Recipes for Success: Tools for Youth with Hearing Loss 2017 SCSHA Convention Recipes for Success: Tools for Youth with Hearing Loss With Mariann C. Carter, M.S., M.Ed., EIPA 3.9, NBCT Sharon B. “Dianne” Dixon, MSP, CCC-SLP, LSLS Cert. AVT, NBCT-retired Jason Wigand, Au.D., CCC-A – Board certified in audiology

Mariann C. Carter, M.S., M.Ed., NBPTS Exceptional Needs Specialist, (Hearing), EIPA 3.9 Mariann has worked in the public schools for over 20 years and is a trained and experienced Elementary and Secondary Educational Leader and a renowned teacher in South Carolina for Deaf and Hard of Hearing children. Mariann has served at the state and national levels for the Office of Exceptional Children in South Carolina. Her teaching experience includes - schools for the deaf, public schools, college level training programs and educational leadership Disclosures: Financial: Mariann Carter is Owner, CEO and Lead Consultant for Carter Hears in Ft. Mill, SC for which she receives a salary. Financial: Nonfinancial: Mariann serves on the Board of SC AG Bell Association for the Deaf and Hard of Hearing.

Sharon B. “Dianne” Dixon, MSP, CCC-SLP, LSLS. Cert Sharon B. “Dianne” Dixon, MSP, CCC-SLP, LSLS Cert. AVT, NBPTS Exceptional Needs Specialist (Hearing) retired Dianne worked 27 years in the public schools as an SLP and Deaf Educator before becoming a Practicum Administrator and Clinical Instructor in the USC COMD Department. She teaches classes aural habilitation. She holds an additional teacher certification in Learning Disabilities, an endorsement in Gifted and Talented Education as well as highly qualified status in early childhood special education with children who are LD or deaf and hard of hearing. She has also worked providing early intervention services to children with hearing impairment and their families. Disclosures: Financial: Dianne Dixon is the Assistant Director of External Clinical Practicum and a Clinical Instructor in the COMD Department at the University of South Carolina for which she receives a salary. Nonfinancial: Dianne serves on the board of the SC AG Bell Association for the Deaf and Hard of Hearing.  

Jason P. Wigand, Au.D., CCC-A Jason is an assistant professor, board certified audiologist, and clinical director of the cochlear implant program at the South Carolina's Speech & Hearing Research Center.  He completed undergraduate work at the University of Kentucky and received his AuD from The Ohio State University.  As a researcher, audiologist and late-deafened adult and bilateral cochlear implant recipient, Dr. Wigand is passionate about helping and educating both adult and pediatric hearing-impaired and their families.  He has provided care in both private practice and nonprofit settings and is continually engaged in contributing to the research and collaboration needed to forward the practice and profession of audiology as the primary provider of care for individuals with balance and hearing-impairments.  Disclosures: Financial: Jason is an Assistant Clinical Professor and Clinical Director of the Cochlear Implant Team in the COMD Department at the University of South Carolina for which he receives a salary. He is a paid consulting audiologist for 360 Care, Inc. in Louisville, KY. Nonfinancial: Jason the President Elect of the South Carolina Academy of Audiology and a board member of the SC AG Bell Association for the Deaf and Hard of Hearing.

A Brief Understanding of the laws IDEA – ADA(title II) -504 Borrowed from Cheryl Johnson, State Department Rep for Colorado, Deaf Ed.

IDEA– ADA(title II)- 504 Borrowed from Cheryl Johnson, State Department Rep for Colorado, Deaf Ed.

IDEA SOUTH CAROLINA Special Education Eligibility Document (SEED) Page 17 & 18 Identifies the type of hearing loss, what kind of adverse effect it needs to have on their learning environment and who is needed to make those determinations at the meeting.

IDEA

IDEA Accepting and Embracing the PROCESS of IDEA USING THE #’s Ensuring Access vs. Success Can a child be “GT” and IEP?

