Tracking Auditory and Self-Advocacy Development

The school year is about half over and assessment and progress monitoring are on everyone’s mind. A colleague and I were just recently in San Diego leading a training that included assessment, school teams are beginning to discuss upcoming spring IEP meetings, and progress reports and report cards are on the horizon. Recently, the itinerant teachers at Clarke’s east coast campuses were able to meet via Skype and the topic of discussion? Assessment. While formal assessments occur every three years for students on IEPs, ongoing monitoring and less formal assessments are necessary in order to track progress, look for gaps in knowledge and ensure that we continue to move our students forward. There are many charts and tools, but below are a few of my favorites for tracking auditory and self-advocacy skills. I hope you find them useful as well!

Functional Auditory Performance Indicators(FAPI)

http://www.tsbvi.edu/attachments/FunctionalAuditoryPerformanceIndicators.pdf

The FAPI is an observation tool designed for use with young children and new listeners. A variety of listening conditions are assessed in the areas of sound awareness through linguistic auditory processing. I complete the FAPI with input from the entire team for several reasons. Completing the FAPI together draws the teacher’s attention to the variety of listening situations that I am observing regularly, which helps the teacher think critically about the development of auditory skills. There are always going to be aspects of the school day that I do not see, so input from the teacher helps provide a complete picture.  It is also a nice way to look at where the student is and where we want him or her to go, opening up conversations regarding inclusion of auditory skill development in the classroom.

Functional Listening Evaluation / Nonsense Sentences

http://www.handsandvoices.org/articles/education/ed/func_listening_eval.html

Functional Listening Evaluations show how students with hearing loss perform under a variety of listening conditions. The link above from Hands & Voices summarizes the objectives, materials and procedures. Specific training is required in order to perform and report on Functional Listening Evaluations correctly. Your local audiologist may be able to guide you in getting trained. While Functional Listening Evaluations can be helpful in determining the potential benefit from consistent use of FM systems, hearing aids, and cochlear implants in the classroom, the evaluations require extensive training, practice, and consistent collaboration with an audiologist. When a full listening evaluation is not able to happen, the Nonsense Sentences can be used independently to help create self-awareness. An excerpt from a Nonsense Sentences write up may look something like this:

Cottage Acquisition Scales for Listening Language and Speech  (CASLLS)

http://www.sunshinecottage.org/index.php/educational_products/our_products/caslls/

The CASLLS are my favorite way of analyzing expressive language! Tracking language development from Pre-Verbal through Complex Sentences, the CASLLS can be used with students at a variety of language levels, and progress can be documented easily over time. I find it challenging to record language samples in writing, so I give my student materials, ask the student to tell me a story and then video tape while the student narrates. I’m then able to transcribe the language sample and complete the appropriate level CASLLS.

Karen Anderson

http://successforkidswithhearingloss.com/building-skills-book

I’ve mentioned Karen Anderson’s book in a previous post, but this is the go-to source in our office for quick auditory and social scales.

Listening Inventory for Education- Revised (LIFE-R)

http://lifer.successforkidswithhearingloss.com/

The LIFE-R is an inventory completed by the student with hearing loss. I use the LIFE-R to open discussions with my student around difficult listening situations and also share with classroom teachers during consult time. For students who are not able to read the questions, I read them aloud as well as the choices.

Placement and Readiness Checklist (PARC)

http://www5.esc13.net/thescoop/deaf-ed/files/2011/12/PARC_2011.pdf

PARC is a checklist that can be used during conversations regarding the most appropriate placement for students with hearing loss when full-time mainstream placement is in question. It looks at a variety of classroom skills and situations and can support difficult placement discussions.

Minnesota Social Skills Checklist

http://www.clarkeschools.org/uploads/files/mainstreaming/Minnesota-Social-Skills-Checklist.pdf 

The Minnesota Social Skills Checklist can be used with students with hearing loss in preschool through high school and it looks at areas such as self-concept, friendship, and pragmatics. This is another tool that can be used over time to highlight areas of need as well as show progress.

