Miguel Perez, now a deaf adult, is seeking monetary damages under the Americans with Disabilities Act (ADA).

The aides assigned to provide sign language services were either unqualified or absent from the classroom for hours. Miguel was advanced to the next grade level based on inflated grades that misrepresented his actual progress, resulting in earning a Certificate of Completion rather than a Diploma, an unexpected outcome to him and his parents. His family sued the school district under the provisions of the Individuals with Disabilities Education Act (IDEA) and were awarded compensatory training post high school, but they were concerned about the life-impact of his poor education. Perez v. Sturgis Public Schools is the first case to determine if monetary damages under ADA would also be a possibility. After an appeal, the U.S. Supreme court ruled that Miguel can sue for “backward-looking” damages under ADA without exhausting the procedures of IDEA first. Read more on this important case and the realities of their responsibilities to the field of deaf education.

The IDEA Settlement Before Case No. 21-887, Miguel L. Perez v. Sturgis Public Schools – A WIN for Deaf Education

On March 21, 2023 the United States Supreme Court reversed the decision of the Michigan Sixth Circuit Court of Appeals in the case of Miguel Perez v. Sturgis Public Schools.  The Supreme Court’s decision now allows families to bring an ADA claim “without first exhausting all of IDEA’s administrative dispute resolution procedures.”

Case History

Miguel Perez, a nine year-old deaf student, qualified for an IEP in 2004 in the Sturgis Public Schools after his family emigrated from Mexico.  From ages nine through twenty, the district provided Miguel with “aides to translate classroom instruction into sign language.” Miguel and his family allege that for years, the aides assigned to provide sign language services were either unqualified or absent from the classroom for hours. They further allege that Miguel was advanced to the next grade level based on inflated grades that misrepresented the progress, or lack thereof, he was making. These misrepresentations led the family to believe that Miguel would graduate with his high school diploma. However, months before graduation, the family learned that Miguel would not be receiving a diploma, instead, he would receive certificate of completion. The family’s response was to then file a complaint with the Michigan Department of Education. They alleged that Sturgis had “failed its duties under the Individuals  with Disabilities Education Act (IDEA) and other laws.”

The case was settled before it reached an administrative hearing. Under the terms of the settlement, Sturgis promised to provide Miguel all the “forward-looking equitable relief he sought, including additional schooling at the Michigan School for the Deaf.”

Implications for Deaf Education in the IDEA claim that Miguel was denied a Free and Appropriate Public Education

Shortages of personnel

Deaf Education as a whole has a long and chronic history of shortages of qualified Teachers of the Deaf and Hard of Hearing (TODHH) and Interpreters, whether in a big city or a small town. However, IDEA requires that students whose IEP stipulates the need for access to instruction through either a TODHH or an Interpreter, or both, receive those services by qualified professionals regardless of personnel numbers. Further, those services which are deemed appropriate cannot be denied based on whether the school has the immediate personnel to provide said services. See IDEA.

This is the intersection between what is guaranteed by law, and what actual resources there are to provide services needed.

Sturgis is a town with a population of roughly 11,000 in 2004 when Miguel Perez and his family arrived in Michigan, and the population has grown by very little. Sturgis is surrounded by towns roughly the same size, with the nearest larger towns (Grand Rapids, Lansing) 95 miles away, and Detroit, the largest city at 150 miles away. In 2004, remote interpreting was not as prevalent as it is today, and highly specialized staff in the immediate area was unlikely to be found. Further, because deafness is a low-incidence disability, the needs of a single d/Dhh student can be at the bottom of a long list of concerns. However, as Miguel Perez and his family have proved, low incidence does not equal low-priority.

Advocating for appropriate services and supports and the argument for a TODHH

Nowhere in the summary of the IDEA complaint written by the Supreme Court of the U.S. is there a mention of a Teacher of the d/Deaf or hard of hearing (TODHH).  Having a TODHH on the IEP team is necessary and critical to evaluating and monitoring the progress of d/Dhh students. Often in small schools the TODHH is looked to for expertise in all things related to serving d/Dhh students, whether they are truly experts or not. The TODHH is often the advocate for the student using data gathered in order to make recommendations to the IEP team that are appropriate. See Why a TODHH.

Good grades do not equal progress

During Perez’s school career, he was given grades that were not truly representative of his abilities. This is why assessment, tracking, and monitoring student progress is crucial to determining effective programming. The defined purpose of IDEA: to ensure that all children with disabilities have available to them a free and appropriate education (FAPE) that emphasizes special education and related services designed to meet their unique needs and prepare them for further education, employment and independent living. Tailoring assessment for d/Dhh is necessary to determine his or her unique needs.

Good relationships with families

Good relationships with families are paramount. There are times when even the itinerant TODHH is the person with whom the family places their trust and contacts first when there are concerns.  Often, this occurs when teachers work with the same students year after year. Be as transparent as you can when there are concerns. When there are successes, even small ones, let the parent(s) know. That positivity may go a long way to nurturing parents’ experience with a school.

Summary

Before the IDEA case went to administrative hearing, both parties reached a settlement. Sturgis “promised to provide Mr. Perez all the forward-looking equitable relief he sought, including additional schooling at the Michigan School for the Deaf.”  But at the time of his graduation, independent living after high school was out of reach.  The district had failed in equipping Miguel with the knowledge and skills he needed to support himself. And now that the Circuit Court’s decision was reversed in regard to ADA, Miguel is free to pursue his lawsuit seeking damages from Sturgis Public Schools under ADA.

Calls to Action

Shortages of Personnel: keep communication lines open

• Keep your supervisors updated of situations where there are shortages.
• Keep your supervisors updated of how you are addressing those shortages and document your efforts.
• Keep your supervisors updated on how the shortages are effecting your students and use data.
• Keep parents in the loop as much as possible.

Advocating for appropriate services and supports and the argument for a TODHH

• Nothing happens without data. Make sure you are collecting evidence to support your recommendations. Qualitative or anecdotal evidence is good, but quantitative (numbers) will often make a big impact. Numbers are sometimes what ‘tips the scale.’
• When a TODHH is needed, refer to the law.

Good grades do not equal progress

• Don’t use grades as your only source of information.
• When an evaluation is necessary, look at the whole student: academic, language and communication, social-emotional, functional, and level of independence.
• If student is receiving grades in classes below grade level, or if rubrics or IEP progress is being used to report how the student is performing, make sure parents know that and are reminded of it frequently.

Documentation

• Use the required format or find your own
• Timely and consistent
• Be objective

Good relationships with families

• Ask how parents would like to be kept informed, give them the best way to keep you informed (email, phone, text, class app, etc).
• Communicate regularly or make the attempt regularly
• Keep communication positive or end on a positive note – offer a possible solution or ask them for their help/advice if it’s an issue of concern
• Let parents know when good things are happening with their child.

References and More information

To read the Supreme Court’s opinion of the case see 21-887 Miguel Luna Perez v. Sturgis Public Schools

Article from ASHAWIRE see What a DHH Student’s Supreme Court Case Means for Special Education

Article from FMGLAW see  Exhaustion Not Required: Perez V. Sturgis Public Schools

Written by Brenda Wellen, M.S., October 2023

Note: The information in this article does not qualify as legal advice.

The post Low Incidence ≠ Low Priority: A Court Case You Need to Know About first appeared on Supporting Success For Children With Hearing Loss.

SOURCE: https://www2.ed.gov/about/offices/list/ocr/docs/hq9806.html

Document Summary: This publication by the Department of Education provides additional guidance about part B of the Individuals with Disabilities Education Act (IDEA) and section 504 of the Rehabilitation Act of 1973 (section 504) as they relate to the provision of appropriate education service to students who are deaf. This guidance is issued in response to concerns regarding Departmental policy on the provision of a free appropriate public education (FAPE) to students who are deaf. Many of these concerns were expressed in the report of the Commission on Education of the Deaf. This guidance is intended to furnish State and local education agency personnel with background information and specific steps that will help to ensure that children and youth who are deaf are provided with a free appropriate public education. It also describes procedural safeguards that ensure parents are knowledgeable about their rights and about placement decisions made by public agencies.  Italics have been added below by the article author.

