Preparing for the IEP Meeting: Booklet

As your IEP meeting approaches, you may want to create a booklet that highlights your child, and provides the IEP team with important documents that help the team decide on appropriate educational services.

Table of Contents:

1. Evaluation Team Report: Part B

• This document will be provided at the Eligibility Meeting that establishes the child has educational need and an IEP must therefore be developed.

2. Future Planning Statement


3. Did You Know?


4. Deaf Students Education Services: Policy Guidance


5. Essential Issues and Aspects of the IEP


6. IEP Checklist


7. Preschool Observations

• I wrote a summary for all area preschool options, including main-stream, cross-categorical and hearing impaired programs. Information included basic program offering (days, times, etc.), age span of children, number of peer language models, communication modes, personnel (teachers of the deaf, special education, general education, etc.), general observations (including lighting, treatment to reduce noise, spill over noise), on-site services (including speech, OT, PT, etc.), auditory training curriculum used and a summary (including daily schedule, snack time interaction, general learning environment, peer interaction, etc.)

Sample of the page dividers we used. We made them

in our school colors, just to show our school pride!

Preparing for the IEP Meeting: Future Planning Statement

As your IEP meeting approaches, you will want to prepare a "Future
Planning Statement". This part of the IEP is for parents to express their goals,
wants, needs and aspirations for their child. It can be very simple, with short-term goals.
Or, it can be very detailed, with long-term, complex goals. Below is our "Future Planning
Statement" from Drew's IEP:

We see the first five years of Drew's life as a critical window where he
needs intensive intervention to establish his communication and listening skills
that he will need in all future educational and life experiences.

In the short term, we see Drew attending [school we requested as educational
placement]. The program will offer Drew extensive, structured and specialized
education curriculum's specifically designed for the hearing impaired child. The
goal for these preschool years is to establish an appropriate foundation of
communication, language, listening and literacy that will hopefully allow him to
integrate into a mainstream Kindergarten class in [our home school district]
with minimal or no services and accommodations.

If Drew receives this appropriate education, we see Drew graduating from High
School and attending college or post-secondary education, should he choose to do
so. We see Drew as a positive, contributing member of society, who is able to
support himself and his family both financially and emotionally, without letting
his deafness define him.

Yeah, that about sums it up.

Drew Update

So, what has Drew been up to these days?

Drew loves playing outside! He has had so much fun helping rake leaves, playing in the leaves and mowing the lawn?!




He mowed for quite some time, making sure to stop and say "Hi!" and "Bye!" to Daddy each and every time. I just love the quality of his voice. And I just love how truly sweet this little boy is!

And here is video of the dinner ritual with Drew. I was truly spoiled by my first born, who will eat just about anything. She will try just about anything! But not my little Drew! He usually starts saying "I don't want that!" before dinner even hits the table. It's just lovely.

It certainly is annoying, but I love the fact that he is able to tell me with his own, whiny words that he "doesn't want to eat that food!" It's just tuna noodle casserole. Who wouldn't want to eat it?

Determining Eligiblity: Relevant Medical Information

During the evaluation process, your school district should ask you for a statement of "Relevant Medical Information". Below is the information we provided to our district.

Andrew was born with profound hearing loss in both ears. The cause of
the hearing loss is genetic defect in the Connexin 26 gene, which disrupts
potassium flow in the inner ear that prevents the hair cells’ stimulation of the
auditory nerve. The hearing loss was diagnosed at birth, and was later
found to be at least 90 decibels in each ear.

Drew obtained bilateral hearing aids in December 2006 at 8 weeks old. With the
amplification, audiological testing showed that Drew was only able to hear at 70
dbs for the lower frequencies. This level of hearing would include an airplane overhead, but no speech sounds or other typical environmental sounds,
such as a doorbell, or dog barking. Parents never saw any reaction to sounds
when Drew was using his hearing aids.

Drew’s parents were aggressive in their quest for Drew to hear. After traveling to St. Louis, Cincinnati, and Cleveland to consult with experts in the field of newborn
hearing loss, cochlear implants, and oral-deaf education, they decided to pursue
simultaneous bilateral cochlear implants, which were almost unheard of at that
time. Not only was it rare for persons to have two cochlear implants, but it was
even more rare for a child to receive two during the same surgery.

After interviewing and comparing three surgeons for this new and relatively untested surgical procedure, they finally found a surgeon in Columbus who would implant Drew simultaneously at a young age. They then fought the FDA guideline which suggested children be at least 12 months old before receiving a cochlear implant, arguing that implanting him at 8 months of age would give him a better chance at having normal speech.

