This multimedia product and its contents are protected under copyright law. The following are prohibited by law: •any public performance or display, including transmission of any image over a network; •preparation of any derivative work, including the extraction, in whole or in part, of any images; •any rental, lease, or lending of the program. Chapter Nine Teaching Students with Sensory Impairments (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 Introduction There remains some debate regarding the best setting in which to provide services for students with sensory impairments. Historically, many students with sensory impairments were served in residential facilities. Today, many students with sensory impairments are served in general education classrooms. Most students with sensory impairments are capable of handling the academic and social demands of general education classroom settings. (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 Accommodations For students with sensory impairments, a variety of academic accommodations may be needed such as: Seating adjustments Sophisticated equipment for listening, communicating, or navigating Support of additional personnel (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 Low-Incidence Disabilities Sensory impairments are considered low-incidence disabilities since there are not large numbers of these students in the school population. These students represent a very small percentage of all students who are disabled. (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 Basic Concepts About Hearing Impairments (HI) HI is a hidden disability. However, when communicative skills are needed, hearing limitations become evident. (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 Placements Relatively few students with profound hearing loss (deafness) are educated in general education settings. More students with mild to moderate hearing impairments are educated in general education settings. When these students are in general education settings, they need major accommodations. These students can function more easily in these settings. Students with minimal hearing loss do not qualify for special education. These students are at a distinct disadvantage if the teacher does not provide recognize and accommodate their problems. (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 Impact of Hearing Loss on Language Acquisition The relationship of hearing loss to language acquisition is very important for teachers to understand. This means that language is a dominant consideration when discussing appropriate education for students with hearing losses. (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 Hearing Impairments Defined Hearing impairment is the generic term used to cover the entire range of hearing loss. Deafness describes a person with a hearing loss that is so severe that speech cannot be understood through the ear alone, with or without aids. Hard of hearing describes individuals who have a hearing loss that makes it difficult, if not impossible, to understand speech through the ear alone, with or without a hearing aid. (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 How Hearing Loss is Measured Hearing loss is often measured in decibel (dB). Individuals with losses from 25 to 90 dB are considered hard of hearing. Individuals with losses greater than 90 dB are classified as deaf. (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 IDEA Definition 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 a child’s education performance. (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 IDEA Definition 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. (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 Definition of Minimal Hearing Loss Minimal hearing loss, which is not included in the federal definition of hearing impairment. This condition, however, can cause problems for students. Minimal hearing loss is defined as a loss of hearing between 16 and 25 dB. (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 Classification of HI Conductive Hearing Loss (mild loss in both ears) Unilateral Hearing Loss (loss only in one ear) Mild Bilateral Sensorineural Hearing Loss (caused by sound not being transmitted to the brain Moderate-to-Severe Bilateral Sensorineural Hearing Loss (more severe loss in both ears) (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 Prevalence of HI About 0.11% of students with hearing impairments are served in special education. Despite this small number, the Centers for Disease Control and Prevention have estimated that as many as 15% of all children experience some degree of hearing loss. This includes those children with minimal hearing loss that does not result in eligibility for special services. (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 Causes of HI There are many causes of hearing Impairments. These include: genetic causes developmental anomalies toxic reaction to drugs infections prematurity Rh incompatibility birth trauma allergies (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 Characteristics of HI Psychological Communicational Academic Social-Emotional (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 Indicators of HI Turns head to position •Gives incorrect of speaker answers to questions Misarticulates certain speech sounds or omits certain consonant sounds Asks for information to be repeated frequently Has frequent colds, earaches, or infections Withdraws from classroom activities that involve listening Uses a loud voice when speaking Appears inattentive and daydreams •Has a confused expression on face Pulling or pressing on ear Has difficulty following directions Has a restricted vocabulary Does not respond when spoken to •Is easily distracted by visual or auditory stimuli •Fidgeting or moving about in seat (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 Formal Assessments The assessment of hearing ability requires the use of various audiological techniques including: Pure-tone audiometry tests Bone conduction