
ITINERANT SERVICES
WHAT
ARE THEY?
Hearing problems are very common among school age children. There are about 8 million children in the United States with some degree of hearing loss. That represents 1 in every 6 elementary students. Research supports that even very mild hearing loss or fluctuating hearing can interfere with a child’s ability to learn. I’m always asked what an itinerant teacher for deaf and hard of hearing students does so I have written a summary of some of the services itinerant teachers provide:
We notify the general education and ESE teachers that there is a student in their class who is deaf/hard of hearing.
We provide training to classroom teachers regarding hearing loss, modifications and accommodations, use of personal hearing aids and other assistive listening devices.
We prepare written information pamphlets about all aspects of deafness for teachers, administrators, counselors, psychologists and other special area teachers.
We monitor the student’s personal hearing aids and/or FM units and refer to the district audiologist when problems arise. The FM units are provided by District.
We refer students to the educational audiologist to determine the listening system that would be the most educationally beneficial.
We refer students for their yearly audiological evaluations and we attend child study teams for initial referrals and for re-evaluations.
We also attend initial placement staffings, re-evaluation meetings, annual IEP reviews, articulation, transition and interim IEPs.
Services provided to our students include weekly sessions away from their general education/ESE classrooms for auditory training.
Auditory training entails augmenting communication needs of deaf/hard of hearing students. We help them to revise information being presented so that they can better “hear”, visually track and interpret the information and instructions being delivered. The setting for these services are varied and depend on the individual student’s needs.
We help them deal with the stress related to constantly having to keep track of what is being communicated by utilizing every sensory avenue available to compensate for insufficient hearing.
Because of their auditory needs, accommodations and modifications are suggested so that deaf/hard of hearing children can pursue gratifying interpersonal relationships rather than experiencing isolation and loneliness. Listening training in conjunction with academics improves our students’ grades, performance and self-esteem.
There are two main types of services an itinerant teacher of the DHH can provide a student. The first is consultation. The teacher of the DHH will provide information to staff working with the child. This information can consist of instructional techniques to use, ways to improve noise ratios in the classroom and information on hearing and listening devices such as hearing aids and personal FM systems. Consultation can also be provided to the student’s classmates in the form of educating them on hearing loss and hearing devices. The teacher of the DHH will also observe the student and may meet with the student to provide consultation to that student on topics dealing with hearing loss. The amount of consultation can range from once a year to weekly depending on the needs of the students and the needs of the teachers.
The itinerant teacher’s range of services for each student may include one or more of the following for consultation services:
· Participate in IEP meetings
· Write reports
· Request annual hearing evaluations
· Check the hearing aid and its mold, both visually and by listening to it
· Orientation, advice, and coaching to the student’s parents
· Orientation, advice, and coaching to the student’s classroom teacher
· Orientation, advice and coaching to other professional staff
· Advocate the student’s needs to other agencies and potential employers
· Advocating for the student’s needs within the classroom and school
· Observation of the student in class and other school environments
The second type of service that can be provided is direct instruction. The need and amount of direct instruction is determined by the IEP team. Students who need assistance in academic areas, language and auditory skills are either provided direct instruction within the classroom environment or pulled out into a quiet environment. Direct instruction can be daily, weekly, or even monthly depending on the needs of the student. What the teacher of the DHH does with the student will depend on the areas that the student needs improvement in.
The itinerant teacher’s range of services for each student may include the services provided under consultation and one or more of the following for direct instruction:
· Instruction in the use and care of hearing aids, cochlear implants and FM systems
· Individual instruction outside the classroom
· Individual instruction in the regular classroom
· Field trips into the community
· Language development
· Auditory training
· Social and emotional support for the DHH student
Working with students who are deaf/hard of hearing requires a team approach to determine the individual needs of each student and to develop an appropriate educational plan.
Our ultimate goal is teaching students to self advocate and become independent learners.
