Добавил:
Sekretar
kiopkiopkiop18@yandex.ru
t.me/Prokururor I Вовсе не секретарь, но почту проверяю
Опубликованный материал нарушает ваши авторские права? Сообщите нам.
Вуз:
Предмет:
Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_4488_Библиотеки_им_академика_М_И_Перельмана
.pdf
29 Speech/Language/Auditory Management of Infants and Children with Hearing Loss
Madell et al., Pediatric Audiology: Diagnosis, Technology, and Management, 3rd Ed. (ISBN 978-1-62623-401-7),
copyright © 2019 Thieme Medical Publishers. All rights reserved. Usage subject to terms and conditions of license.
Now that the fitting of bilateral devices (two HAs or CIs or
bimodal stimulation) is considered best clinical practice, the
structural organization of individual training sessions has been
forever altered. Particularly during the adjustment period of
having amplification on both ears, some portion of each therapy
session should be directed toward listening with each device
separately and under bilateral conditions. Realizing that one of
the expected benefits of bilateral device use is improved listening
in noise, training tasks should be used where the hearing aid or
implant user is expected to follow spoken language in the presence
of competing background noise. Potential noise sources could
be commercially available four-talker babble audio recordings22
or even talk radio. Over time, the signal-to-noise ratio between
the speech and noise should be decreased to aord practice in
listening environments that better simulate those encountered in
everyday social interactions.
Pitfall
The national mandate to conduct EI sessions within the home
environment is sometimes erroneously viewed by clinicians and
parents alike as an opportunity for parents to merely observe or
opt out of participating in the sessions (e.g., using therapy time
as a break or opportunity to complete household chores while
the child is otherwise engaged).
she can be expected to achieve greater auditory performance from
those baseline levels if provided with appropriate technology and
sucient auditory-based speech and language training.
Systems like Signed English or Cued Speech23 coupled with
auditory training may be the appropriate intervention for some
older children who were taught visually in earlier intervention
and educational programs or who do not have sucient auditory
access. Yoshinaga-Itano23 reported that it is indeed possible to
map acoustic cues and speech production cues onto an existing
or intact sign language system. Both Signed English (i.e., a manual
communication system) and Cued Speech (i.e., a phonemic-based
system that uses hand shapes and body positioning to correspond
to speech) would aord an older child who is attempting to
advance her auditory skills with the best match between what
she hears and what she sees. In contrast, American Sign Language
(ASL) is a separate language with its own syntax and grammar; it
is not designed to be used with spoken language. If ASL is paired
with spoken language, a mismatch is created that may complicate
the language-learning process.
Pitfall
Some teachers and clinicians report that they use ASL with
English word order. However, because spoken language and ASL
are incompatible communication systems, the child will have
incomplete access to both spoken English and ASL as functional
and complete language systems if they are to be used together.
29.6.2 Direct Intervention Services
The primary objectives of providing hear ing habilitation and rehabilitation to pediatric hearing aid or implant users is to develop
and expand functional listening skills for the purposes of continued language learn ing and enhanced communicative inter actions.
Young children fitted with either conventional amplification or CIs
require direct instruction to master the vocabulary and linguistic
structure of the language being directed to and around them.
Their active involvement in meaningful social-communicative
interactions with their typically developing and normal-hearing
peers significantly enriches their language learning eorts.
However, the increased auditory access aorded by a CI has
been observed to facilitate more incidental learning (e.g., learning
from mere exposure) in these children relative to their profoundly
hard-of-hearing peers fitted with conventional HAs. During the
critical language-learning period (between birth and 3 years of
age), the process of attaching meaning to auditory cues occurs
with an ease and naturalness that are not observed when listening
and speech are initiated at later ages.
Ongoing parent-child-centered training should be provided to
an infant or young child with HAs or a CI at least twice a week
for 60-minute sessions. Regardless of how often direct therapy
services can be delivered, auditory-verbal intervention is recommended if the family’s desired outcome for their child is spoken
language. (See Chapter 27 for more information about dierent
communication approaches.) In accordance with the child’s age
and exhibited skills upon entering the hearing habilitation process,
29.6.3 Training Strategies
Several published auditory curricula oer parents and professionals hierarchical guidelines for auditory skill emergence and
a variety of useful training activities.
sometimes inappropriately viewed as cookbooks to address
the individual training needs of a child fitted with HAs or CIs.
However, a thorough understanding of the underlying principles
and training strategies of the auditory-verbal/listening and
spoken language intervention model best complements the
current trend of providing evidence-based intervention to this
diverse population. Auditory-verbal/listening and spoken language approaches emphasize the development and reliance upon
auditory cues to receive, comprehend, and use spoken language
in the context of meaningful, real-life experiences.
There is a growing repertoire of available smartphone and
tablet apps developed to supplement face-to-face intervention
services for children with hearing loss. Ranging from apps that
measure the loudness level of toys or the surrounding environment to those that provide interactive tasks fostering listening,
comprehension, and self-monitoring of the child’s productions,
apps are motivating, manipulative, and mobile to children across
the ages. They can also facilitate literacy, written language, and
social skills (when used cooperatively in group sessions). The fact
that many apps can automatically monitor progress is an added
advantage supporting their use.
24,25,26
These curricula are
311
IV Educational and Clinical Management of Hearing Loss in Children
Madell et al., Pediatric Audiology: Diagnosis, Technology, and Management, 3rd Ed. (ISBN 978-1-62623-401-7),
copyright © 2019 Thieme Medical Publishers. All rights reserved. Usage subject to terms and conditions of license.
Appendix 29.1 Commercially available tests
Tests Infants Preschool School-aged Teenage Bilateral
27
IT-MAIS
LittlEARS
FAPI
APT/HI
ESP
COT
TAC
Mr. Potato Head
Common Phrases
AB Lists (CASPA)
LNT
28
29
30
31
32
33
34
35
36
38
HINT39 X X X
AZ Bio Sentences
40
Language Functioning
Tests Infants Preschool School-aged Teenage Bilateral
41
CSBS
MacArthur-Bates CDI
43
CASLLS
44
Reynell
45
PLS-5
46
PPVT-4
47
CELF-4
48
SPELT-3
49
OWLS-II
42
X X
X X
X X
X X X X X
X X X X X
X X
X X X X
X X
X X X X
X X X X
X X X
X X X
X X
X X
X X X
X X X
X X X
X X X X
X X X
X X X X
X X X
Speech Production
Tests Infants Preschool School-aged Teenage Bilateral
GFTA-2
50
X X X X
Intelligibility Measure X X X
Test Stimuli Skill Domain Availability
Infant Toddler-Meaningful
Auditory Integration Scale
(IT-MAIS)
27
LittlEARS Auditory Questionnaire
Detection, discrimination, recognition, environmental
sound and speech
28
Detection, discrimination, recognition, comprehension
of environmental sounds, songs, phonemes, words,
Speech perception Advanced Bionics
Speech perception MED-EL Worldwide,
Innsbruck, Austria
sentences
Functional Auditory Performance
Indicators (FAPI)
Auditory Perception Test for the
Hearing Impaired (APT/HI)
Early Speech Perception Test
31
(ESP)
29
30
Detection, discrimination, recognition, comprehension
from sounds to sentences
Speech perception Texas School for the Blind and
Visually Impaired
Detection, discrimination, recognition, comprehension Speech perception Plural Publishing Inc., San
Diego, CA
Suprasegmentals, phonemes, words Speech perception Central Institute for the Deaf
and Hard of Hearing, St.