Providing a Free and Appropriate Public Education

The Secretary of Education believes that the unique communication and related needs of many children who are deaf have not been adequately considered in the development of their IEPs. To assist public agencies in carrying out their responsibilities for children who are deaf, the Department provides the following guidance. The Secretary believes it is important that State and local education agencies, in developing an IEP for a child who is deaf, take into consideration such factors as:

1. Communication needs and the child’s and family’s preferred mode of communication; How do they communicate?
2. Linguistic needs; How much do they understand – language comprehension? Rate of presentation – slow, fast?
3. Severity of hearing loss and potential for using residual hearing; Estimation of level of access to communication?
4. Academic level; and How much delay in language/academics/ability to participate as compared to peers?
5. Social, emotional, and cultural needs including opportunities for peer interactions and communication. Access to interactions with other students who are DHH? Challenges in group work or peer-to-peer communication? Actions to deal with the student being a teasing target?

In addition, the particular needs of an individual child may require the consideration of additional factors, i.e.,

1. The nature and severity of some children’s needs will require the consideration of curriculum content and method of curriculum delivery in determining how those needs can be met.
2. Including evaluators who are knowledgeable about these specific factors as part of the multidisciplinary team evaluating the student will help ensure that the deaf student’s needs are correctly identified.

Least Restrictive Environment

The Secretary is concerned that the least restrictive environment provisions of the IDEA and Section 504 are interpreted, incorrectly, to require the placement of some children who are deaf in programs that may not meet the individual student’s educational needs.

• Any setting, including a regular classroom, that prevents a child who is deaf from receiving an appropriate education that meets his or her needs including communication needs is not the LRE for that individual child. How much language can the child access and comprehend in the classroom? If hearing loss is limiting access and/or direct communication, or severity of language delay interferes with comprehension of instructional materials thereby preventing the student from keeping pace with peers, then provision of FAPE needs to be considered to identify a placement where the child can comprehend/access appropriately.
• Any setting which does not meet the communication and related needs of a child who is deaf, and therefore does not allow for the provision of FAPE, cannot be considered the LRE for that child. Full time placement in an inclusion setting satisfies FAPE only if the child can access communication effectively.

Placement

The provision of FAPE is paramount, and the individual placement determination about LRE is to be considered within the context of FAPE. The Secretary is concerned that some public agencies have misapplied the LRE provision by presuming that placements in or closer to the regular classroom are required for children who are deaf, without taking into consideration the range of communication and related needs that must be addressed in order to provide appropriate services.

The Secretary recognizes that regular educational settings are appropriate and adaptable to meet the unique needs of particular children who are deaf. For others, a center or special school may be the least restrictive environment in which the child’s unique needs can be met.

A full range of alternative placements as described at 34 CFR 300.551(a) and (b)(1) of the IDEA regulations must be available to the extent necessary to implement each child’s IEP. There are cases when the nature of the disability and the individual child’s needs dictate a specialized setting that provides structured curriculum or special methods of teaching. Just as placement in the regular educational setting is required when it is appropriate for the unique needs of a child who is deaf, so is removal from the regular educational setting required when the child’s needs cannot be met in that setting with the use of supplementary aids and services.

The obligation to fully inform parents includes informing the parents that the public agency is required to have a full continuum of placement options available to meet the needs of children with disabilities, including instruction in regular classes, special classes, special schools, home instruction, and instruction in hospitals and institutions.

Refer to the full document for all of this information provided by the US Department of Education.

Author: Karen Anderson

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The post Legal Issues in Serving Children with Hearing Loss first appeared on Supporting Success For Children With Hearing Loss.

private or public insurance hospital school or domain

I recently had a call from a parent of a kindergarten student with hearing aids who was told by her private school that 1) the parent must pay for the FM/DM system and 2) that the child could not receive any special support for her learning needs due to the impact of the hearing loss. Like many parents she wanted to know if it was true that students in private or charter schools cannot receive special supports and services. The answer? Yes and No.

PRIVATE SCHOOLS – Some do, some don’t provide specialized services and supports

No private school can discriminate on the basis of race, color, or national origin, in admissions or in hiring, or anything else; those that do would lose their non-profit status from the Internal Revenue Service.

Many students with disabilities attend private schools that are under contract with public and charter schools; these students retain their right to a “free and appropriate public education,” or FAPE, in a “least restrictive environment,” or LRE. If the private school accepts students with disabilities and agrees to provide specialized services and supports, then these services should be appropriate to meet the identified needs of the student. This would
include services by a teacher of the deaf/hard of hearing, speech language pathologist, and/or educational audiologist whenever needed to meet appropriate IEP goals or supports, like selection and fitting of hearing assistance technology (HAT).

When families are seeking private school placement, they may be told that the school does not provide any special education services, meaning that if they choose to enroll their child in such a private school, they will be waiving the right to LRE and IEP services. If a family chooses to forego the services offered by their public schools, required by their Individualized Education Plan, and opts for a “parental placement” for their child instead, they also give up FAPE and LRE.

Under the Americans with Disabilities Act, private schools must provide “auxiliary aids and services” to students with disabilities who are otherwise qualified for admission, so long as these accommodations would not change the fundamental nature of the program or result in significant difficulty or expense. The clause about expense is why many parents of children in private schools must pay for HAT equipment for their child rather than having the school bear this expense.

Additional requirements under the ADA follow if the school receives public funds (such as through a state voucher program). In that case, schools cannot exclude a voucher participant based on disability if, “with minor adjustments,” such a student could reasonably participate in the private school’s education program. Religiously-controlled schools are exempted from these ADA requirements unless they receive federal funding.

SOURCE:   https://www.educationnext.org/private-schools-allowed-discriminate/

CHARTER SCHOOLS – All do, with the same expectations for appropriate services and supports

Section 504 requires charter schools to conduct any recruitment activities and provide the opportunity to apply to a charter school on an equal basis. During the admissions process, a charter school may not ask a prospective student if he or she has a disability. Limited exceptions include that, if a school is chartered to serve students with a specific disability, the school may ask prospective students if they have that disability. When a student with a disability is admitted to and enrolls in a charter school, the student is entitled to FAPE under Section 504. After enrollment, a charter school may ask if a student has a disability, which includes, whether a student has an individualized education program (IEP) or Section 504 plan.

The primary purpose of the IDEA Part B program is for States and school districts to make FAPE available to eligible children with disabilities and to ensure that IDEA’s rights and protections are afforded to eligible children and their parents. Under IDEA, all students with disabilities, including charter school students with disabilities, must receive FAPE through the provision of special education and related services in a properly-developed IEP.

A charter school may not unilaterally limit the services it will provide a particular student with a disability. The responsible charter school LEA, or the LEA that includes the charter school, must provide a program of FAPE for the student in the least restrictive environment (LRE) in which the student’s IEP can be implemented.

States must ensure that charter school LEAs and LEAs that include charter schools meet all their responsibilities under Part B of IDEA, including the LRE requirements. In this context, the LRE provisions require that, to the maximum extent appropriate to their needs, students with disabilities attending public charter schools be educated with nondisabled students.

