/staff/student interview; language sample; classroom observations)
A. Oral Speech/Language Patterns: preferred language spoken at school/home
by student; interpreters/parents reports related to understanding student in
home language; staff/peer reports about understanding student’s oral language
in educational setting; participation in classroom oral activities
Oral language analysis: imitative or spontaneous; mean length of utterance;
complexity of utterances; ability to string sentences together; ability to share
information or relay messages
Written language analysis: copy or spontaneously produce words/sentences;
mean length of sentences; complexity of sentences/paragraphs/stories; takes
notes during class; composes personal notes/letters; demonstrates various
writing styles; composes various genre; completes applications/forms
B. Compensatory/Listening Skills: (MN Compensatory Skills Checklist; classroom observation)
Student uses visual clues to gain information by observing body language or
visual clues; asks for clarification of information; adjusts amplification to
maximize listening opportunity; requests appropriate seating; inform
staff/peers of hearing loss; initiates interactions with peers/adults; answers
questions based on classroom instructional materials
C Alternate Communication Modalities: (Observation; parent/staff reports; language samples)
l. Preferred Modality: ASL, oral/aural, cued speech or combinations of
the above modes
2. Cochlear Implant: follow-up therapy related to implant; auditory
training method used to support usage of implant
3. Use of Interpreter: primary language interpreter(bilingual setting),
ASL, cued speech, oral/aural or a combination of interpreters
STUDENT’S EDUCATIONAL HISTORY
I. Present Instructional Setting: (classroom observation; teacher and student interview)
A. Physical features of classroom: traditional/open classroom; lighting;
desk arrangements; tile/carpet/curtains to reduce noise; general background noise
B. Instructional Format: lecture; collaborative group projects; routine movement
within the building; use of visual aids; organizational study guides used at site
II. Academic Achievement: (Cum Files/Special Education Evaluation)
A. General School Records Related to Reading, Math & Writing Skills:
summarize past two years of attendance; credits earned; report card grades;
national/state test results in the above skill areas; staff comments related to class
participation and/or hearing concerns
B. General Education Academic Support: other related services provided by
regular education such as English Language Learner classes or other small group
learning experiences to support academics (volunteers at site, after school tutoring
programs, etc.)
C. Special Education Assessment: present levels of performance established in the
Assessment Summary Report
III. Social/Behavioral Interaction:
(health records; cum; staff/parent interview; classroom observation; attendance)
A. Behavior Reports: teacher reports; office referrals; delinquency; outside
agencies that provide support to the student
B. Interpersonal Relationships: talks to peers; chosen by peers; has friend(s) at
home/school; asks adults for help appropriately; transfers messages accurately/
timely/willingly/reliably
C. School Involvement Level: joins extracurricular activities; serves in student
government; helps to plan social events
D. Neighborhood Involvement: participates in local park/religious activities;
joins clubs sponsored by community organizations; helps with civic or cultural
events; has won awards/achievements
III. Transition Planning for students turning age 14+
(TIPS Transition Planning Guide or Career Game/Re Hot Jobs or Enderle-Severson Transition
Rating Scale; DHH Transition Survey; MN Compensatory Skills Checklist)
A. Interest Testing: career planning at building site as part of regular education
B. Transition Testing: future plans in Home Living; Recreation & Leisure;
Community Participation; Post-secondary & Life Long Learning;
Employment (See list above for possible inventories to use with students.)
C. DHH Transition Interview: identify assistive technology in daily life;
explain how personal hearing loss impacts home/training/work sites; aware of
Relay Services, Rehabilitation Services, etc; understands legal rights to access
interpreters in community/educational situations; understands “reasonable
accommodations” and how to appropriately ask for the services.
Strategy to Determine Service Level and Minutes
1. Gather all the above information
2. IEP Team Agrees on Student-based Needs: The older the student, the more
important it is to have the student identify and prioritize their own educational needs.
By becoming actively involved in the planning process, the student will be much
more likely to actually achieve the goals and objectives in their IEP.
 Develop list of educational needs: needs are directly related to the
information previously collected
 Prioritize the needs based on one or more of the following criteria:
-severity of discrepancy of performance compared to same age peers OR
to peers who have lived in the USA for the same number of years as the student
has lived in the USA
-sequentially needed to be able to learn the next skill
-the importance of a need area to be accomplished in order to meet the
student’s transition goals (learning specific job skill; driving a car, etc.)
