Alison King, MSP, CCC-SLP, LSLS Cert.AVT
• Gain a better understanding of the unique
role that medical and educational facilities
have in assisting students with physical
and/or sensory disabilities
• Learning to recognize the unique
characteristics of students who have
physical and/or sensory disabilities
• Gain a greater understanding the eligibility
process for these students leading to service
delivery
• Learn how to find other resources which
may be beneficial for you as a professional
to best serve your student’s needs
• http://www.ted.com/talks/deb_roy
_the_birth_of_a_word.html
IDEA contains provisions for services
for students with physical or sensory
disabilities defined as:
– Orthopedic Impairment
– Hearing-Impairment
– Deafness
– Deaf-Blindness
"Orthopedic impairment" means a severe
orthopedic impairment that adversely affects a
child's educational performance. The term
includes impairments caused by congenital
anomaly, impairments caused by disease (e.g.,
poliomyelitis, bone tuberculosis, etc.), and
impairments from other causes (e.g., cerebral
palsy, amputations, and fractures or burns that
cause contractures). (34 CFR 300.8(c)(8))
Virginia DOE Statistics
2010 Child Count Data
There were 905 students between
the ages of 0-22+ that had the label
of Orthopedic Impairment.
http://www.doe.virginia.gov/special_ed/reports_plans_stats
/child_count/
Cerebral Palsy
Cerebral – brain
Palsy – lack of muscle control
CP as defined by the Mayo Clinic -disorder of
movement, muscle tone or posture that is
caused by an insult to the immature, developing
brain, most often before birth
http://www.mayoclinic.com/health/cerebral-palsy/DS00302
Cerebral Palsy – Etiology
Prenatal – before birth
Perinatal – during birthing process
Postnatal – after birth
Red flags: anoxia, stroke, prematurity, bilirubin
levels (jaundice)
Spina Bifida
open spine; malformation of the
spinal cord prior to birth
Occurs at various levels and degrees
Spina Bifida Occulta- mildest
Meningocele – covering of the spinal cord
protrudes through the opening
Myelomeningocele – spinal cord covering and
a portion of the spinal cord protrude
through the opening
http://www.childrenshospital.vander
bilt.org/services.php?mid=8205
Who will need to be involved in the
educational evaluation process?
What areas might need to be
addressed and how should they be
addressed?
May include:
– Psychological Evaluation
– Sociological History
– Educational Evaluation
– Classroom Observation
– Occupational Therapy Evaluation
– Physical Therapy Evaluation
– Speech-Language Assessment
– Vision/Hearing screening
• Legal Blindness – based on acuity and
field of vision
Acuity (clearness of vision)
• 20/200 while wearing corrective lenses
Field of Vision (spatial array of vision)
• Less than 20 degrees (normal is 160)
• Congenital- born with vision loss prior
to visual memories being established
• Adventitious – caused by an advent
whether that is a progressive loss due
to a hereditary (inherited condition) or
trauma
“Visual impairment including
blindness” means an impairment in
vision that, even with correction,
adversely affects a child’s educational
performance. The term includes both
partial sight and blindness. (34 CFR
§300.8(c) (13).
• Medical definition – clinical
measure (arbitrary) used to
determine eligibility for federal
benefits
• Educational definition – considers
the impact of visual impairment
on educational performance
Virginia DOE Statistics
2010 Child Count Data
There were 618 students between the ages of
0-22+ that had the label of Visual Impairment.
Of these, 35 students are served in state
operated programs (VSDB – Staunton).
http://www.doe.virginia.gov/special_ed/reports_plans_stats
/child_count/
• Low vision – can read print visually, but may
require optical aids to do so
• Functionally blind – typically use braille for
reading and writing; can use functional vision
for navigating then environment
• Totally blind – no meaningful input through
visual sense; read braille typically
• Damage to Cones – color blindness and
poor contrast sensitivity
• Damage to Optic Nerve – acuity
impacted; fragmented (spots)
• Damage to Macula – acuity impacted
• Damage to Retina – acuity and field of
vision are impacted
• Damage to Lens - cloudy
• Evaluations recommended are based on
information received from the parent, teacher, and
medical records.
• Review of medical information by the TVI (Teacher
for the Vision Impaired)
• Functional Vision Assessment
–
–
–
–
–
Communication
Orientation and mobility
Daily Life
Sustained Tasks
Social skills and interactions (pragmatics)
http://www.lea-test.fi/en/assessme/educearl/index.html#part3
• Low vision evaluations are typically
completed by an ophthalmologist or
an optometrist to determine if there
are “accommodations” that could be
beneficial.
• These accommodations can include
changes in lighting, larger print,
glasses with colored lenses,
magnifiers (handheld, lamp, video).
Other Evaluations may include:
– Psychological Evaluation
– Sociological History
– Educational Evaluation
– Classroom Observation
– Occupational Therapy Evaluation
– Physical Therapy Evaluation
– Speech-Language Assessment
• Reading Instruction through Braille
– Braille is tactile reading that does not have
a one-to-one correspondence to the
alphabet.
– Braille consists of 169 symbols and 450
rules for how to use those symbols
Consider the exposure time to print that
children with “normal” vision have had in
comparison to children with a Vision
Impairment…thoughts?
• Additional areas to be addressed
may or may not include:
–
–
–
–
–
Academic
Social
Daily Life Skills
Accommodations
Other?
What is your goal when writing an IEP?