SOURCE: https://sites.ed.gov/idea/files/dcl-factsheet-201612-504-charter-school.pdf

PARENTS HAVE CHOICES

The typically smaller class sizes and high expectations of private schools are attractive to many families as their children with hearing aids or cochlear implants can perform age-appropriate work, but struggle in large group listening environments. Yet most young children with hearing loss continue to require specialized supports and services, such as work on auditory skill development, language, self-advocacy, and social communication, especially in the first years of elementary school. Private schools may or may not provide any of these supports. Charter schools can provide more creative environments or specialized themes that may suit a student with hearing loss. If families choose to go the charter school route, then they must be very involved in IEP planning and discussions of needed supports and accommodations. Whatever specialized services would be expected in a public school should also be provided in a charter school. Public schools may struggle to extend the staff and supports needed so that all students under their jurisdiction will receive appropriate services. A fully involved IEP team, including families, can make well-informed placement decisions for students who are deaf or hard of hearing.

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Online education has been a struggle for many students. Those with hearing loss have additional issues when accessing virtual education. The CAVE Checklist or Communication Access in Virtual Education has been increasingly in use by DHH professionals since last fall. To learn about the CAVE and see some results in report form, Read More.

Timing is everything. The CAVE Checklist  was released just as many educators of students who are deaf or hard of hearing were searching for ways to ensure their students were receiving appropriate access to online learning AND ways to illustrate to school teams the need for appropriate access if the student’s access was less than required to meet class expectations. The CAVE  was received with much excitement and relief as a means to obtain information about student access levels during online learning.
Download:   English CAVE,   Spanish CAVE,   French CAVE,   Fillable English CAVE.

The CAVE Checklist poses 10 questions that students must read (or consider in interview format) and then select the answer that applies in the situation most of the time. Very similar to the LIFE-R Student Appraisal (online, fillable form, or with pictures), the student must select  one of 6 responses.  Not every situation will apply to every student. Situations indicating appropriate access will be marked by the student as always or mostly easy. Situations in which difficulty was indicated need to be addressed for appropriate access needs.

The CAVE further asks the student what they think would help them most during online learning:

1. 1.) To have/use at home during e-learning I would like to:
2. 2.) During only learning my teachers would:
3. 3.) My comments about online learning

Example Use in Assessment Reports

Excerpts from example reports were provided by Vicki Anderson, AuD, Educational Audiologist. Details have been altered for student confidentiality.  Excerpts relate specifically to online learning situations to illustrate how the CAVE Checklist and an online FLE can assist in identifying access needs and recommendations.

Kindergarten (bilateral loss moderate, hearing aids, DM system, classroom amplification system):

Communication Access in Virtual Learning (CAVE Checklist): Developed by Karen L. Anderson, Ph.D. (2020), this self-assessment tool was designed to identify possible communication access issues that may occur during virtual education situations. Students check off closed-choice emojis representing their responses ranging from “Always Easy” to “Always Difficult” or “Doesn’t Happen”.

The CAVE was completed on STUDENT’s behalf by her father and older brother, who help her with her online classes.  There were no online learning situations that were rated as Easy for STUDENT.  Even the best-case scenario (teacher’s face is visible on screen and a boom microphone is used) was rated as Sometimes Difficult for her to hear and understand the words the teacher is saying.  When (1) the teacher’s face is visible but she is not using a microphone, (2) when her face is not visible (e.g., showing a worksheet but she is using a microphone), (3) when her face is not visible nor is she using a microphone—any of these virtual situations are Mostly Difficult for STUDENT to access the content.  An interpreter and/or captioning is currently not used and captioning, nor is any other accommodation made to allow STUDENT to understand her classmates in discussions.  It was indicated that during e-learning, family thinks it helps her most to listen through the built-in speaker of her tablet, and to be able to see teacher’s face and the faces of her classmates when they are talking.

In virtual learning, the teacher should use a boom microphone and assure STUDENT can see her face, with the computer camera on to allow student speechreading.  Age-appropriate captioning (e.g., key words and vocabulary) is recommended for all live or recorded sessions, including, PowerPoint and video presentations. With continued exposure, captioning and speechreading will improve her communication access and support her listening.

Elementary (bilateral loss mild, hearing aids, DM system)

Online Functional Listening Evaluation: this functional assessment samples the communication access of hard of hearing students in various virtual learning conditions.  We know that students with typical hearing respond with 90+% accuracy when listening in noise, even when the noise level is equal to the speech presentation level.  It is reasonable to assume that the degradation in sound that occurs when a teacher’s voice is presented over an internet streaming service (like Zoom) will not significantly decrease the speech perception and auditory comprehension ability of students with typical hearing.  For equal access, students with hearing loss should be able to perform with at least 90% accuracy during online learning presentations.

STUDENT was administered the online FLE test by the educational audiologist during a Zoom meeting accompanied by his IEP Manager.  Nonsense Children’s Phrases (C.D. Johnson, 2011) were presented under conditions representing the various teaching scenarios experienced during on-line learning. Nonsense Phrases were used to simulate new curriculum or new vocabulary.  STUDENT was wearing headphones over his hearing aids. Three conditions were tested. (1) In the ideal or “best” virtual condition, the presenter wore a boom microphone, the camera was on and STUDENT was encouraged to watch the face of the person speaking. The camera was turned off, as in a PowerPoint presentation, but the boom microphone was still used.(3) the computer microphone only was used along with the camera (visual speechreading cues). After that the computer mic was used and the camera was turned off, which exemplifies a typical live PowerPoint presentation.  Finally, to sample two in-person learning scenarios, a clear face mask was worn with only the computer microphone (no boom microphone), and lastly a clear mask was worn while using the boom microphone (this would also represent use of the Roger microphone plugged into the STUDENT’s tablet).
Results show that for STUDENT to achieve equal access to school curriculum as his normally hearing peers, for virtual learning he needs the “ideal” teaching modality where teachers use a boom microphone AND allow speechreading with the cameral ON. For in-person education in a COVID environment, teachers should wear a clear mask AND use his remote microphone system.  In virtual learning, teachers should use boom microphones and assure he can see their face with the computer camera on, and use captioning for PowerPoint or video presentations.

High school (fluctuating conductive hearing loss, student choice to not use DM system, classroom amplification systems in use in each classroom)

Communication Access in Virtual Learning (CAVE Checklist): Developed by Karen L. Anderson, Ph.D. (2020), this self-assessment tool was designed to identify possible communication access issues that may occur during virtual education situations. Students check off closed-choice emojis representing their responses ranging from “Always Easy” to “Always Difficult” and “Doesn’t Happen”.  STUDENT reported appropriate (“Mostly Easy”) access in 5 of 10 online learning situations.  Two situations were rated as “Sometimes Difficult”: 1) When teachers show information on the screen and their face is not shown, and they are not using a microphone (only the computer microphone); 2) When classmates are talking into the microphone of their devices during a group discussion.  Three accommodations she indicated “Doesn’t Happen” included use of her remote microphone technology during online learning, teachers’ use of captioning, and captioning of students’ comments.  Teachers’ wearing a boom microphone, assuring teacher’s face is visible on the screen, repeating or rephrasing students’ comments, and consistently using closed captioning for all talkers will improve and assure appropriate and equal access to online learning for STUDENT, compared with her typically-hearing peers.

Peers’ comments in class discussions should be repeated in-person and in virtual settings. In virtual learning, teachers should use boom microphones and assure she can see their face, with the computer camera kept on.  Captioning should be used for all live or recorded sessions, including, PowerPoint and video presentations.

Summary

Access denied is opportunity denied. Children with IEPs due to being deaf or hard of hearing comprise only 1% of the total number of children receiving special education services. For almost all of the other 99% the educational issue is due to a learning disorder, and not secondary to sensory access issues. Virtual education adds greater challenge to students who are deaf or hard of hearing.

Having the tools to identify student access issues and the data to make the case for appropriate access accommodations to be provided is a necessary step for students with hearing loss.

Academic success is driven by communication access. I encourage you to use the CAVE Checklist and perform the online FLE to gather the access data needed so that our students CAN be full participants in learning at the rate expected of their peers.

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The post ACCESS Check first appeared on Supporting Success For Children With Hearing Loss.

