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

roboldgeary@kssdb.org

mcote@kssdb.org

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 Deaf-Blindness 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 learningSecondary 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 loss2. by degrees / types of sensory loss3. 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.)

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 NEEDSWhen you meet a person who has DB… 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. Pre-intentional 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 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-to-always-consider-when-intervening-for-students-with-deafblindness

Social Emotional

Encouraging Relationships and Bonding Fostering Trust Stress Intervener Support

Resources for Social Emotional

SPARKLEwww.sparkle.usu.edu

Intervenerswww.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

Resources for Concept Development

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 Deaf-Blindness, what do I do?

• Go to kansasdeafblind.kssdb.org• Download the application and instructions.• Mail the application and supporting documents

to: Kansas Deaf-Blind Project

Rebecca Obold-Geary1100 State Ave. Kansas City, KS 66102

• Questions: contact Rebecca Obold-Geary roboldgeary@kssdb.org 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 learner-

up 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?

• 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 breesmother@gmail.com

KS DB Project Directors:

Megan Cote- mcote@kssdb.org

Rebecca Obold-Geary- roboldgeary@kssdb.org

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 mcote@kssdb.org

On-line Module RESOURCES

Kansas Deaf-Blind Project Learning ModulesEast Carolina University deaf-blind modules

mast.ecu.edu/picker.php Select Students with Deafblindness (left column): Modules: Introduction, Developmental Impact, Educational ImplicationsEast Carolina University Mini Modules http://www.ecu.edu/cs-educ/ci/sped/dbproject/Mini-Modules.cfm

Intervener training opportunities

Credential Program:Utah State University www.usu.eduwww.intervener.org

Other TrainingOpen Hands Open Access: Deaf-Blind Intervener Learning Modules nationaldb.orgEast Carolina University http://www.ecu.edu/cs-educ/ci/sped/dbproject/DB-Intervener-Certificate.cfm

Additional Resources National Center on Deaf-Blindness

nationaldb.org

literacy.nationaldb.org Home Talk

http://documents.nationaldb.org//HomeTalk.pdf Tips for Home and School from Nevada Deaf-

Blind Projecthttp://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

***REMEMBER*** 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. Deaf-blindness is unique and complex disability.

SUMMARY

A child with deaf-blindness is NOT a “deaf child” who cannot see or a “blind child” who cannot hear

Deaf-blindness is a unique

and complex disability!