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High Interest Web Sites for Itinerant Deaf/Hard of Hearing Students and for Teachers
http://pepnet.org/itransition4.asp
http://www.wordpower.ws/idioms/a.html
http://fcat.fldoe.org/fcatrelease.asp
http://grammar.ccc.commnet.edu/grammar/
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Writing
Goals and Benchmarks
The following adaptations may be utilized for creating individualizing IEP goals and benchmarks as well as documentating needed accomodations:
Environmental
Input
Output
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Kelby Brick, VP of regulatory and strategic policy, discusses the historic FCC ruling of June 24, 2008, and the demonstration calls placed a few days later. These calls, for the first time, connected hearing and deaf participates using a real, 10-digit phone number. |
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The needs of most students can be met without impeding classroom routine. However, I have included a list of general considerations and teaching suggestions which may increase the likelihood of successful inclusion. I offer them in the hope that they will assist you in accommodating and educating the student who is deaf or hard of hearing in your class. General Considerations: · Successful inclusion is the product of careful planning, preparation, and team work. Key team members are the school principal, the classroom teacher, the parents, and the itinerant teacher for D/HH. Additional help and input should be obtained from available support personnel in psychology, speech and language, and medicine. Team members must meet regularly and co-ordinate their efforts in planning the child's program, objectively assessing his progress and evaluating the appropriateness of his current placement. · The child with a hearing loss is, first of all, a child. Treat him as you do other children in the class. Expect him to meet general classroom standards for both behavior and academic work. · Parent involvement is absolutely essential to successful inclusion. Frequent parent-teacher communication will help parents realize that their home provides unique opportunities for social, emotional and linguistic development that go beyond the scope of what is possible in the classroom. Inform and involve parents: use home-school notebooks; send home advance information on upcoming class topics and new vocabulary; arrange parent-teacher teleconferences and meetings; encourage parents to involve their child in extracurricular activities- church groups, sports, Guides and Scouts etc. · Hearing loss often leaves gaps in the incidental learning of general information, specific concepts, vocabulary, idioms, specific nuances, and the rules for common games. A teacher should never assume that the child who is deaf or hard of hearing knows something just because most of the class does. Whenever possible, check for these gaps and ask parents, teacher, or tutor to work on these concepts. · The child with normal hearing will mirror your attitude towards the child who is deaf or hard of hearing. Familiarize the whole class with hearing, hearing aids and what a hearing loss means. Answer their questions in a matter of fact way. Your comfort in providing information and dealing with their questions will help to demonstrate your acceptance and help them to accept their peers who are deaf or hard of hearing. · Students may find it difficult to understand the speech of the child who is deaf or hard of hearing. Your sensitivity in dealing with these students will be very important in helping the student who is deaf or hard of hearing adjust to your class and maintain a feeling of self-worth. · Amplification, when prescribed, is essential for effective classroom participation. However, amplification, unlike eye glasses, does not bring about normal hearing. Unfortunately, all sounds are amplified equally by a hearing aid. As a result, the background noise level may exceed the level of conversation. This can be distracting to the child and make it difficult for him to discriminate speech sounds, particularly during group discussions. An FM amplification unit often reduces some of the background noises and distortions picked up by a personal hearing aid. However, no hearing aid guarantees automatic understanding of everything said. · A child's hearing loss may fluctuate. The degree of hearing loss is affected by severe colds, respiratory illnesses, changing acoustical conditions in the classroom and auditory fatigue. The concentration that a child who is deaf or hard of hearing must sustain to obtain comprehension can lead to frustration and fatigue. · Fatigue should not be equated with disinterest, inappropriate behavior and cognitive delays. Opportunities for recreational activities and independent work can serve as a respite from intensive listening and speechreading. · It is impossible for a student who is deaf or hard of hearing to take notes and lipread the teacher at the same time. Since the student may miss some of the lecture or classroom discussion, he must rely heavily on class notes when studying for a test or exam. A reliable student who is particularly skilled at taking notes, could be appointed to serve as a "buddy" to the student. The buddy could assist in notetaking, interpretation of directions. He could alert the student who is deaf or hard of hearing to changes in class routine, the correct page in a text, school announcements over the PA system, homework, phrases, brief outlines and discussion summaries. |
Specific Teaching Tips
DO:
Face the child when talking.