The primary difference between students with hearing loss and their typically hearing peers is that they do not access verbal communication as fully as others. Accommodations are truly the lifeline to our students being able to achieve and progress as effectively as peers.

Accommodations are sometimes seen as ‘being taken care of’ by making a quick statement on the IEP or perhaps checking off some boxes. Since the learning issues caused by hearing loss are due to decreased access to verbal information, accommodations – including appropriate auxiliary aids and services – are intended to ‘level the playing field.’ Accommodations need to be considered carefully, discussed thoroughly, implemented consistently and then monitored to ensure that they are indeed, providing equal access to classroom communication.

Unless appropriate and effective accommodations are provided, the student with hearing loss will be discriminated against in the classroom as they are expected to perform as well as other students without being provided the same information. Of course discrimination is a harsh word and educators do not intentionally discriminate against any student. In the US, the Americans with Disabilities Act requires schools to ensure that communication for students with hearing loss is as effective as communication for others. Accommodations, specifically auxiliary aids and services must be provided to afford these students an equal opportunity to obtain the same result, to gain the same benefit, or to reach the same level of achievement as that provided to others.  Whenever accommodations are not provided, not used consistently, or not effective the student does not have an equal opportunity to achieve as their peers.

How well a student is able to perceive speech in a classroom will impact educational performance. Students who are deaf or hard of hearing are at high risk for delayed vocabulary acquisition, vocabularies of smaller size and sophistication, struggling with the English verb system, lack of access to morphological information. This overall may appear insignificant (low average performance per normed assessment) but it can significantly affect academic achievement.

Auditory Learner Access Needs

Students who are hard of hearing do not have normal hearing restored by hearing aids or cochlear implants. Under typical classroom listening conditions they will ALWAYS have to put forth more effort, to ultimately perceive fragmented communication. With more effort put toward listening, there are fewer cognitive resources available for the student to recognize all of the words, comprehend them and integrate them into their knowledge base. This is why a student with hearing loss typically requires information to be repeated 3 times when a typically hearing student would need to have it presented only once. While a student may ‘communicate normally’ in a 1:1 conversation across a small table in a quiet room (3 feet), that ability is not predictive of how accurately the student will be able to listen at a distance (class discussion) and in the presence of typical levels of classroom noise. Similarly, hearing thresholds on an audiogram are also not predictive of speech perception as only 39% of the ability to understand speech in noise can be predicted from hearing thresholds. Hearing assistance technology (HAT), specifically personal FM/DM systems, are the ONLY means to optimize the auditory signal a student receives.
(*Based on information from Kym Meyer, Educational Audiologist)

Visual Learner Access Needs

The academic information received by visual communicators is totally reliant upon the skills of their sign language interpreter or cued speech transliterator. A 2005 study evaluated 2100 educational interpreters in the US using the Educational Interpreters Performance Assessment. The results found that about 60% of the interpreters evaluated had inadequate skills to provide full access. The study suggested that many students receive interpreter services that seriously hinder reasonable access to class curriculum and social interaction. A 2009 study focused on the accuracy of translation as measured by number of key science words included in a CART transcript or in videos of sign interpretation. “Best” interpreters /CART providers were selected who knew the study was about accuracy were selected. Participants transcribed or signed three science videos by NASA. The accuracy interpreters for the three videos was 81%, 80.1%, 62.7%. The accuracy of the CART providers was 98.5%, 96.9%, 97.2% resulting in an average accuracy of 75% for interpreters and 97% for CART transcription.  The bottom line is that sufficient “through the air” access to verbal instruction and classroom communication cannot be assumed because an interpreter or CART is provided in the classroom.

Suggestions for Determining Appropriate Accommodations

• Make the case. Impress upon the student’s classroom teacher and school team that accommodations are truly the student’s lifeline to equal communication access, and therefore the opportunity to obtain the same achievement as class peers. Obtain data to estimate the students’ level of access.
• Be consistent in your approach to recommending FM/DM/HAT hearing assistance technology. The physics of sound is immutable. To receive optimized access to verbal communication in school, students who are auditory learners need to use HAT starting with school entry and continuing as long as the student is willing to comply. Even if a teacher is loud, animated and does not move around the classroom much, the student with hearing loss will still not be receiving optimal auditory input without the use of HAT.
• Emphasize that one size does not fit all. While IDEA does not require ‘optimal’, the ADA requires equal access. This is a case where the ‘bar’ for ADA is higher than it is for IDEA. Even with HAT providing optimal auditory input, a student with hearing loss will not have normal hearing restored. Per a court case: “ADA requirements regarding students who are deaf or hard-of-hearing are different than those imposed by the IDEA.” Additional accommodations are necessary to close this gap. Because IDEA and ADA requirements are not identical, there may be some situations in which a child has accommodations as part of an IEP and also requires a 504 Plan to address the auxiliary aids and services needs per ADA.
• Grades do not matter when it comes to accommodation needs. Children who are hard of hearing or deaf WILL need accommodations. How well or how poorly they perform in the classroom is not a determinant for whether accommodations should be provided. Some students put in many more hours of homework than their peers, often sacrificing social opportunities, to earn and maintain high academic achievement. The necessity to expend these extraordinary efforts can be a sign that discrimination is occurring. The case study provided by the ADA as part of the Frequently Asked Questions described a high achieving secondary student who had an FM system but also needed CART services so that he had full access to class discussions. If a student is not found to be eligible for an IEP, then this reflects the school team’s belief that the student will be able to experience one year’s growth in one year’s time without special support. In Deal v. Hamilton Board of Education (6th Circuit, 2004), the court ruled that “meaningful educational benefit must be gauged by the child’s potentialities.” Thus, accommodations will ALWAYS be necessary, whether via an IEP, 504 Plan or both.
  
  Response to: “He seems to be doing okay academically; I don’t think we need to get him an FM/DM system.”  If a student in a wheelchair was assigned to a classroom with a narrow door would it be okay to have the student participate by sitting out in the hallway? In other words, would it be okay for him to not have to be included in a class with a door wide enough for the wheel chair because the student’s academic performance was not a concern?  Ignoring auditory inclusion needs is the same issue.

• Consider communication needs situation-by-situation. This not only makes sense, it is another requirement of ADA. A form has been provided below to assist teams in these discussions.
• There is no ‘set list’ for appropriate accommodations. An Accessibility Considerations handout lists examples of auxiliary aids and services. This can be used as a starting place for discussion but should not be seen as limiting accommodation choices. Auxiliary services can include teacher inservice and progress monitoring by a specialist in DHH. The federal Every Student Succeeds Act encourages specialized instructional support providers to support literacy and collaborate with classroom teachers, thus allowing special educators to work with classroom teachers on behalf of regular education students.
• It is the school’s responsibility to ensure that the provided accommodations are effectively providing equal access to classroom communication. For students who are grade 3 and above it is suggested that they complete the Listening Inventory For Education – Revised (LIFE-R) Student Appraisal (Teacher Tools Takeout 0099, 0052, 0100) at the beginning of the year and review the results at the end of the first quarter to discuss if, with the accommodations, the student feels as though access has improved. Routine classroom observations and performance monitoring can also be helpful to determine the effectiveness of the accommodations being provided.

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The post Accommodations – Lifeline to Equal Access first appeared on Supporting Success For Children With Hearing Loss.

The world of education has shifted sharply once we began our societal response to the COVID-19 pandemic. Yet, we remain responsible for offering an equal educational opportunity to students with hearing loss. To do so we must identify and address access issues in online learning situations. Some current issues for our students who are DHH are:

• Concerns about equal access in distance learning
• Teaching practices to enhance or limit access
• Ways to gather information that shows a student’s level of access

Equal access was already a challenge! The Title II ADA requirement that schools are required to ensure that communication for students who are deaf and hard of hearing are as effective as communication for others [ADA Title II 28 C.F.R. 35.160 (a)(1)] was already a tall order for students who are hard of hearing since it is a fact that no hearing devices in current existence restore normal hearing ability. Even in a classroom setting the provision of hearing assistance technology, interpreter services, and captioning still are often not sufficient to close the access gap.