 Assign a weight/importance to the needs on a scale of 1-10: the more
important the needs, the more direct service time should be allocated to meet
that need and visa versa. (See attached Rating Scale)
3. Determine which staff person available would best service that need:
Speech/Language; English Language Learner(ELL) teacher; Itinerant DHH Teacher;
Special Education Teachers at the site; Social-emotional issues by the School Social
Workers; Behavior Intervention Teacher; Occupational/Physical Therapist; Music
Therapist; etc.
4. DHH Direct/Indirect Service: The student based needs determine whether Direct or
Indirect Service is appropriate for the student:
 Indirect Service: training for staff concerning DHH issues; training related to
specific communication needs; meeting with staff to monitor student’s
compensatory/listening skills or academic skills; observing student to monitor
progress (but not meeting with the student to discuss the observation)
 Direct Service: working directly with student in the classroom setting or in a
separate area on specific skill areas (auditory training skills; compensatory
skills; academics; transition/self-advocacy skills
5. Student’s Daily Schedule and Minutes of Service:
Consider the number of times and the duration of time that the student is out of the
regular education setting. Prioritized which needs must be achieved before another
need should be taught. For example during the Kindergarten year the student is in
school for about 2 ½ hours per day. It becomes even more critical to prioritize and
select appropriate goals that would allow the student to be included on the prereading skills in the regular classroom. This might mean that the student should have
collaborative support during the lesson in the classroom setting to learn good
listening/compensatory skills rather than being taught in a separate area. When the
student is in a full day program, additional individual service time might be added to
teach specific sound-symbol associations necessary to develop first grade reading
skill levels. Try to reduce student movement as much as possible (EX: place
amplification equipment near or in the regular education classroom so the student
does not have to walk long distances to get equipment). Plan the specific student
schedule with the classroom teacher and student during the IEP meeting whenever
possible. This allows service to begin as soon as the IEP is signed. It also helps the
student to give input about which services are important enough to have it imbedded
in the daily routine and which the student feels able to learn with peers in the regular
education setting. The IEP Team ultimately determines the service level
and exact minutes each service provider should serve. The following
checklist can become a guide. The higher the score in an area: the
higher the need for direct service minutes.
Continue to the next page for the
Checklist for Determining Service
Student Name:________________________________
Birth date: _____________
CHECKLIST TO DETERMINE
DHH DIRECT/INDIRECT LEVELS
& MINUTES OF SERVICE
______Primary Language Spoken: (scale 1-10; (1) English to (10) a few English words)
______Attendance (# of absences during past two years)
______Severity of Hearing Loss (scale 1-10; (1) mild to (10) no response)
______Consistency of Past Education (number of moves; exposure to concepts sequential)
______Number of outside agencies serving the student
______Number of Additional Health and Educational Needs: (besides DHH)
______Use of Amplification at home: (scale 1-10; from consistently (1) to (10) rarely)
_____Use of Amplification at school: (scale 1-10; from consistently (1) to (10) rarely)
______Present Educational Setting meeting student needs:
(scale 1-10; from (1) consistently to (10) rarely)
______Communication Modality (scale 1-10; from (1) well imbedded to (10) learning new skill)
______Oral Language: (scale 1-10; (1) intelligible to strangers to (10) rarely intelligible to familiar people)
______Compensatory/Listening Skills in Educational Setting:
(scale1-10 from consistently (1) to (10) rarely)
______Reading Scores (discrepancy from grade level or from # of years in USA)
______Math Scores (discrepancy from grade level or from # of years in USA)
______Written Language: (scale 1-10; (1) understandable/accurate to (10) confusing ideas /inaccurate)
______Social/Interpersonal Skills:
(scale 1-10; (1) many positive peer interaction to (10) few positive peer interactions)
_______Behavior
Skills: (Scale 1-10: (1) no adult interventions to (10) suspension/expulsion)
______Transition Skills if 14+ (scale 1-10; (1) independent to (10) totally dependent)
______Other Contributing Factors: (List and prioritize separately)
*Higher scores in various areas indicate the need for Direct
Service rather than indirect service. The higher the score, the
more minutes a staff person should serve per week/month.