· Get his attention before speaking to him.
· Signal the beginning of a new topic.
· Repeat or summarize important points made in class presentations or group discussions.
· Check comprehension. Ask the child who is deaf or hard of hearing to repeat directions or to answer questions requiring a substantive response.
· Rephrase your message if the child doesn't understand with repetition only.
· Speak from a position where the light is on your face.
· Speak normally. Use a moderate rate with no exaggerated mouth movements.
· Seat the child where he may see you and the other students.
· Be flexible about seating. Permit the student to move or exchange seats if this is necessary for comprehension.
To Assist the Student to Follow Class Presentations and Discussions:
Try to present information visually whenever possible. Use overhead projectors, slides, charts, pictures, etc.
· Provide a written summary of the text of audio materials, records, tapes and radio/TV programs.
· Use video and TV programs with closed caption (cc).
· Write new vocabulary, lesson summaries on the blackboard, the overhead, or on handouts.
· Put spelling words in sentences to provide contextual clues.
· Avoid dictation. The child who is deaf or hard of hearing cannot speechread and write at the same time.
To Assist in Language Development:
Accept the child's imperfect expressive language.
Serve as a good language mode by responding to his incomplete utterances with complete structural correct sentences.
Note the child's language errors and discuss them with the itinerant teacher. Work closely with the itinerant teacher and the parents in developing and reinforcing new vocabulary and providing sufficient practice for specific language structures.
Use, check comprehension of, and if necessary, teach categorical terms, slang words, idioms and multiple meanings.
Encourage the child who is deaf or hard of hearing to: speak to you and the other children; inform you or his "buddy" when he has not understood what was said; get involved in class discussion; give oral reports.
Encourage reading. Work with the parents to stimulate both functional and recreational reading. Arrange visits to the library or bookmobile. Expose the child to content area books, story books, age appropriate magazines, comics, newspapers, etc.
Ask the child to: repeat directions and reiterate assignments; answer substantive questions throughout the class lessons; produce and proofread written reports and compositions.
Ask the child to repeat, rephrase, write, dramatize, or draw his message if you do not understand him. Demonstrate your desire to communicate by attending to him until you do understand.
Familiarize the child with the use of reference materials such as the encyclopedia and the dictionary. Promote the dictionary as an aid to pronunciation. Teach diacritical markings, accent marks, and syllabification.
DON'T:
· Mumble, shout, or exaggerate.
· Walk around when talking.
· Obstruct the child's view of your mouth by holding a book in front of your face.

The IEP Checklist
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IEP CHECKLIST: RECOMMENDED ACCOMMODATIONS AND MODIFICATIONS |
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Name: _______________________________ |
Date:_____________________________ |
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Amplification Options
Assistive Devices
Communication Accommodations
Physical Environment Accommodations |
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Instructional Accommodations
Curricular Modifications
Evaluation Modifications
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Navigating the Hearing Classroom with a Hearing Loss
Excellent examples of what our hard of hearing students experience every day in school.
Kathy Vesey and Beth Wilson have different sorts of hearing loss, personalities, interests, and aptitudes. Yet, as hard of hearing students who successfully navigated mainstreamed education, they find their struggles were remarkably the same.