Encouragement is not the same as effective solutions. A 3/21/20 Supplemental Fact Sheet¹ from the US Department of Education clarified that special education and related services can be provided through distance instruction and that many disability-related modifications and services, like captioning and sign language interpreting, may be effectively provided online. The Fact Sheet encouraged parents and educators to collaborate creatively to use high-and low-tech strategies to meet the needs of students with disabilities. This encouragement resulted in a steep learning curve by all teachers, and especially those who work with students who have access issues due to hearing or vision limitations.

All instruction must be fully accessible to students who are deaf and hard of hearing.

Access Concerns:

1. a. When teachers provide online instruction during which only a PowerPoint presentation or documents are visible, the student is not able to speechread. Once we go back to meeting face-to-face in schools it is likely that many school staff will wear masks. How much is the student’s access impacted without speechreading?

1. b. When teachers instruct over an internet streaming service without using a microphone (standard mic that plugs-in to the computer or FM/DM microphone) the speech signal is degraded and adds to comprehension issues. How much is the student’s access to distance learning is impacted without the use of a microphone?

For students with hearing loss to experience equal access, we need to identify barriers first.

Perform a modified Functional Listening Evaluation procedure in an online teaching situation

We know that students with typical hearing respond with 90+% accuracy when listening in noise, even when the noise level is equal to the speech presentation level. It is reasonable to assume that the degradation in sound that occurs when a teacher’s voice is presented over an internet streaming service (like Zoom) will not significantly decrease the speech perception and auditory comprehension ability of students with typical hearing.

For equal access students with hearing loss should be able to perform with at least 90% accuracy during online learning presentations. Ideally, you will have performed the FLE under classroom conditions and have the percent scores under different listening conditions that can be compared to the following.

Suggestions on how to perform this functional check of listening accuracy during online learning:

1. a. Download and print out the Common Children’s Phrases.

1. b. Prepare to present Children’s Nonsense Phrases within the Common Children’s Phrases There are 8 lists of 20 items. You can place a + or o next to each sentence to record responses.

1. c. LIST 1: Use a microphone plugged into your computer as you present and encourage the student to watch your face. Even a standard SmartPhone headset will work with most media devices to improve speech signal clarity. This simulates the best listening condition.

1. d. LIST 2: Turn off your webcam or do not allow the student to watch your face. Continue to use your microphone. This simulates listening when the teacher is presenting a PowerPoint presentation while livestreaming and her face is not visible.

1. e. LIST 3: Unplug your microphone and present the list of words in the speechreading condition. These results will indicate how important it is for the student to have the teacher always use a microphone during online learning.

1. f. LIST 4: Present the nonsense phrases without using the microphone or allowing speechreading. Too many students are currently expected to learn in this situation. With the data you’ve now obtained you can demonstrate the level of barrier to understanding posed by not using a microphone and/or not allowing speechreading.

1. g. LIST 5 and 6: If you have a mask with a transparent inset available, repeat the conditions with and without using the microphone. This will provide you with some data as to just how important it is for a teacher to use a transparent mask once we return to school, and the potential barrier posed to having the teacher’s face viewed in this manner.

Check comprehension of what the student can hear (or see)

Schools have not been excused from conducting assessment or gathering progress monitoring data. Norm-referenced tests have strict administration protocols. That said, modifications can be made as long as they are referenced in the test report with the caveat that use of the norms may not be as accurate as if the original administration protocol was used.

For the purposes of students who are deaf or hard of hearing we really want to know how students perform on auditory (or sign interpreted) comprehension tasks relative to their typical class peers. Results will reflect (1) the degree to which hearing loss is posing as a barrier to comprehension along with (2) the impact of any language issues the student may experience. This is true whether the student is face-to-face in a quiet room, or in an online learning situation.

Suggestions for performing assessment of comprehension of spoken information

1. a. Gather comprehension data using the Oral Passage Understanding Scale (OPUS) for grades K-12. This test only takes 10-15 minutes to complete. It identifies how well a person can integrate and apply knowledge of use of words and word combinations, grammar and inferential meaning.

1. b. Gather comprehension data using the Listening Comprehension Test 2 for grades 1-6 or the Listening Comprehension Test Adolescent for grades 7-12. This test assesses comprehension of main idea, listening for details, vocabulary, reasoning and understanding messages. It takes about 30 minutes to administer.

1. c. Conduct an Informal Evaluation of Auditory Comprehension of Information with and without Accommodations. This functional assessment procedure refers to how to conduct comparison testing in a typical classroom environment (or simulated classroom noise vs. quiet). Adapt the procedure to online learning by reading a story and answering comprehension questions with and without a microphone, with and without speechreading, speechreading through a mask, with and without captioning, etc.

1. d. For hard of hearing students DO NOT ALLOW SPEECHREADING as this is an inconsistent listening condition.

1. e. If a HAT (FM/DM system) is typically used with the student be sure to use it while performing comprehension assessments.

1. f. If captioning is typically used during instruction it can be used while performing the assessments.

1. g. For students who are Deaf and use an interpreter, if at all possible have what you say when administering the test be presented by the interpreter the student uses in the classroom setting. Allow the student to view your face and the interpreter so the student’s ‘triangle of communication’ is as typical as possible.

LIST OF RECOMMENDED ASSESSMENTS: The list includes recommendations for both functional and formal assessments for ages 3-5 years and school-age students. In evaluations, it is appropriate to look closely at social/emotional, self-advocacy, and the possibly subtle phonological/morphological awareness and ‘Swiss cheese’ language skills that impact comprehension and reading fluency.

Read more information on tailoring assessment procedures to the needs of students with hearing loss.

References:

1. 1. March 21, 2020 Supplemental Fact Sheet Addressing the Risk of COVID-19 in Preschool, Elementary, and Secondary Schools While Serving Children with Disabilities
2. 2. The Effect of IQ on spoken language and speech perception development in children with impaired hearing. Cochlear Implants International, (11)1, June, 370-74.

The post Assessment of Online ACCESS first appeared on Supporting Success For Children With Hearing Loss.

Students with hearing loss, whether hard of hearing or deaf, are at high risk for deficits in syntax due to their imperfect perception of the English language. Word endings, tense, and other grammatical features are often lost when these ‘bits and pieces’ are not perceived. Extra direct instruction in grammar and syntax is usually necessary for students with hearing loss, as their missing bits often result in poorer comprehension – whether of conversation or the written word. These deficits can be glaring when a student turns in a written assignment.

The challenge: Effectively teaching grammar and syntax is a daunting task. Hearing peers largely absorb correct syntax through listening alone and have a good handle on it as they begin to develop reading skills. As early as kindergarten, typical students following the general education curriculum should be able to (with adult assistance) speak/sign, read, and write a grammatically correct sentence as simple as “I like pizza.” to as complex as “My brother rides his red bike around the park after school.” By the fourth grade, typical students should be able to speak, read, and write sentences as simple as “I like pepperoni pizza from Pizza Hut.” to as complex as “Jason, Kim and I rode in my mother’s dark blue Suburban to the movies on Friday night where we saw three of the most popular students in our school.”  By middle school, typical students are responsible for the intricate content of novels. They are often given a prompt or topic as a writing assignment and a few ideas at which point they are on their own to generate the rest. Where typically hearing and developing students gradually absorb syntax with minimal extra instruction, students with hearing loss often have to work hard to keep up with this rate and complexity of typical development.

