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14.AR-In School

Aural Rehab SLP401

Early treatment If amplification and EI are in place by 6 months of age, a child is much more likely to acquire age- level language and learning milestones (Downs & Yoshinaga-Itano, 1999)
CORE Overall Participation, Education
CORE Assessment/CARE Management (E) Environmental factors. Giving strategies to use in their environment.
Why AR in schools? -Impact of HL on learning (15dB thresholds, instead of 20dB). -Tendency for low math and reading scores compared to typically hearing peers -General impact on language (less incidental learning) -Mandated services
Hearing Loss and Learning The more severe the loss, the more difficult learning can be (McFadden & Pittman, 2008). -Even mild losses put children at risk. -Unilateral losses can also put children at risk
18 months -Normal Hearing (NH): Vocabulary of 25 words. -Profound HL: No words
2-3 years -NH: Understands directions, uses short sentences, asks questions. -PHL: Few words, yells and points to express desires
3-4 years -NH: Makes long sentences -PHL: Some single words
17 years -NH: >80,000 words. -PHL: Vocabulary less than a 3rd grader
PL 94- 142: Education of all Handicapped Children Act (1975) -1st Mandate: FAPE -2nd Mandate: Each public agency must have a system in place in order to ensure that HAs/CIs/FM systems are functioning appropriately. -Opened the door for AR in school settings
PL 99-457: Education of Handicapped Act Amendments (1st Reauthorization, 1986) Included birth to 5 population Formally brought AR into the area of EI services for infants/toddlers and their families.
PL 101-476 Individuals with Disabilities Education Act (IDEA) 1990 New name - IDEA Removed "handicapped" from title. -Use of people-first language. -Children with hearing loss vs. hearing impaired. -Preferred to be looked at as an individual who happens to have a disability
Amendments to IDEA 1997 -Functional educational goals related to performance and expectations. Progress reports at least as often as those without disabilities. -Integration of special ed. goals into general ed. -Curriculum through inclusion of the general education teacher.
Amendments to IDEA 2004 Aligned law with the 2001 NCLB Act 16
IDEA Key Concepts -FAPE -LRE -IEP
FAPE -Free and Appropriate Education -Paid for by public funds -Appropriate left vaguely defined
LRE -Least Restrictive Environment synonymous with mainstreaming -the most access to educational, social, and emotional support -IDEA left this open to interpretation depending on situation.
LRE continuum -Full-time, regular education in home school district or neighborhood -Regular ed. with in-class support (SLPs or teacher of HI) -Regular ed. with pull-out into another classroom -Part-time regular ed / part-time special ed. (resource room).
LRE continuum (contd) -Full-time special ed. in school district with small # of other children with HL/ neighborhood (Separate or Self-contained classroom) -Full-time special ed. / center-based / in or out of child’s neighborhood -Residential home (St Mary's)
Mild-moderately-severe HL May succeed in a regular classroom if full support is provided to address variety of language and listening needs that can impede learning
LRE may be different for those who are deaf Commission on Education of the Deaf (1988) – “placement of a deaf child in a regular classroom, even with an interpreter, may be more restrictive than placement in a fully signing environment with deaf peers”.
DOE - "Policy Guidance” “ the communicative nature of the disability is inherently isolating” FAPE supersedes LRE (A=appropriate)
Choosing an Approach for School (Review) 1.Oral - Aural 2.Sign Only 3.Combined Approach: TC 4.Cued Speech
Oral - Aural Method -Oral (speech communication) -Aural (use of residual hearing) -Speech reading?Yes. Sign-language?No. -Later: Auditory - Verbal Method (discourages speech reading as well). -52% of those with Mod-Sev loss
Sign Only ASL primary language. -11% of children. [1% are bi-bi signers (bi-lingual / bi-cultural)]. -Speech production and listening skills are not emphasized.
Total Communication (1960s) Use of some form of sign (ASL, SEE – depicting an oral language with manual symbols) Spoken language. Residual hearing. Speech reading. Nonverbal communication – body language and facial expressions. 34% of those with HL.
Cued Speech Developed (1960s) -Visual support system to facilitate speech reading. -1% of classroom instruction (Gallaudet)
What is AR in the School? (6) 1.Screening and assessment 2.Management of amplification 3.Direct instruction and indirect consultation 4.Hearing conservation (teen music habits) 5.Evaluation and modification of classroom acoustics 6.Transition planning to postsecondary placements
Screening and Assessment (4) 1.Early ID of HL (newborn screening) 2.K-12 screening (state mandates) 3.Assessment (rescreen after failed screening) 4.Assessment (yearly with known loss): conventional testing, speech recognition, speech reading, and performance with amplification.
Early Identification and Screening (NYS) Within 6mos of admission and grades k, 1, 3, 5, 7 and 10 +. School nurse (training not addressed by law). Includes, but not be limited to, pure tone and threshold air conduction screening (also tymp, OAE). Equipment standards not addressed by law. P
Management of Amplification/Audition: Big 3 Personal HAs. FM systems. CIs. (also sound fiels ample., asstv devices.)
Monitoring Programs Daily visual inspection. Listening check. Semesterly electroacoustic analysis of HAs and FM systems (black box)
Direct Instruction (3) Listening skills. Speech production. Use of language.
Indirect Consultation Audiologist trains teacher to perform listening check; SLP provides information on how to develop language skills within the curriculum.
Hearing Conservation (Prevention & Monitoring) Monitor fluctuating hearing levels of children who: Are taking ototoxic drugs and Experience chronic otitis media
Evaluation and Modification of Classroom Acoustics (3 components) 1.Noise levels 2.Reverberation 3.Distance between teacher and student
Noise Typically greater than teacher’s voice: Children working in groups. Feet on floors. HVAC, computers, more.
Reverberation Linoleum/tile, Plaster/Brick Wall vs Carpet, Ceiling Acoustic Tile
Distance between student and teacher Ideal: 60 dB SPL from 6 feet (best achieved through FM system).
FM System types (2) Personal or Sound field (whole room, desktop, or loop).
FM System components (2) 1.Transmitter Unit 2.Receiver Unit: receives, amplifies, and delivers signal to student’s ears. Attached or built in (can have FM only)
Classroom Acoustics Fed. gov: Acoustics of a school should allow for full acoustic access to oral instruction.
Transition Planning to Postsecondary Placements ITP, GAP
Individualized Transition Plan Once students graduate, SE guidelines no longer in place. Must include a statement of responsibilities of each public agency/participating agency before the student leaves the school setting. 71% dropout rate vs. 47%.
Guide to Access Planning Interactive curriculum to help teens and young adults develop personal responsibility and self advocacy skills.
AR Team 30 – 40% of children with HL have additional disabilities: Teachers (reg., Deaf/HH, sp. ed.), educ. aud., SLP, nurse, psych, PE, mobility/orientaion specialists.
Created by: ashea01



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