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 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.

Lost intervention opportunities: Over 25% of infants who failed newborn hearing screening had no documented diagnosis of hearing ability. Although many students with hearing loss receive early identification followed by early intervention, almost 20% of those who were diagnosed with a hearing loss following newborn hearing screening did not receive early intervention.

Some children receive cochlear implants as infants or toddlers without the necessary intensive intervention to develop age-appropriate oral language. Other families choose to use sign language without the needed instruction in ASL or connections with the Deaf community to develop fluency, even to meet the vocabulary growth needs of a young child. Still other families ‘want it all’ but are not provided intensive support by skilled interventionists to be able to provide both a rich auditory and visual communication environment.

Such missed opportunities for early development can result in a scenario like the following:

“We have a student entering kindergarten who received cochlear implants at ages 2 and 3. His oral language development is 2 years delayed. Because he is so delayed, the school team is suggesting we put an interpreter with him in a regular kindergarten class. The family knows a few signs but they want him to listen and speak. How do we figure out the most appropriate program for him?”

Note:

The recent Optimizing Outcomes for Students who are Deaf or Hard of Hearing Educational Service Guidelines (NASDSE, September 2018¹) and the still relevant policy guidance on Deaf Students Education Services (US Department of Education, 1992²) are both valuable resources in helping to answer this question.

Full-Inclusion as a Driver: With the push toward full inclusion in the classroom, including limiting pull-out for specialized instruction, school teams may seek to provide an interpreter in the situation above as a way to address communication needs in the inclusive environment. However, for the varying communication needs of students with hearing loss, an interpreter may be an inappropriate solution, or only a part of a solution, to meet these communication needs. As made clear from the following paragraph², school teams must thoroughly understand a student’s communication needs, how to provide the least restrictive educational environment and the appropriately intensive specialized instruction in light of those communication needs.

Meeting the unique communication and related needs of a student who is deaf is a fundamental part of providing a free appropriate public education (FAPE) to the child. 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. 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.” ²

To consider these language and communication special factors, the IEP team should ask¹:

• What is the child’s primary language and mode of communication?
• What communicative needs and opportunities does the child have? Can he comprehend what is said in school?
• Does the child have the skills and strategies necessary to meet those communicative needs and take advantage of communication opportunities? (social, self-advocacy)
• Can the child fulfill his or her need to communicate in different settings? (listening in noise, social situations)
• Does the child communicate appropriately and effectively, and if not, why not? (full participant in class?)

Strategies to Obtain Information About Communication Needs

Considerations for the school team to answer what communication services are appropriate include:

1. 1. 1. What is his most effective communication mode of communication? The PARC checklists should help to tease this out (PARC Instructional Communication Access Checklist, followed by the appropriate grade level readiness checklist).

1. 1. 2. What is his degree of delay compared to the language level of typical peers? An extensive language assessment must be performed, including listening comprehension. If providing an interpreter is being discussed, then assessment needs to be performed to determine his development level with both languages. Assessments that provide age expectations for learning ASL can be found in this document.

1. 1. 3. Is there reason to believe that there is a cognitive component that is further impairing language growth (nonverbal IQ measure by someone skilled in DHH cognitive assessment)? When provided appropriately intensive services focused on oral language development was rapid progress made? Given intensive ASL instruction, not just interpreter services, does he pick up language at a rapid rate?

1. 1. 4. What intensity of services are required for him to learn language at a pace of more than one month of development for one month of time? The school team can complete this matrix that assists teams in teasing out student communication, skill level, impact of hearing loss on education and resulting service intensity needs. This is a situation where it is highly likely that a full-day inclusive classroom setting is the most restrictive placement for a student to receive FAPE.

1. 1. 5. What service providers are need for him to develop language quickly? A teacher of the deaf/hard of hearing and/or speech clinician with extensive training in oral education of students with hearing loss is likely necessary to reach the eventual goal of age-appropriate language.

Targeted assessment data is necessary to determine appropriate placement and IEPs goals. Appropriately educating most students with hearing loss requires specialized knowledge, appropriate intensity of DHH  services, accessibility accommodations for effective classroom communication, and contact with DHH peers.

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Research has consistently revealed that a ‘good’ result of early intervention for children with hearing loss is a standard score of -1 SD to -1.5 SD on norm-referenced language tests (standard score 78-88 range). All too often teachers of the deaf/hard of hearing have sat in meetings where the evaluation team has described these results as ‘normal’ and ‘he will be okay.’ After all, special education is not preventative, it is for children who have identifiable disabilities. ‘Low-normal’ does not equal a disability. Yet professionals who work with these students realize that there ARE language issues, including ‘Swiss cheese language’ which influences comprehension, delays in syntax learning, and in early literacy skills.