What we need to know about syntax skills whether students use spoken language or a sign system:

• Can the student speak/sign a sentence with a subject and a verb?
• Use tense markers?
• Use singular and plural forms? Many times, the /s/ on the end of plural words is not heard. The same can hold true for the possessive ‘s. If the student uses ASL, plural is shown by repeating the sign, such as CHAIR-CHAIR-CHAIR for “chairs”
• Use articles and determiners? (the, a, that, this, etc.).
• Are there any descriptive words being used? Prepositions?
• For ASL users, is the student using classifiers? Nonmanual markers?

Assessment: As with other areas of instruction, it always helps to start with the basics – identifying the student’s challenges. As part of a functional assessment for syntax, taking language samples is a great way to take inventory of what a student knows. Use a smart phone to record a student as you read a book together or discuss a topic. Try to obtain about 50 utterances, which may take more than one session with some students. After doing recorded language samples several times, you will begin to feel adept at listening and looking for patterns in the student’s language. Other assessment methods are provided as follows.

Does the language make sense? (Is it sequential?)

When language samples have been analyzed, gaps can be determined as can targets for instruction.  Whatever your method for obtaining data whether it is language sampling, formal tests, or functional assessments suggested below, syntax is an important piece of the reading and  comprehension puzzle and must be assessed!

Other tools for gathering functional data:

Test of Grammatical Structures (TAGS)   PRESCHOOL and ABOVE

Part of the Preschool Language Pack, the CID Teacher Assessment of Grammatical Structures (TAGS) is a series of three rating forms developed to evaluate a child’s understanding and use of the grammatical structures of English. The rating forms provide a representation of grammatical structures for children with hearing loss who develop grammatical structures in smaller increments and at slower rates compared to children who are typically developing. This starter kit is a guide to using the CID TAGS system for teaching and tracking receptive and expressive language development in oral children who are deaf and hard of hearing. It can also be used to evaluate sentence structure for children who use sign language. The TAGS rating forms enable teachers to:

• determine present levels of syntax skills
• determine syntax goals for IEPs and lessons
• track syntax development over time and
• report syntax progress to parents and other professionals

Grammar Chipper Chat     GRADE K-5

These materials allow you to explore 16 of the grammatical structures found on most language assessments (i.e., CELF, TOLD). Each grammar area has 20-30 color-coded question cards with a sentence prompt on one side and images on the reverse side. The student fills in the missing word on the question side using the pictures as cues. A functional assessment can be performed using these cards. A subset of cards in each of the 16 areas (i.e 3-4 cards) can be shuffled together and presented in random order to the student. Additional cards can be presented in the areas in which there are errors to verify that there is a lack of functional use (up to 10 cards per problematic area). Refer to Brown’s Stages to assess or intervene in sequence of development. A valuable means to pinpoint issues and monitor progress in syntax learning.

Cracking the Grammar Code  GRADE 5 – ADULT
Within the 149-page FREE downloadable  Syntax Skill Pretests and Simple Skill Activities
sample book, there are pretests teachers can use to identify students’ skill levels. Each pretest has a rubric to diagnose specific skills in the broader category. The pretests and answer keys are provided for the following syntax skill areas: Nouns, Articles, Conjunctions, Verbs, Pronouns, Adjectives-Adverbs-Prepositional Phrases, Finding the Subject, and Subject-Verb agreement. A passing score is 80% on any of these functional assessments. If your student does not pass various parts of the pretest the specific lesson to start on within the Cracking the Grammar Code workbooks is provided.

Download the Free Syntax Skill Pretest book and start assessing your students ASAP!

Formal, norm-referenced testing

There are a number of test instruments typically administered by speech language pathologists that will assess a student’s level of syntax development. If a student has received an evaluation by a speech language pathologist in the previous 6 months it is often useful to review those results for insights into specific areas of syntax deficit that have already been identified.

Teachers of the deaf/hard of hearing often perform assessments related to students’ listening comprehension ability, specifically the ability to recall and understand information presented by others. Two popular assessments for this purpose also provide some information about student syntactic understanding or use. While not an extensive investigation into syntax, if a TDHH is performing one of these tests anyway, it may provide a starting place to focus additional syntax assessment, for example with the Cracking the Grammar Code free syntax skill pretest book.

Oral Passage Understanding Scale (OPUS)

For ages 5.0 to 21 years, the Oral Passage Understanding Scale is a measure of listening (auditory) comprehension. It evaluates a person’s ability to listen to passages that are read aloud and recall information about them. This ability is key to success in the classroom and social situations. It also measures memory skills, which are integral to listening comprehension. OPUS identifies how well a person can integrate and apply knowledge in three structural categories of language:

1. 1. Lexical/Semantic: knowledge and use of words and word combinations
2. 2. Syntactic: knowledge and use of grammar
3. 3. Supralinguistic: knowledge and use of language in which meaning is not directly available from the surface lexical and syntactic information.

Measuring higher-level comprehension skills, including inference and prediction, yields more detailed information beyond simply whether or not the individual can comprehend. These skills require deeper processing abilities.

Test of Narrative Language-2 (TNL2)

For ages 4.0 – 15-11, the TNL2 provides a format that shortcuts the typical lengthy language sample analysis process. No transcription is necessary. Children’s answers to the comprehension questions and their stories can be reliably scored from audio recordings (use your Smart Phone!). The instructions are scripted and clear examples are used for scoring. The TNL should be of great benefit in identifying students who have adequate language, but issues using their language ability for ongoing interactions in an age-appropriate manner.

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The post Missing Bits Results in Syntax Deficits first appeared on Supporting Success For Children With Hearing Loss.

A recent US court case¹ made it clear that students with hearing loss must receive an eligibility assessment that identifies areas of suspected need secondary to hearing loss must be evaluated with sufficient intensity to satisfy in depth evaluation. The special factors considerations² also need to be applied throughout the evaluation process. Furthermore, the LEAD-K³ movement has spotlighted the need for appropriate, tailored assessment of children who are deaf or hard of hearing.  The big question from the field of education for children with hearing loss is ‘What assessments should we be using?’

The IDEA law is consistent about looking at educational performance needs when considering a student’s eligibility for specialized instruction and support. Educational performance is not equivalent to academic performance. While academic performance needs to be considered, it is no more important to consider than the other areas specified by IDEA which are functional, behavioral, social needs and any other performance considerations relevant to the specific child. If a school team only considers grades for eligibility then they are using a sole criterion, which goes against the IDEA requirement that eligibility determinations be made with consideration of at-risk areas as determined by the suspected area of disability.

Our students with hearing loss may ‘look fine’ in the classroom, yet we realize that there are usually subtle differences/needs that, added together, cause academic performance to erode over time. Even ‘good’ students with hearing loss can qualify IF there is someone on the multidisciplinary team who truly understands the impact of hearing loss on development AND uses appropriate assessments to use to tailor the evaluation process to the risk areas of students with hearing loss. Teachers of the deaf/hard of hearing and educational audiologists should have/receive the training needed to feel comfortable in assessment.

The defined purpose of IDEA⁴: To ensure that all children with disabilities have available to them a free and appropriate education that emphasizes special education and related services designed to meet their unique needs and prepare them for further education, employment and independent living. Performance of the expanded core skills needed for full participation (self-advocacy, communication repair, knowledge about hearing loss, amplification independence, etc.) are necessary for a student to be fully prepared to function as an adult. These are NOT standard areas of evaluation for other students with special needs, but they must be considered as part of a tailored assessment for students who are deaf or hard of hearing.

LIST OF RECOMMENDED ASSESSMENTS: The list includes recommendations for both functional and formal assessments for ages 3-5 years and school-age students. In evaluations, it is appropriate to look closely at social/emotional, self-advocacy, and the possibly subtle phonological/morphological awareness and ‘Swiss cheese’ language skills that impact comprehension and reading fluency.