Louis, MO
Common Objects Token (COT)
32
Test
Test for Auditory Comprehension
33
(TAC)
Discrimination, recognition, comprehension of verbal
directions
Speech perception MED-EL Worldwide,
Innsbruck, Austria
Detection, discrimination, recognition, comprehension Speech perception DLM Teaching Resources
Allen, TX
312
29 Speech/Language/Auditory Management of Infants and Children with Hearing Loss
Madell et al., Pediatric Audiology: Diagnosis, Technology, and Management, 3rd Ed. (ISBN 978-1-62623-401-7),
copyright © 2019 Thieme Medical Publishers. All rights reserved. Usage subject to terms and conditions of license.
Pitfalls
Not all apps have “educational value.”
•
An SLP or LSLS might use the app as an “end goal” as opposed
•
to a means of reinforcing an auditory or speech-language
target.
29.7 Conclusion
Documenting auditory skill emergence and speech-language
progress over time is the final component of the comprehensive
communication management of children who are deaf or hard of
hearing. The professional literature is expanding with the results
from a diverse body of research eorts, directed toward identifying critical prognostic indicators of success or benefit from current
technology and training options.
have quantifiable evidence with which to determine the eectiveness of the hearing habilitation and rehabilitation programming
Mr. Potato Head
Common Phrases
AB Lists Computer Assisted
Speech Perception Assessment
(CASPA)
Phonetically Balanced
Kindergarten (PBK) List
Lexical Neighborhood Test (LNT)
Hearing in Noise Test (HINT)
AzBio Sentences
Communication and Symbolic
Behavior Scales (CSBS)
MacArthur-Bates Communication
Developmental Inventories
Cottage Acquisition Scales for
Listening, Language & Speech
(CASLLS)
Reynell Developmental Language
44
Scales
Preschool Language Scale-5
45
(PLS-5)
Peabody Picture Vocabulary
Test-4 (PPVT-4)
Clinical Evaluation of Language
Fundamentals (CELF-4)
The Structured Photographic
Expressive Language Test-3
(SPELT-3)
Oral & Written Language Scales
(OWLS-II)
Goldman-Fristoe Test of
Articulations-2 (GFTA-2)
34
35
36
37
40
41
43
46
47
48
49
50
9,19
As a result, SLPs and L SLSs now
Words, sentences Speech perception Indiana University School of
Sentences Speech perception Indiana University School of
Phonemes, words Speech perception Journal of American Academy
Phonemes, words Speech perception ASHA, Washington, DC
38
Phonemes, words, sentences Speech perception Auditec, St. Louis, MO
39
Sentences Speech perception Auditec, St. Louis, MO
Recognition Speech perception Auditory Potential, LLC
42
Words, phrases Receptive/expressive Paul H. Brookes Publishing
Words, phrases, sentences Speech perception/
Words, sentences Receptive/expressive Super Duper Publications,
Words, sentences Receptive/expressive Pearson, San Antonio, TX
Words Receptive/expressive Pearson, San Antonio, TX
Words, sentences, paragraphs Receptive/expressive Pearson, San Antonio, TX
Morphology, grammar, syntax Receptive/expressive Janelle Publications, DeKalb,
Words, sentences, paragraphs Receptive/expressive Western Psychological
Phonemes, words, sentences Articulation Pearson, San Antonio, TX
they aord. However, documentation from ongoing diagnostic
training, in combination with regularly scheduled comprehensive
assessments, should direct future intervention for an individual
child. Information from research and clinical domains, in turn,
motivates the manufacturers to improve the programming schemas of digital aids and CI speech processors to meet the needs of
a
n increasingly younger and more diverse population of spoken
language communicators with significant hearing loss.
29.8 Appendix
The following diagnostic protocol aords a listing of commercially available tests and how they could be used to meet the
requirements of a comprehensive functional listening assessment and speech-language evaluation. T his listing is by no means
exhaustive or intended to suggest that other test measures might
not also be useful. Please see the table on the following pages for
more descriptive information about the tests and where they can
be obtained. Some are discussed in Chapters 9 and 22.
Medicine, DeVault Otologic
Research Laboratory
Medicine, DeVault Otologic
Research Laboratory
of Audiology
Co., Baltimore, MD
Co., Baltimore, MD
Production, receptive
Sunshine Cottage, San
Antonio, TX
Greenville, SC
IL
Services, Torrance, CA
313
IV Educational and Clinical Management of Hearing Loss in Children
Madell et al., Pediatric Audiology: Diagnosis, Technology, and Management, 3rd Ed. (ISBN 978-1-62623-401-7),
copyright © 2019 Thieme Medical Publishers. All rights reserved. Usage subject to terms and conditions of license.
Discussion Questions
1. What variables most inuence the acquisition of optimal func-
tional listening skill emergence and age-appropriate speech
and language skills?
2. What role do realistic expectations and consistent communicative demands play in the emergence of listening, spoken
language, and literacy skills?
3. How does an SLP or auditory-verbal practitioner identify the
present level of functioning and training needs for a child who
cannot respond on formal test measures?
4. Why should the teenager be actively involved in the
decision-making process regarding her communication
management?
5. What are the advantages and disadvantages of using digital
technology in the management of children with hearing loss?
