Transcript Interventions for Children with Vision and Hearing Loss

Interventions for Children with
Vision and Hearing Loss
32nd Annual KDEC Conference
February 27, 2014
Presenters: Megan Cote &
Rebecca Obold-Geary
Co-Directors of the Kansas Deaf-Blind Project
[email protected]
[email protected]
kansasdeafblind.kssdb.org
The Kansas Deaf-Blind Project
• A Federally Funded 5 Year Grant
(we are currently in year 1)
• Based at the Kansas State School
for the Blind in KC, KS
Our Mission:
To identify and serve learners with DeafBlindness and their families in the state of
Kansas.
Intro to Deaf-Blindness:
DEAF-BLINDNESS does NOT imply
that an individual
sees or hears absolutely nothing
DEAF-BLINDNESS simply means that
the individual experiences both a vision
and a hearing loss, to some degree.
Key Questions:
Two key questions to ask, when
assessing whether a learner has DB:
1. Does she have enough vision to
compensate for her lack of hearing?
2. Does she have enough hearing to
compensate for her lack of vision?
(John McInnes)
Deaf-Blindness is a disability…
 about
INFORMATION GATHERING
 which LIMITS ACCESS
 which is EXPONENTIALLY MORE
than a hearing loss plus a vision loss
Deaf-blindness…
 affects
two of a learner’s three
DISTANCE SENSES and
 necessitates that she use IMPACT
SENSES (i.e., taste, touch,
kinesthetic) to gather information
Types of “Information
Gathering” (i.e., LEARNING)
 Direct
learning
 Secondary learning
 Incidental learning
Here are some stats…
In the United States, over 10,000
children and youth (birth - 22 years)
experience deaf-blindness.
 Of
this 10,000, approximately 5%
experience total deafness and total
blindness
 But approximately 91% of these 11,000
children and youth also experience
additional disabilities
ETIOLOGIES of DB
In general, children might be at risk for having
combined vision and hearing losses , due to a:
 hereditary syndrome or disorder
 pre-natal condition
 post-natal condition
 family history
 head injury or direct trauma to ear / eye
 prematurity
CATEGORIZING DB
1. by time(s) of onset of sensory loss
2. by degrees / types of sensory loss
3. BOTH—by time(s) of onset and
degrees of sensory loss
By far, the best predictor of an
individual learner’s needs / skills
is the #3 model of categorization.
Deaf-blind Simulation
How did you feel during the simulation?
What is the object?
What were the properties of the object that
helped you identify the object?
What are the concepts related to the
object?
Sensory Perspectives
Sensory Perspectives DVD
A set of interactive simulations of a
variety of conditions related to deafness,
blindness and deaf-blindness.

https://hopepubl.com
GENERAL CHARACTERISTICS
Learners with DB often demonstrate:
inconsistent responses to sounds or visual
images (i.e., use of remaining skills)
 a distorted perception of the world, due to lack of
non-distorted information from the distance
senses
 balance problems
 delays in motor development
 tactile sensitivity or defensiveness
 an overactive startle response

GENERAL CHARACTERISTICS
(con’t.)
difficulty interacting with things in the
environment in a meaningful way
 difficulty in communicating with people in
a meaningful way
 difficulty in establishing / maintaining
inter-personal relationships
 difficulty in generalizing information
 light gazing
 stereotypy (fear, confusion, sensory deprivation)

CHARACTERISTICS RELEVANT TO
LEARNING
It is important to remember that learners
who have DB often:
lack the ability to anticipate events
 are deprived of many of the most basic extrinsic
motivations (i.e., curiosity); sensory info is so
distorted it is ineffective as a source of
motivation to explore and interact with people
and the environment
 will not benefit from being left alone, for long
periods of time, with toys / materials

CHARACTERISTICS RELEVANT
TO LEARNING (con’t.)