A related tool is the Minnesota Compensatory Skills Checklist which assesses the students understanding of his hearing needs as well as advocacy and management of amplification.

http://www.clarkeschools.org/uploads/files/mainstreaming/CompensatorySkillsChecklist.pdf

Teacher (or Parents) Evaluation of Aural / Oral Performance of Children

TEACH:

http://outcomes.nal.gov.au/Assesments_Resources/TEACH%20ratings%20with%20coverpage%20260509.pdf

PEACH:

http://outcomes.nal.gov.au/Assesments_Resources/PEACH%20ratings%20with%20coverpage%20260509.pdf

The TEACH and PEACH are tools developed in Australia that I like to use with preschool children and early listeners. Teachers complete the TEACH and parents complete the PEACH. As with other scales, I like to work with the team when completing the TEACH and PEACH so that we can have conversations regarding our observations and goals for the student. One of my favorite aspects is that they are narrative which allows for open responses, there are no multiple choice questions so they can seem less judgmental.

Encouraging Class Participation

There are many reasons to encourage our students to participate in class. It helps the teacher get a better sense of what our students know and where they need clarification. It allows typically hearing peers to see the student with hearing loss as an equal contributor to the class. Participation empowers our students as they are heard and acknowledged. However, participation does not always come naturally; it is a skill that often must be taught. When I observe in a classroom, participation is one of the many things I look for. How does my student’s participation compare to that of his or her peers? Participation means knowing that a peer is speaking and turning to face that person; raising a hand to answer a question; responding verbally when called on; initiating interactions during small group work; responding to a comment made by a peer – the list is vast and varying.

For elementary students, the classroom teacher plays a leading role in helping all students learn how to participate.  Most classrooms have rules for participation around what good listeners do. Many have systems in place where the person speaking stands. One fourth-grade teacher I worked with required students to summarize what the previous person said before commenting to ensure that all students were listening to each other (e.g. “Jack said he thinks the answer is _______, but I think…”). Often, elementary classrooms have agreed upon visual cues that students can use to indicate that they share the same idea or perspective (such as a hand signal). When these systems are not in place naturally, we must work with teachers to set up good listening and participation expectations for the whole class.

At times, even with clear expectations, my students report reluctance to participate in class for a variety of reasons, ranging from fear of being wrong to feelings of discomfort regarding their speech quality. Knowing why a student is hesitant helps me strategize with the student. One of my third graders reported that she did not like to answer questions in class because she didn’t want to be wrong in front of her peers. Yet, when I checked in with her, she often had the correct information! In order to help my student overcome her fear of speaking in class, I devised a system with her classroom teacher. The teacher gave me a list of questions she was planning to ask during a period of instruction and my student had to choose one that she was comfortable answering. She was able to write in her response, knowing that while I observed, the teacher would call on her to answer that question. Having the answer written out in front of her, she knew that she could not be “wrong.” She was initially anxious, but after a few times using this method she began to relax and her participation gradually increased, even without previewing all the questions.

Another elementary student had the opposite problem. Wanting so desperately to appear knowledgeable in front of his peers, he raised his hand to answer every question, called out responses, and went on tangents giving far more information than was necessary to answer the question. The frustration was noticeable as his peers rolled their eyes or groaned every time his hand went up. My student and I spent time observing together, paying attention to how other students responded to questions and shared information. Working with his teacher, we set up a system where he had three marbles in his desk, which equaled three participation turns during an instructional period.  Each time he answered a question or made a comment, he had to give a marble to his teacher. Knowing he could only answer three questions, this helped my student self-regulate and make contributions that were more thoughtful and meaningful. It also gave others a chance to contribute. He no longer needs the marble system and his contributions are appreciated by his peers rather than dreaded.