When Vesey and Wilson were tested for hearing loss in their respective kindergartens, they adopted the same strategy. Both pretended that they could hear. Vesey, taking her cue from the response of other students tested in the same room, succeeded. Her hearing was perfect in both ears, according to this exam. Wilson followed the same strategy. She watched the children ahead and tried to memorize how they responded; she noticed that the nurse’s arm muscles twitched when she activated the tone. Wilson responded just
like the other children and to every sound—but the ear she pointed to did not correlate with the ear in which the tone had sounded; the ear she “heard” in was random. Said Wilson, “I was caught.” Why did we pretend? Why did no one know? Hard of hearing children learn amazing coping strategies. They learn quite early to find visual clues in their environment that will make up for what they don’t hear. Vesey recalls consulting in a kindergarten class where there was one hard of hearing student. During the observation, the teacher administered a test. The children, seated in a row of individual cubicles, listened and circled the picture that depicted the word said by the teacher. Vesey watched as the hard of hearing child cleverly and subtly cheated his way through the entire test by leaning back in his chair as if stretching and yawning and glancing at his classmates’ answers. His timing was perfect and no one noticed. When the activity was completed, the teacher proudly said that the child had all of the words correct, and was doing just fine in the class. She was shocked when Vesey described what she saw—and that in fact the child did not understand the words at all. Hard of hearing children face unique stresses as they go through the school system.
STRESSES
FACED
BY HARD OF HEARING STUDENTS
Sitting at the Front of the Classroom
Ask any adult who was hard of hearing as a child, and he or she will rant and rave about being stuck at the front of the classroom. It feels like punishment. It is difficult to blend in when “Wilson” or “Vesey” is mixed in with the “Andovers” and “Booths.” It may be necessary, but still a lot of information comes from the middle and back of the room, and it is impossible to tell where the voice is coming from and who said what.
Being Different
Vesey, when she entered her new high school, was determined to keep her hearing loss private. She lasted three weeks! Her grades dropped markedly, but the defining moment was in French class when the teacher gave the class a dictation. Vesey wrote down the first “la” she saw and left the rest of the paper blank. The desire to blend in can lead children to refuse accommodations. Better a “C” or “B” without the hard of hearing label than an “A” with appropriate accommodations and the label. In the hearts of hard of hearing children, passing—as a hearing person as well as on tests—is mandatory. Full potential is a luxury.
Self-Advocacy
On the dreaded first day of class, a hearing student can arrive just in time for the start of class, sit anywhere he or she wants, and only have to do good work and be attentive to be on the teacher’s good side. The hard of hearing student, on the other hand, must arrive early, ambush teachers to establish accommodations, and interrupt teachers when they turn around, turn off the lights, play an audiotape, show a movie without captioning, and deviate from the supplemental material. Wilson had a teacher that always sat in front of the window. After a few weeks of watching sun and silhouette, she asked the teacher to move.
When the teacher sat at the front of the room, she could see her face and had a better chance at lipreading. Wilson remembers a teacher who insisted on uncaptioned movies and another who provided an exam on audiotape; when she questioned this, she was told she “could sit nearer.” Vesey remembers an interpreter who translated at such a distance from teachers and instructional material that students needed a third eyeball. Students who develop skills in advocating for themselves and their communication needs are going to be more successful in the education system. At the same time, it’s a difficult balancing act to constantly advocate while attempting to fit in and be accepted by one’s peers—not to mention teachers. In high school and college, hard of hearing students learn to pick
their battles. When faced with a teacher who refuses to provide accommodations or half-heartedly attends to the needs of the hard of hearing student, what are the options? Complain to the principal or dean? Risk receiving a low grade? Change to another class? These negotiating skills are important, especially as students transition to or from high school or college. Technology is a double-edged sword for hard of hearing
people. Technology brings better hearing aids, more assistive devices, captioning, e-mail, and pagers, as well as the means to search the Internet instead of using the telephone. It also brings more speech-based training materials and interactive programs that require hearing for full use. It brings electromagnetic interference into the classroom that can cause problems for hearing aids and assistive devices.
Lipreading
Only about 25 percent of English is visible on the lips. Lipreading, an important augmentation to hearing, is an art. It is an especially useful tool for those who hear low tones, but not high tones. Sounds that are ambiguous can sometimes be clarified if you see the speaker. For example, the “s” sound and “f” sound have similar low frequency components, yet look very different on the lips. Lipreading requires constant focus and is quite tiring and stressful. By the end of the day, students who lipread are exhausted.