Low average language results reflect the impact of hearing loss, not capability. So often for our students, qualification for specialized instructional services hinges on the results of language assessment. A study⁵ found that 40% of students with hearing loss have a capacity for higher language levels beyond what test scores indicate. Further⁶, language learning for students with hearing loss occurs on average at 70%, or just above 2/3, of the rate of children with normal hearing. It is appropriate to anticipate that most children with hearing loss upon school entry will have some delay in expressive and/or receptive language, with greater degrees of hearing loss predicting greater levels of language delay. Also, the nature of hearing loss causes incidental language to be missed whenever a child is further away from about 3-6 feet of the speaker. This typically results in ‘spotty’ or ‘Swiss cheese’ language rather than solid overarching language delays. A student may therefore score higher than his or her actual functional language ability, based on the actual questions asked during the assessment and the individual’s particular vocabulary or conceptual knowledge.

One strong finding from the robust 2015 Outcomes of Children with Hearing Loss Study⁷ was that normative test scores overestimate the abilities of children who are hard of hearing as they are unlikely to reflect the level of effort that students are expending to maintain competitiveness with peers. Although 80%⁸ of children born deaf in the developed world receive cochlear implants, the success rate with cochlear implants is highly variable and cannot be assumed to ever ‘fix’ all language development issues, even for children with the best outcomes. We must consistently communicate with our school teams that students with hearing loss are not language disordered. Language, social, and reading delays occur secondary to lifelong decreased access to communication.

EVERY student with hearing loss who is going through initial assessment needs to have cognitive testing in order to accurately and appropriately estimate if/how much the hearing loss has impacted development based on the student’s ability compared to peers with typical hearing.⁹ Students with hearing loss (DHH-only) experience delays secondary to access issues. It is important to know the cognitive ability of each student with hearing loss as their communication access needs must be accommodated so that they reach the same level of achievement as their cognitive peers.

Although testing is performed in a few weeks’ time, evaluation isn’t just about a snap shot, it is about performance over time. Case in point, we received a call from a parent of a 5^th grader who is hard of hearing. The child had an IEP in kindergarten and grade 1 and was then dismissed. By the end of grade 4 the reading scores had decreased. The school team wasn’t concerned because the student ‘wasn’t very bad yet.’  Time should be taken to consider the percentile scores on reading across time to see if there has been a decline.  When looking at eligibility, dig into prior testing and see if there is evidence of declining percentile ranking in test results over time. For example, in grade 2 did the child score at the 48^th percentile in reading as compared to the 26^th percentile in grade 4? A public agency must provide a child with a disability special education and related services to enable him or her to progress in the general curriculum. The fact that there is a decline indicates that there are special needs that have not been addressed for the student. Access needs and/or deficits in specific skills foundational to reading comprehension would then need to be identified.

Sometimes administrators make the point that schools must provide educational benefit for students but do not have to guarantee that the student reaches his or her potential. Per the March 2017 decision of the US Supreme Court, schools may not settle for minimal educational progress by disabled students. Educational programs must be reasonably calculated to enable a child to make progress appropriate in light of the child’s circumstances. In the case of students with hearing loss, the expectation would be to provide full access to school communication and specialized instruction to fill in learning gaps PLUS support typical/expected levels of progress in the classroom. Therefore, evaluation must be tailored to identify the access, learning, and functional performance needs of every student with hearing loss so that they can progress equal to their cognitive peers.

References

1. 1. Ninth Circuit Court of Appeals, June 1, 2018, S.P. v. East Whittier City School District: https://successforkidswithhearingloss. com/wp-content/uploads/2019/01/Court-case-RE-need-for-thorough-assessment-highlighted.pdf
2. 2. IDEA section 300.324(2)(iv): Consider the communication needs of the child, and in the case of a child who is deaf or hard of hearing, consider the child’s language and communication needs, opportunities for direct communications with peers and professional personnel in the child’s language and communication mode, academic level, and full range of needs, including opportunities for direct instruction in the child’s language and communication mode.
3. 3. LEAD-K: Language Equality and Acquisition for Deaf Kids. https://successforkidswithhearingloss.com/wp-content/uploads/2019/01/Court-case-RE-need-for-thorough-assessment-highlighted.pdf
4. 4. The 2004 IDEA Commentary provides an overall ‘setting the stage’ for the IDEA law; on this webpage.
5. 5. Language underperformance in young children who are deaf or hard-of-hearing: are the expectations too low? Journal of Developmental & Behavioral Pediatrics. September 19, 2017. Results² focused on children with hearing loss who have language levels within the average range on standardized measures. Researchers identified a mismatch between the cognitive level children test at and the expectations for their language skills. In examining the abilities of their 152 young child subjects they found that at least 40 percent have a capacity for higher language levels – beyond what their language test scores indicate.
6. 6. The Effect of IQ on spoken language and speech perception development in children with impaired hearing. Cochlear Implants International, (11)1, June, 370-74. A 2010 study³ found that children were learning language at approximately 2/3 of the rate (or 70% of the rate) of their normally hearing peers. Subjects were 62 children ages 5-12 years who used oral communication and attended oral early intervention or school settings. Children in preschool learned language at a faster rate than children attending primary school. On average, children attending preschool were learning at 0.78 of the rate for normal hearing children as compared to a rate of 0.67 for students in primary school. Speech perception scores did not plateau until children had, on average, the language ability of a typically hearing 7-year-old.
7. 7. Epilogue: Conclusions and Implications for Research and Practice. Ear and Hearing, 36, 92S-98S. Sole reliance on norm-referenced scores may overestimate the outcomes ofCHH. When the children who are hard of hearing (CHH) were compared with the norm-referenced group on various measures, the differences were small. However, when compared the CHH to a sample of CNH who were matched on age and SES, the size of the effect of HL on language doubled to two thirds of a standard deviation. These results question the sole reliance on comparison to norm-referenced test scores for judging eligibility. Standardized test scores may overestimate CHH as they are unlikely to reflect the level of effort that students are expending (cognitive and perceptual resources) to maintain competitiveness with peers in secondary schooling, where the cognitive demands increase. We need to closely monitor the outcomes of CHH including comparing their performance relative to neighborhood grade-mates. Many CHH in the OCHL study represent the best-case scenario. We might expect that a sample with greater diversity on these dimensions would not perform as well as the OCHL cohort
8. Language acquisition for deaf children: Reducing the harms of zero tolerance to the use of alternative approaches. Harm Reduction Journal, 2012, 9-16. Today, 80% of children born deaf in the developed world are implanted with cochlear devices. Due to brain plasticity changes during early childhood, children who have not acquired a first language in the early years might never be completely fluent in any language. If they miss this critical period for exposure to a natural language, their subsequent development of the cognitive activities that rely on a solid first language might be underdeveloped, such as literacy, memory organization, and number manipulation.
9. Addressing the Need for Appropriate Use of Norm-Referenced Test Instruments. Supporting Success, December 2017.

Karen L. Anderson, PhD, Director, Supporting Success for Children with Hearing Loss; 2019 Early March Update.
This information is not intended as legal advice.  http://successforkidswithhearingloss.com

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The post Eligibility – Even with Good Grades first appeared on Supporting Success For Children With Hearing Loss.

The IDEA law is consistent about looking at educational performance needs when considering a student’s eligibility for specialized instruction and support.  Educational performance is not equivalent to academic performance. While academic performance needs to be considered, it is no more important to consider than the other areas specified by IDEA which are functional, behavioral, social needs and any other performance considerations relevant to the specific child. If a school team only considers grades for eligibility then they are using a sole criterion, which goes against the IDEA requirement that eligibility determinations be made with consideration of at-risk areas as determined by the suspected area of disability.

Our students with hearing loss may ‘look fine’ in the classroom, yet we realize that there are usually subtle differences/needs that, added together, cause academic performance to erode over time. Even ‘good’ students with hearing loss can qualify IF there is someone on the multidisciplinary team who truly understands the impact of hearing loss on development AND uses appropriate assessments to use to tailor the evaluation process to the risk areas of students with hearing loss. Teachers of the deaf/hard of hearing and educational audiologists should have/receive the training needed to feel comfortable in assessment.

