1. SPED 537 ECSE Methods Multiple Disabilities Ch 6 Deborah Chen, Ph.D. California State University, Northridge March 27-28, 2006

2. Key Strategies: Visual Impairment Social interactions Language and communication development Concept development Orientation and mobility Adaptations

3. Incidence 30-40% of children in DHH programs have another disability Up to 70% of children with Down syndrome have a hearing loss Children with disabilities more at risk for hearing loss than typical peers

4. Risk Factors Family history Maternal infections e.g., TORCH Prematurity Hypoxia Low Apgar score High bilirubin level Ototoxic medications NICU admission Head trauma

5. Risk Factors Craniofacial anomalies Cerebral palsy Certain syndromes Childhood infections Certain neurodegenerative disorders Recurring otitis media

6. High Risk Signs Atypical appearance of face or ears Medical condition Atypical listening behaviors Atypical vocal development Other behaviors

7. Informal Assessments Functional Hearing Screening (child not diagnosed with hearing loss) VS Informal Assessment of Child’s Use of Hearing (child identified as deaf or hard of hearing)

8. Functional Hearing Screening Not identified as having a hearing loss Unusual response to auditory stimuli Atypical appearance of face and/or ears Risk factors associated with birth history and etiology of disability

9. Purpose: Functional Hearing Screening Should this child be referred for an audiological evaluation? What instructional strategies and adaptations will support this child’s understanding of auditory information ?

10. Informal Assessment of Child’s Use of Hearing Diagnosed as having a hearing loss May wear hearing aid(s) Some environmental/intervention adaptations may have been made Does not respond consistently to sound

11. Purpose: Informal Assessment of Child’s Use of Hearing How effective are current strategies and adaptations in encouraging this child’s listening skills? What changes or additional strategies and adaptations are needed to encourage this child’s understanding of auditory information?

12. Procedures Background information (age, disability, medical and educational information) Teacher and/or parent interviews Systematic observations of routine activities “Eliciting situations”

13. Interview Questions Hearing tests Favorite toys and activities Response to voices Response to environmental sounds Vocalization and language

14. Systematic Observations Environment Context Background noise or quiet Child Distance from sound source Listening skills Interaction with others Communication

15. Hierarchy of Responses to Sound Reflexive or awareness Alerting or attending Localization Discrimination Recognition Comprehension

16. Child Responses Type of responses (motor, vocal, verbal) Response time Consistency and clarity of response Response level

17. Data Analysis What do you know about this child’s use of auditory information and learning level? - Questions - Suggestions

18. Intervention plan (Do not implement) Measurable objective related to communication or language Meaningful context Input, adaptations and supports Data collection and evaluation procedures How do you know your intervention is effective?

19. Assignment Components Functional Screening/Informal Assessment Interview Observations (routine and elicited situations) Data collection forms Intervention Plan Measurable learning objective Routine analysis Evaluation plan and data collection form