Listening
At lunch time, Wilson first pretended she didn’t feel well. When it was discovered that she wasn’t really ill, the school arranged for her to eat in the nurse’s office, a practice she maintained throughout most of her elementary and high school years. After a full morning of straining to hear, lipreading, and trying to make sense of partial information, Wilson did not want to face her fellow students in a noisy cafeteria. For hard of hearing people, listening—the act of receiving pieces of sound, resolving ambiguities, and filling in the missing holes—is hard work.
Isolation
We missed so much conversation. Having asked peers to repeat what they said, the most common response seemed to be, “Nothing.” In upper elementary school, Vesey attended a speechreading class for five hard of hearing students, and for the first time met other kids like her. Our renditions of the “Pledge of Allegiance” were hysterical, but it was terrific to laugh together. Both Vesey and Wilson turned to sports. It was a way to combat isolation without communication requirements. Surprising to some people, music may be another key
component of socializing for hard of hearing students, especially for teenagers. At the school dance, no one can really hear the conversation because the music is too loud. Actually, the louder the better for Vesey and Wilson, who really enjoyed music even when they didn’t understand the words.
Developing a Full Identity
People with hearing loss represent a broad spectrum of hearing ability, coping strategies, and cultural identity. Where do we fit? Vesey and Wilson feel comfortable in both the hearing and deaf worlds. Both learned sign language as adults. Both use the same description of this experience—that they are very fortunate to be accepted by both hearing and deaf “worlds” and that they can enjoy the richness of deaf culture. Unfortunately, not many hard of hearing people experience this. It is sad when people believe that the greatest success of a person with a hearing loss is to live—or at least pass—every day as a hearing person. Learning sign language did not alter our identities, but rather it offered us another valuable tool in the coping toolbox. Wilson once explained to her employer how and when each of these tools might be used:
• If the meeting is with less than seven people and she knows all of them, she only requires a hearing aid.
• If the meeting is with seven people and she doesn’t know all of them or some have accents, an interpreter is required.
• If the meeting is with more than seven but less than 15 people that she knows, a loop system will work.
• If the meeting is in a classroom setting, the FM will work.
• If it is a large interactive meeting, an interpreter is necessary.
• If the meeting is online, captioning is required.
The point is that different settings equal different strategies and different tools, and to some extent, each tool lends itself to a different identity.
Teaching the Teacher
Vesey returned from school one afternoon and told her mother that the teacher had explained a new coping strategy. The teacher told Vesey: “Tell me when you don’t hear or miss something.” Vesey was puzzled. “How am I supposed to know what I didn’t hear?” she asked her mother. Unfortunately, teachers and others often asked, “Did you hear okay?” But the person with a hearing loss is the worst judge of what he or she heard. Our biggest problem is not what we don’t hear, but what we think we heard. For people who were born with a hearing loss, what they hear feels normal. As an adult, Vesey discovered that her fourth-grade teacher was related to the principal of a nearby school for the deaf. She feels that much of her success was due to this teacher’s behind-the- scenes coaching. She and her teachers developed a nonverbal communication system. She would give teachers a certain look, and they would automatically repeat and rephrase without Vesey having to raise her hand and ask. This was a huge help—not only was the information accessible, but Vesey also avoided the embarrassment and the stress of constantly asking teachers to repeat. Teachers need to know the basic facts about deafness, especially that good speech does not equate with good hearing. Vesey lost her hearing after she had started to speak. Speech and hearing are related but they are not equivalent.
Getting Permission to Teach the Peers
Wilson noted that her most successful classes were the ones where teachers were willing to talk openly about hearing loss. Every student sees the hearing aid and the hard of hearing student’s struggle. When the hard of hearing student engages in dialogue about hearing loss with the teacher and class, he or she is more comfortable for the rest of the year. It is also helpful to meet the other hard of hearing students in the school, both for social reasons and to reduce the student’s feeling of being “different.”
