ITINERANT SERVICES

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 may provide, depending on your specific school system's procedures and regulations, as well as each state's procedures. Please check with your particular state and school for more detailed information on the role of the itinerant teacher within your school system.

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.

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:

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 as well as the particular state's procedures and regulations regarding itinerant services.

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

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.

Itinerant Teacher of the Deaf and Hard of Hearing

The itinerant teacher must ensure that deaf and hard-of-hearing students, like all students, have programs in which they have direct and appropriate access to all components of the education program, including but not limited to recess, lunch, and extracurricular social and athletic activities. Itinerant teachers of the deaf and hard of hearing may provide direct instruction and/or consultative services to deaf and hard-of-hearing students enrolled in general education classes, center based programs, state or charter school programs, or home or hospital programs. When appropriate caseloads for itinerant teachers are considered, factors such as mileage, direct service versus a consultation model, age of students, number of students with additional disabilities, and dynamics of the school climate must also be considered. A ratio of 1:10 to 1:24 is an appropriate caseload, depending on the school system's rules and procedures for itinerant services

Typical responsibilities of the itinerant teacher may include but are not limited to:

High Interest Web Sites for Itinerant Students who are Deaf / Hard of Hearing and for Teachers

10 Ways To Have More Fun At Your IEP Meeting

Wear costumes. On the meeting invitation, say, "Festive Dress Required."
As an equalizer, require all attendees to wear Groucho glasses.
Require all attendees to bring a musical instrument.
Provide refreshments: Jalapeno Cheetos, and red Kool-Aid.
Invite Hillary Rodham Clinton. List her name on the cover sheet.
Try this introductory exercise: If you were a color, what color would you be and why?
Play background music-anything by Frank Zappa.
Give everyone a set of five flash cards to be used as the mood strikes:
* Who invited him?
* I love your hair!
* Where did you get it done?
* I’m sure we can trust that this will get worked out.
* Does the law have any bearing on this?
* Excuse me for 10 minutes while I can call my lawyer.
Have the TV in the room tuned to the Court Channel.
Keep score. Give a really nice door prize to the IEP team member (parents excluded) who makes the most positive comments about your child. Award grand prize to the IEP team member who makes the most negative comments about your child - the winner gets to provide 36 hours of respite care, in their home, to your child.

Writing Goals and Benchmarks

The following adaptations may be utilized for creating individualizing IEP goals and benchmarks as well as documenting needed accommodations:

The following are adaptations currently in use in classrooms with deaf and hard of hearing students. Teachers should evaluate each prospective adaptation individually, before and after implementation.

Environmental

Seat student in best place to permit attending and participation.
Give student a swivel chair on casters.
Use a semicircular seating arrangement.
Reduce noise and reverberation with carpeting, draperies, acoustic ceiling tile, and/or acoustical wall treatments.
Use flashing lights along with bells for signaling class schedule.
Use flashing lights for safety alarms (e.g., fire, tornado).

Input

Use a radio frequency transmission unit (FM) system.
Stand where the student can read lips.
Face the student when talking.
Use an overhead projector.
Employ an educational interpreter.
Team teach with a teacher of students who are deaf or hard of hearing.
Preteach important vocabulary and concepts.
Modify class schedule to reduce fatigue (e.g., include opportunities for active involvement).
Provide a study guide of the key concepts, questions, vocabulary, and facts when introducing new material. Include page numbers where information can be found in textbook.
Provide a copy of the teacher's notes.
Highlight key words or concepts in printed material.
Supplement lesson with visual materials (e.g., real objects, pictures, photographs, charts, videos).
Use graphic organizers to present material.
Provide manipulatives for multi-sensory, hands-on instruction or activities.
Use peer tutoring.
Use a notetaker.
Use cooperative learning experiences.
Develop learning centers.
Use games for drill and practice.
Use concise statements or simplified vocabulary.
Use a "Buddy System" whereby another student restates the directions or helps the student who is deaf or hard of hearing stay on task.
Cue student visually to indicate that someone is talking during class discussions or during intercom messages.
Repeat information that has been expressed by a person out of view or delivered over the intercom.
Write short summaries of the lesson or of the chapters of the textbook.
Use a peer tutor, paraprofessional, or volunteer to review work, important concepts, vocabulary, and facts with the student.
Use commercial software to provide practice and review material.
Use captioned movies and television programs.
Divide and organize lengthy directions into multiple steps.
Demonstrate directions to clarify what needs to be undertaken.
Check for understanding by having the student restate the directions.
Break long-range projects into short-term assignments.
Post the date on the board when assignments and projects are due. Remind frequently.
Increase the number of practice examples of a rule, concept, or strategy prior to assigning seatwork or homework.
Shorten length of assignments and provide additional opportunities for practice.
Teach organizational skills and assist student to generalize these skills.
Teach student reading comprehension strategies (e.g., textbook structures such as headings, subheadings, tables, graphs, summaries).
Provide duplicate sets of materials for family use and review.
Have student summarize at the end of the lesson.
Use thematic instruction to unify curriculum.

