Friday, December 18, 2015

Assessment Considerations for Students with Hearing Loss: Part Two

This post is a continuation from last week’s, in which I explained variables to consider when assessing skills in speech, language, and self-advocacy. 

For the areas of assessment covered in this post—audition, academic/ reading/ writing, and psychological/ cognitive assessments—I have again listed some tests that your team may want to consider when assessing deaf or hard of hearing students. Because each student faces unique challenges and possesses different strengths, you will have to work with your team to determine the best options.  My suggestions are meant to serve as examples.

Audition: As part of a comprehensive assessment, we need to know what our students are accessing. A FunctionalListening Evaluation is sometimes a good option to get a sense of the student’s access in the classroom. Other less formal measures such as those on Karen Anderson’s site take less time to administer and provide similar information.

Examples of audition tests:
·      Functional Auditory Performance Indicators (FAPI)
·      Contrasts for Auditory and Speech Training (CAST)
·      COMPASS Test of Auditory Discrimination

Academic/Reading/Writing: Many schools use a version of the Woodcock-Johnson to assess academic skills. While this is generally considered to be the standard test, savvy students can appear more skilled than they actually are by guessing correctly on the multiple-choice items. More challenging tests—such as the Weschler Individual Achievement Test (WIAT)—which require students to read passages and respond to open-ended questions may provide a better picture of the student’s skills. Formal reading (including phonemic awareness, phonics, fluency, decoding, vocabulary, accuracy and self-correction, and comprehension) and a writing assessment should also be included with test results compared with student work samples.

Examples of academic/reading/writing tests:
·      Dynamic Indicators of Basic Early Literacy Skills (DIBELS)
·      Phonological Awareness Literacy Screening (PALS)
·      Gray Oral Reading Test 5 (GORT 5) 

Psychological/Cognitive: Testing in this area is most often done by the school psychologist and analyzes verbal and non-verbal abilities as well as auditory memory. A critical component of this testing is to look at the difference between verbal and non-verbal scores. Often our students with hearing loss will score lower in the verbal portions of the test as a direct result of their hearing loss, which indicates the need for intervention. 

Examples of psychological/cognitive tests:
·      Weschler Intelligence Scale for Children  (WISC)
·      WPPSI for younger children, WAIS for students age 17 and older

How are you involved with student assessment?

Saturday, December 12, 2015

Assessment Considerations for Students with Hearing Loss: Part One

December! How is it possible that we are almost half way through this school year? Many of my students have evaluations coming up in the spring and I’ve already begun working with my teams to ensure comprehensive testing in the next few months by meeting with teachers, discussing concerns and progress with parents, and analyzing my own session notes. I am not always the one to administer the tests, but I am always involved in the analysis and offering expertise on hearing loss. Sometimes I am even able sit in during the testing, since the school professionals who administer formal tests likely have experience with the administration and analysis, but may not understand how hearing loss impacts the results. Additionally, school staff may not have an understanding of the best tests to administer in order to get an accurate picture of our students’ skill levels.

The following areas must be addressed in comprehensive testing for students with hearing loss. In addition, I have listed some tests that your team may want to  consider when assessing students with hearing loss. Every student has different needs and therefore different tests are appropriate in each situation and many more assessments are available, not just the ones I’ve listed here!

This week I’ll cover speech, language, and self-advocacy assessments. Next week, I’ll go over assessments in the areas of audition, academic/reading/writing skills, and psychological/cognitive abilities.

Speech: Speech assessments are most often administered by the student’s SLP. It is still necessary for the TOD/HOH to be part of the analysis of test results. As TODs, we understand how auditory access impacts speech production. Comparing articulation errors to the student’s audiogram and using our knowledge of hearing technology, we can work with SLPs to set high (but reasonable) expectations for articulation goals. For example, we know that students with cochlear implants may not have great access to short vowel sounds and may need practice in discriminating and producing these sounds at the word or sentence level.  In contrast, a student with a high frequency loss may have limited or no access to high frequency speech sounds even with hearing aids. Such information shared with the SLP can enhance the productivity of speech sessions, rather than creating frustration for the SLP and the student.