CASESTUDY: Example
Basic Data: Male; Age: 16; Hmong; Arrived in USA at age 9(in country for 7 years);
Parents speak very little English; Hmong primary home language; verbally fluent in both
Hmong and English; No prior formal education
Hearing Loss: diagnosed at age 9yrs.-7mo.; bilateral, sensori-nueral, mild to moderate;
chronic ear infections until age 11
Amplification: 2 ear-level hearing aids at age 10; not worn at home so kept in school and
staff enforced wearing of aids until entered Middle School; then student refused to wear
any amplification; Presently very little compliance with appropriate
compensatory/listening strategies
Academics: Not passed MN Basic Standards Test in Reading(5th grade level) or Math(6th
grade level) at age 16; English written language at about 4th grade level; social
adjustment concerns and some gang involvement; Parents concerned and supportive but
unable to change home/school compliance to rules/regulations; Hmong interpreter needed
to communicate with parents; Parents can not help with homework or read written
communication sent by staff
School Behavior: repeated absences for partial or total day; truancy filed; one 5 day
suspension for fighting; Manifestation Determination Status: behavior understood by
student as unacceptable in school setting so decided it was not due to his hearing loss.
Staff concerned that he has Oppositional Behavior Patterns but never diagnosed by
clinical testing. Tested for Attention Deficit Disorder (ADD); results not conclusive due
to hearing loss and language barriers. Psychological Testing had inconclusive ability
ratings-in average to slightly above average but possibly higher considering a second
language and hearing loss.
CHECKLIST TO DETERMINE
DHH DIRECT/INDIRECT LEVELS
& MINUTES OF SERVICE
___6__Primary Language Spoken: (scale 1-10; (1) clear English to (10) very few English words)
__35__Attendance (# of absences during past two years)
___2_Severity of Hearing Loss (scale 1-10; (1) mild to (10) no response)
___4_Consistency of Past Education (number of moves; exposure to concepts sequential)
___2__Number of outside agencies serving the student
__2/3__Number of Additional Health and Educational Needs: (besides DHH)
__10__Use of Amplification at home: (scale 1-10; from consistently (1) to (10) rarely)
__8__Use of Amplification at school: (scale 1-10; from consistently (1) to (10) rarely)
___3__Present Educational Setting meeting student needs:
(scale1-10; from consistently(1) to (10) rarely)
___6__Communication Modality (scale 1-10; from (1) well imbedded to (10) learning new skill)
___7__Oral Language: (scale 1-10; (1) intelligible to strangers to (10) rarely intelligible to familiar people)
___7__Compensatory/Listening Skills in Educational Setting:
(scale1-10 from consistently(1) to (10) rarely)
___2__Reading Scores (discrepancy from grade level or from # of years in USA)
___1__Math Scores (discrepancy from grade level or from # of years in USA)
___3__Written Language: (scale 1-10; (1) understandable/accurate to (10) confusing ideas/inaccurate)
___8__Social/Interpersonal Skills:
(scale1-10; (1) many positive peer interaction to (10) few positive interactions)
___10__Behavior
Skills: (Scale 1-10: (1) no adult interventions to (10) suspension/expulsion)
___5_Transition Skills if 14+ (scale 1-10; (1) independent to (10) totally dependent)
IEP Team Decisions
Needs Prioritized in order as follows:
 Attendance: Parents/School Social Worker communicate weekly by phone using
a Hmong interpreter (written in the adaptation section of IEP)
 Behavior Skills: School Social Worker and County Caseworker arrange for
outside of school counseling sessions 1 time/week for 60 minutes and 55 minutes
direct service with Behavior Interventionist at building site in a social skills group
with other Hmong students ages 14-18 one time per week. Indirect-15 min. to
monitor behavior and communicate with staff/parents
 English Language Learner(ELL): regular education ELL class 1 hour/day
 Academics: Special Education Resource Teacher-reading and writing skills;
direct service for 55 minutes/day
 Compensatory/Listening Skills: Deaf/Hard of Hearing Teacher-45 minutes
direct service(DS) and 15 minutes indirect service(ID), both DS and ID are 1
time per week to establish use of amplification and compliance with classroom
listening strategies/self-advocacy skills; DS is provided by meeting with the DHH
teacher after school; ID services are to observe in classes and communicate with
staff/parents
 Audiology: monitor hearing and amplification: Indirect 20 min. 3 times/year
D.
SPECIAL EDUCATION AND RELATED SERVICES TO MEET GOALS AND OBJECTIVES
Instruction or Service
Provided
Audiology
Teacher Deaf/HardHearing
Behavior Specialist
School Social Worker
Academic
Location
General
Special
Education Education
X
X
X
X
X
Anticipated
Frequency
3 times/year
1/week
1/week
1/week
5/week
Adaptations Section: Mention ELL services
Total Minutes
Per Session
Indirect
Direct
15
15
Service
Start
Anticipated
Date
Duration
45
55
15
55
Interagencies: County SSW/counseling
1 year
1 year
1 year
1 year
1 year