References
[1] National Institutes of Health. Early Identification of Hearing Impairment in
Infants and Young Children: NIH Consensus Development Conference Statement,
March 1–3, 1993. Bethesda, MD: National Institutes of Health; 1993 https://
consensus.nih.gov/1993/1993HearingInfantsChildren092html.htm. Accessed
January 3, 2018
[2] National Conference of State Legislatures. Newborn Hearing Screening Laws.
http://www.ncsl.org/research/health/newborn-hearing-screening-state-laws.
aspx. May 2011. Accessed January 3, 2018
[3]
ller MP. Early intervention and language development in children who are
Moe
deaf and hard of hearing. Pediatrics 2000;106(3):E43
[4] Sininger YS, Grimes A, Christensen E. Auditory development in early amplified
children: factors inuencing auditory-based communication outcomes in children with hearing loss. Ear Hear 2010;31(2):166–185
[5]
Yoshinaga-Itano C, Sedey AL, Coulter DK, Mehl AL. Language of early- and
later-identified children with hearing loss. Pediatrics 1998;102(5):1161–1171
[6] Geers AE, Strube MJ, Tobey EA, Pisoni DB, Moog JS. Epilogue: factors contributing
to long-term outcomes of cochlear implantation in early childhood. Ear Hear
2011; 32(1, Suppl):84S–92S
[7] Kronenberger WG, Beer J, Castellanos I, Pisoni DB, Miyamoto RT. Neurocogni-
tive risk in children with cochlear implants. JAMA Otolaryngol Head Neck Surg
2014;
140(7):608–615
[8] Pisoni DB, Conway CM, Kronenberger WG, et al. Ecacy and eectiveness
of cochlear implants in deaf children. In: Marschark M, Hauser PC, eds. Deaf
Cognition: Foundations and Outcomes. Oxford, UK: Oxford University Press;
2008:52–101
Anderson K
[9]
Optimizing Achievement for Students with Hearing Loss. Hillsboro, OR: Butte
Publications; 2011
[10] Quittner AL, Leibach P, Marciel K. The impact of cochlear implants on young deaf
children: new methods to assess cognitive and behavioral development. Arch
Otolaryngol Head Neck Surg 2004;130(5):547–554
[11] Cole EB, Flexer C. Children with Hearing Loss: Developing Listening and Talking,
Birth to Six. San Diego, CA: Plural Publishing; 2015
[12]
Sus
curriculum for parents of low-socioeconomic status and their deaf and hard-ofhearing children. Otol Neurotol 2016;37(2):e110–e117
[13]
Anderson K, Smaldino J. L
surement tool. Hear J 1999;52(10):74,
Anderson K
[14]
Hearing Loss; 2004.
[15] Ying E. Speech and language assessment: communication evaluation. In: Ross
M, ed. Hearing-Impaired Children in the Mainstream. Parkton, MD: York Press;
1990:45–60
[16] United States Congress. House Committee on Education and Labor. Subcom-
mittee on Select Education. Oversight of Public Law 94–142—the Education
f
Education of the Committee on Education and Labor, House of Representatives,
Ninety-Sixth Congress, First Session. Washington: U.S. Government Printing
Oce; 1980
[17] Stredler-Brown A. A model of early intervention for children with hearing loss
provided through telepractice. Volta Review 2012;112(3):283
L, Arnoldi KA. Building Skills for Success in the Fast-Paced Classroom:
kind DL, Graf E, Leel KR, et al. Project ASPIRE: spoken language intervention
istening Inventories for Education: A classroom mea
L. Secondary SIFTER. Tampa, FL: Supporting Success for Children with
or All Handicapped Children Act: Hearings before the Subcommittee on Select
[18] National Council on Disability (U.S.). The Education of Students with Disabilities:
Where Do We Stand? A Report to the President and the Congress of the United
States. Washington, DC: National Council on Disability; 1989 https://www.ncd.
gov/publications/1989/September1989. Accessed January 3, 2018
[19] De Conde Johnson C, Seaton J. Educational Audiology Handbook. 2nd ed. Clifton
Park, NY: Delmar; 2011
[20] Flexer C, Madell J, Hewitt J. Alexander Graham Bell Association’s Recommended
Protocol for Audiological Assessment, Hearing Aid and Cochlear Implant Evalua
tion, and Follow-up. http://www.agbell.org/Speak/Alexander-Graham-Bell-
Associations-Recommended-Protocol-for-Audiological-Assessment-Hearing-
Aid-and-Cochlear-Implant-Evaluation-and-Follow-up. June 2014. Accessed
Januar
[21] Estabrooks W, ed. 101 Frequently Asked Questions about Auditory-Verbal
[22] Auditec. Four Talker Noise [compact disc]. St. Louis, MO: Auditec; 1984
[23] Yoshinaga-Itano C. Successful outcomes for deaf and hard-of-hearing children.
[24] Koch ME. Bringing sound to life: Principles and Practices of Cochlear Implant
[25]
[26] Estabrooks W. Auditory-verbal ages and stages of development. In: Estabrooks
[27] Zimmerman-Phillips S, Osberger M, Robbins A. IT-MAIS: Infant-Toddler Mean
[28]
[29] Stredler-Brown A, Johnson DC. Functional Auditory Performance Indicators:
[30]
[31]
[32] Plant G, Moore A. The Common Objects Token (COT) test: A sentence test for
[33] Trammell J, Farrar C, Francis J, et al. Test of Auditory Comprehension. North
[34] Robbins A. The Mr. Potato Head Task. Indianapolis, IN: Indiana University School
[35] Robbins A, Renshaw J, Osberger M. Common Phrases Test. Indianapolis, IN:
[36] Mackersie CL, Boothroyd A, Minniear D. Evaluation of the Computer-Assisted
[37] Haskins HL. A phonetically balanced test of speech discrimination for children
[38] Kirk KI, Pisoni DB, Osberger MJ. Lexical eects on spoken word recognition by
[39]
[40] AzBio Sentences. Tempe, AZ: Auditory Potential, LLC; 2013
[41] Wetherby AM, Prizant BM. Communication and Symbolic Behavior Scales Devel
[42] Fenson L, Marchman VA, Thal DJ, Dale PS, Reznick JS, Bates E. MacArthur-Bates
-
[43] Wilkes EM. Cottage Acquisition Scales for Listening, Language & Speech: User’s
[44] Edwards S. Reynell Developmental Language Scales III. London, UK: NFER-Nelson;
[45] Zimmerman IL, Steiner VG, Pond RE. Preschool Language Scales, Fifth Edition
[46]
[47] Semel-Mintz E, Wiig E, Secord W. Clinical Evaluation of Language Fundamentals,
[48] Dawson JI, Stout CE, Eyer JA. SPELT-3: Structured Photographic Expressive Lan
[49]
[50]
y 3, 2018
Practice. Washington, DC: Alexander Graham Bell Association for the Deaf and
Hard of Hearing; 2012
Semin Hear 2000;21(4):309–326
Rehabilitation [video tapes]. Timorium, MD: York Press; 1999
Moo
g JS, Biedenstein JJ, Davidson LS. Speech Perception Instructional Curriculum
and Evaluation (SPICE). St Louis, MO: Central Institute for the Deaf; 1995
W, ed. Cochlear Implants for Kids. Washington, DC: Alexander Graham Bell
Association for the Deaf and Hard of Hearing; 1998:387–399
ingful Auditory Integration Scale. Valencia, CA: Advanced Bionics LLC; 2001
Kuehn-Inacker H, Weichbold V, Tsiakpini L, Coninx F, D’Haese P. LittlEARS Audito-
ry Questionnaire Manual—Parent Questionnaire to Assess Auditory Behaviour in
oung Children. Innsbruck, Austria: MED-EL; 2003
Y
An Integrated Approach to Auditory Development. Colorado Department of
Education. Special Education Services Unit. http://www.tsbvi.edu/attachments/
FunctionalAuditoryPerformanceIndicators.pdf. 2003. Accessed January 3, 2018
Allen S
G. Auditory Perception Test for the Hearing Impaired (APT/HI). San Diego,
CA: Plural; 2016
g JS, Geers AE. Early Speech Perception Test for Profoundly Hearing-Impaired
Moo
Children. St. Louis, MO: Central Institute for the Deaf and Hard of Hearing; 1990
profoundly hearing impaired children. Aust J Audiol 1992;14(2):76–83
Hollywood, CA: Foreworks; 1981
of Medicine; 1994
Indiana University School of Medicine; 1995
Speech Perception Assessment test (CASPA). J Am Acad Audiol 2001;12(8):390–396
[master’s thesis]. Evanston, IL: Northwestern University; 1949
pediatric cochlear implant users. Ear Hear 1995;16(5):470–481
Nils
son M, Soli SD, Sullivan JA. Development of the Hearing in Noise Test for the
measurement of speech reception thresholds in quiet and in noise. J Acoust Soc
Am 1994;95(2):1085–1099
opmental Pro
Communicative Development Inventories User’s Guide and Technical Manual.