Using Norm-Referenced Tests to Determine Eligibility

The purpose of the testing is to identify an educational disability or adverse educational effect on educational performance. For children with hearing loss, assessment needs to be sufficient in scope and intensity to identify gaps in auditory (or sign language development), language, narrative discourse, academic, literacy, and social language skills. Information needs to be collected that reflects the student’s ability to function in situations similar to the school setting, including typical use of amplification.

Norm-referenced tests typically have various subtests, each of which assesses one type of ability area. These subtest scores are rolled together into an overall or total score for the norm-referenced test. It is often claimed that only the overall score from the norm-referenced test can be used to determine eligibility. This is frustrating to persons who work with students with hearing loss as there are often one or more subtests that show areas of need, but the overall score average is within the acceptable range.  Section 300.304(b)(2) of IDEA states that a single measure or assessment cannot be used as a sole criterion for eligibility. So yes, a single subtest score cannot be used to determine a child as eligible. This is misleading. If the area of need identified by the low performing subtest(s) was also demonstrated by other norm-referenced and/or functional measures, then the child’s area of need would have been demonstrated with more than one measure. If there is a substantial need identified, go the extra step to verify it. This can make the difference between eligibility for supports and services or no specialized help for the child. For more discussion on using subtest results to determine the need for further testing, read here.

Another aspect of norm-referenced testing is that the measures are designed to identify areas of delay or disorder. To use an analogy, we can compare the knowledge and skills learned each year to a row of 12 bricks to build a wall. Every year there would be a row built up, starting from infancy. Think of each brick as collectively representing vocabulary and concepts learned during one month of exposure. Consider our students who did not consistently use amplification, or were not consistently exposed to fluent sign, during early childhood and how that would impact their ‘row of bricks development’ as compared to typically developing hearing peers. Norm-referenced tests, specifically the overall scores, consider development as ‘How high is the wall?’ as compared to typical learners. Children who have cognitive delays or learning disorders would have shorter walls. Children with hearing loss are typically found to have walls almost as high as their age peers (low average) but what is NOT identified is the gaps in learning that are typical of children with hearing loss due to communication access limitations that vary over time.

To combat this, the person specializing in the education of children with hearing loss needs to be part of the evaluation team (IDEA Section 300.321(4)(i)(5)). We need to press for evaluation in the areas that we know are at highest risk for issues due to the impact of hearing loss. In looking at the list below, it is clear that the test battery typically used by the school team to evaluate children suspected of learning disorders will not capture the most likely areas of need for students with hearing loss. Moreover, we need to work with the team to discuss evaluation measures that can provide the norm-referenced results of the specific skills needed to tailor the assessment to specific areas of educational need, as required by IDEA (Section 300.304(c)(2)). Refer to Steps to Assessment for information on specific measures.

Areas of learning most likely to be impacted by hearing loss:

• Understanding group discussions or participating in small group work due to distance/noise in class and socially
• Vocabulary:  Gaps due to decreased ability to overhear incidental language (‘Swiss cheese language’)
• Syntax: Incomplete understanding of rules (i.e., cannot hear /s/ or /ed/; do not understand plurals, possessives, past tense)
• Working Memory: ability to retain fragmented parts of words heard and new spoken/signed vocabulary
• Listening skills:  Can be challenges with simple discrimination of sounds, phrases or comprehension of conversation or verbal instruction in class (they may hear but not process the full meaning)
• Attention: Periodic inattention due to listening fatigue and gaps in understanding; ‘tuning out’ when it is challenging
• Early reading: Phonology/phonemic awareness issues related to not distinctly hearing speech sounds
• Language processing: due to fragmented hearing, vocabulary gaps, syntax and morphology gaps, slower listening rate, reduced understanding words in context
• Viewing information from different perspectives, understanding emotions of others, critical thinking
• Social language: Socially awkward, delays in pragmatic language, nonverbal social cues, and appropriate peer interactions
• Passive or immature skills in responding when they do not understand what was said; lack of self-advocacy

Influence of CONSISTENT use of hearing devices on language outcomes: Consider our students who did not consistently use amplification, or were not consistently exposed to fluent sign, during early childhood and how that would impact their ‘row of bricks development’ as compared to typically developing hearing peers. Children with more consistent DAILY hearing aid use have better language and auditory outcomes than children with less consistent use, averaging 2/3 of 1 standard deviation difference². This is especially true for children with hearing loss of 41-70 dB. If children with hearing loss already perform in the low average range for language, an additional 2/3 of 1SD delay can make a lifelong difference in school outcomes. Consistent hearing use is a big key to protecting against language delay and catching up or keeping up with language/learning.