With my older students, I share my observation notes and we are able to have candid conversations about what I’ve observed, set goals and strategize to make participation more meaningful. For one student, this initially meant tallying how many times she turned to look at a peer who was speaking. Once she mastered that skill and could articulate the importance, she commented that she often missed what a soft-spoken boy said, realizing that she was missing his answers to questions as well as information he contributed to the discussion. She later implemented the communication repair strategies we practiced together (e.g. “I heard you say_____but missed the last part.”). Now, this student is working on commenting on what her peers say, rather than just focusing on answering her teacher’s questions. She reports that she is feeling more connected to her peers, participating in the debates and discussions that happen in class rather than being an observer.

For high school students, support with participation may look different for each student. One student brings me oral presentations so that we can practice together and write in words phonetically to build her confidence when presenting. Another student was placed in a history class that involved many group projects. Together, we outlined her individual strengths as a group member (note taking, organization of ideas, layout and artistic design of visual supports, oral presentation) as well as areas of weakness and skills she should look for in a partner (written syntax, grammar, transitions between topics).  Her teacher reported that she handled group projects in a surprisingly mature manner and showed leadership skills that she had not demonstrated previously.

Our individual time with students is important, but classroom time must be meaningful as well. I strive to make sure my students are “heard” in the classroom just as much as their typically hearing peers. What helpful strategies have you seen related to class participation?

A Positive Sense of Self

My second grade student doesn’t just think his hearing aids are cool, he knows that they are cool! He looks on with amazement as I check them at the start of our sessions, softly exclaims, “Cool!” as I remove wax from the tubing, and quickly flips to a designated page in my notebook where he can give himself a “check plus” for reporting a dead battery earlier in the day. He wears his hearing aids like a fashion accessory, showing off his new orange and yellow marbled earmolds.

My current junior high student is also very comfortable with her hearing loss. She gave her elementary school graduation speech last year to a room full of parents, teachers and friends. She articulately described learning that some students with hearing loss attempt to hide their technology, going on to talk about how that never even occurred to her.

These students are confident and proud, but unfortunately not all of the students we serve feel this way. What happens when our students do not have accepting attitudes about their hearing loss and hearing technology? How can we help them to see themselves in a more positive light?

I have two new students this year, one in high school and one in upper elementary school. During the beginning-of-the-year “Getting to Know You” activities, it quickly became clear that both were embarrassed by their hearing technology. Each student expressed feelings of isolation and anxiety over being “different.” Both were reluctant to express their needs to teachers for fear of “annoying” them.  I began a series of activities designed to help these students to set goals in order to gain a greater sense of self-confidence.

During our individual sessions, each student identified areas she feels confident advocating, and areas she does not yet feel comfortable. Building on their individual strengths, we created short-term goals for each student to improve self-advocacy and self-acceptance. For the high school student, we started by reviewing her audiological records and standardized testing so that she could gain a deeper understanding of her abilities. My student was surprised to learn that her standardized tests placed her in the average intelligence range. My student had always perceived herself as being “stupid,” and this glimpse into information adults knew but never shared was key for countering her inner critic.

Her next goal was to create a Powerpoint presentation about her hearing loss and listening needs and present it to all of her teachers. She did an amazing job! Finally, she met with a disabilities services counselor to discuss accommodations available for college and the job market. Currently, we are researching deaf adults who are working in my student’s field of interest. Seeing successful adults with hearing loss achieve their dreams has helped to change her perspective on her own abilities and potential. Her newfound confidence has shown up in other ways, as well; during a recent observation, I saw her change her hearing aid battery in class, rather than leaving the room as she’s done in the past. I consider that a step in the right direction in terms of acceptance of her hearing technology and of herself.  

For my elementary student, we agreed that she would tell one new person about her hearing loss each week, carry her FM transmitter between classes, and create a Powerpoint presentation to share with teachers. She expressed concern that she is the only one in her school with hearing loss. To address this concern, we are in the process of setting up a mentor relationship with an older student with hearing loss. Her teachers and family are on board and supporting her in these short-term goals.  Beaming, this student recently reported that she told the staff at the after school program that she wore hearing aids (her “person of the week”), “And they just said, ‘Ok, cool. So what do you need me to do?”  