hearing tests (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 Informal Assessment Teachers and school personnel should engage in informal assessment of students suspected of having a hearing impairment. Informal assessment typically focuses on observing students for signs that might indicate a hearing loss. (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 Realities of the General Education Classroom Students with HI vary greatly in their need for supports in the general education classroom. Students with mild losses typically need minimal supports. Students with severe hearing impairments typically require specialized instructional techniques such as: Alternative communication methods Use of interpreters (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 Continuum-of-Placement Options Placement of students with HI ranges from general education classrooms to residential schools for the deaf. The topic of educational placement has been the most controversial aspect of educating students with HI. The placement decision for students with HI should be based on the unique needs of the student and the IEP process. (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 Placement Trends The trend is towards educating more students with HI in general education classrooms. During the 1998-1999 school year: almost 60% of all students with HI were educated in general education classrooms for at least 40% of the school day. fewer than 10% of students with HI were educated in residential settings. (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 Standard Operating Procedures Students with HI should be required to follow the same rules, routines, and procedures expected of other students. Some procedures may have to be modified to accommodate special needs. Example: Students may need to be allowed to leave their seats to get the attention of a student who cannot hear a spoken communication. Example: Teacher may want to establish a buddy system in which a student with normal hearing is assigned to assist the student with a hearing impairment (e.g., taking notes, notifying of fire drill). (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 Physical Considerations Seating is a major consideration. Teachers need to ensure that students are seated to maximize the use of their residual hearing and/or to have an unobstructed view of an interpreter. Students with HI need to be seated so that they can take advantage of all visual cues. Teachers should seat students who use interpreters so that they can easily see the interpreter, the teacher, and any visuals that are used. (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 Teaching Tips Seat student in the best place to facilitate attending and participating. Seat students in a semicircular arrangement to increase sight lines for students and teacher. Position teacher so that the student can read lips. Position teacher so that he or she faces students when talking. (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 Creating a Favorable Environment Attention must be given to creating a supportive acoustical environment throughout the classroom. Acoustical modifications include: Acoustical ceiling tiles Carpeting Thick curtains Rubber tips on chair and table legs Proper maintenance of ventilation systems, lighting, doors, and windows (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 Preinstructional Considerations Allow students to move about the room to position themselves for participation in ongoing events. Provide visual reminders indicating the amount of time left for an activity or the end of class. Acquire or develop visually-oriented materials to augment orally presented topics. Let students use swivel chairs. Ensure that adequate lighting is available. Include a section of the lesson plan for special provisions for students with HI. Reduce distractions and competing noise by modifying the classroom environment. Use cooperative learning arrangements to facilitate student involvement. Use homework assignment books and make sure students understand their assignments. (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 Communication Strategies The most challenging aspect of teaching students whose hearing is impaired is making sure that: they participate in communicational activities that are occurring in the classroom. they are able to handle the reading and writing demands of the classroom. (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 Communication Strategies Students who have profound hearing loss must rely on alternative means of communication such as sign language or lip reading. Teachers need to remember that sign language does not follow the grammatical conventions of English. (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 Communication Strategies Students may use some form of manual communication such as American Sign Language (ASL). Teachers are not required to learn this language. Teachers should make an effort to know some of the more common signs and to be able to finger-spell the letters of the alphabet as well as numbers one to ten. If students can communicate only by using sign language, an interpreter will most likely need to be present. Teachers should know basic information about the roles and functions of an interpreter. (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 Communication Strategies Another form of communication that may be effective is cued speech. Cued speech is a system of hand cues that enhances lip-reading. Eight different handshapes represent consonant sounds and four hand positions represent vowel sounds. By using the signs near the lips, students have cues that help with their lip-reading. (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 Tips for Delivery of Instruction Make sure students are attending. Provide short, clear instructions. Speak clearly and normally; do not exaggerate the pronunciation of words. Keep your face visible to students. Avoid frequent movements around the classroom, turning your back on students while talking, and