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Effects of Deafness on Reading Students who are deaf or hard of hearing often exhibit delayed development in vocabulary and language skills and this has negative effect on their ability to comprehend the written word. They approach the task of learning to read with limited auditory language and distorted auditory input. A total phonics approach to beginning reading instruction simply directs the focus to the student's area of greatest need. Basal readers may also be problematic. Although controlled for vocabulary, they employ complex syntax and figurative language at an early level. They presume a level of linguistic proficiency which some deaf or hard of hearing students have not attained. Despite these potential hurdles, students who are deaf or hard of hearing, given good language models and a multimedia approach to teaching reading, can and will learn to read. Print is the medium in which they meet language in the same form as normally hearing people. Reading will be the tool for their exploration of academic subjects and for the expansion of their language. However, they will experience some problems directly related to their impaired hearing and to the language delay it frequently imposes. For students who are deaf or hard of hearing, language competency is the key to social and academic success. Social interaction in an environment rich in oral language is the optimum setting to increase this language competency. For teachers, this is the challenge. An awareness of a student's potential language learning difficulties will be the first step in modifying good teaching so that students who are deaf or hard of hearing will attain their true potential in the regular classroom.
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Effects of Deafness on Language Development Deafness results in an auditory deprivation which impacts on the development of the auditory language system. Both comprehension and expression, i.e., understanding and speaking are affected. A primary goal of education is to develop a level of linguistic proficiency to function successfully in society. Hearing children at school entry, while not yet literate, are well on their way to developing linguistic proficiency. Spontaneously, without direct teaching, they have mastered the complex rule-governed language of their environment. They know most, if not all, of the speech sounds (phonology), the function words and affixes (morphology), and the syntactically correct sentence types (syntax) of their language. For them, becoming literate involves learning the visual or print form of the already mastered auditory language. Reading and writing then become the vehicles for language expansion and for academic learning. At school entry, the child who is deaf or hard of hearing may not have attained the fluency in auditory language taken for granted in hearing children. The route to literacy or competency in the visual language system will be longer and more arduous than that of hearing peers. However, the innate human potential for language acquisition is there. For many children who are deaf or hard of hearing, the environmental trigger for continued activation of this potential will be the linguistically rich environment of the public school. Students who are deaf or hard of hearing will present unique educational challenges. There are many barriers they face in attempting to comprehend classroom instruction and the educational materials provided for their use. These problems are mainly language based and may stem from one or more of three areas: the student may simply not have acquired the vocabulary or the language structures being utilized in the discussion; or the student may have not yet developed the pragmatic skills to help them deal with their lack of comprehension, ie., they may not know how to formulate a request for repetition or clarification; or the student has developed a low sense of self-esteem from making repeated mistakes because of not hearing things correctly and has become less of a risk taker and will pretend to understand even when he doesn't. Students who won't or can't seek help when they don't understand are at high risk for failure in an inclusive setting. To combat this problem, it is necessary for teachers to check comprehension by periodically asking questions of the student that require expansion of the topic. It may also be necessary to instruct the student in the techniques necessary to request clarification or repetition. Language will not grow nor will it become the instrument for academic learning unless the student who is deaf actively participates in his own language learning. When a child is deaf or hard of hearing, the auditory input he receives is limited and distorted, therefore, it is not surprising that he makes errors in auditory discrimination and speech articulation. However, the language difficulties which pose the most persistent problems for the student who is deaf or hard of hearing are more profound and not related to the auditory deprivation, but to the very nature of the language itself. These language learning difficulties pervade all aspects of linguistic development. They occur in Semantics (word meaning), Morphology (word affixes and function words) and Syntax (word order). Hearing is the distance sense which allows people to experience events outside their visual field. Deprivation of, or impairment in this distance modality may result in increased concern with the observable, the real, the here and now. Reduced language input and a more concrete orientation are likely reasons for the Semantic (word meaning) difficulties experienced by most children who are deaf or hard of hearing. |