A Predictable Downslide in School Performance: With exposure to a dynamic language environment in a structured classroom setting, many typically hearing children who have low-average language ability can begin to catch up to their more average peers. This assumption cannot be applied to children with hearing loss. A dynamic classroom language environment typically provides less access to communication than what the child experienced in early childhood. It is typical for our students to have their learning trajectory decrease once they enter school, meaning their rate of learning actually declines due to increased issues clearly accessing communication. If a child was not made eligible for specialized instruction, be sure that a 504 Plan is developed and include periodic monitoring by a DHH specialist as part of the necessary auxiliary aids and services (education in regular classes with supplementary services, read FAQ 4).

An evaluation team has the responsibility to appropriate assess students to identify areas of need that will interfere with educational performance. To this end, IDEA Section 300.304 requires that teams gather relevant functional, developmental, and academic information about the child. Academic information is only one part of educational performance. This is especially important for students with hearing loss who often have functional performance issues related to decreased access, such as challenges following directions, participating in group work, listening comprehension, and fatigue. These are all relevant functional performance issues that must be considered when evaluating a student’s need for specialized instruction and support.

References

1. Spencer, P., & Marschark, M. (2010). Evidence-Based Practice in Educating Deaf and Hard-of-Hearing Students. “Children who are identified early and receive early intervention have been found to demonstrate language development in the “low average” level compared to hearing children.” (pg 42) Read more about book.

2. McCreery R. W., Walker E. A., Spratford M., et al. (2015). Longitudinal predictors of aided speech audibility in infants and children. Ear Hear. 36:24S–37S Go to article.

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We need to not only strive to close language and learning gaps, we need to simultaneously support our students in keeping up with the day-to-day learning in the classroom. We MUST monitor progress to know if full access is truly occurring and to ensure that our students are keeping pace with classroom expectations. Without appropriate support, the trajectory of educational performance shown above is all too likely. Students who are deaf or hard of hearing with no other learning issues – with full access to school communication – CAN progress at the expected rate IF they are receiving the appropriate intensity of focused support.

Monitor and Compare – Progress from Year-to-Year

Review your student files semi-annually for young children and annually for school-age students. Specifically, look at norm-referenced test results, like the high-stakes tests or language evaluations. Have the student’s percentile scores stayed constant? With your focused intervention and appropriate supports, has the student’s percentile scores improved? Or, like the figure above depicts, has the student experienced inappropriate access issues and insufficient supports causing a decrease in performance over time.

For example, consider a student who scored in overall reading in grade 2 at the 48^th percentile, at the 38th percentile in grade 3, and at the 30^th percentile in grade 5. The student still continues to fall within 1 standard deviation from the mean, or within the ‘average’ range. However, a drop of 18 percentile points over 3 years certainly raises the question about adequate yearly progress and if the access accommodations and services have truly ‘leveled the playing field’ for the student with hearing loss. The school team may not be concerned because the student still scores ‘average’ but to a professional with a background in the impact of hearing loss on learning, this trend should demand that more focused and appropriate supports/access accommodations be provided.

Infants and Toddlers

An integral part of early intervention services includes monitoring the growth in skill development for young children with hearing loss. If a child was identified at birth and received amplification/intervention within a couple of months, then the goal is one month of development per one month of age. If the hearing loss was identified and amplification/intervention not provided until 3 months or later, then the goal is more than one month of growth per one month of age. If a child with a delay only gains 6 months of development in a 6-month period then he or she will never catch up to age peers by school entry.

The following are resources that can be used by interventionists/parents to track skill growth over time.

• Communication Development Monitoring – checklists for parents of children ages 8-36 months to complete every 6 months to track expressive vocabulary growth as compared to typically developing peers. Checklists can hang on refrigerator as a reminder to families about words appropriate for them to include in daily conversations. It will also be handy to mark when a word has been learned. Graphs for boys and girls show growth via percentile ranks. Scoring examples are also posted to assist in identifying the growth in months for every 6-month period.

Auditory Skills Checklist 1   Auditory Skills Checklist 2– Approximately 85% of children with hearing loss have hearing loss of 70 dB or better. Of the approximately 15% who have 71-110+ dB hearing loss, about half receive cochlear implants. Finally, based on one state’s 2013 data (NC), of the families who chose a communication option, 92% chose spoken language for their children. Only 2% chose ASL and 6% chose simultaneous communication. Fewer than 1% chose Cued Speech. Based on this, it is clear that for the vast majority of children, growth in auditory skill development is very, very important to their future success and should be diligently tracked from infancy.