Andrew continued wearing his hearing aids until he received simultaneous cochlear
implants, which were first activated at age 9 months. These implants were
activated fully by age one. Activation involves slowly turning the
implants on so that he gradually became accustomed to hearing. The
cochlear implant is an array of 22 electrodes inserted in the cochlea of each
ear, with an accompanying magnetic receiver which is implanted in his
skull. Andrew wears external processors on each ear, which are programmed
by a skilled pediatric audiologist. The external pieces consist of microphones
which pick up sound, the processor which “codes” the sound, a magnetic receiver
(referred to as a coil) which transmits the electronic stimulus to the internal
parts. His mother described his hearing as “electronic” and not natural, often
referred to as acoustic. Drew will never hear as well as a hearing person does,
and he will never hear more than a slice of the frequencies others do.
Fortunately, his implants are programmed to pick up most of the speech
frequencies.

Immediately following activation, Andrew began aggressive auditory training with professionals specifically trained in teaching deaf children how to listen and speak. Drew has attended therapy a minimum of two hours a week in a formal, clinical setting. These therapists have been instrumental in ensuring the processors are mapped appropriately, that Drew is meeting listening and language milestones and for his overall language and communication progress. This therapy has been essential in the development of spoken language for Drew.

Potential Problems
1) Equipment Maintenance

His mother noted that equipment issues are very common
and impact Andrew’s ability to hear properly. Faulty baby worn wires,
coils, dirty microphone covers, loose batteries and cracked controllers can
cause the speech processor to turn off. Dirty microphone covers can muffle the
sound being coded by the speech processor. Some potential areas that could
affect microphone clarity include dirt, sand and moisture. Also, if anything is
placed over Drew’s ears, such as a hat or hood, ability to hear is compromised.

2) Internal Failure

An additional area of concern is breakage of the internal parts. A fall or bump at the “right” spot on the head can cause the magnetic receiver or electrode array to break. This would require surgery, and the process of reprogramming (referred to as mapping) would be extensive.

3) Static Electricity

Static also presents a problem. A static charge can trigger the processor to turn off, or in the case of a strong static charge, can erase the map on the processor, which would
require an appointment with the audiologist. Areas to avoid include plastic play
equipment and fleece clothing.

4) Ear Infections

Ear infections can cause the equipment to work inefficiently, and have the potential
to cause an infection around the implant which could require its removal.
Fortunately, he has had very few ear infections, and all ear infections are
treated aggressively by Drew’s ENT/Surgeon.

5) Moisture

The speech processors (“ears”, as they are referred to by
Andrew and his family) are not allowed to get wet, so he can not wear them when
swimming or bathing. Andrew is now able to take his “ears” off by
himself. He is also now able to sometimes let his parents know when
they are not working.

6) Hearing In Noise and Sound Localization

Lastly, noisy situations, including classrooms, restaurants and the outdoors, can be difficult for Andrew, as sound localization and quality is affected.

Educational Implications

His parents judge Andrew in need of continued auditory training/listening therapy, in order to develop his communication skills and ultimately literacy skills. They
would like a preschool teacher, specifically one for the deaf, who would
reinforce what he learns in an auditory training program, which will fine tune
his ability to listen within his environment and will benefit him significantly
when he moves to the mainstream.

As cochlear implant maps change over time, his parents daily check his hearing using the ling six sounds. Drew’s teacher will also be expected to review Drew’s ling sounds each morning as he arrives at school. Lings are six sounds (/oo/, /e/, /m/,
/sh/, /ah/, and /s/) that predict well his ability to hear all other English
phonemes. This check needs to be conducted in a variety of conditions, such as with noise, at a distance of 6, 9 or 12 feet and when the speaker is using a listening hoop. An equipment check is required at the beginning of each day to make sure the processors are on and working.

Another concern is literacy. Knowing that adult deaf people have an average reading level of fourth grade, the parents are concerned about Drew’s ability to learn to read. While speech alone is a huge concern, reading and greater literacy is a task that will be learned over many years. Drew’s Mom reports having struggled with literacy and knows how frustrating those struggles will be.

Drew needs to have an intensive literacy program, with teachers that are trained in teaching the deaf to read to provide a foundation that can be built upon during the school age years. Without this foundation, the parents are very concerned that Drew will fall behind and require significant intervention throughout his entire school career. With appropriate preschool education, they are hopeful that his needs will be minimal once he is of school age. The primary goal is literacy, with speech being only
one part of being literate in society at large.

