In the March 22, 2017 US Supreme Court decision, Chief Justice Roberts wrote, “…IDEA demands more. It requires an educational program reasonably calculated to enable a child to make progress appropriate in light of the child’s circumstances.”  If a child is not fully included, school officials must look at the child’s unique needs and required level of specialized instruction before developing an IEP that is “pursuing academic and functional advancement.” If a child is 6 months behind expected achievement levels, an itinerant DHH teacher cannot maintain a year’s growth and also make up the level of delay with only twice per week 30-minute sessions of service. Providing an inappropriate amount of educational support will not result in the needed level of student outcomes nor will it make teachers of the DHH appear effectual.

“Kids in the middle” refers to students who may not be served in delivery models that consist of direct services from a teacher of the deaf and hard of hearing. Therefore, the resulting services may, or may not, adequately address the communication, social, and academic needs of these students. Central to the concept of special education is the idea that the Individual Education Planning Team will collaboratively determine the special and general education services a student needs, based on the goals and objectives developed for him or her. This process is meant to ensure that each student will receive services tailored specifically to his or her unique set of needs. With the recent clarification by the US Supreme Court it is anticipated that school teams will once again consider the amount and intensiveness of services necessary to allow students with hearing loss to progress at a rate typical of hearing peers. Our goals should focus on helping students become effective communicators, competent readers, and knowledgeable consumers of goods and services.

One result of the Supporting Success survey last April to identify the roles and responsibilities of itinerant teachers of the deaf/hard of hearing indicated that 25% of respondents used matrices to guide their discussions in the determination of the level of service delivery. With increased pressure to ‘serve less, more remotely’ under the assumption that the student will learn as well when teacher of the DHH services are minimized, many teachers and districts are exploring or implementing the use of service delivery matrices.

It is important to preface this discussion recognizing that a service delivery matrix can only be a guide to decision making, assisting in team discussions and not the final word in appropriate levels of service. The focus needs to remain on “what the student needs to catch up and keep pace.”

Hearing loss results in learning needs that are unique, including some areas of need that cannot be effectively addressed in a mainstream classroom (refer to Early October Bimonthly Update). For the teacher(s) of the DHH who would like to begin the conversation of using a service delivery matrix, the following handouts may be a helpful addition to discussions with administration:

• Why Involve the Teacher of the Deaf/Hard of Hearing on the Assessment Team and the IEP?
• Role Comparisons: Supporting Students Who are Deaf or Hard of Hearing
• Considerations for Assessment & Service Provision for Children with Hearing Loss

Below are examples of matrices that are already in use. Some are DHH specific while others are not. Some take into account the social, technology, accommodations, and self-advocacy needs of students and others do not.

Use of a service delivery matrix may provide the evidence basis needed for justification of appropriate levels of service to meet student needs – academic, class participation and expanded core skill development. 

Example Matrices for Determination of Level of Service Delivery

• Educational Impact for Students who are Deaf or Hard of Hearing The Michigan Department of Education – Low Incidence Outreach has produced an exceptionally helpful tool that has recently been made computer fillable. It is suggested that persons interested monitor their website for the new fully accessible version to be released.
• Hearing Itinerant Services Rubric Many varying factors are considered within the 3-page matrix. Individual child issues or circumstances need to be carefully considered as well as the rubric recommendations. Thanks much to SEDOL in Illinois for sharing this 2014 resource.
• Service Delivery Guide for Educating Students Who are Deaf and Low Functioning was developed by Region 4, Houston Texas in 2016. As the title indicates, this matrix is different from the others as it is specific to students who are Deaf-plus.
• Matrix of Services was developed by the Florida Department of Education Bureau of Exceptional Education and Student Services in 2017 as guidance to indicate the intensity of support required to meet the needs of students identified as exceptional. It is not DHH specific. Be sure to download the large Matrix of Services Handbook that provides detailed explanations of all domains for appropriate use. Note: this large file may take extra time to access.

2018 © Karen L. Anderson, PhD, Late November Update, Supporting Success for Children with Hearing Loss http://successforkidswithhearingloss.com This information is not intended as legal advice.

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By Martie Martin, M.S.

Expectations in a nutshell

As itinerant teachers, we are asked to solve every problem that the deaf or hard of hearing student encounters. Not only are we supposed to be knowledgeable about any of the academic subject matter the student encounters in school, but we’re also supposed to know about every form of technology, the latest in CI processors and “please fix this, by-the-way”. Fix the equipment or fix the student, it doesn’t matter as long as its accomplished within the 15 minutes block we have in our schedule to see the student and then get to the next school site. We’ll stop back in a month, if our schedule hasn’t been comprised by an IEP meeting or quite simply, a flat tire on our car. Does this sound like you?