Examples of speech tests:
·      Clinical Assessment of Articulation and Phonology (CAAP)
·      Goldman Fristoe Test of Articulation II

Language: Comprehensive language assessments will include vocabulary; relationships between words; and receptive and expressive language tests at word level, as well as in connected speech/passages.

TODs understand how hearing loss impacts language development and rather than simply looking at the percentile rank or standard score, we can analyze the test items that our students miss and look for patterns in the errors. The majority of my students are “average” according to their scores but with a closer analysis of the test items, patterns emerge and these are the areas I want to be sure to address during my time with the student in order to bridge the “gaps” we so frequently hear about. Again, even if I am not the one administering these tests, I always ask to meet with the test administrator and look at the breakdown of test items.

Additionally, language samples provide real life examples of what our students produce. Comparing formal testing with language samples allows for a more complete picture of our student’s language skills.

Examples of language tests:
Peabody Picture Vocabulary Tests – expressive and receptive vocab
·      Critical Evaluation of Language Fundamentals  (CELF )
·      Cottage Acquisition Scales for Listening Language and Speech (CASLLS)
·      Oral and Written Language Scales (OWLS-II)
·      Comprehensive Assessment of Spoken Language (CASL)
·      Test of Narrative Language (TNL)
·      Test of Written Language 4 (TOWL IV)

Self-Advocacy / Pragmatics: Karen Anderson has many tools that can be used with students of a variety of ages and abilities and I've described how I use some of them in an earlier post. Some are observational tools that I use in the classroom and others I fill out with teachers. A student-completed report is always included as well. Such assessments can be supplemented with anecdotal data from observations within the classroom. Areas to look at include pragmatics, social skills, the student’s understanding of and ability to explain his hearing loss and amplification, and the student’s ability and willingness to self-advocate.

Examples of self-advocacy tests:
·      Test of Pragmatic Language (TOPL)
·      Minnesota Social Skills Checklist
·      Placement and Readiness Checklist (PARC)

Stay tuned for my next post, in which I’ll discuss considerations for assessments in audition, academic skills, and cognitive abilities.

How are you involved with student assessment?

Tuesday, November 17, 2015

Parents are Critical Members of their Child’s Support Team

How much time do you spend on email and phone calls in a typical week? If your days are anything like mine then the answer is, “a lot!” In addition to working with school staff and students, communication with parents takes a great deal of time but is so important.

            Parents are critical members of the team and, as itinerant TOD/HOH, our role in communicating with families can sometimes be unclear to school staff and to parents themselves. In the worst-case scenario, school teams may feel threatened, wondering what it is we are reporting to the parents, and parents may view us as being in allegiance with the school at the expense of their child’s needs. However, in the best-case scenarios, parents and school staff welcome open communication and see it as a benefit to all. As TOD/HOH, we can take steps to regularly communicate in meaningful ways with parents and school teams in order to create trust among all team members.

            School teams must understand why we need to communicate with families and we must take steps to alleviate any fears or misunderstandings they may have about what it is we are reporting. One school I worked with expressed concern that the parents may view their child’s teacher as incompetent if I talked with them before and after my classroom observations. A staff member at another school informed me that my regular communication with families may make the teachers in the building look “lazy” as this type of communication was not standard at their school. I have also heard concerns related to being seen as a “spy” more than once! In each situation, in addition to building trust within the school in other ways, offering to CC (copy) relevant team members on emails to parents and summarizing phone conversations to relevant staff members, have both, over time, lessened these worries. Below are tips for keeping parents in the loop!