Other concerns include, but are not limited to, articulation, consonant deletion, consonant production through listening only (using a listening hoop where the speakers mouth is concealed) and grammar. Drew has also developed an issue with speech production, where he will “stutter” as he searches for the word(s) he needs to
answer a question or to convey his need(s).

Eligibility for Special Education - School Age

After the initial transition meeting, a multi-factored evaluation must be completed by and at the expense of the school district of residence if there is a suspected disability (as determined at the 120 Transition Meeting). For our deaf or hard of hearing children, currently enrolled in birth to three years of age services, this transition through the evaluation and writing of the Individual Education Plan should be seamless. Our case, as you know, was everything but seamless.

The evaluation process is supposed to be very detailed, with testing of the child in a variety of settings completing a variety of tasks. The testing performed on Drew was completed in one setting, an isolated, small, quite therapy room. In addition, only one test was administered. The PLS-4 was completed in this setting, and Drew's IEP team, including myself and Drew's Dad, his EI therapist, a parent advocate, and then representatives from the school district, attempted to determine educational needs off of this one test.

Here's the problem: The PLS-4 sucks. It's basically like a vocabulary test, which when administered to a deaf child with any almost-normal language makes them look like an absolute genius. It's completed in a quite - seriously quite - environment, and allows for rephrasing and gestures. Seriously. If the speech therapist didn't think Drew understood her the first time, she would rephrase her question and allow him additional time to answer. What a joke! Will he get that extra time in a noisy classroom? Will the teacher even know he struggled to understand the context of the sentence? Will the teacher constantly repharse her directions until Drew understands? Heck no!

I seriously sat in my chair as the test was administered knowing there would be an issue if the district was only going to base my son's needs off of this test. To give an example, in the expressive category of the test, the school therapist could not find a threshold level of language for Drew. She stopped the test at 60 months (or five years of age). He never got more than two answers in a row incorrect. I mean, it was really quite disgusting. Of course, I know the amount of work, therapy, language that went in to that score, but I knew the school district would take that test as basis for denying my son services. (And I was right...)

Here's the thing about the whole evaluation process: No one, no one, understands hearing loss! At our MFE Meeting, where eligibility for an IEP is determined, Drew's Dad and I spent forty-five minutes explaining Drew's aided and unaided audiogram, cochlear implants and their educational impact and the effects of hearing loss on children in a classroom setting. The school district representative didn't even know what the threshold for normal hearing children is, nor did she understand that even with his cochlear implants, Drew's hearing is not restored to normal levels. Her comment when we explained cochlear implants? "That's fascinating!" Oh, it is just disgusting.

After a three-and-a-half hour meeting trying to establish Drew eligible for services, the meeting ended with the Special Education Agency representative storming out of our meeting. It was eventually decided, over the course of a week, that additional testing needed to be administered in order to determine Drew's educational needs. (Of course we knew this going in to the original testing, as it is supposed to be a multi-factored evaluation, and I can hardly see how an evaluation takes in multiple factors when only one test is administered, but I am just the Mom.)

Below is the evaluation that was conducted that resulted in eligibility. I would strongly encourage parents to make sure that the TACL-3, Goldman-Fristoe Test of Articulation and SPICE are administered, as they are excellent at identifying the speech sounds that our children can not hear, and omit in their speech. This is the summary:

Drew was seen on August 27, 2009, to further assess his auditory and articulation skills. He was accompanied by his mother. This assessment session lasted for approximately 90 minutes and Drew again exhibited an attention span and ability to focus on structured activities that appears more mature than his age. Testing was administered in a relatively quiet room with Drew sitting on his own in a chair, approximately 6 feet from a low volume air conditioning unit. Testing was alternated between listening and speaking tasks, in order to help Drew maintain his attention. He needed to return to some tests to complete sections.

Drew was administered the Test for Auditory Comprehension of Language, Third edition (TACL-3). Norms for 3-0 year olds were used to derive his scores. Drew obtained a TACL-3 quotient of 102 (mean=100, s.d.=10), which is within the average range. He obtained the following sub test standard scores (mean=10, s.d.=2): I. Vocabulary=8, II. Grammatical Morphemes=11, III Elaborated Phrases and sentences=12. Drew’s sub test scores were all within the average range. During this assessment, Drew demonstrated difficulty identifying both simple and elaborated sentences, characterized by lengthy pausing, repeating sentences quietly a few times and looking to the examiner for clarification, and reviewing picture choices. Lengthier pauses of up to 20 seconds were noted on 4 out of 17 sentences during the Grammatical Morphemes sub test and 5 out of 15 sentences during the Elaborated Phrases and Sentences sub test. Single repetitions of TACL-3 sentences are allowable following pauses of more than 10 seconds for children younger than 5-0. Drew required at least one repetition and extra time before responding to almost half of all sentences presented. Sometimes he required 2 and 3 repetitions of sentences, including simple structures such as “The cat is in the box.”, “The boys ran.”, and “She jumped rope.”