2nd ed. Baltimore, MD: Brookes Publishing; 2006
Guide. 2nd ed. San Antonio, TX: Sunshine Cottage School for Deaf Children; 2001
1997
(PLS-5). San Antonio, TX: Pearson; 2011
Dunn L
(PPVT-4). San Antonio, TX: Pearson; 2015
Fourth Edition (CELF-4). San Antonio, TX: Pearson; 2003
guage Test. DeKalb, IL: Janelle Publications; 2003
Carrow-Woolfolk E. (OWLS-II) Oral and Written Language Scales. 2nd ed. Tor-
rance, CA: Western Psychological Services; 2011
Goldman R, Fristoe M. Goldman-Fristoe Test of Articulation 2 (GFTA-2). San
Antonio, TX: Pearson; 2000
file (CSBS DP). Baltimore, MD: Brookes Publishing; 2002
M, Dunn DM, Lenhard A. Peabody Picture Vocabulary Test, Fourth Edition
-
-
-
-
314
30 Educational Placement Options for School-Aged Children with Hearing Loss
Madell et al., Pediatric Audiology: Diagnosis, Technology, and Management, 3rd Ed. (ISBN 978-1-62623-401-7),
copyright © 2019 Thieme Medical Publishers. All rights reserved. Usage subject to terms and conditions of license.
30 Educational Placement Options for School-Aged Children
with Hearing Loss
Carrie L. Spangler, Erin C. Schafer, and Leslie Allen
Summary
This chapter provides an overview of existing school placements
and services for children with hearing loss as well as federal
and state laws that mandate appropriate supports and services
for children and families. There is a continuum of placements,
ranging from residential schools solely for children with hearing
loss to a fully mainstreamed environment at the child’s neighborhood school. The child’s educational team, including the
parents, will need to determine the most appropriate placement
by considering the physical and learning environments, instructional style, support services, school culture, and the individual
child’s hearing and education needs.
Keywords
bullying, self determination, mind map, peer group, adolescent/
teens
Key Points
Placement options should be determined based on the indi-
•
vidual child’s needs.
There are practical tools that may guide professionals, par-
•
ents, and guardians in decisions about the optimal placement
for their student/child.
IDEA 2004 and Section 504 are laws that protect and ensure
•
that students with hearing loss have access across the educational continuum.
Accommodations and, at times, modications are necessary
•
for students with hearing loss.
Related service educational team members with knowledge
•
and skills working with students with hearing loss are essential for the IEP and 504 team.
30.1 Introduction to Educational
Placement Options
Program (IEP); and the family’s primary communication mode,
such as listening and spoken language (LSL) or total communication (see Chapter 27 on communication choices). Some children
will not require special education services under IDEA and will,
instead, receive services under Section 504 of the Rehabilitation
Act of 1973. (See Chapter 31 for more detailed information about
education and access laws.)
30.2 IEP and 504 Plans
Before discussing placement options for children with hearing
loss, it is helpful to understand the two major laws that guide
educational placement and accessibility options for all individuals with disabilities.
An IEP and a 504 plan2 are similar in that they both serve to
legally protect as well as provide accommodations, supports,
and services to children who have disabilities. An IEP, which is
governed by IDEA, is a plan that provides specially designed educational instruction, accommodations (i.e., ensure full access in
the classroom), and/or modifications (i.e., changes to curriculum)
for children with hearing loss. If a student with hearing loss does
not need specially designed instruction, a 504 plan may be more
appropriate.
A 504 plan ensures that students with hearing loss receive the
accommodations needed to participate in school with no restrictions, similar to children with no hearing loss. Professionals working with students with hearing loss require a deep understanding
of the laws in order to eectively advocate for services. Additional
guidance on the laws can be found at the U.S. Department of
Education’s website.
Pitfall
If school-based professionals are not trained and educated about
the laws related to serving students with hearing loss, the child
may not be able to reach his or her potential at school.
The optimal educational placement of a school-aged child with
hearing loss is critical to ensure that he or she is working to the
highest potential in the least restrictive environment (LRE). The
LRE, as defined by the Individuals with Disabilities Education
Act (IDEA),1 is the regular environment where children without
disabilities are educated. However, IDEA also acknowledges that
some children may require special classes or separate schooling
when the nature or severity of the disability precludes education in regular classes with the use of supplementary aids and
services. In addition to LRE, other factors will guide decisions
regarding educational placements for children with hearing loss
including: child and family needs; coexisting disabilities; goals
and objectives listed in the child’s Individualized Education
To guide parents, administrators, general education teachers,
and special educators on decisions regarding the optimal placement for a child, there are published placement and readiness
hecklists for children who are in preschool and kindergarten,3
c
elementary school,4 or secondary grades.5 Each checklist includes
a list of questions under the following subheadings: physical environment (e.g., classroom acoustics); learning environment (e.g.,
centers, schedule, and behavior management); instructional style
(e.g., use of visual information); school culture (i.e., support for
students with disabilities); and individual child considerations.
