Georgia State University Series: Early Intervention with Children who are Deaf and Hard of Hearing Part 1, Presentation 1 July 2001

Early Intervention Challenges

What’s Happening!  34 States passed UNHSI legislation  Approximately 2050 hospital screen  Approximately 2200 hospitals do not screen  ~ 2 million babies not screened  Legislation is variable  Shortage in trained Pediatric Audiologists a/o: June 2000

Annual Report to Congress on the Implementation of the Individuals with Disabilities Education Act( )  There are 70,833 students with Hearing Impairments Nationally  ~11,000 Deaf and 60,000 Hearing Impaired students Nationally

Challenges  Legal Requirements  Communication Options  Cultural Sensitivity  Technology

Legal Requirements  HR 1193; The Newborn and Infant Hearing, Screening and Intervention Act of 1999  HB 717; Georgia’s UNHS Law signed into affect 4/13/1999  IDEA (Current version of and ; Education of Handicapped Children Act)

Law  The Law Provides for : –IFSP Individualized Family Services Program –IEP Individualized Education Program

IFSP  Family Centered Philosophy  Multidisciplinary Teams (including Parents)  Present Levels of Development in: –Cognition –Physical –Adaptive –Social/emotional –communication  Vision, Hearing and Health Status  Family concerns, priorities and resources related to enhancing development

IFSP  Major outcomes expected to be achieved for the child and family and the criteria, procedures, and timeliness to measure progress toward achieving the outcomes  Specific early intervention services necessary (including the frequency, intensity, and method) to meet the unique needs of the child and family

IFSP  The projected dates for initiation and the anticipated duration of the services  The name of the service coordinator who will be responsible for implementing the plan and coordinating with other agencies and persons

IEP  Placement  Present levels of educational performance  Annual Goals  Special education and related service provided  Participation with nondisabled children  Participation in state and district-wide assessments

IEP (continued)  Dates when services and modifications begin  Statement of transition service needs for children age 14 and older  Measurement of progress

Communication Options  Auditory/Oral  Auditory Verbal  Cued Speech  Total Communication  American Sign Language (Bilingual/ Bicultural)

Auditory/Oral  Teaches to make maximum use of residual hearing through the use of amplification.  Teaches to use residual hearing with speech (lip) reading.  Teaches to speak.  This approach does not use sign language.  Philosophy is to prepare children to live and work in a predominately hearing society.

Auditory/Verbal  Similar to the auditory/oral approach, but it does not encourage speech (lip) reading.  It emphasizes the exclusive use of auditory skills through one-on-one teaching.  Sign language is not used.  There is an emphasis on the importance of placing children in the regular classroom as soon as possible.

Cued Speech  This is a visual communication system combining eight handshapes (cues) that represent different sounds of speech.  Cues are used simultaneously with speaking.  The use of cues significantly enhances lip reading ability because it helps to distinguish sounds that look the same on the lips.

Total Communication  This method uses a combination of methods to teach a child.  It includes a form of sign language, finger spelling, speech reading, speaking, and amplification.  The sign language used, called SEE (Signing Exact English), is not a language. It is constructed to follow English structure.

American Sign Language (Bilingual/Bicultural)  American Sign Language is taught as the child’s primary language, and English is taught as a second language.  ASL is recognized as a true language in its own right.  This method is used extensively within the Deaf community.

Cultural Sensitivity

Assistive Technology This term refers to devices that amplify hearing. Researchers have found that babies learn the basics of their native language by the age of 6 months, long before they utter their first words. Amplification is an effective tool in allowing residual hearing access to be maximized.

Examples of assistive technology include:  Assistive Listening Devices (ALDs) –These include alerting devices that can be used to signal the phone ringing, the alarm clock going off, the doorbell, etc.  FM Systems  Induction Loop Systems  Hearing Aids  Cochlear Implants Oticon Behind the Ear

When selecting a device, it is important to consider:  Where the communication occurs  The degree of hearing loss  Who is responsible for providing the device  Interference with personal amplification  The age of the user  The type of loss Oticon In the Ear

The FM System An FM system is a multi-unit system in which the speaker wears a microphone and the listener wears a wireless receiver. The speaker’s voice is isolated and amplified, then picked up by the receiver attached to the listener’s hearing aid. Personal FM Systems Model PFM 350

The Induction Loop System A loop of wire is set up around the perimeter of a room, creating an electromagnetic field. The speaker wears a microphone, but all sound within the sound field is amplified and picked up by a receiver worn by the listener. This is good for interaction with babies because they are relatively stationary and communication is localized. Lifeline Amplification Systems- A+ Amplification System

Hearing aids come in many shapes and sizes. Behind the Ear (BTE) In the Ear (ITE) In the Canal (ITC) Completely in the Canal (CIC) Bone Conduction- Vibrating Hearing Aid

The Cochlear Implant The cochlear implant (CI) was designed for profoundly deaf individuals who do not receive benefit from traditional hearing aids.

The CI is surgically inserted through the mastoid bone into the cochlea, located in the inner ear. The surgery lasts 2-3 hours and requires an overnight stay in the hospital. After 4-6 weeks the CI is “tuned” by the audiologist to match the individual’s needs. The surgery destroys any residual hearing in that ear. There are also life changes that must be made to protect the user and the CI itself. This is a decision that must involve the child and the parents, and be the result of substantial research and consideration.

This is just a glimpse into the realm of Early Intervention for Children who are Deaf and Hard of Hearing. Upcoming presentations will further discuss each of these topics in detail.