The work is not done. It will be an ongoing process throughout their lives but the more we can help our students see the good in themselves and take those difficult steps towards self-advocacy and self-acceptance, the more opportunities will open for them in the future. Everyone has something to work through and at times I know I am pushing my students to their limits in acknowledging their personal struggles. However, it is important to help these students surpass the boundaries they've set for themselves. Making connections with other students with hearing loss as well as successful adults helps our students to see the endless opportunities ahead of them. Patience, listening, and support are key components to the work we do. I do not have a hearing loss. I’ve never experienced the emotions my students describe. But I can be a sounding board for ideas, an ear for frustration and fear, and a cheerleader to celebrate every small victory on the path to self-acceptance.

How do you help your students accept their hearing loss and hearing technology?

Maximize FM Use

So, you went out and introduced yourself to everyone in the schools where you work, right? Perfect! Now you’re going to need the IT department and it’s a good thing you know each other J

Schools spend a great deal of money on FM systems for our students and it is our job as the itinerant teachers of the deaf to make sure that teachers are maximizing the use of the FM. I want to highlight a few of my favorites strategies here.

How many times have you walked into an assembly to find your student with no access to the person who is speaking? During assemblies, there are often multiple speakers making it necessary to pass the microphone from one person to another. Some of the speakers may have no experience with the proper placement of the FM microphone. It can also be cumbersome for the speaker(s) to wear the FM transmitter while talking into the main auditorium microphone. I have the perfect solution! In one school, we used rubber bands and a ruler to attach the FM transmitter to the auditorium microphone. I listened through a student’s hearing aid while another adult spoke– it sounded good! My students also reported improved access with this method as opposed to the shuffling of the FM transmitter back and forth.

                                                

When a classroom does not have a pass around microphone for peers to use, teachers often comment on the difficulty of passing their transmitter around for discussions. Generally, students do not know how to hold the transmitter microphone unless they have been explicitly taught, and my students with hearing loss complain of hearing “scratching” as it is passed around the room, impeding their access even further! My colleague shared the picture below of one clever solution:

                                               

Made from rulers and tape, students are now able to hold and pass the transmitter- without any scratching sound! Instantly, access improves!

Media shown on the Smartboard or other projectors is becoming more and more common in classrooms. While our students with hearing loss have visual access through the use of captions, they deserve to have equal auditory access as well. One of my cochlear implant users spoke with me about the poor quality of sound she perceived when the microphone of her FM transmitter was placed near the Smartboard speaker. Determined to resolve the problem, she and I investigated! We went online, we called audiologists, we called the FM manufacturer- there was an inexpensive solution… a splitter! I was able to purchase a splitter for under $10 at a local audio store. Connecting the splitter to the FM transmitter was not so simple (here's where IT comes in). I spoke with the head of the IT department at the school and he met me one morning in the classroom before students arrived. He knew what to do right away and was able to set up the splitter. Now, the class hears the media though the Smartboard speakers and my student gets the audio sent directly to her CI through her FM receiver. Because each classroom technology set up is different, I have enlisted the help of the IT department at each school where I work to help me set up splitters. I have had 100% success. I highly recommend it!

                                                           

What are other ways you maximize FM use for your students ?

“Sometimes You Wanna Go Where Everybody Knows Your Name"

After I hear the buzzer, I open the heavy front door and turn left. I need to sign in and get my visitor badge before picking up my student. I hear an excited squeal as I approach the office. One of my favorite receptionists stands in front, leaning over the front desk. “Let’s see what shoes you’re wearing!” she exclaims, grinning. “I heard those heels and I knew it was you!”

Because we work in so many different schools, the life of an itinerant can sometimes seem like a lonely one. But, with some effort, it is possible to build meaningful connections with teachers, receptionists, paraprofessionals, and administrators all over the state! I’ve grown as an educator by observing teachers of all grade levels throughout the day. I’m invited to the monthly breakfasts before school and the baby showers after.  I feel elated! I feel connected! I feel like a member of a team!  And -- most importantly -- because everyone knows who I am, my students get what they need in their schools.