Sources of the information needed to complete the checklists
may include the child’s current and potential teachers, parents,
315
IV Educational and Clinical Management of Hearing Loss in Children
Madell et al., Pediatric Audiology: Diagnosis, Technology, and Management, 3rd Ed. (ISBN 978-1-62623-401-7),
copyright © 2019 Thieme Medical Publishers. All rights reserved. Usage subject to terms and conditions of license.
and IEP team members. Information obtained is through observations of the child, the child’s environment, academics, and other
information to help determine appropriate placement options.
The following sections of this chapter will provide an overview
of the educational placement options that may be considered by
the IEP team.
30.3 Preschool Placement Options
(3–5 years)
Helping families navigate the preschool process can be a challenge. Many factors need to be considered in order to help families and those in the educational system make the best choice for
a child with hearing loss. Depending on the age of diagnosis of
hearing loss, the child from birth to age 3 years may have been
receiving services under Part C of the Federal Law. In order to be
eligible for services under part C, a child will need to meet one
of the following criteria: (i) developmental delay in the areas of
cognitive, physical, communication, social adaptive or (ii) a diagnosed physical or mental condition that has a high probability
of resulting in developmental delay.6 The focus of these services
is on supporting the family to enable them to meet the developmental needs of their child with a delay or disability. However,
once a child reaches age 3, Part B services under IDEA govern
service delivery by the local educational agency (LEA). The focus
of these services is now on the child’s educational need. As stated
previously, an eligible child is one who is 3 through 21 years of
age and, by reason of one or more conditions, is unable to receive
reasonable educational benefit from regular education. Hearing
impairment including deafness is one of the categories of disabilities eligible for special education services under IDEA.
An evaluation to determine the need for special education for
children with hearing loss should include an audiologic evaluation, otologic evaluation, speech and language assessment, vision,
psychological assessment, an assessment of physical functioning,
and other evaluations relevant to the child’s needs. Once the areas
in which a child will require services is determined by certified/
licensed professionals, an IEP team meeting is scheduled to review
all of the assessment results. The IEP team, including the family,
will determine whether the student qualifies for special education
preschool services under IDEA. If the preschooler with hearing
loss qualifies, an IEP is developed by the professionals, teachers,
school administrators, and parents. The IEP plan outlines the
continuum of placement choice, services, goals, and objectives
for each area of service and also for related services (described
in greater detail subsequently). If a child is not eligible for Part
B preschool services, the school must include suggestions of
other appropriate services for the child. Suggestions may include
private therapies, private preschool, community activities, and/
or the creation of a 504 Plan to ensure access, such as improved
signal-to-noise ratio.
Preschool service opportunities vary as to location and characteristics, which impact the intensity of services and level of
personnel involvement. When considering dierent placement
options for preschoolers with hearing loss, there is not a “one
size fits all” program option. The key to appropriate selection of a
preschool is meeting the individual needs of each individual child
with hearing loss. Meeting individual needs includes taking into
consideration a child’s overall functioning and goals in a variety
of areas, not just the development of listening and speech skills.
The Placement and Readiness Checklist (PARC) Part 2A (placement
checklist for preschool/kindergarten children) oers a two-part
instrument to guide the educational team in considerations related
to placement and service options for children who are deaf or hard
of hearing (D/HH).
team consider the individual needs of the preschooler including
the child’s communication, language, preacademic, and social
needs in the context of the continuum of preschool environments.
Parents are critical members of the team as well and will be the
final decision makers regarding the child’s communication mode.
The Parent Checklist: Preschool/Kindergarten Placement for Children
Who Are Deaf and[sic] Hard of Hearing7 oers families a structured
tool to analyze dierent programs to help parents participate in a
team decision about the best placement for their child.
3
The placement checklist considerations help a
30.3.1 Preschool Continuum of
Placement Options
Private Preschools: Private preschools vary widely in the types
•
of curriculum and programs they oer, and the cost of tuition
can vary significantly. This option would be appropriate for a
D/HH preschooler who has attained age-appropriate speech
and language skills. Careful evaluation of the program and
philosophy is important for families including determining
acceptance of hearing loss and willingness to make reasonable
accommodations for the child. The educational background of
the teachers in this classroom will vary widely from limited
or no college education to master’s degrees in early childhood
education.
Head Start Preschool: The Oce of Head Start (OHS) is a
•
federally funded program that is operated by local entities.
Head Start promotes the school readiness of young children
from low-income families through local programs. Head Start
and Early Head Start programs support the mental, social, and
emotional development of children from birth to age 5 years;
preschool services may be full-day, half-day, or home-based
programs. Most Head Start teachers have Child Development
Associate (CDA) credentialing as well as degrees in early childhood education. Again, it is important for the family to utilize
a tool such as the Parent Checklist to determine whether the
needs of their child will be met in the classroom.
State Preschool Programs: IDEA defines that appropriate
•
prekindergarten programs must be provided to all children
between the ages of 3 and 5 years who have one or more of the
disabilit ies enumerated in IDEA . States and loc al school distr icts
are required by federal law to educate preschool-age children
with disabilities in typical early childhood programs alongside
children who do not have disabilities to the maximum extent
appropriate. Many programs are “cross categorical,” serving
all children regardless of disability category. Some districts
have developed specialized preschool programs to address the
specific needs of children with hearing loss. A classroom can
have up to eight students who are on an IEP and up to four
“peer models,” or preschoolers without disabilities. Typically, a
316
30 Educational Placement Options for School-Aged Children with Hearing Loss
Madell et al., Pediatric Audiology: Diagnosis, Technology, and Management, 3rd Ed. (ISBN 978-1-62623-401-7),
copyright © 2019 Thieme Medical Publishers. All rights reserved. Usage subject to terms and conditions of license.
classroom will have a teacher with a degree in early childhood
education as well as a teacher assistant. Again, it is important
to use the PARC and Parent Checklist to evaluate appropriate
placement options for each student with hearing loss.
Public and private Auditory/Oral (A/O) or Listening and
•
Spoken Language (LSL) preschool programs: LSL programs
teach infants and young children to use hearing and speech
to develop spoken language for communication and learning.
Children typically attend a preschool or early elementary
program taught by teachers of the deaf [TODs], early childhood teachers, Listening and Spoken Language Specialists
(LSLSs), and speech-language pathologists (SLPs; described
subsequently) with A/O and LSLS training and experience. Sign
language is not used in the LSL approach; however, natural
gestures that are used in typical conversation are included.