Sections of the Speech Perception Instructional Curriculum and Evaluation (SPICE) were attempted, in order to screen selected auditory skills. During more casual conversations on familiar topics, Drew was observed to respond more readily than he did during structured sentence comprehension tasks. He demonstrated an ability to delay and correctly repeat back modeled sentences following demonstrations with toys during play. He did continue to require extra processing time, repetitions, rephrasings and exaggerated key words intermittently, in order to respond in conversations. Drew responded to most simple questions and some more complex questions accurately. He was able to comment back with related statements readily, when presented with statements that he understood. When Drew did not understand a question or statement, he often did not respond and/ or would smile and look to the examiner for more information. Due to Drew’s level of fatigue, he was unable to respond to tasks, requiring him to identify among SPICE word sets of up to 4 choices or maintain his attention for a large enough sample of oral directions with one to two key words varied.

Drew was administered Simple Consonant Steps 1 and 2 sections of the Phonetic Level Speech Evaluation and items 1 through 26 of the Goldman Fristoe Test of Articulation 2. These tests were used to obtain information on Drew’s ability to auditorally discriminate and produce sounds when imitating syllables and words. Results of the Phonetic Level Speech Evaluation indicate that Drew can consistently imitate single syllables with initial position /b,p,w,f,m,n,y/ sounds, using only audition. Drew was inconsistent in imitating single syllables with initial position /v/ and /h/ using only audition. He was able to improve or repair both /v/ and /h/, through speech reading and tactile cues. Drew was unable to imitate syllables with voiced or voiceless /th/, final position /p,t,d/ and initial position /sh,s,z,l,/ using only audition. It should be noted that Drew produces most of these consonant sounds (except /th/), that he could not imitate in syllables correctly, when producing familiar words in connected speech samples. Specific substitution errors noted when Drew imitated syllables during this test were: vowel for /h/, /d/ for /t/, /s/ for /z/, /n/ for /y/, voiced /th/ for /z/, /l/ for voiced /th/, /p/ for /t/, and /b/ for /v/. Drew also demonstrated the following substitutions when imitating or identifying words during administration of the Goldman-Fristoe and TACL-3, that are related to difficulty with auditory discrimination of consonant sounds: /h/ for /k/, /t/ for final position /p/, and /t/ for final position /k/. These sounds were also noted as correctly produced in familiar words produced by Drew, during connected speech samples. Consistent substitution errors with voiced and voiceless /th/, /l/ (vocalized and glided), /r,er/ (glided and vocalized) were again noted in connected speech samples and when imitating words included in the Goldman Fristoe Test of Articulation 2. These later types of errors are common in children Drew’s age with normal hearing, although he may have difficulty discriminating them. Because Drew was unable to complete the Goldman-Fristoe Test of Articulation 2, he did not obtain a standard score for this test. Remaining words included consonant clusters. Drew has shown emerging skills with /s/ and /z/ clusters and inability to produce /l/ and /r/ clusters in connected speech samples.

After the completion of a more multi-factored evaluation, Drew was found to be a student of educational need under the category of Hearing Impaired - Deafness (who would have thunk?). Below is Drew's Educational Need Statement:

Drew has difficulty identifying/comprehending both simple and elaborated
sentences. Drew needs direct instruction to: improve and practice his
comprehension skills, to maintain development of his auditory memory skills,
which will help reduce processing time, and he needs to acquire and maintain
these skills at a pace typical of his age group. Drew needs to apply these
skills to verbally indicate his need for clarification when he doesn't
understand.

Drew needs direct instruction on phonetic listening skills in order to better
produce and discriminate among phonemes, especially for those sounds he doesn't
hear well, in order to improve overall auditory skills. Further development of
phonetic skills will improve his understanding and use of word endings and
sentence endings.

Drew needs to maintain expressive and receptive vocabulary at a level typical
for his age group. To do so, he will require direct instruction, which will
include ample practice along with repetition and review.

Happy Halloween!

Love, Tinkerbell and Batman

Story Books

Wow! Have you seen these?

I've been working on uploading our family pictures from the year - I'm a little behind. And I happened to see these books! I have not ordered one, so I don't know exactly what they look like, but to me, they seem like a perfect thing for our little HOH/deaf kiddos! There is one about birthdays, bed time and farm animals. Too cute.

Enjoy!