How do we Begin? The Early Years Narrate your daily routines. Know what is expected of typically developing peers of same age. Track developmental milestones. Share songs rhymes and finger plays. Know the age and grade appropriate curriculum standards and us the to guide pre-teaching. Gaining Appropriate Auditory Access Acquiring Basic Advocacy & School Readiness Skills Practice active listening. Developing Basic Cognitive, Language, Auditory and Production Skills Capitalize on incidental learning opportunities. Play with sounds.

It All Starts with Access! Auditory Access Language Access Access to Services Advocacy – Gaining Access & Accommodations Assuming Responsibility for Needs Parental Advocacy Self Advocacy The sentient questions are: What does the parent need to assume responsibility for? When do we begin turning responsibility over to the child? What can a child be expected to do/advocate for him/herself at a given age? How does that early advocacy look?

Self-advocacy Self-advocacy development must begin at a very early stage in life Self-advocacy requires the development of a strong self-esteem and self- confidence Self-advocacy skills are first modeled by the parents, care-givers & teachers Understanding the multiple parameters of hearing loss is critical for all involved

Self-advocacy: extending strategies from home to school At home, families can model how to reduce noise, decrease distance when communicating, use FM’s/assistive devices It makes sense that once families learn how to implement these strategies at home, extending them to the preschool environment and coaching teachers become second nature.

Auditory Fatigue and the Learning Process Active listening is hard work and sometimes causes auditory overload and fatigue. There is little downtime available for an auditory vacation in the middle or high school day. Since s/he cannot tune out or turn off in class as still pass and probably does not want to tune out or turn off his social interactions, auditory overload is a frequent problem. The student needs a plan for taking advantage of opportunities for auditory vacation.

Self-advocacy: fostering to successful application For an educator or supporter of students with hearing loss, once the foundational pieces are in place following parental training, the role shifts from teaching new information to coaching successful application of this information to ensure student listening success in the classroom. Classroom demonstrations (i.e. how to use the equipment for various class listening requirements; modeling presentation adjustment to meet student’s needs; demonstrating in- class listening check strategies) Debriefing/keeping parents in the loop - in person; phone; e-mail - set up a system

Self-advocacy: knowing listening environments in schools Understanding classroom dynamics is a critical piece in self-advocacy development What are the classroom acoustic dynamics? What is the classroom acoustic support? Other school environments (media center, library, gym, lunch room, music room, playground) Different noise levels (signal-to-noise ratio needs for effective communication) Types of listening and language demands in various school environments ALD(s) equipment access in various school environments

Developing as a Self-Advocate This is the age when the child should be learning to interpret and explain his or her audiogram. S/he should be getting in touch with how the hearing loss affects his/her activities of daily education and living. S/he should be doing progressively more monitoring and trouble shooting of his/her amplification device, nearly independent. S/he should assume complete responsibility for proper care of the amplification device. S/he should know (from parent communication) and be asking for the documentation promised on the IEP or 504 plan if these accommodations are not already being used consistently. S/he should begin participating in his her own IEP meeting. S/he should begin developing and implementing back up plans for note taking, seating or device failure. S/he should be independently choosing and using preferential seating tailored to the classroom and the teacher.

THE TOOLBOX Every toolbox will look a bit different and we will use our tools in different ways. The important thing is that we know what “jobs” we must be prepared to do and we amass the “tools” that allow us to do those “jobs” efficiently and competently. Some “tools” include things we do so consistently that that they have become engrained in our daily routines. Other “tools” are the devices and supports we rely upon to stay on the developmental paradigm. Still others are the educational/developmental frameworks which guide us.