• "Deafness" means a hearing impairment that
is so severe that the child is impaired in
processing linguistic information through
hearing, with or without amplification, that
adversely affects the child’s educational
performance. 34 CFR § 300.7 (c) (3)
• "Hearing Impairment" means an impairment
in hearing, whether permanent or fluctuating,
that adversely affects a child’s educational
performance but that is not included under
the definition of deafness in this section. 34
CFR § 300.7 (c) (5)
Virginia DOE Statistics
2010 Child Count Data
There were 1,473 students between
the ages of 0-22+ that had the label of
Hearing Impairment and 25 who had
the label of Deaf-Blindness.
http://www.doe.virginia.gov/special_ed/reports_plans_stats/ch
ild_count/
There were 357 students provided
services in state operated programs.
111 students provided services at
VSDB Staunton.
– HI – 71 (under 5% of total population)
– VI – 35
– DB – 5
• Congenital – hearing loss is present
at birth
– Genetic
– Prenatal infections (ex. CMV)
• Acquired – hearing loss after birth
–
–
–
–
Progressive hearing loss (hereditary)
Trauma (Turn down your earbuds!)
Ototoxic medications
Otitis Media (ear infections)
• Conductive -Occurs when sound is not
conducted efficiently through the outer
ear canal to the eardrum and the tiny bones
of the middle ear. This type of hearing loss
can often be corrected medically or
surgically
• Sensorineural - (SNHL) occurs when there
is damage to the inner ear (cochlea), or to
the nerve pathways from the inner ear to
the brain. Most of the time, SNHL cannot be
medically or surgically corrected
• Mixed – Combination of both conductive
and sensorineural
dB (decibels) – loudness level
Hz (hertz) – frequency (pitch)
Degree of hearing loss
Hearing loss range (dB HL)
Normal
–10 to 15
Slight
16 to 25
Mild
26 to 40
Moderate
41 to 55
Moderately severe
56 to 70
Severe
71 to 90
Profound
91+
• http://www.starkey.com/hearingloss-and-treatment/identifyhearing-loss/Hearing-LossSimulator
Universal Newborn Hearing Screening
• In 2005, 91.5% of the nearly 4 million babies born in
the US had their hearing screened prior to leaving the
hospital. (CDC)
• 1 month= All infants are screened for hearing loss prior
to discharge from birthing/neonatal facilities, or within
one month of birth.
• 3 months= All infants referred from the screening
process complete diagnostic audiological evaluation.
• 6 months= All infants with diagnosed hearing loss
receive appropriate interventions
including amplification and Early Intervention.
• Hearing aids – Selected and
programmed based on an
individual’s loss (dB and
frequency)
• Cochlear implants – Does NOT
restore hearing! Used for
sensorineural hearing loss or
auditory neuropathy
• http://www.youtube.com/watch?v
=Poyj7U2wzhQ
• http://www.youtube.com/watch?v
=Poyj7U2wzhQ
• ASL (American Sign Language) –
bilingual approach which uses
American Sign Language and
English; ASL has it’s own distinct
grammar and linguistic principles.
• Auditory-Verbal- Emphasis of
developing spoken language
through listening
• Cued Speech - An auditory-visual
communication approach with the use of
hand cues with the natural mouth
movements of speech, specifying each
sound (phoneme) of spoken language
clearly
• Auditory-Oral - An approach that
teaches a child to use his/her remaining
hearing through amplification and the
use of speechreading/natural
gestures/visual cues to aid the child’s
understanding of language.
• Simultaneous Communication- an
educational philosophy that uses
spoken language and sign
language simultaneously. The
sign is English-based.
Who decides what (or if)
amplification should be used?
Who decides what communication
option should be used?
When are these decisions made?
• Audiological Information
• Auditory Skills or Sign Skills
Assessments
• Psychological Evaluation
• Sociological History
• Educational Evaluation
• Classroom Observation
• Speech-Language Assessment
• PT/OT evaluations
Personal FM systems – connects
directly to the HA or CI
•
Decreases the “distance” factor
•
Provides the best opportunity for
the child to hear and not miss
important information from the
teacher.
Soundfield amplification – speakers
in the classroom
• Things to consider…
– History
– Communication modality
– How long they have been hearing
– Parental choices
– LRE (?)
It is all about LANGUAGE!
• Read the short case study.
• Complete the Appropriate Eligibility
Checklist(s) and made 3 suggestions for IEP
development if they are eligible. If they are
not eligible, make 3 suggestions for their
education (i.e. 504, reading specialist, medical
plan).
What are 3 important items that we
need to take away from tonight?
AG Bell Association for the Deaf and Hard of Hearing
http://listeningandspokenlanguage.org/
National Cued Speech Association
http://www.cuedspeech.org
National Association of the Deaf
http://www.nad.org
VCU Cochlear Implant Program
http://www.vcu.edu/ent/cicenter/
American Foundation for the Blind
http://www.afb.og
http://www.perkins.org
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http://www.ted.com/talks/deb_roy_the_birth_of_a_word.ht
ml
http://www.doe.virginia.gov/special_ed/reports_plans_stats
/child_count/
http://www.mayoclinic.com/health/cerebralpalsy/DS00302
http://www.childrenshospital.vanderbilt.org/services.php?
mid=8205
http://www.aph.org/advisory/2013adv03.html
http://www.medel.com/blog/photographic-tour-of-thecochlea
http://www.asha.org/public/hearing/Degree-of-HearingLoss/
http://www.starkey.com/hearing-loss-andtreatment/identify-hearing-loss/Hearing-Loss-Simulator