As itinerants, it takes time and persistence to build connections with the numerous people in each school building, especially when we are only there once a week or once a month. Yet, when we are able to build meaningful relationships with the staff at each school, the benefits to our students are immeasurable.  When a receptionist knows my name and the name of the student that I work with, she is more likely to help me arrange a quiet space for our direct service pull-out. When a paraprofessional understands my role, and his own support is validated, he is more likely to remember to text me when my student is out sick (and save me a long drive). When a classroom teacher views me as a colleague, he is more likely to implement my suggestions for providing visual access during instructional periods. When an administrator views my student's in-service PowerPoint or iMovie (hand delivered by myself and my student, of course!), he is more likely to follow though on acoustical modifications in the classroom. When a principal understands my role and how it is different from that of the other service providers, she is more likely to suggest services for additional students with hearing loss in the building.

It’s never too late to build connections, even months after the school year has begun. If you have not been introduced to a key person on the student's team, take a moment to seek that person out and introduce yourself. If administrators do not know your student by name, help your student set up an informal meeting where he or she can share a project or a piece of writing you are working on together. There will come a time when support is needed and having connections with school staff can help you get your student what he or she needs. Do you know everyone?

Special Education Director
Rarely visible in the school buildings, it may be easiest to call or email to introduce yourself and explain your role. Mention anyone on the team who has been particularly helpful to you. All administrators like to hear positive feedback about their staff!
Principal and Vice Principal
Introduce yourself by stopping by the office(s). Share highlights of your work with the student and, again, identify any teacher or paraprofessional who has made a difference in your work.
Receptionists and Guidance Counselors
The receptionists tend to know all the details of how the school is run! Be sure to greet them by name as you sign in. Guidance counselors have power in schools. If your student needs something changed or adjusted, it will be easier if you have a relationship with the guidance counselor.
School Nurse
The nurse can often be involved in the daily listening check and troubleshooting of amplification. Make sure you connect!
Cafeteria Workers­­ and Custodians
A colleague recently shared a story about a cafeteria worker who was not aware of a student's hearing needs and reprimanded a peer for walking over to speak to the student with hearing loss when the cafeteria rules state that students must remain seated. Everyone needs to know who our students are and how their needs may vary in each setting.
The IT Department
From enabling captions to helping you with splitters and audio adjustments, these are your go-to people in every building!
“Specials” Teachers and Paraprofessionals
Modifications may be necessary for art, music, P.E. etc. The Clarke resource, Have You Heard?contains handouts that can be shared with these professionals. Paraprofessionals often attend "special" classes with the students. If they are informed and trust your suggestions, carryover is more likely to happen throughout the student's day.
Librarians
Librarians are great resources for information and may also be willing to purchase books featuring characters with hearing loss for the school library. One of my students wrote a letter to her librarian requesting that these books be purchased as part of a project on persuasive writing. I met with the librarian prior to having my student deliver the letter so that I could explain the project. This librarian not only purchased books but engaged the student in every step of the process!
Teachers
Classroom teachers, special education teachers, reading specialists, writing specialists… you should connect with every adult working with your student on a regular basis. Collaboration is key!
Speech Language Pathologists
We often collaborate closely with the S/LP on the student's team --  a strong working relationship is important.
Every Person You Meet in the Hall
“Hi! I’m Heather. I’m the teacher of the Deaf working with _______ this year. I don’t think we’ve met?” Take a minute to say hello - you might end up working with this person at some point in the school year!

How do you connect with key people at your schools?