The defined purpose of IDEA⁴: To ensure that all children with disabilities have available to them a free and appropriate education that emphasizes special education and related services designed to meet their unique needs and prepare them for further education, employment and independent living. Performance of the expanded core skills needed for full participation (self-advocacy, communication repair, knowledge about hearing loss, amplification independence, etc.) are necessary for a student to be fully prepared to function as an adult. These are NOT standard areas of evaluation for other students with special needs, but they must be considered as part of a tailored assessment for students who are deaf or hard of hearing.

LIST OF RECOMMENDED ASSESSMENTS: The list includes recommendations for both functional and formal assessments for ages 3-5 years and school-age students. In evaluations, it is appropriate to look closely at social/emotional, self-advocacy, and the possibly subtle phonological/morphological awareness and ‘swiss cheese’ language skills that impact comprehension and reading fluency.

Low average language results reflect the impact of hearing loss, not capability. So often for our students, qualification for specialized instructional services hinges on the results of language assessment. A study⁵ found that 40% of students with hearing loss have a capacity for higher language levels beyond what test scores indicate. Further⁶, language learning for students with hearing loss occurs on average at 70%, or just above 2/3, of the rate of children with normal hearing. It is appropriate to anticipate that most children with hearing loss upon school entry will have some delay in expressive and/or receptive language, with greater degrees of hearing loss predicting greater levels of language delay. Also, the nature of hearing loss causes incidental language to be missed whenever a child is further away from about 3-6 feet of the speaker. This typically results in ‘spotty’ or ‘Swiss cheese’ language rather than solid overarching language delays. A student may therefore score higher than his or her actual functional language ability, based on the actual questions asked during the assessment and the individual’s particular vocabulary or conceptual knowledge.

One strong finding from the robust 2015 Outcomes of Children with Hearing Loss Study⁷ was that normative test scores overestimate the abilities of children who are hard of hearing as they are unlikely to reflect the level of effort that students are expending to maintain competitiveness with peers. Although 80%⁸ of children born deaf in the developed world receive cochlear implants, the success rate with cochlear implants is highly variable and cannot be assumed to ever ‘fix’ all language development issues, even for children with the best outcomes. We must consistently communicate with our school teams that students with hearing loss are not language disordered. Language, social, and reading delays occur secondary to lifelong decreased access to communication.

EVERY student with hearing loss who is going through initial assessment needs to have IQ testing in order to accurately and appropriately estimate if/how much the hearing loss has impacted development based on the student’s ability compared to peers who do not have hearing loss.⁹ Students with hearing loss (DHH-only) experience delays secondary to access issues. It is important to know the cognitive ability of each student with hearing loss as their communication access needs must be accommodated so that they reach the same level of achievement as their cognitive peers.

Although testing is performed in a few weeks’ time, evaluation isn’t just about a snap shot, it is about performance over time. Case in point, we received a call from a parent of a 5^th grader who is hard of hearing. The child had an IEP in kindergarten and grade 1 and was then dismissed. By the end of grade 4 the reading scores had decreased. The school team wasn’t concerned because the student ‘wasn’t very bad yet.’  Time should be taken to consider the percentile scores on reading across time to see if there has been a decline.  When looking at eligibility, dig into prior testing and see if you can make the case with declining percentile ranking in test results over time. For example, in grade 2 did the child score at the 48^th percentile in reading as compared to the 26^th percentile in grade 4? A public agency must provide a child with a disability special education and related services to enable him or her to progress in the general curriculum. The fact that there is a decline indicates that there are special needs that have not been addressed for the student. Access needs and/or deficits in specific skills foundational to reading comprehension would then need to be identified.

Sometimes administrators make the point that schools must provide educational benefit for students but do not have to guarantee that the student reaches his or her potential. Per the March 2017 decision of the US Supreme Court, schools may not settle for minimal educational progress by disabled students. Educational programs must be reasonably calculated to enable a child to make progress appropriate in light of the child’s circumstances. In the case of students with hearing loss, the expectation would be to provide full access to school communication and specialized instruction to fill in learning gaps PLUS support typical/expected levels of progress in the classroom. Therefore, evaluation must be tailored to identify the access, learning, and functional performance needs of every student with hearing loss so that they can progress equal to their cognitive peers.

References

1. Ninth Circuit Court of Appeals, June 1, 2018, S.P. v. East Whittier City School District: https://successforkidswithhearingloss. com/wp-content/uploads/2019/01/Court-case-RE-need-for-thorough-assessment-highlighted.pdf
2. IDEA section 300.324(2)(iv): Consider the communication needs of the child, and in the case of a child who is deaf or hard of hearing, consider the child’s language and communication needs, opportunities for direct communications with peers and professional personnel in the child’s language and communication mode, academic level, and full range of needs, including opportunities for direct instruction in the child’s language and communication mode.
3. LEAD-K: Language Equality and Acquisition for Deaf Kids. https://successforkidswithhearingloss.com/wp-content/uploads/2019/01/Court-case-RE-need-for-thorough-assessment-highlighted.pdf
4. The 2004 IDEA Commentary provides an overall ‘setting the stage’ for the IDEA law; on this webpage.
5. Language underperformance in young children who are deaf or hard-of-hearing: are the expectations too low? Journal of Developmental & Behavioral Pediatrics. September 19, 2017. Results² focused on children with hearing loss who have language levels within the average range on standardized measures. Researchers identified a mismatch between the cognitive level children test at and the expectations for their language skills. In examining the abilities of their 152 young child subjects they found that at least 40 percent have a capacity for higher language levels – beyond what their language test scores indicate.
6. The Effect of IQ on spoken language and speech perception development in children with impaired hearing. Cochlear Implants International, (11)1, June, 370-74. A 2010 study³ found that children were learning language at approximately 2/3 of the rate (or 70% of the rate) of their normally hearing peers. Subjects were 62 children ages 5-12 years who used oral communication and attended oral early intervention or school settings. Children in preschool learned language at a faster rate than children attending primary school. On average, children attending preschool were learning at 0.78 of the rate for normal hearing children as compared to a rate of 0.67 for students in primary school. Speech perception scores did not plateau until children had, on average, the language ability of a typically hearing 7-year-old.
7. Epilogue: Conclusions and Implications for Research and Practice. Ear and Hearing, 36, 92S-98S. Sole reliance on norm-referenced scores may overestimate the outcomes ofCHH. When the children who are hard of hearing (CHH) were compared with the norm-referenced group on various measures, the differences were small. However, when compared the CHH to a sample of CNH who were matched on age and SES, the size of the effect of HL on language doubled to two thirds of a standard deviation. These results question the sole reliance on comparison to norm-referenced test scores for judging eligibility. Standardized test scores may overestimate CHH as they are unlikely to reflect the level of effort that students are expending (cognitive and perceptual resources) to maintain competitiveness with peers in secondary schooling, where the cognitive demands increase. We need to closely monitor the outcomes of CHH including comparing their performance relative to neighborhood grade-mates. Many CHH in the OCHL study represent the best-case scenario. We might expect that a sample with greater diversity on these dimensions would not perform as well as the OCHL cohort
8. Language acquisition for deaf children: Reducing the harms of zero tolerance to the use of alternative approaches. Harm Reduction Journal, 2012, 9-16. Today, 80% of children born deaf in the developed world are implanted with cochlear devices. Due to brain plasticity changes during early childhood, children who have not acquired a first language in the early years might never be completely fluent in any language. If they miss this critical period for exposure to a natural language, their subsequent development of the cognitive activities that rely on a solid first language might be underdeveloped, such as literacy, memory organization, and number manipulation.9. Addressing the Need for Appropriate Use of Norm-Referenced Test Instruments. Supporting Success, December 2017.

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