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cannot benefit from incidental or secondary
learning, but must be taught through direct
instruction
cannot independently learn from mistakes,
because she is unable to correctly understand the
results of her actions
may not benefit from group instruction, alone,
because she cannot learn from watching and
listening to others
The best way to informally gauge cognitive skills
is by observing the way she “remembers”
LEARNERS WITH DB
Almost always experience…
feelings of vulnerability
 more security / safety in a seated position
 lengthier periods of time, learning to trust
others / the world
 challenges counteracting boredom

LEARNERS WITH DB (con’t.)
And…
 perceive time very differently
 respond positively to enhanced textures
 find it difficult to interpret movement
 fatigue more rapidly than same-aged
peers
 demonstrate increased tactile sensitivity,
particularly around the face
LEARNER NEEDS
A learner who has deaf-blindness
needs to…
 understand CONCEPTS through
MORE THAN ONE sensory
/communicative mode
 have the opportunity to learn and
interact in an ENHANCED CONTEXT,
in order to know what is going on
around her
LEARNER NEEDS
Deaf-blindness requires a learner’s
partners to take time to…
 plan how a learner will RECEIVE
information in every activity
 plan what a learner will DO in every activity
 consider the IMMEDIATE physical, visual,
and auditory ENVIRONMENTAL
CONTEXTS of every activity
LEARNER NEEDS
When you meet a person who has DB…

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treat her as you would anyone else
address her directly, not through an interpreter,
intervener, or anyone else
let her know who you are, and when you enter /
leave the room
use the words, “see,” “hear,” and so on naturally
describe things that are happening, or are about to
happen
remember that behaviors affect attitudes!
LEARNER NEEDS
When communicating with a person
who has DB…
be in close proximity to her (yet respectful)
 alert her that a communicative interaction is
about to begin or end
 use multi-modal communication
 wait for her to respond
 provide choices, in order to allow her some
control

Interventions
Communication
Environmental
Social/Emotional
Concept development
Communication

Multi-modial communication
Objects
 Coactive signs
 Signals and cues
 Calendar systems

Wait time
 Watch entire child
http://library.tsbvi.edu/Play/83

Resources for Communication

Communication Matrix by Charity
Rowland
www.communicationmatrix.org
The Communication Matrix is designed to assess the
expressive communication for learners who use very early
stages of communication and progress slowly. Preintentional through beginning language are addressed in
relation to refusing, obtaining, social interactions and
seeking information.
Resources for Communication
Communication Map by Kathleen Stremel
http://www.oregondb.org/Assess.html
 Kansas Deaf-Blind Project Learning
Modules: Communication Mapping
training.distancementorship.org

The Communication Map is designed to assess
expressive and receptive communicative intents and
forms. The visual profile provides information for short and
long term programming.
Resources for Communication
Watkins, S. & Clark, T.C. (1991). A
coactive sign system for children who are
dual-sensory impaired. American Annuals
of the Deaf, 136, (4), 321-324.
 Project Salute

www.projectsalute.net
 http://www.projectsalute.net/Learned/Learne
dhtml/Coactive.html

Environmental Considerations
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Vision
 Contrast
 Size
 Lighting
Hearing
 Noise to sound ration
 AcousticsTactile/touch
Olfactory
Tactile/touch
Taste
Proprioceptive and Vestibular
Resources for Environmental
Considerations
National Center on Deaf-Blindness
https://nationaldb.org/library Environmental Consideration
Checklist by Dr. Mary Morse
 Perkins Webcasts: Adapting Environments for
Individuals with Vision Loss by Darrick Wright
http://www.perkins.org/resources/
 10 Issues to Always Consider When Intervening for
Students with Deafblindness by David Wiley
http://www.tsbvi.edu/resources/3114-10-issues-toalways-consider-when-intervening-for-students-withdeafblindness

Social Emotional
Encouraging Relationships and Bonding
 Fostering Trust
 Stress
 Intervener Support

Resources for Social Emotional
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SPARKLE
www.sparkle.usu.edu

Interveners
www.intervener.org
Concept Development
Concepts vs. Skill
 Concepts

Concrete concepts (i.e. chair)
 Semi Concrete concepts (i.e jumping)
 Abstract Concepts (i.e. nervousness)