Strategies for the Reluctant FM User

As a teacher of the deaf and hard of hearing, I love FM!  FM systems – wireless devices made up of a transmitter and receiver– can make it feel like the teacher’s voice is right next to the student’s ear. The signal-to-noise ratio is improved!  Attention improves! Who wouldn’t want this? The answer is, unfortunately, many of our students. The excuses are endless: “The receiver sticks out.” “I can’t hear the other students.” “Oh, I don’t need it in this class.” “FM doesn’t actually help me that much so I’m not going to use it.” “I think it’s broken.” “I don’t want to carry the transmitter around all day.” And on, and on, and on…

Still, achieving FM success is possible, even with the most reluctant user. The first step to ensure that the equipment is in working order is to ask the student how it is functioning and to listen to it yourself. The sound should be consistent, not intermittent, with no static or distortion. The teacher of the deaf should also check with the managing audiologist to be sure that the students’ hearing aids have been verified using Real Ear to Coupler Difference (RECD) and for transparency. Proper settings will ensure proper amplification. It may be true that your student does not perceive sound as he or she should.

Students who do not feel that they benefit from FM may need to develop a greater sense of self-awareness as part of their self-advocacy program. Using the Common Phrases auditory checklists or the Listening Inventory for Education- Revised (LIFE-R), both available from Karen Anderson, can help students identify areas where they struggle with auditory comprehension. If students are not aware that they are missing auditory information, they will not see any need for a resolution! These tools are designed to help students better understand what and how they hear.  Students must understand why these inventories are being used so that it doesn’t feel like the teacher is merely pointing out flaws. Such tools can also be used with younger students who use FM willingly to emphasize the benefit and prevent future rejection.

Students often comment that they are not able to hear their peers as clearly when the FM is in use and therefore reject using it. For some CI users, this may be due to the internal settings of the processor map and may be resolved by having the managing audiologist adjust the mixing ratio in the student’s cochlear implant speech processor(s). This will ensure that the student is receiving a proper signal from the environmental microphone when an FM system is in use. Requesting a copy of the student’s cochlear implant MAP will allow you to see the settings in the speech processor when connected to the FM.  Audiologists want the best for their clients, and as the teacher of the deaf, you are in a position to help the audiologist maximize the student’s access.

Include the student in choosing a class where they can try out the FM system for the first time. We know that the FM is designed to reduce the signal-to-noise ratio and is most beneficial for students in larger classes. With that being said, large classes may actually be the most uncomfortable setting for our reluctant FM users to begin a trial. I often work out a compromise with my students and begin the FM use in one class each day, typically a small class where the student feels more comfortable, and with a teacher who will be supportive. For students who are willing to use FM in some classes but not others, it is important to find out why – perhaps the teacher is not muting and unmuting the microphone appropriately, making it difficult for the student to concentrate or follow along. Students may also need a listening break and not even realize it! Choosing not to use FM during some classes may be their way of getting this reprieve from concentrating. With this knowledge, you can work with your student to find alternative times for listening breaks.

Encourage classroom teachers to support the student in FM use but not to pressure them or embarrass them in front of their peers. One of my reluctant FM students recently reported, “[Teacher] keeps saying, ‘Well, that’s what your FM is for. Bring it to class,’ in front of everybody. It’s just annoying.” I have a trusting relationship with this student, and like many teenagers, her resistance to the equipment grows as outside pressure to wear it increases. I have since had conversations with teachers encouraging them to allow me to be the “bad guy” around FM use since the student and I have an agreed-upon plan. If you do not have a trusting connection with your reluctant FM user, find out who does and guide that person in helping begin consistent FM use.

Most importantly, listen to what your reluctant FM user is telling you. Many legitimate concerns can be addressed through adjustments to the FM programs, building self-awareness, or starting slowly. Although I’d love every student to start the year using the FM full-time in every class, I know that patience, and slow integration of FM – as well as making my student a partner in decisions regarding FM use – will pay off in the long run! Still not convinced? Listen to what my high school student, Stephanie, has to say!

(To access captions, view the video on YouTube.)
Try these strategies with your reluctant FM user and let us know how it goes! What other strategies have you used successfully to help your student accept an FM system?