The Tool Bag Spare parts (cords, earhooks, etc.) Batteries Dry aid kit/box Disposable poncho Pack of carbonized notepaper Hearing device cleaning kit Alcohol wipes, microfiber cloths (NOT baby wipes…lotion on them can degrade silicone earmold/parts, tubing, earhooks, etc.) HA/CI accessories

What should be in the Primary parent notebook? Audiograms Speech & Language Evaluation IFSP/IEP Plan of Care – to include a “who does what” with regards to the onsite school staff and educators Progress Reports Daily Listening Checks Log All Penitent Medical Reports Device Specifications & Trouble Shooting Guides Service Provider(s) Contact Information. E.g. physician, surgeon, audiologist, SLP Developmental Scales Notebook Paper to Record Questions and New Information Empty Page Protectors **Most recent reports should always be on top**

What the ultimate Notebook Should Contain Insurance information Copies of all listening device equipment information, user guides, troubleshooting guides, how-to guides. Current audiogram (within one year) Copy of all documentation provided to the Office of Student Disabilities List of current medications complete with dosage List of drug/food allergies Prohibition of MRI if you are a cochlear implant user List of physicians and services provider contact information for your hometown and your college town. A copy of your Student Disability Plan

What are the Challenges on the Horizon? Transition from middle school to high school Transition from high school to college, technical school or workforce. Attaining a sufficient SAT or ACT and GPA to gain college admission. Independent management of medical and hearing issues. Job or college interviews Resume and college essays

What We Build From The Building Blocks Foundation & Frameworks Access Basic Concepts Language/Communication Analysis Story Grammar Main Idea, Main Characters, Time Setting, Place Setting, Initiating Event, Attempted Resolution , Resolution Graphic Organizers Signal Words Curriculum Standards Developmental Scales Access Receptive Language Expressive Language Vocabulary Syntax Morphology Literacy Phonemic Awareness, Phonics, Fluency, Vocabulary, Comprehension, Written Expression

Some Important Benchmarks Somewhere between kindergarten and first grade, a child begins to merge print awareness with phonemic awareness to encode and decode words. By the end of second grade, formal instruction of phonics morphs into word study, stems, roots and decoding and encoding in meaningful chunks. Rather than most new vocabulary being learned within the context of the Language Arts Block, by 3rd grade the vocabulary load increases exponentially and comes through the content areas which are now separate subjects. Reading fluency is crucial to comprehension when indulging in the deep reading necessary for content area learning.

Text Comprehension Identification and Reading of High Frequency Words Identification and Reading of Non-Phonemic Words Sorting and Matching Words Reading and Listening to a Variety of Texts Plan, Do, Review Identification and Reading of High Frequency Words Plan, Do, Review

What should The Child’s Notebook Contain? For very small children, their notebook is essentially an experience book filled with pages of captioned picture of important people, places and events in his life. For the Primary Grades It is “A Learning Log” Copies of all medical and audiometric information.   Copies of all hearing device information, user guides, troubleshooting guides, how-to guides. Troubleshooting photos to be taken of steps the student can independently complete such as: physical inspection of device/components; identify specific component labels; how to check the battery; how to check device components are seated properly; how to ‘re-boot’ device; how to sync with the personal FM system; what to do if device fails; what steps can be taken to maintain auditory access if one of the HAs, CIs, or FM is not functioning properly CA spelling dictionary Graphic organizers of information management & story planning Formulas for different poetry forms Simple grammar rules Vocabulary supports Carbonized note-taking paper

Developing Content Literacy Reading in a content area is different form reading for enjoyment. First one needs to scan for new vocabulary, bold face, view pictures and then Note Topic or paragraph headers to help build a framework for understanding the material. It is, by and large, necessary to read more slowly and deeply in order to understand the complex nonfiction that typically appears in content area text books.

Chunks and Stems Onset rime chunking is helpful for young children when decoding and spelling Study of common prefixes and suffixes helps students who are a bit older Study of roots and stems helps older students read and comprehend as well as spell http://www.rfwp.com/series/vocabulary-word-within-the-word- program-by-michael-clay-thompson

Why Pre-Teach and Re-Teach Concepts and Vocabulary The student needs to hear the vocabulary words pronounced correctly before he/she forms an understanding of the words connected with his/her possible misproduction. He needs background knowledge in context in order to key in on the words when s/he hears them in the regular classroom. Some concepts and vocabulary will still require re-teaching and practice in order to be come part of the student’s working knowledge and vocabulary bank.

