1. Evidence-Based Practices in Deafblindness: Communication and Literacy
Council for Exceptional
Children 2017
Susan M. Bruce
Cathy Nelson
Brent Stutzman

2. Where did the evidence for this presentation come from?
Analysis for the CEEDAR Center of articles published between on 12 topics
More in depth analysis on just communication and literacy addressed in articles appearing (Bruce, Nelson, Perez, Stutzman, & Barnhill (2016).

3. What is the CEEDAR CENTER?
CEEDAR stands for: Collaboration for Effective Educator Development, Assessment, and Reform
Technical assistance project (federally funded)
Includes commitment to identify evidence-based practices (also known as “essential components”)
Interested in the preparation of students with disabilities for higher education and career readiness
Over course of 5 year grant, will collaborate with individuals in 20 states
With state departments of education over licensing
With personnel preparation programs
With local school districts to support program evaluation

4. Innovation Configurations
Identification of evidence based practices from the existing literature (research studies, practice literature) on teaching students with disabilities
Innovation configurations currently completed: two on reading (K-5 and 6-12 grades), writing, math, transition, universal design for learning, culturally responsive teaching, principal leadership, content learning with technology, use of technology in preparation of pre-service teachers, severe disabilities, sensory impairments, improving challenging behaviors of students with severe disabilities, classroom and behavior management for Tier 2 and Tier 3 strategies, English Language Learners, literacy instruction for students with multiple and severe disabilities.

5. Our Analysis Process for Sensory Disabilities Innovation Configuration
Examined publications about research studies and practice literature in 12 topic areas for Deaf/Hard of Hearing, Visual Impairment, and Deafblindness ( )
NOTE: Calculated the level of evidence for each practice that EMERGED from analysis of the literature
Thus some important practices were not identified because there were no studies and a lack of professional literature.
(Ferrell, Bruce, & Luckner, 2014)

6. Twelve Topic Areas Addressed
Administration (including team membership)
Assessment
Assistive Technology
Communication*
Early Identification & Early Intervention
Life Skills (including Orientation & Mobility)
Literacy*
Mathematics
Placement/Inclusion (including collaborative teams)
Science
Social-Emotional/Behavioral*
Transition

7. Identifying the Level of Evidence
See document: The CEEDAR Center Evidence Standards
4 levels of evidence:
Strong
Moderate
Limited
Emerging

8. Defining Evidence Levels
Strong: 1+ strong causal design + 1+ moderately strong –or- 5 single subject design -or- 5+ correlational studies
Moderate: 3+ moderately-strong causal designs -or- 3 single-subject designs (with 20+ participants and 2+ different research teams) -or- 3 correlational designs - or- 2+ meta-analyses or syntheses (with quality indicators for syntheses)
Limited: At least 1 causal design study -or- 1 single- subject design study -or- 1 correlational study -or- 1 meta-analysis or synthesis (with quality indicators for syntheses)
Emerging: Primarily relying on professional literature other than research studies

9. Reviewing Findings: Communication
Communication development and social interactions should be emphasized every day in the context of natural environments. LIMITED
Communication programming should address forms/modes, intents/functions, content, context, and pragmatics. EMERGING
Apply child-guided approaches to support communication development and different types of dialogues. LIMITED

10. Communication, cont.
Apply systematic approaches to increase the rate and variety of communicative intents/functions expressed. MODERATE
Implement individualized communication programming that reflects knowledge of the student’s level of communication. EMERGING
Communication Matrix
Improve adult communication partner skills through systematic demonstration and modeling. LIMITED

11. Communication, cont. Tactile approaches and strategies are effective
Touch cues
Hands for learning
Tangible symbols
Tactual sign language
MODERATE

12. Communication, cont.
Tangible representations/symbols are a critical form of communication for prelinguistic students who are deafblind. MODERATE

13. Reviewing Findings: Literacy
An expanded view of literacy (that goes beyond traditional reading and writing) is required to address the needs of students who are deafblind and prelinguistic. EMERGING
Daily schedules/anticipation shelves, integrated story boxes, experience stories, home/school journals, and choice-making as literacy lessons.
Provide a literacy rich environment with hands on experiences to conceptually ground the literacy experiences. EMERGING

14. Related Publication on Evidence-Based Communication & Literacy Practices
Bruce & Borders (2015) situates findings largely from CEEDAR review in their appropriate theoretical groundings: (1) Developmental, (2) Behavioral, and (3) Social-Interactionism-a theory from Deaf education that applies well to approaches in deafblindness.