Public and private sign language preschool programs: Sign
•
language programs teach young children to use sign language,
such as American Sign Language (ASL), as their primary mode
of communication and language development. As in other
programs, children attend full- or half-day preschool. Most
teachers in these programs have degrees in deaf education.
30.3.2 Preschool Case Study
Sam is a 3-year old with bilateral cochlear implants (CIs). He
is in the transition process from early intervention or Part C
services to preschool services. He is an inconsistent user of his
CIs. His language levels range from 12 to 16 months receptively
and expressively. The family has chosen spoken language as his
modality of communication, and listening and spoken language
as the desired outcome. The parents have investigated educational placement options and found a regional listening and
spoken language public preschool program in the neighboring
school district. The school district of residence oers a sign
language program and states that it can meet Sam’s needs eec-
tively. However, the district is not meeting Sam’s or his family’s
needs. Instead, it is predetermining placement of service based
on what it has to oer.
Pitfall
Hearing loss is a lower-incidence disability, and school district
personnel may not understand the continuum of communication options.
IDEA, Section 300.46 (a)(2)(iv), states that “the IEP team shall
consider the communication needs of the child, and in the case
of a child who is deaf or hard of hearing, consider the child’s
language and communication needs, opportunities for direct
communications with peers and professional personnel in the
child’s language and communication mode, academic level, and
full range of needs, including opportunities for direct instruction
the child’s language and communication mode.”
1
30.4 School-Age Placement Options
(5 to 21 Years)
Universal newborn hearing screening, early diagnosis, early
amplification, and early intervention are allowing more students with hearing loss to be educated in the general education
classroom. Statistics from the U.S. Department of Education
show that over 86% of students with hearing loss are educated
primarily in their regular school, with varying percentages in
the mainstream and/or in support classes.8 However, children
who are D/HH should not be made to fit into the program that
happens to exist in their neighborhood school. The needs of the
student, which are informed by the family’s desired outcomes
(including communication) for the child, data, team input, and
evaluation are all factors that should drive program, services,
and placement.
There is a full continuum of placement, program, and service
options to serve D/HH students eectively, including those students with additional disabilities. These placement options will
vary for each individual student. A key factor for placement options
will depend on whether the student with hearing loss qualifies for
an IEP or a 504 plan. Some school-aged children with hearing loss
will not qualify for special education; however, the student may
receive a 504 plan in order to receive services, accommodations,
or hearing technology, such as digital or frequency modulation
(DM/FM) systems or computer-assisted real-time translation
(CART). A team similar to the IEP team, including professionals,
administrators, and parents, generates the 504 plan. Generally,
students who have 504 plans are educated in general education
classrooms.
The key to appropriate selection of a school-age educational
plan is considering and meeting the individual needs of each child
with hearing loss as outlined in IDEA 2004. IDEA regulations state
that the IEP team must consider the communication needs of the
child, and in the case of a child who is D/HH, consider the child’s
language and communication needs, opportunities for direct communication with peers and professional personnel in the child’s
language and communication mode, academic level, and full range
of needs, including opportunities for direct instruction in the
child’s language and communication mode.
Several states have developed a “Communication Plan checklist” for IEP team guidance.10 Teams may also want to utilize the
PARC when considering the continuum of options appropriate for
each student with hearing loss. Part 1, or the Readiness Checklist,
gives insight into meaningful participation in the educational
setting including the general education setting.11 As mentioned
previously, Part 2, Placement Checklist (in this case Part 2B for
elementary or 2C for secondary students), gives assistance to the
IEP team in evaluating accessibility and appropriateness of the
continuum of educational placements.
The following examples illustrate the need for a continuum
of services for D/HH students. One cannot simply create a chart,
implement a policy, or take a philosophical stand about placement issues for this unique population of students. Each student’s
needs must be individually accounted for prior to discussion
about placement options.
9
4,5
317
IV Educational and Clinical Management of Hearing Loss in Children
Madell et al., Pediatric Audiology: Diagnosis, Technology, and Management, 3rd Ed. (ISBN 978-1-62623-401-7),
copyright © 2019 Thieme Medical Publishers. All rights reserved. Usage subject to terms and conditions of license.
Public general education placements (i.e., mainstream setting)
•
with all necessary support services, such as itinerant teachers
credentialed in D/HH education, interpreters, CART (communication access real-time translation), and educational audiology enable students with hearing loss to be educated in their
neighborhood school, the same school that they would attend
if they did not have a disability (hearing loss). Typically, this
placement consists of a classroom of 20 to 30 students with
one or two general education teachers. It is important to note
that many children will need to attend the regional program
(described next) to gain access to sign language interpreters.
Public regional programs (combined in resource and general
•
education settings) provide the critical mass of age- and
language-appropriate opportunities for direct instruction
and communication with sta, peers, personnel, and services.
These programs may be housed in a central location within a
school district, or several school districts may form a consortium in order to meet the unique needs of educating children
with hearing loss. Within this program, children may receive
instruction in self-contained classrooms with a limited number
of students or in general education classrooms with 20 to 30
students, with or without modifications to the curriculum.
A state school for the deaf (residential and day school) is a
•
public, state-funded school option. Characteristics of these
schools will vary from state to state depending on philosophy
and enrollment. Some schools for the deaf provide direct
instruction using sign language, others provide only oral
instruction, and still others may oer both sign language and
oral instruction. Students enrolled in state schools for the deaf
may attend day classes or may live on school grounds because
of the distance from their homes.
Special, self-contained classrooms (partial or full day) for
•
students with hearing loss and special education resource
programs (partial or full day) in public schools, as required
by federal and state laws, may be available in the student’s
neighborhood school district or provided at another location.
Private Listening and Spoken Language Education and/or
•
OPTION schools,12 similar to preschool programs, utilize a
highly trained educational team of TODs, SLPs, audiologists,
and other professionals while partnering with the family to
educate students with hearing loss. Utilizing hearing technology (cochlear implants, hearing aids, and hearing assistive
technology), students learn educationally and develop meaningful communication through listening and speaking.
Further possibilities include nonpublic schools, virtual
•
schools, home instruction, hospital instruction, and institutions required by federal and state laws to meet the needs
of students with disabilities that cannot be met within the
traditional public school setting.
30.5 Related Services and
Classroom Accommodations
504 are assessed to determine the need for related services,
which may include speech-language pathology, audiology, interpreting, psychological, physical and occupational therapy, child
nd parent counseling, mobility services, social work, and medi-
a
cal services for diagnostic or evaluation purposes. In most states,
these services are provided only in public school placements.
Included in this chapter are the most common related services
that are provided to students with hearing loss. It is important
to remember that each student is an individual, and services will
vary based on the assessment and needs.