Output

Allow more time to complete assignments.
Allow students to make models, role play, develop skits, and create art projects to demonstrate their understanding of the information.
Allow written or drawn responses to serve as an alternative to oral presentations.
Allow student to use computer/word processor.
Use cooperative learning experiences to develop cooperative small group projects.
Use peer tutors, paraprofessionals, or volunteers to work with student on task.

Social

Teach hearing students to sign.
If the student uses an oral approach, teach hearing students how to position themselves so the deaf or hard of hearing student can lipread.
Make books about hearing loss and deafness available.
Invite deaf or hard of hearing adults to come to school and share stories.
Implement a circle of friends program (see Perspectives, Volume 12, Number 5).
Structure activities and experiences for deaf and hearing students to work together.
Teach units on social topics (e.g., friendship, avoiding fights, emotions, stealing, dating, dealing with divorce).
Provide direct instruction on specific social skills (e.g., starting conversations, giving compliments, responding to criticism).

Adaptions help students participate meaningfully in learning.

Behavioral

Provide consistent expectations and consequences with regard to classroom routines and rules.
Place general rules and behavior expectations on charts displayed in the room or on a sheet of paper placed on the student's desk.
Use interest inventories to identify positive and negative reinforcers for each individual.
Use assignment books and/or folders to increase organizational and memory skills.
Provide regular feedback and check progress often.
Home-school contracts -- develop a contract with student's family whereby when specific behaviors are demonstrated in school, the student receives a specified reinforcer at home.
Send a daily or weekly report card home.
Use corrective feedback (e.g., "I would like you to take out a book and read when you finish your work, rather than bothering the person sitting next to you.").
Increase frequency of descriptive praise (e.g., "You really paid attention and stayed in your seat for the past 15 minutes.").
Use a behavioral contract (written agreement between teacher and student regarding student behavior and agreed-upon consequences).
Use response cost procedures (taking away a privilege, points, or reward).
Use time out.
Limit the number of distractions by establishing an isolated work/study area.
Teach student anger control strategies.

Evaluation

Use peer tutor, paraprofessional, or volunteer to work with student to review for test.
Allow test items to be signed to the student and the student to respond in sign.
Allow tests to be taken with teacher or paraprofessional who works with students who are deaf or hard of hearing.
Provide extra time to complete tests and quizzes.
Allow test items to be read to the student.
Modify vocabulary used in test items to match student abilities.
Modify the number of test items.
Provide short tests on a more frequent basis.
Chart progress or lack of progress.
Provide additional information to explain test questions and instructions.
Allow student to use notes/study guide/textbook on tests.
Evaluate daily work/participation in addition to tests.
Use projects or portfolios in lieu of tests.
Provide graphic cues (e.g., arrows, stop signs) on answer forms.
Give alternative forms of the test (e.g., matching, multiple choice questions, fill in the blank, true/false questions, short answer questions, essay questions).
Teach test-taking skills.

Grading

Use IEP as the criteria for grade.
Develop contract as basis for grade.
Use a pass/fail system.
Write descriptive comments and give examples regarding student performance.
Use a checklist of competencies associated with the course and evaluate according to mastery of the competencies

Perspectives in Education and Deafness by John Luckner and Pete Denzin

Please check out the new technology that is expanding communication around the world for deaf and hard of hearing people.

Click on each to see which of these solutions could be right for you, your child or your student.

Following Your Child’s Lead:
The Dance of Language

By Sara Kennedy

Not so long ago, I looked down at a 14 month old toddler in my lap after learning that she could not hear. Those intense blue eyes confounded me – did I know her? Did she know me? Communication as I had known it halted altogether. Sara Madeleine became again, in my fear of the unknown, the little stranger that she had been to me on her first day of life, before we started the dance of learning to know one another. Like most parents, I don’t think I heard another word the audiologists said after “your daughter has a profound hearing loss.”