15. Bruce & Borders (2015): On Theories
Developmental Theory: Development is continuous (sequential) or discontinuous (as in stages, symbolization process)
Behavioral Theory: Communication behaviors are learned because of influence of behavioral principles-reinforcement, modeling, shaping, fading, prompting systems
Social Interactionism Theory: Language acquisition-reciprocal, interplay between child, partner, environments (Peter Paul, 2001, D/HH field)

16. Communication Frameworks: Tri-Focus Framework
Tri-focus Framework (Siegel-Causey & Bashinski, 1997)
The learner
The partner
The environment
Five broad strategies: (1) enhancing partner sensitivity to learner’s expressions; (2) augmenting speech input; (3) utilizing routines; (4) increasing communication opportunities for child; and (5) modifying the communication environment to enhance communication.

17. Communication Frameworks: Four Aspects of Communication
Form
Function
Content
Context
(a common framework in deafblindness)

18. Related Publication on Evidence-Based Practices in Communication & Literacy
Bruce, Nelson, Perez, Stutzman, & Barnhill (2016) provides much greater detail on the research designs and findings on communication-and only addresses studies published So, if you read something in CEEDAR doc and want to know more detail, this is a good resource.
This article framed all findings using the four aspects of communication: Form (mode), Function, Content, & Context
This article included qualitative studies that were not eligible for calculation of evidence in CEEDAR review.
Article is part of a special issue on deafblindness

19. Bruce, Nelson, Perez, Stutzman, & Barnhill (2016)
Table within article states study reference, # of participants, intervention strategies, and key findings across 36 studies published

20. Sampling of Communication Findings Across Studies
Use of dual communication boards (child and adult); use of technology (to elicit visual attention and expression in symbols); identification of partner behaviors to support communication; importance of wait time; affective attunement strategies; teaching peers without disabilities about how the child who is deafblind communicates; ensuring that teacher’s communication is accessible (not speech alone); common expressive gestures: contact point, head pat, touch/tap object, push object, coactive clapping and reaching (different types)…

21. Sampling of communication findings, continued
Joint attention may occur without eye contact- substituting body orientation and physical referencing; highly preferred activities are usually the context for higher rates of intentional communication acts

22. Sharing Joint Attention and Affect

23. Sampling of Literacy Findings
Experience stories, home-school journals, meaningful choice-making opportunities, personalized story boxes, and the daily schedule as literacy lessons; importance of being mindful about literacy opportunities at the preschool level- to include pre-braille instruction, computer use, and daily schedules; importance of print-rich environments, classroom labeling, designated library area, reading aloud, daily news…; importance of input across modalities to support literacy development

24. Implications for Practice
Individual selection of vocabulary to match preferred referents (to increase vocabulary)
Apply principles of systematic instruction to increase rate of expressive communication and to increase variety of functions expressed
Apply principles of child-guided instruction to improve conversation-turns, sharing of affect, quality of interactions.
Improve partner skills-matching instructional targets for adults/peers to child’s needs.
Be sure adults are proficient in teaching literacy lessons that are uniquely designed for this population (tangible daily schedules…)

25. Implications for Research
Most developed areas: tangible representations; interventions with adult communication partners; increasing rates of communication
High need areas in literacy: reading, writing, choice-making, experience stories, technology use, literacy for learners who are presymbolic
Need for researchers to state inclusion of children who are deafblind in title or abstract; when included as subgroup-provide findings specific to children who are deafblind; clear participant and setting descriptions…

26. References
Please see the Innovation Configuration on Sensory Disabilities to see the full list of references (across the three disability areas).
Easiest to locate by:
Google: CEEDAR Center-then click on “Innovation Configuration” heading within GOOGLE-as opposed to going to the CEEDAR site and locating it.

27. References for updated topics on communication and literacy (not included in CEEDAR review)
Bruce, S. M., & Borders, C. (2015). Communication and language in learners who are deaf and hard of hearing with disabilities: Theory, Research, and Practice. American Annals of the Deaf, 160,
Bruce, S. M., Nelson, C., Perez, A., Stutzman, B., & Barnhill, B. A. (2016). The state of research on communication and literacy in deafbindness. American Annals of the Deaf, 161,
Luckner, J., Bruce, S., Ferrell, K. A. (2016). A summary of communication and literacy evidence-based practices for students who are deaf and hard of hearing, visually impaired, and deafblind. Communication Disorders Quarterly, 37(4),

28. References, continued
Paul, P. (2001). Language and deafness. 3rd Edition. San Diego, CA: Singular.
Siegel-Causey, E. & Bashinski, S. M. (1997). Enhancing initial communication and responsiveness of learners with multoiple disabilities: A tri-focus framework for partners. Focus on Autism and Other Developmental Disabilities, 12,

29. Questions and Answers
If your question requires a longer conversation than time allows today, please contact:
Susan Bruce: or