standing in front of a bright light source. Use gestures and facial expressions. (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 Tips for Delivery of Instruction If the student reads speech, make sure that your mustache and beard are trimmed to maximize visibility. Maintain eye contact with the student, not the interpreter. Encourage students to request clarification and to ask questions. Check with students to confirm that they are understanding what is being discussed or presented. Identify other speakers by name so that students can more easily follow a discussion among more than one speaker. (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 Tips for Delivery of Instruction Repeat the comments of other students who speak. Paraphrase or summarize discussions at the end of a class session. Write information when necessary. Have students take responsibility for making themselves understood. Provide students with advance organizers such as outlines of lectures and copies of overhead transparences. (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 Tips for Delivery of Instruction Provide summaries, outlines, or scripts of videotapes, videodiscs, or films. Let students use microcomputers for word processing and for checking their spelling and grammar. (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 Tips for Addressing Social-Emotional Needs Create a positive, supportive, and nurturing classroom environment. Help the students with normal hearing understand the nature of hearing impairment and what they can do to assist. Help students develop problem-solving skills. Encourage class involvement through active participation in classroom activities and interaction in small groups. Practice appropriate interactive skills. Help students develop realistic expectations. Let students know that you are available if they are experiencing problems and need to talk. Encourage and assist students to get involved in extracurricular activities. Prepare students for dealing with the demands of life and adulthood. (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 Assistive Listening Devices Assistive listening devices (ALDs) include hearing aids and other devices that amplify voices and sounds, communicate messages visually, or alert users to environmental sounds. Even children with mild losses (16dB to 25dB) may have problems hearing faint or distant speech without some amplification. Hearing aids are the predominant ALD found in schools. (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 Tips for Maximizing Students’ Use of ALDs Know what type of ALD a student uses. Ensure that the system is functioning properly. Understand how the device works. Make sure background noises are minimized. Be able to determine whether a hearing aid is working properly. Make sure students avoid damaging their hearing aids by accident. Help students keep their Be sure students turn off the hearing aids working properly. transmitter when not engaged in instructional activities to prevent battery loss. Keep spare batteries on hand. Perform troubleshooting of all components of the system. (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 Promoting Inclusive Practices Students with HI may have a particularly difficult time associating with the “hearing” culture. Teachers must ensure that these students become part of the community of the school and class and are socially accepted by their peers. Teachers may have to orchestrate opportunities for social interactions by using such strategies as: Grouping Pairing students for specific tasks Assigning buddies Establishing a circle of friends (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 Basic Concepts About Visual Impairments (VI) Although the number of students whose vision creates learning-related problems is not large, having one such student in a classroom may require a host of accommodations. Vision plays a critical role in the development of concepts, understanding of spatial relations, and the use of printed material. Students with VI may need adaptive devices or techniques such as: Braille Optical Devices (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 Visual Impairments Defined Blindness has different meanings depending upon context. Legal blindness refers to a person’s visual acuity and field of vision. It is defined as a visual acuity of 20/200 or less in the person’s better eye after correction, or a field of vision of 20o or less. (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 Visual Impairments Defined An educational definition of blindness implies that a student must use Braille or aural methods in order to receive instruction. (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 Visual Impairments Defined Low vision indicates that some functional vision exists to be used for gaining information through written means with or without the assistance of optical, nonoptical, or electronic devices. (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 Classification of Visual Impairments Refractive Errors (farsightedness, nearsightedness, and astigmatism) Retinal Disorders Disorders of the Cornea, Iris, and Lens Optic Nerve Problems (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 Other Types of Visual Impairments Strabismus – improper alignment of the eye Nystagmus – rapid involuntary movements of the eye Glaucoma – fluid pressure buildup in the eye Cataract – cloudy film over the lens of the eye Diabetic Retinopathy – changes in the blood vessels of the eye caused by diabetes Macular Degeneration – damage to the central portion of the retina, causing central vision loss Retinitis Pigmentosa – genetic eye disease leading to total blindness (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 Tunnel vision denotes a condition caused by deterioration of parts of the retina, which leaves the person with central vision only. Individuals who have tunnel vision can see as if they are looking through a long tube; they have little or no peripheral vision. (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 