The Basis of Success

I count on clever students and smart teachers to help me with my work. That’s why I lay the groundwork early in the school year for the teacher who tolerates interruptions and the student who takes control of his/her hearing loss. At the beginning of the school year I am focused on the teacher. What is needed to make the year successful? Meeting with me, meeting with last year’s teacher, all staff in-service, equipment monitoring, academic monitoring, seating, consulting about the other student who has an IEP? To make the year successful, the needs can change, but meeting the teacher where s/he has concerns is the most supportive action I can take. The average classroom teacher has never had a student with a hearing loss, and s/he is expected to accommodate that student along with the 5 other IEP identified students and the 5 unidentified students in the classroom.

Elementary School Push-In

At the elementary level, when I walk into the classroom and there are management issues, I stand or sit next to the noisiest kids and watch the teacher. I model the behavior that I want to see from them while in close proximity. Those students may not have a hearing loss, but they impact my student. Or, maybe I help the table of students struggling with the assignment—I’m a teacher, I can teach general education students and my student benefits from seeing that I don’t isolate him/her from his/her peers and that other students need help, too. The teacher will notice and usually appreciate my help. This makes it easier when I briefly raise any academic concern, such as, “I noticed my student wasn’t understanding the direction about writing, but the other students seemed to be following the instruction. I’m certain that my student didn’t hear the part about using —.” While I want to support my student, the best support I can give is to be sure the teacher knows what I see specifically, not in general terms. “My student’s not hearing the instruction” is not nearly as helpful as “my student missed the instruction about… It would be really helpful if you wrote an example on the board while you’re explaining it.”

Fitting in Technology Checks

And yes, I check the hearing aids and whatever hearing assistive technology is used in the classroom. I work with the student to check his/her equipment in the classroom. We are usually off to the side, but if another student has a question, I encourage my student to answer it. “What’s that?” becomes a dual opportunity to build advocacy and build a friendship.

By the end of elementary school, my student can trouble shoot whatever equipment s/he is using and report to me or the teacher any problems. I email the parents updates as I see them. Not every parent is responsive to my request for new earmolds, but everyone involved with the child, including the student, knows I made the request—in writing. With the bilingual student, I use an interpreter to call the parent when possible, and I call the clinical audiologist about the concern. In one school district, the audiologist had a form that she filled out about the status of the hearing aid, and gave this to the student or sent it home to the parent. The form was on NCR paper, so the audiologist had a copy. It was also translated into Spanish.

Middle School Push-In

In middle school, the push in model looks a little different. I start with the same approach with the teachers, provide a checklist of information, limited to one page, and a more personal cover sheet about the student’s strengths and preferences. In the first month, I make multiple visits to the core subjects of that student, observing the teaching style and the student’s access to instruction. I’ll catch up with the student in a brief conversation in the hall. “I noticed xyz, do you think that is the best position for you in the classroom? Where would be a better seat? Do you want to tell the teacher, or do you want me to mention it?” Here’s the dilemma, while I want the students to advocate for themselves and we’ve talked about it, the reality is that they are shy about approaching a new teacher at the beginning of the school year. If I can assist initially, with the understanding that the teacher will check in with the student and s/he provide honest feedback, then the communication will be easier in the future.

The other support I rely on is the student’s ability to text me as soon as any equipment or access is problematic. I get permission from the parent, usually during the IEP or 504 meeting, exchange phone numbers and then the texts start to come in. It’s so empowering to the student to manage his/her own needs in these areas. Does it work all the time? No, but if I’m contacted some of the time, that’s better than not-at-all.

High School Push-In

At the high school, I provide the initial introduction letters to the teachers, I might sit in on a class or two briefly, but basically, I am relying heavily on the text messages and my occasional drop in visits with the student. If the IEP indicates that I am supposed to work directly with the student on specific academics or advocacy, then I schedule the student during his/her homework lab or library. I follow up with teachers when there are concerns, student confusion or access issues that aren’t being addressed.

Appreciating the Working Relationship

At the end of the school year, I always write a personal note to the teacher thanking him/her for being patient with my interruptions and providing support for the student. I might give a small gift card or other appreciation, depending on how disruptive the equipment/situation had been during the school year. One year we never could remove the intermittent personal FM hum while patched into the installed soundfield system. I had people traipsing in and out of the room on a weekly basis for months and ultimately the teacher ended up wearing two transmitters—that was over-and-above for my student.

Push-In by the SLP to Support Students with Hearing Loss in a Center-Based Setting

Experienced SLPs can provide auditory and speech therapy in the DHH classroom very successfully. They can have their own FM “channel” and can see what was happening in the classroom then carry over the activity to therapy weaving in the goals. They could choose to do a small group activity with students when the opportunity arises.Daily speech “aerobics” can be done with the class. And yes, even when focusing on listening skills, the presence of distraction and background noise can be an effective tool for determining the child’s proficiency. All of the students can be actively involved in not only their speech/listening goals, but also each others’, and best of all, the teacher can be actively involved, so carry over is fabulous. This approach is counter-intuitive, but with the right staff it can be effective, so it’s worth exploring. One year, the primary DHH classroom was studying about Christopher Columbus. The speech therapy “area” became a ship, idioms derived from sailing or fishing terminology became the lessons and articulation goals spun off of that. The teacher used the idioms regularly in the language arts curriculum. One of the teachers brought her sailing dinghy to school for the day and everyone was “on board” or they would have to “walk the plank”.