As a health care provider, what surprised me next was that it was up to us, as parents, to decide how we wanted to communicate with her. There weren’t reams of double blind randomized controlled trials to tell us that a majority of children learned to read and write well or to speak or to become CEO’s with this or that method. It was up to us, a couple who couldn’t yet define otoacoustic emissions or knew anything about the oppression of Deaf people in history… to choose Maddie’s first language.

That choice was both easier and more complicated than we knew at the time. What I wish I had known then is that your child, your little stranger, has all the answers. Your child wants to communicate with you. She is dying to communicate. When you have that Helen Keller moment, whenever it happens, when they know /water/, signed or spoken or both, is the same as that cool, clear stuff streaming and swirling in the bathtub, when they make some attempt at getting across /light/ and Dad hands them the coveted flashlight: that is power, and you can almost feel the synapses bursting forth in the child’s growing brain. Language is born, and the structure of their very brains begins to change. How do you start the fireworks?

Starting Out

I think it is our job not so much to choose the language as to lead them to the smorgasboard of language in all its forms: voice, print, expression, gesture, whispers and yelling, worrying and celebrating. And watch them and see what tools they pick up. What speaks to their needs. We started, personally, on an oralist track, seeing that the wider world wasn’t so sign friendly. It wasn’t long after that we were sitting with our home visit clinician and aghast to see that Maddie was far below her age, far below in all aspects of communication save one: gestures. For us, it just made sense to throw ourselves into sign for that reason, though I had never before moved my hands when I talked. Honestly. She also appeared to be looking deeply at us as we talked -- perhaps looking for tonsils? So we continued to use our voices. She eventually loved wearing the hearing aids (this is a learned skill for those with recalcitrant babies and toddlers). We realized that aids were part of the deal if she seemed interested in speech and hearing, so that became as routine as getting dressed and putting shoes on every few hours. Shoes, a particular fetish, were featured in her first baby-fisted sign.

This method worked well until she started getting impatient with us looking for signs for words we didn’t know. For years, we knew that if Maddie knew a sign, she knew the word and knew what it meant. When a therapist wisely suggested just giving her the word in voice until we had a chance to look it up, her vocabulary expanded greatly. Her verbal language soon outstripped her signed words. When asked rhetorically “what is the sign for that?” she began to say imperiously: “Why don’t you ask the sign dictionary?” (Brat!) I think you can nurture a bias towards one mode or method just up until you meet other families who are succeeding brilliantly with other methods. Or you see children failing despite a family’s best efforts to follow a specific mode. My four children are vastly different, one from another; it only makes sense that deaf/hh children are just as different from each other. One size fits no one precisely.

A World of Words

In following your child’s lead, teach them to expect to understand the world. I see teens who are deaf just “checking out” of the social scene at times, and I wonder if they have a little “learned helplessness” in their perception of the world. The world is, for sure, an irrational, often unfriendly place to us, let alone our kids. If Maddie learns that no question is unwelcome and no explanation too hurried at home, perhaps she’ll more actively take her place in communicating in the big bad world. I tell her right away if I don’t understand her and I try never to accept her partial understanding of me, either. She’s come to be annoyed by the comprehension questions we are often firing at her, but I can take that flash of blue eyes a little longer. I knew we were on the right track when she began collecting her favorite idioms and suspecting when she didn’t understand us that it was yet another English weirdism.

So my daughter’s smorgasboard of language currently features her (incessant) talking to us, we sign and talk to her for best reception, and she uses a full time interpreter to access her fourth grade life in a neighborhood school. In noisy environments, she uses more sign. She opted to try to sleep with her two year old cochlear implant on at the summer camp she insisted on attending. She stops voicing when she has her best friend over for an occasional gigglefest. We read and read and read to her as she hasn’t yet taken up this pastime just for fun yet, but nonetheless she reads above her grade level. The language-buffet will likely change as she matures. What will she drop? What will she keep? I’m not sure. We just brought her to the feast.

Think About It

Your feast is likely to look very different. My advice? Meet deaf and hard of hearing adults and older kids whenever you can to expand your knowledge of what is possible. If you have a passionate provider or more with many success stories, ask him/her point blank why they think Method X, Y or Z is or isn’t a good fit for your child. Ask what it is about your family’s “culture” that might make or break a method in your house. Help your child fall in love with language not because of state assessment scores, but because it is powerful. It is human. It is one of our most compelling, complex needs. Then watch your child and see what she is telling you through her behavior. All behavior is communication. Communication you can follow, like a dance, until your child takes the lead one day.