Start a phone or email routine: Find out how parents like to be contacted and let them know when you will be in touch. Some parents are worriers. These are the ones we hear from constantly. Others, for various reasons, are extremely difficult to get ahold of - even when we really need them! Set expectations at the beginning of the year that allow you to create boundaries while still meeting the needs of the families that you work with. For students who I see monthly or only a few times a year, I call or email parents before and after each visit. For students who I see more regularly, I contact families bi-weekly, either by email or phone with an update and to hear their concerns. Knowing that I will be in touch is reassuring for the parents.  

Video Share: Consider videotaping your work with a student on occasion and sharing it with the family. This is really helpful especially for families moving from early intervention to a school setting since the initial transition can be shocking! Parents go from being key players in their child’s learning to having very limited interaction, if any, during therapies! In some cases, I’ve videotaped my sessions (with permission) to share with families so that they can still feel connected. One parent reported playing the videos at home, giving her son extra “sessions” at home!

Communication Books: Use a communication book that goes home on a regular basis with the student where you and the parent share information. This is not a new idea but can be a very effective way of communicating for all students. It’s also helpful for me when students have multiple service providers who use the book so that I know what my student is working on in other settings and can stay up to date as well!

Online Documentation: Make use of today’s technology! A colleague of mine works in a school where each staff member and the parents contribute to an online document. This process is similar to a communication notebook but rather than the student bringing the book between home and school, all notes are done online.

Translations: Be aware and sensitive to parents who may not be English language users and find ways to communicate with them. I don’t speak Spanish but one of my families does! I am fortunate to have a colleague who can translate my letters home to this family. When they respond, my colleague translates for me once again. Bi-lingual parents may already feel left out of school information and I want to be sure my families know exactly what I’m doing with their children!

Hand Written Notes: Handwritten letters are always an option. Not all the families that I work with have consistent access to phones or computers but that shouldn’t limit communication!

The parents with whom I work have varying levels of participation in their children’s school programs. Some parents contact me almost daily, others I hear from more irregularly. Regardless, meeting parents where they are and helping them to stay involved is a critical component of this job. It is our job to reach out to all parents!

How do you work with parents?

Friday, October 30, 2015

Supporting Each Other: Teachers of the Deaf and Educational Audiologists

It’s a typical Monday. One of your students has a dead hearing aid battery. Another is experiencing some static through her FM system. In another classroom, the student pass-around microphone is no longer synced with the soundfield tower. As teachers of the deaf/hard of hearing we are called upon to troubleshoot, re-sync, inspect and clean amplification on a daily basis. We know our students and their equipment well and have no choice but to learn how it all works together! Teachers and other school staff come to depend on us to help resolve problems with the hearing technology, including equipment malfunctions. But this is only one part of our job as the bulk of our time is spent consulting with staff and directly instructing our students. The ideal situation would be if every school we work in had an educational audiologist on the team. School teams may not understand the need for both an audiologist and a TOD so we have to make efforts to help them understand the role we each play in the student’s education. When there is no educational audiologist on the team, there is generally little or no contact between the audiologist and the school. It is critical that the TOD and audiologist collaborate and communicate regularly to ensure optimal access for our students in school.

In explaining the differences and overlapping responsibilities of the TOD and audiologist to school staff, some factors to consider include:


Additionally, teachers of the deaf/hard of hearing see the application of hearing technology in the classroom and the student’s access. We have important information to share about a student’s academic progress, speech and language development, auditory comprehension and equipment use in the classroom. We must also communicate with the audiologist around problems with equipment in case adjustments need to be made. I find communicating with the audiologist via an email the easiest but phone calls or in-person visits are sometimes options as well.

Audiologists are knowledgeable about equipment and the student’s hearing needs from observing the student in the booth. They must communicate about technology to the TOD/HOH including changes in FM settings, adjustment to CI maps and HA settings (e.g. activation of noise reduction options) as this will affect the student at school. This information is often communicated in reports which can be sent directly to the TOD with parent permission.

Teachers of deaf/hard of hearing and audiologists are both important members of a student’s team. How do you collaborate with your student’s audiologists?