Substitute Teacher Pitfalls

My greatest frustrations are the substitute teachers who are not informed or choose not to provide access, and the students who say nothing to those teachers! I consider that issue to be a breakdown in the communication link between the classroom teacher and/or principal, case manager and the substitute, so I’ll send reminder emails to each of them. The teacher usually wants to know and is appreciative.

More information:

Pull-Out or Push-In Service Delivery Model: Conducive to Students or Teachers?

About the author:At her core, Martie Martin is an educator who is fascinated by the learning process. She started out in the mid-70’s as a teacher for the deaf/hard of hearing, teaching high school students reading at Mystic Oral School, Mystic, CT. After teaching in special day classes, she “graduated” to itinerant teaching (her passion), started a private practice, later obtained a degree in audiology, and has been contracting with school districts in the San Francisco Bay Area for nearly 30 years. She is a graduate of Purdue University (Speech Pathology), University of Oklahoma (Deaf Education) and San Francisco State University (Audiology).

Posted November 2014

The post Push-In Services for Students in the Mainstream first appeared on Supporting Success For Children With Hearing Loss.

How Much Service???

Guidance via the Hearing Itinerant Services Rubric

Every child’s needs must be considered individually to determine the frequency and intensity of services to provide a free and appropriate education. That said, how do you decide if a child receives 30 minutes of DHH teacher time 3 times a week or if it is appropriate to provide monthly consultation? It is all too easy for budgetary restrictions to determine service provision unless you have a means to systematically consider the relevant factors and make a logic-based decision about the appropriate amount of service. The leadership and DHH staff at the Special Education District of Lake County, just outside of Chicago IL, worked for an extended time to craft a rubric to assist them in determining appropriate levels of DHH service.

As you will see, many varying factors are considered within the 3-page

Hearing Itinerant Services Rubric. Of course, individual child issues or circumstances need to be carefully considered as well as the rubric recommendations, but use of this Service Rubric may provide the evidence basis needed for justification of appropriate levels of service to meet student needs – academic, class participation and expanded core skill development.
Thanks much to the leadership of Lori Degman and the DHH staff at SEDOL for sharing this resource!

Another matrix for service determinationhas been made available from the Michigan Department of Education – Low Incidence Outreach.
Go here to view

Educational Impact for Student who are Deaf or Hard of Hearing and for more background on this resource.
Thanks to the Michigan Department of Education Low Incidence Outreach for creating this valuable resource!

Service Delivery Guide for Educating Students Who are Deaf and Low Functioning was developed by Region 4, Houston Texas in 2016. As the title indicates, this matrix is different from the others as it is specific to students who are Deaf-plus.

Specially Designed Instruction for Students with Auditory Impairments is a 1-page summary of the areas of specially designed instruction that should be considered for students with hearing loss. The page lists the areas of Language, Communication, Cognition, Literacy, Academic Concepts, and Social-Emotional. For each area the impact on content/skills, teaching methodology, and delivery are listed. Thanks to the folks in Region 4, Houston Texas for their creativity in developing this resource.

Iowa Expanded Core Curriculum Skills also has an extensive bulleted list of expectations of 4 levels of skill development.

K-12 ASL Content Standards developed by the Clerc Center at Gallaudet University. The ASL Content Standards help for planning and monitoring ASL development in children who are deaf or hard of hearing visual communicators.

Charts: Model of Service Delivery + Response to Intervention Supports for Children with Hearing Loss

Models of Support Services (availability of services from an itinerant teacher of the deaf/hard of hearing)

The information below has been derived from sections of the law, Office of Special Education Program comments and discussion provided at the
U.S. Department of Education’s Individuals with Disabilities Education Act (IDEA). The guidance provided in this website helps clarify the intent of IDEA and may be useful to professionals and parents alike who are trying to advocate appropriate services and supports for children with hearing loss.

Who should provide services?

In order to provide appropriate intervention to meet IEP goals, service providers must have the knowledge and experience of what services to provide and specific teaching strategies to address these needs. Children with hearing loss have learning issues secondary to reduced access, not due to learning disorders. While they may have attention, language, reading and other issues that appear similar to students with disordered learning, the teaching strategies to address these issues are often different, requiring a background in deaf/hard of hearing education. Refer to the following handouts:

Why Involve the Teacher of the Deaf/Hard of Hearing?

Comparison of Roles in Supporting Students with Hearing Loss

The post Issues: Determining Service Delivery first appeared on Supporting Success For Children With Hearing Loss.