Impact of Vision Problems Whether or not the student has usable residual vision is an important issue, as is the time at which the vision problem developed. Students who are born with visual loss have a much more difficult time understanding some concepts and developing basic skills than students who lost their vision after they have established certain concepts. (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 Prevalence of VI Vision problems are common in our society. Corrective lenses allow most individuals to see very efficiently. Visual impairments increase with age as a result of the aging process. Approximately 0.04% of students are classified as visually impaired. (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 Causes of VI Genetic Causes Premature Birth Anoxia Retinal Degeneration Physical Trauma Infections (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 Characteristics of Students with VI Psychological Characteristics Academic Characteristics Communicational Characteristics Social-Emotional Characteristics The most educationally relevant characteristic of students who have visual impairments is the extent of their visual (c) Allynefficiency. & Bacon 2004Copyright © Allyn and Bacon 2004 Assessment of VI Formal Assessment Typical eye examination assesses visual acuity and field of vision. The Snellen Chart is commonly used to assess visual acuity. Informal Assessment Typically involves observation of behaviors Teachers need to be aware of behaviors that could indicate a visual problem. (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 Eligibility To be determined eligible for special education, students with visual problems must meet guidelines established by the states under IDEA. These guidelines focus on the visual acuity of students: Students with a 20/200 acuity or worse, in the better eye with best correction, are eligible under the “blind” category. Students with a visual acuity of 20/70 to 20/200 are eligible as low-vision students. (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 Continuum-of-Placement Options Students with visual impairments must have a full range of placement options and be evaluated individually to determine the most appropriate placement. Although some students who are totally blind function very well in general education settings, many are placed in residential schools where they receive more extensive services. (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 Placement Trends Today, the trend is in the direction of more inclusive placements. During the 1998-1999 school year: more than 85% of students with VI were served in general education classrooms at least 40% of the school day. almost 50% were served in general education classrooms more than 80% of the school day. fewer than 10% were educated in residential schools. (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 Standard Operating Procedures The same standards of expected behavior should be applied for all students, including those with visual problems. Students with visual limitations, however, may need special freedom to move around the classroom, to find the place they can best see demonstrations of participate in classroom activities. (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 Physical Considerations Students with visual problems need to know the physical layout of the classroom so that they can navigate through it without harming themselves. Appropriate seating is extremely important for students who are able to use their existing vision. Placement of the student’s desk, lighting, glare, and distractions should be addressed. (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 Preinstructional Considerations Class schedules must allow extra time for students who use large-print or Braille. Test-taking procedures must be modified. Preparing an enlarged version of the test Arranging for someone to read the test Special instruction in study skills (e.g., notetaking, organizational skills, time management, and keyboarding) may be needed. (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 Specific Accommodations Assign a classmate to assist students who need help with mobility in emergency situations. Teach all students in the class the proper techniques of being a sighted guide. In advance, inform staff members at fieldtrip sites that a student with a visual problem will be part of the visiting group. Tell students with visual problems when you are entering or leaving a room. (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 Specific Accommodations Have all students practice movement patterns that you expect of them. Orient students to the physical layout and other distinguishing features of the classroom. Maintain consistency in placement of furniture, equipment, and instructional materials – remove all dangerous obstacles. Keep doors to cabinets, carts, and closets closed. (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 Specific Accommodations Assist students in getting into unfamiliar desks, chairs, or furniture. Eliminate auditory distractions. Seat students to maximize their usable vision and listening skills (usually frontand-center). Ensure that proper lighting is available. Create extra space for students who must use and store a piece of equipment (e.g., Braille, notebook computer). In lesson plan, include accommodations for the student with visual problems. (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 Materials and Equipment Vision specialists can help teachers select appropriate materials and equipment to enhance the education of students with VI. Many educational materials may pose difficulties for students with visual problems. Size of Print Typically, this can be addressed by enlarging the print. Contrast of Print It is very hard to enhance the contrast of photocopied (c) Allyn & Bacon 2004Copyright © Allyn materials. and Bacon 2004 Tips for Enhancing Photocopies Avoid using both sides of the paper. Do not give a student with a VI a poor copy and say, “Do the best you can with