Six areas of concept development
affected by DB
Objects exist
 Objects have permanence
 Objects differ
 Objects have names or labels
 Objects have characteristics
 Objects have functions or use
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Resources for Concept Development
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Perkins. Strategies for Early Cognitive Skills/Concept
Development http://www.perkinselearning.org/
Cause and Effect
Object Functions
Object Permanence
Taking Turns
SPARKLE
http://www.sparkle.usu.edu/Topics/concept_development/index.
asp
What a Concept by Jim Durkel at the Texas School for the Blind
https://www.tsbvi.edu/seehear/spring00/concept.htm
Teaching Strategies and Content Modifications for the Child
with Deaf-Blindness by Kate Moss at the Texas School for the
Blind https://www.tsbvi.edu/seehear/archive/strategies.html
If I suspect that I have a learner with DeafBlindness, what do I do?
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Go to kansasdeafblind.kssdb.org
Download the application and instructions.
Mail the application and supporting
documents to:
Kansas Deaf-Blind Project
Rebecca Obold-Geary
1100 State Ave.
Kansas City, KS 66102
Questions: contact Rebecca Obold-Geary
[email protected] or 913-305-3087
Kansas Deaf-Blind FUND
If a child is on the Deaf-Blind Registry,
the educational team can apply for
materials to support the learnerup to $3,000 annually.
This is done through Joan Houghton at
KSDE or her assistant, Cynthia Penrod.
Applications are submitted in the Spring.
Kansas Deaf-Blind PROJECT
vs.
Deaf-Blind FUND
Project:
Federally Funded
Based at Kansas State School for the Blind
Fund:
State Funded
Based at KSDE under Joan Houghton
One of only 2 states in the country to have such
an allocation.
How does the Kansas Deaf-Blind Project provide
support?
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Provide free TA in the school & in the home.
Provide parent scholarships for training- to attend conference(s),
Project SPARKLE.
Provide state-wide trainings & district trainings
Intervener training scholarships @ USU.
Family weekends.
Partner with Families Together to offer trainings.
Facebook page.
Parent-to-Parent Mentorship.
Distance Mentorship.
Access to free on-line training modules related to Deaf-Blindness.
The Kansas Deaf-Blind Project
kansasdeafblind.kssdb.org
KS DB Family Specialist:
Dinell Smith [email protected]
KS DB Project Directors:
Megan Cote- [email protected]
Rebecca Obold-Geary- [email protected]
Kansas Deaf-Blind Project
Learning Modules
Twelve modules developed by Dr. Susan
Bashinski:
training.distancementorship.org
1. Interactions with Touch
2. Interactions with Objects
3. Calendar Systems
4. Communication Mapping
5. Development of Communicative
Intentionality
Kansas Deaf-Blind Project
Learning Modules
6.Gestural Development
7. Hand under hand strategies
8. Piaget and the symbolization continuum
9. Utilizing Routines
10. Introduction to Vision Loss
11. Introduction to Hearing Loss
12. Introduction to Learners with Deaf-Blindness
To receive a user name and password email
[email protected]
On-line Module RESOURCES
Kansas Deaf-Blind Project Learning Modules
East Carolina University deaf-blind modules
mast.ecu.edu/picker.php
Select Students with Deafblindness (left column):
Modules: Introduction, Developmental Impact,
Educational Implications
East Carolina University Mini Modules
http://www.ecu.edu/cseduc/ci/sped/dbproject/Mini-Modules.cfm
Intervener training opportunities
Credential Program:
 Utah State University www.usu.edu
 www.intervener.org
Other Training
 Open Hands Open Access: Deaf-Blind
Intervener Learning Modules nationaldb.org
 East Carolina University http://www.ecu.edu/cseduc/ci/sped/dbproject/DB-IntervenerCertificate.cfm
Additional Resources
National Center on Deaf-Blindness
nationaldb.org
literacy.nationaldb.org
 Home Talk
http://documents.nationaldb.org//HomeTal
k.pdf
 Tips for Home and School from Nevada
Deaf-Blind Project

http://www.unr.edu/ndsip/
Additional Resources continued
Washington Sensory Disabilities Services:
Deaf-Blind www.wsdsonline.org
 Perkins School for the Blind: Webcasts
www.perkins.org look for Teaching
Resources
 KS DB Library loans for teams working
with a learner on the Kansas Deaf-Blind
registry kansasdeafblind.kssdb.org
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***REMEMBER***
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Learners who have deaf-blindness are an incredibly
heterogeneous group
Deaf-blindness is a disability about information gathering!
Partnering with a learner with deaf-blindness involves
INVITING THE CHILD “OUT” to join the work and to build
levels of connection with her
A learner with deaf-blindness is NOT a “deaf” child who
cannot see or a “blind” child who cannot hear. Deafblindness is unique and complex disability.
SUMMARY
A child with deaf-blindness is NOT
“deaf child” who cannot see or
 a “blind child” who cannot hear
a
Deaf-blindness is a unique
and complex disability!