Pre-teaching & Re-teaching Pre-teaching provides the child with hearing impairment with crucial information and awareness s/he needs in order to have the same chance to recognize and respond in his/her mainstream class. Constant front loading of vocabulary and contextual references are required for the students to participate fully in the mainstream class. Re-teaching should be reserved for difficult material not mastered after pre-teaching and regular classroom instruction have occurred.

Curriculum Supports Long range plans Curriculum standards Nmemonics and memory devices Alternative algorithms Graph organizers note taker/scribes Amplification Interpreting services Captioning

Types of Vocabulary Listening Vocabulary- words that we need to know to understand what we hear Speaking Vocabulary – words we use when we speak Reading Vocabulary – words we need to know to understand what we read Writing Vocabulary – words we use in writing

Vocabulary Levels of Word Knowledge Unknown –meaning is unknown  completely unfamiliar Acquainted – meaning is somewhat familiar  some idea of basic meaning Established very familiar  can immediately recognize meaning and use word correctly Crucial for comprehension and fluency when reading.

Terms and Clarification Oral Reading Fluency Levels Independent – relatively easy text for the reader with no more than 1 in 20 words difficult for the reader (95%) Instructional- challenging but manageable text for the reader with no more than 1 in 10 words difficult for the reader (90%) Frustration – difficult text for the reader with more than 1 in 10 words difficult for the reader (<90%)

Some Useful Tools for Assessing Reading & Written Language Make use of the standardized test scores and lexile level ranges. Use Literacy Assessment for my diagnostic text Assessment in Speech-Language Pathology: A Resource Manual 4th Edition pp 325 – 355 OWLS Analytical Reading Inventory 9th Edition Language Sampling

Analytical Reading Inventory Analytical Reading Inventory 9th edition Comprehensive Standards-Based Assessment for all Students including Gifted and Remedial ISBN: 0137012926 ISBN-13:9780137012923 Authors: Mary Lynn Woods, Mary Lynn J Woods,Alden J Moe  Provides Independent, Instructional and Frustration Levels for Word Recognition and Passage Fluency and Comprehension Comprehension Questions are coded as to type of question Allows for structured language sampling through retelling of passage. Has several sets of reader Passages to help avoid tainting results by learning of assessment passages previously used NOTE: There is now A 10th Edition available through Pearson Learning. http://www.pearsonhighered.com/educator/product/Analytical-Reading-Inventory- Comprehensive-StandardsBased-Assessment-for-All-Students-Including-Gifted-and- Remedial/9780133441543.page

OWLS OWLS-II™ Oral and Written Language Scales, Second Edition (OWLS-II) by Elizabeth Carrow-Woolfolk, PhD  Overview: Identify and remediate oral and written language problems Qualification Level: B Age Range: 3:0–21:11 (LC/OE); 5:0–21:11 (RC/WE) Administration: Paper-and-pencil Completion Time: LC: 10–20 minutes; OE: 10–30 minutes; RC: 10–30 minutes; WE: 15–30 minutes Scores/Interpretation: Age- and grade-based standard scores (M = 100, SD = 15), test age equivalents, percentile ranks, and descriptive categories; plus 5 Composites—Oral Language, Written Language, Receptive Processing, Expressive Processing, and Overall Language Processing Scoring Options: Software or manual scoring

Spelling Informal Spelling Assessments Spell Links http://www.learningbydesign.com/why-spell-links-.html

Many Faces, Many Places, Many Spaces As the student progresses through the curriculum, the number of classes, classrooms and teachers he or she will have on a regular basis. Every room, content area and teacher will placed different demands on the student. The student needs to develop a preferential seating plan which will allow him/her with the best access to instruction for each class. He/She must be prepared for class and monitor his/her own progress and needs. What should the student consider when choosing appropriate seats for each class?

General Fatigue and Other Factors As hard as it to listen actively with your ears, it is also a challenge to remain visually attentive to the interpreter as the day progresses. A good note taker is often a must regardless of the communication mode used by a student with hearing impairment. Getting that necessary down time must be planned. Students may find themselves in a double bind situation when trying to work in academic support with the academic day so full. What are some potential solutions?