this.” Avoid old or light worksheet masters. Copy over lines that are Avoid worksheet light with a dark masters with missing marker. parts or creases. Give the darkest copies of handouts to student with visual problems. Make new originals when photocopies become difficult too read. (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 Avoid the use of colored inks that produce limited contrast. Do not use colored paper. It limits contrast. Using LargePrint Materials Large-print materials may be used inappropriately. These materials should be used only as a last resort after other techniques, such as the following, have been tried: Optical devices Reduction of (c)the distance Allyn reading & Bacon 2004Copyright © Allyn and Bacon 2004 Optical, Nonoptical, and Electronic Devices These devices may help students by enlarging printed images. Teachers will need to learn about these devices to ensure that they are used properly and are in working order. Teachers should consult with a vision specialist to learn how to use these (c) Allyn & Bacon 2004Copyright © Allyn devices. and Bacon 2004 Use of Braille Students with severe visual limitations may use Braille as the primary means of working with printed materials. Students who use Braille can use a computer to write in Braille and then have the text converted to standard print (the reverse process is available as well). Teachers should consult with a vision specialist if they have a student who requires Braille. (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 Specific Accommodations Call students by name, and speak directly to them. Vary the type of instruction used, and include hands-on lessons, cooperative learning, and real-life materials. Take breaks at regular Use high-contrast intervals to minimize materials, whether fatigue in listening or paper or the using a Brailler or optic chalkboard – dry erase device. boards may be preferable. Ensure that students Avoid using materials are seated properly so with glossy surfaces that they can see (if and, if possible, dittoed they have vision) and materials. hear you clearly. (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 Use large-print materials only after other methods have been attempted and proven unsuccessful. Use environmental connectors (e.g., ropes or railing) and other adaptations for physical and other recreational activities. Avoid using written materials with pages that are too crowded. Social-Emotional Considerations Research is mixed as to whether or not students with VI are less well adjusted than their sighted peers. There is evidence that some students with VI experience social isolation. Social skills instruction may be needed. Teachers need to remember that vision is needed to learn many social skills (e.g., observing & imitating). (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 Tips for Addressing Social-Emotional Needs Encourage students with VI to become independent learners and to manage their own behavior. Create opportunities for students with VI to manipulate their own environment. Teach students how to communicate nonverbally. Reinforce students for their efforts. Help students develop a healthy self-concept. Provide special instruction to help students acquire social skills. Work to eliminate improper mannerisms that some students with VI display. (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 Examples of Technology Magnifiers Closed-Circuit Television Monoculars Braille Printers Speech Input/Output Devices (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 Strategies for Promoting Inclusive Practices Remember that the student with a VI is but one of many students in the classroom with individual needs and characteristics. Use words such as see, look, and watch naturally. Introduce students with VI in the same way you would introduce any other student. (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 Strategies for Promoting Inclusive Practices Include students with VI in all classroom activities, including physical education, home economics, etc. Use the same disciplinary procedures for all students. Encourage students with visual problems to move around the room just like other students. (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 Strategies for Promoting Inclusive Practices Use verbal cues as necessary to cue the student with a visual impairment about something that is happening. Provide additional space for students with VI to store materials. Allow students with VI to learn about and discuss with classmates special topics related to vision loss. (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 Strategies for Promoting Inclusive Practices Model acceptance of students with VI as an example to other students. Encourage students with VI to use their specialized equipment. Discuss special needs of the student with a VI with specialists, as necessary. Always tell a person with a VI who you are as you approach. (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 Strategies for Promoting Inclusive Practices Help students avoid mannerisms associated with VI. Expect the same level of work from students with VI as you do from other students. Encourage students with VI to be as independent as possible. (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 Strategies for Promoting Inclusive Practices Treat students with VI as you treat other students in the classroom. Provide physical supports for students with concomitant motor problems. Include students with VI in outdoor activities and team sports. (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 Cultural Values to Consider Communication Health Beliefs Family Structure Attitude Toward Authority Etiquette Expectations of Helping Time Orientation (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 Personnel Supports for the General Educator Vision Specialist Orientation and Mobility Instructor School Health Personnel Counselors Adaptive Physical Education Instructor Vocational Specialists (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004