30.5.1 Primary Related Service Providers
for Children with Hearing Loss
IDEA 2004 §300.34(a) defines related services as transportation
as well as developmental, corrective, and other supportive ser-
vices as are required to assist a child with a disability to benefit
from special education. It includes speech-language pathology
and audiology services, interpreting services, psychologic services, physical and occupational therapy, recreation, including
therapeutic recreation, early identification and assessment of
disabilities in children, counseling services, including rehabilitation counseling, orientation and mobility services, and
medical services for diagnostic or evaluation purposes. Related
services also include school health services and school nurse
services, social work services in schools, and parent counseling
and training. In most states, these services are provided only in
public school placements. The following sections highlight the
qualifications and job description of several of the most common
related service providers for students who are deaf or hard of
hearing.
Educational Audiologist
According to IDEA Part B,1 34 CFR §300.34(c)(1), audiology
includes:
(i) Identification of children with hearing loss
(ii) Determination of the range, nature, and degree of hearing
loss, including referral for medical or other professional
attention for the habilitation of hearing
(iii) Provision of habilitation activities, such as language habil-
itation, auditory training, speech reading, (lipreading),
earing evaluation, and speech conservation
h
(iv) Creation and administration of programs for prevention of
hearing loss
(v) Counseling and guidance of children, parents, and teachers
regarding hearing loss
(vi) Determination of children’s needs for group and individual
amplification, selecting and fitting an appropriate aid, and
evaluating the eectiveness of amplification
Related services, classroom modifications and accommodations,
and hearing assistive technology may substantially enhance a
child’s listening and learning abilities. Children who qualify for
special education under IDEA and also for services under Section
Speech-Language Pathologist
SLPs have the specialized preparation, experiences, and opportu-
nities to address communication eectiveness, communication
318
30 Educational Placement Options for School-Aged Children with Hearing Loss
Madell et al., Pediatric Audiology: Diagnosis, Technology, and Management, 3rd Ed. (ISBN 978-1-62623-401-7),
copyright © 2019 Thieme Medical Publishers. All rights reserved. Usage subject to terms and conditions of license.
disorders, dierences, and delays due to a variety of factors
including those that may be related to hearing loss.13 Some SLPs
have taken steps to provide additional services to children with
hearing loss by obtaining the LSLS certification from the Alexander
Graham Bell Academy for Listening and Spoken Language. LSLS
are licensed SLPs, audiologists, or educators of the deaf who
have become certified in helping children who are D/HH develop
spoken language and literacy primarily through listening.
14
Teacher of the Deaf or Hard of Hearing
TODs13 address the acquisition and development of communicative competence with an understanding of the linguistic,
cultural, cognitive, developmental, familial, visual, auditory,
tactile, and motor inuences. These teachers aim to:
(i) Establish a classroom or other learning environment to
meet the physical, cognitive, cultural, linguistic, and communicative needs of the child
i) Plan and utilize strategies, appropriate materials, and
(i
resources for implementing educational experiences that
support the development of communicative competence
(iii) Provide consistent comprehensible language(s) appropriate
to the needs of the child regardless of the modality or form
(iv) Apply first- and second-language teaching strategies to
teaching English (e.g., through ASL appropriate to the needs
of the child and consistent with the program philosophy)
(v) Facilitate and support communication among D/HH chil-
dren and adults, hearing children and adults, including
family/caregivers
(vi) Monitor and evaluate the child’s communicative com-
petence on a regular basis in academic and nonacademic
contexts including the child’s use of signs, cues, speech,
and/or assistive technologies
(vii) Provide instruction and/or support for eective use of com-
munication supports such as interpreting, transliteration,
note-taking, real-time captioning, telecommunications, and
computing
Educational Interpreter
IDEA Part B, 34 CFR §300.34(c)(4), defines interpreting services15
to include the following when used with respect to children
who are D/HH: oral transliteration services, cued language
transliteration services, and sign language transliteration and
interpreting services. Specifically, the role of the educational
interpreter includes eectively communicating classroom
information between the teacher, the deaf student, and other
hearing students according to the language level of the student
and the goals of the IEP. There are many aspects to the educational interpreter’s job that require more than simply conveying
what words and grammar the teacher and other students say,
including implementing the student’s IEP, using the appropriate
modality and language; interpreting at the appropriate language
level, clearly conveying all aspects of meaning and content and
making sure that the lessons are clear; making appropriate use
of fingerspelling; facilitating and supporting participation and
social communication; and monitoring student comprehension.
30.5.2 Classroom Accommodations and
Classroom Modications
The terms “accommodation” and “modification” tend to be used
interchangeably; however, there is a dierence in the services
provided under each term. Accommodations alter or improve
the way a student receives information or instruction or the way
the student communicates during class. Basically, the changes do
not alter or lower the standards or expectations for a subject or
test. Strategic seating in the front of the class, reducing auditory
distractions (i.e., background noise), ensuring student’s attention
before speak ing, and using a buddy system for notes are exa mples
of accommodations. There are numerous other accommodations,
which are summarized by Johnson and Seaton16 in a document
known as the IEP/504 Checklist.17 Through the child’s IEP or 504
Plan, classroom accommodations may be formally developed
and documented.
Modifications, on the other hand, result in curricular and/or
instructional changes to meet the student’s academic needs.18
When modifications are made, students with disabilities are not
expected to master the same academic content as others in the
classroom. Examples of modifications include shortened reading
assignments, preteaching vocabulary, supplementary work/read-
ings, and simplified exams.
30.5.3 Assistive Technology
Under IDEA,1 assistive technology is defined as an item, equipment, or system that is used to increase, maintain, or improve
functional capabilities of children with disabilities. However,
assistive technology does not include a medical device, such as a
cochlea r implant. The most common as sistive technology for c hildren with hearing loss is remote microphone technology. These
systems, which consist of a teacher transmitter and a student
receiver, are sold by multiple manufacturers and aim to reduce
the deleterious eects of classroom noise, reverberation, and distance from the teacher. During use, the frequency modulation/
digital modulation (FM/DM) system significantly improves the
signal-to-noise ratio at the child’s ear because the teacher’s voice
is transmitted directly to the student’s receiver via FM or DM
transmission. The FM/DM receivers can be electrically coupled
to any hearing aid or cochlear implant, may consist of soundfield
speakers (i.e., classroom audio distribution system [CADS]), or
may also be self-contained in a small, ear-level device designed
for children with normal hearing but processing diculties (e.g.,
autism spectrum disorder). Significant improvements in speech
recognition in background noise are well documented for children with hearing aids, cochlear implants, or auditory processing
i
ssues while using FM/DM systems relative to no system.