Predicting Demands More separate and distinct course requirements and choices requires the student to accurately predict the cumulative demand of his or her schedule. Often class levels are designated in the course catalogue but not always. Often the HH Teacher will have previous experience with certain classes and instructor and can help tailor the schedule to meet the student’s needs and limitations. What factors must be considered?

The Foreign Language Dilemma The foreign language requirement can be a real challenge for a student with hearing loss. Some things to consider: Tonal languages liked Mandarin and Cantonese are probably not the best choice because they rely so greatly on the ability to discriminate and produce subtle inflections that change the meanings of a single syllable. Some schools offer ASL for foreign language credit. Latin is a great option. It is available to all schools in SC through the Virtual school. It is a dead language but the stems and roots learned in Latin can boost SAT and ACT scores. https://virtualsc.org/

Information Processing & Avoiding Overload Content area courses impart huge amounts of information and the learning is not always integrated or presented within a relatable context. Middle and high school students take many content laden courses. A student may quickly find him/herself overloaded. This is particularly true of the 2nd quarter when review is finished and new content begins pouring in from all directions. How can a student avoid becoming overwhelmed by the inevitable overload?

Peer Relationship Challenges Change is not limited to classes and school site. Middle schoolers and high schoolers face many social changes as well. There may be difficulty communicating with peers. Peers may influence the student’s willingness to ask for assistance, consistently use amplification or take advantage of their prescribed accommodations. Hormones are in full tilt complicating matters greatly. Programming changes for hearing devices, specifically with cochlear implants, are commonly needed. I am not suggesting that the teacher or parent become the student’s friend but needs to be a non- judgmental listener and a consultant of sorts. How can we help our teens navigate the peer pool?

Owning The Disability and Becoming Proactive Basically you can look different or be different. If the student rebels and decides not to use the amplification consistently, fails to take proper advantage of supports offered, or continues to expect the TOD or his/her parent to run interference, he is not learning and practicing the self advocacy skills he/she will need in order to become an independent successful adult. What can we do to help him/her own the disability so her or she can manage it properly?

Keeping Everyone on the Same Page Teens often do not communicate with adults. Too much independence too soon is not a good thing nor is deterring independence. We must find a balance. Regular classroom teachers tend interact less and less with the parent as the student progresses through the system. The TOD may be the only person who sees the situation form all sides. How do we keep our team intact without stifling independence and self sufficiency?

The Heart of the IEP Part One: Disability Statement (what does this mean) What is its importance? Strengths Each area identified there must be at least one strength. Weaknesses Under each area a clear depiction of the weaknesses must be clear. Parent Input Will I see Social Studies and Science on the IEP, why or why not? Disability category for children with Hearing Impairment is often mislabelled or not used at all. – Problem with that when time for 504. Language content, usage, and applicability should be the focus of this age group. Working with instructors and considering push in services to give direct meaning to language and function during learning time is CRUCIAL.

The Heart of the IEP Part Two Where is the student right now? Agreeing on the type of assessments Assessing in Communication Mode Understanding what the information is sharing How does this testing relate to how s/he accesses information in the learning and community/social environment? What tools are used for this?

The Heart of the IEP Part Three Can you link the present level weakness to a goal? Does the goal make sense? Is it meaningfully measured? What kind of goals would you expect to see in this age group? (Discussion)

The Heart of the IEP Part Four Understanding the differences between accommodations and modifications What specific accommodations should be considered for this age range? Are we considering peer interaction, what does that look like? Social/Academic nuances that need to be addressed Age Range – preferrential seating, sign language interpreter/fm system/ pass around mics? Asking Yes/No questions? Peer interactoin, how is that fostered or encouraged Social and Academic nuances at the age from 3rd (8) – 6th (11/12)

The Heart of the IEP Part Five Services Time How is that determined What are considerations at this age that are different from other ages What does Language Age or overall Language Development have to do with this specifically? What tools are available to look at this?

Time to work on your own Recipes The four parts Explain Learn Discuss Create

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