• ASL Development for those families and children who use sign language, skill development should also be monitored. Information on this webpage includes an extensive developmental checklist for ASL skills. Once a child is in kindergarten the ASL Content Standards below should be used as a guide to development.

• Pragmatics Checklist – as children transition from early intervention it is critical to determine language performance in all areas. Pragmatics is often overlooked. Pragmatics, or social communication, will not develop at a typical rate, or in the same way for children with hearing loss unless addressed. It is typical for a 7-year-old with hearing loss to have the pragmatics skills of a 3-year-old!

• Hearing aid use and independence is a concern, even for our youngest children with hearing loss. Families need to develop confidence in monitoring hearing devices and supporting full time use. Strategies for Keeping Hearing Aids On and Achieving Effective Hearing Aid Use in Early Childhood are resources to assist in these goals.

School Age

NEW!  ASL Content Standards – K – 12. Developed by Gallaudet, these comprehensive standards are truly impressive! They were developed to ensure that deaf and hard of hearing children acquire and learn ASL in much the same way that hearing children in the US acquire and learn English.  Whichever communication modality is used by a student, he or she must have the prerequisite skills to adequately communicate both receptively and expressively.  Most families at this point prefer that their child learn to listen and speak. This preference does not always result in a child who has school entry skills. Whether the family has chosen to use sign from birth, or it is the modality deemed to be most effective for learning by a school team due to child’s lack of progress learning to listen and speak – a student must progress through learning ASL in a developmental sequence to prepare them to make academic gains at least at the rate of their class peers. The ASL Content Standards for K-12 grade students is a huge step forward in determining instruction needed and progress monitoring of ASL knowledge and use.

CURRICULUM BASED MEASURES: There is a need for functional assessments to monitor students’ academic performance. Curriculum based measures provide a specific approach to measuring student learning that includes repeated measurement (weekly, monthly) across extended periods of time using general outcome indicators that are sensitive in the rate of change demonstrated in the performance of a task of the same difficulty. While curriculum-based measures (CBM) have been commonly used in public education, it is appropriate to consider CBM use for students who are deaf/hard of hearing specifically. Developed as part of a grant from the U.S. Office of Special Education Programs, the University of Minnesota has developed extensive progress CBM materials designed specifically for teachers of the deaf/hard of hearing to monitor students who have hearing loss and/or language differences.

Go to the Education Resources for Teachers of Deaf/Hard of Hearing Students resource page for extensive training resources for teachers and specific means to monitor student progress. This truly is an amazing resource and would be great for professional learning collaboratives or self-study. The measures take only a few minutes each week!

MAZE ASSESSMENT: Monitoring performance via the MAZE assessment is a common form of curriculum-based measurement. Maze presents sentences or short stories with every 7th word missing. The student must select which of 3 words best fits the missing word in the sentence. Clearly, as can be seen in the bar graph, even our students with hearing loss who do not have IEP services and supports are not performing like their age peers. Learn more about creating MAZE reading passages here.

Monitoring Progress of Expanded Core Skills

Expanded core curriculum refers to those skills that students with hearing loss need to learn to be able to access the general education curriculum and fully participate. Even if a student is provided access to effective communication as required by Title II of the ADA, he or she still needs to learn the skills to independently, and confidently, navigate as a person with hearing loss in a mainstream setting. These areas will not be taught specifically and yet they must be learned if full participation in the classroom is expected.

Per the Iowa Expanded Core Curriculum guidance, hearing loss adds a dimension to learning that requires explicit teaching, such as information gained through incidental learning. It has been estimated that for persons without hearing loss, 80% of information learned is acquired incidentally. No effort is required. Any type of hearing loss interrupts this automatic path to gain information. This incidental information must be delivered directly to students who are deaf or hard of hearing. Most teachers without specialized training related to hearing loss do not have the expertise to address the unique needs of students who are deaf or hard of hearing. Therefore, IFSP & IEP team collaboration with educational audiologists and teachers of students who are deaf or hard of hearing is necessary in addressing academic and social instruction and the assessment of these areas. In order to close this information gap, the Expanded Core Curriculum for Students who are Deaf or Hard of Hearing (ECC-DHH) was developed. Texas has developed a Livebinder with extensive information about ECC and resources to support implementation.

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The post Progress Monitoring – Gains Equal to Peers? first appeared on Supporting Success For Children With Hearing Loss.

Americans with Disabilities Act – Clarification for Schools

The post Access via the Americans with Disabilities Act first appeared on Supporting Success For Children With Hearing Loss.