However, for children with hearing loss, electrically coupled FM/
DM receivers result in significantly better speech recognition in
noise compared to classroom soundfield speakers.
Other types of assistive technology may include a videophone,
alerting devices, captioning (e.g., CART), or speech-to-text software. Of these, CART is the most commonly used technology
and necessitates a stenographer, a stenotype machine, laptop
computer, and software to provide the real-time translation. The
19,20,21,22
19
319
IV Educational and Clinical Management of Hearing Loss in Children
Madell et al., Pediatric Audiology: Diagnosis, Technology, and Management, 3rd Ed. (ISBN 978-1-62623-401-7),
copyright © 2019 Thieme Medical Publishers. All rights reserved. Usage subject to terms and conditions of license.
student is seated near the laptop computer in order to follow
along with the lecture translated by the stenographer. All of the
aforementioned technologies share the same goals of improving
the functional capabilities, ensuring equal access to learning, and
addressing the educational needs of children with hearing loss.
30.6 Conclusion
Students with hearing loss in the school system make up a
heterogeneous population. Individualized assessments with a
team of qualified professionals who have experience working
with students who have hearing loss will help determine the
continuum of services that are needed. Utilizing tools such
as the PARC can help the educational team incorporate IDEA
2004 key regulations as well as help determine appropriate
related services, accommodations, and modifications that are
needed for each individual student. A simple chart or philosophy
cannot be used to determine the placement and services for this
unique population of students. The goal is for each child to have
a productive and successful experience throughout his or her
educational career.
Discussion Questions
1. What is the best educational placement for a child who has
hearing loss?
2. Who are the essential members of the educational team
for a student with hearing loss? Describe each member’s
qualications.
3. What are ve common accommodations that may be used for
a student with hearing loss in the educational environment?
4. If a new student who uses bilateral cochlear implants moves
into the district, what do you need to consider to ensure that
the student has a successful educational experience?
References
[1] Individuals with Disabilities Education Act, 20 U.S.C. § 1400; 2004
[2] Section 504 of the Rehabilitation Act of 1973, 34 C.F.R. Part 104
[3] Johnson CD, Beams D, Stredler-Brown A. PARC: 2A—PS/Kindergarten Place-
ment Checklist. http://successforkidswithhearingloss.com/wp-content/up-
loads/2011/08/PARC_2011-Chap-7.pdf, 12th–15th pages of 23. Revised 2011.
Accessed January 4, 2018
[4]
[5]
[6]
[7] DeConde Johnson C, Beams D, Stredler-Brown A. Parent Checklist: Preschool/
[8] Snyder TD, de Brey C, Dillow SA. The Digest of Education Statistics 2014. NCES
[9]
[10] Davenport C, Belhorn T. Ohio Communication Plan for a Student Who Is Deaf or
[11] Johnson CD. PARC: 1—Readiness Checklist. http://successforkidswithhearingloss.
[12] OPTION Schools, Inc. https://optionschools.org/ 2013. Accessed January 4, 2018
[13] American Speech-Language-Hearing Association. Roles of Speech-Language
[14] The AG Bell Academy for Listening and Spoken Language. http://www.agbell.org/
[15] Boys Town National Research Hospital, U.S. Department of Education, University of
[16] DeConde Johnson C, Seaton JB, eds. Educational Audiology Handbook. 2nd ed.
[17] Johnson C. IEP/504 Checklist: Accomodations and Modifications for Students
[18] Great Schools. Accommodations, Modifications, and Alternate Assessments:
[19] Wolfe J, Morais M, Neumann S, et al. Evaluation of speech recognition with per-
[20] Schafer EC, Kleineck MP. Improvements in speech recognition using cochlear
[21] Schafer EC, Mathews L, Mehta S, et al. Personal FM systems for children with
[22] Wolfe J, Morais M, Schafer E, et al. Evaluation of speech recognition of cochlear
D, Darr M, Elliott S. PARC: 2B—Elementary Placement Checklist. http://
Johnson C
successforkidswithhearingloss.com/wp-content/uploads/2011/08/PARC_2011Chap-7.pdf, 16th–19th pages of 23. Revised 2011. Accessed January 4, 2018
D, Darr M, Elliott S. PARC: 2C—Secondary Placement Checklist. http://
Johnson C
successforkidswithhearingloss.com/wp-content/uploads/2011/08/PARC_2011Chap-7.pdf, 20th–23rd pages of 23. Revised 2011. Accessed January 4, 2018
.S.C. §1432(5)(A)(B)
20 U
Kindergarten Placement for Children Who Are Deaf and Hard of Hearing. https://
www.handsandvoices.org/pdf/parent_checklist.pdf, 2003. Accessed January 4,
2018
2016–006. Washington, DC: U.S. Department of Education, National Center
for Education Statistics; 2016:114 https://nces.ed.gov/pubs2016/2016006.pdf.
Accessed January 4, 2018
.F.R. Part 300.324(a)(2)(iv)
34 C
Hard of Hearing. http://www.ohioschoolforthedeaf.org/Portals/0/Outreach/
Documents/communication%20plan%20and%20guidance%20updated%20
sep
t%202013.doc. Published September 2013. Accessed January 4, 2018
com/wp-content/uploads/2011/08/PARC_2011-Chap-7.pdf, 2nd–11th pages of
23. Revised 2010–2011. Accessed January 4, 2017
Pathologists and Teachers of Children Who Are Deaf and Hard of Hearing in the
Development of Communicative and Linguistic Competence. http://www.asha.
org/policy/ps2004-00232.htm. 2004 Accessed January 4, 2018
AcademyDocument.aspx?id=433. Accessed August 8, 2016
Colorado—Boulder. Classroom Interpreting. http://www.classroominterpreting.org/
Interpreters/role/index.asp. Accessed January 4, 2018
Cengage-Delmar Learning; 2012
Who are Deaf and Hard of Hearing. http://www.handsandvoices.org/pdf/IEP_
Checklist.pdf. Revised 2014 for Hands & Voices. Accessed January 4, 2018
How They Aect Instruction and Assessment. http://www.greatschools.net/
LD/school-learning/accommodations-IEP.gs?content=713. February 8, 2016.
Accessed January 4, 2018
sonal FM and classroom audio distribution systems. J Educ Audiol 2013;19:65–79
implants and three types of FM systems: A meta-analytic approach. J Educ Audiol
2009;15:4–14
autism spectrum disorders (ASD) and/or attention-deficit hyperactivity disorder
(ADHD): an initial investigation. J Commun Disord 2013;46(1):30–52
implant recipients using a personal digital adaptive radio frequency system. J Am
Acad Audiol 2013;24(8):714–724
320
Соседние файлы в папке Библиотека им академика М.И. Перельмана