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from Spring 97 issue

CHECKLIST FOR DEAFBLIND CENSUS OF TEXAS

To be considered as deafblind for the purposes of being included in the Federal census and receiving services from Deafblind Outreach, a child (birth to 21) would have to meet at least one condition in each of the three areas (Hearing, Vision, Developmental Concerns). CIRCLE ALL APPLICABLE

Suggested uses for this CHECKLIST
1) To evaluate each of the students in special education
2) To present to parents as a tool to help develop an understanding of their child's needs for program modification because of sensory deficits.
3) To keep in child's records.

Hearing

(* examples/definitions at end of this section)

1. Documented auditory handicap meeting Texas eligibility requirements as cited in the commissioner's/SBOE rules

or

*2. Documented unilateral hearing impairment (conductive, sensorineural or mixed) of at least 15 dB

or

*3. Documented bilateral hearing impairment (conductive, sensorineural or mixed) of at least 15 dB

or

*4. Documented syndrome, disease or disorder associated with hearing loss

or

*5. Documented syndrome/disorder associated with a progressive hearing loss

or

*6. Diagnosis of a central auditory processing disorder (CAPD) by a speech/language pathologist and an audiologist. A psychologist or diagnostician may also participate in the diagnosis

or

At Risk

*7. Documented chronic/persistent otitis media

or

8. Caregivers/professionals who know the child suspect impaired hearing based on the following:

a) significant and otherwise unanticipated delay in receptive and/or expressive speech-language skills
b) responses to full range of auditory stimuli in the environment is less than anticipated

or

*9. Ototoxic medications

or

10. Prematurity

or

*11. Balance problems

*EXAMPLES for Hearing

2/3. A conductive hearing loss is caused by problems in the outer ear or middle ear (e.g.) blockage of the car canal, damage to the ear drum, problems with the bones in the middle ear, fluid in the middle ear.

A sensorineural hearing loss is caused by nerve damage to the inner ear.

A mixed hearing loss is a combination of conductive and sensorineural impairments.

4. List of syndromes/diseases causing hearing loss:

• Bacterial meningitis
• CMV

5. List of syndromes/diseases causing progressive losses:

• CMV
• Norrie Syndrome
• Goldinhar Syndrome
• Hurler Syndrome

6. Reports from professionals may include such terms or descriptions as:

• central auditory processing problem
• central auditory processing dysfunction
• difficulty in understanding what is heard

7. Otitis media/middle ear infection when chronic (lasting longer than 3 weeks) and recurring can inhibit language/communication development.

9. Some common ototoxic substances:

• antibiotics: tetracycline, streptomycin
• anticancer drugs: methotrexate, aminopterin

11. Some balance problems may be caused by structural damage to the inner ear which may also result in hearing loss.

Vision

(* examples/definitions at end of this section)

1. Documented visual handicap meeting Texas eligibility requirements as cited in the commissioner's/SBOE rules

or

2. Documented monocular vision (vision in one eye)

or

*3. Documented syndrome, disease or disorder associated with vision loss

or

*4. Documented syndrome/disorder associated with a progressive vision loss

or

*5. Diagnosis of cortical visual impairment from an ophthalmologist and/or neurologist

or

6. Documented visual impairment of 20/70 or worse after correction in better eye or a loss in visual field

or

At Risk

*7. Diagnosis of nystagmus

or

*8. Diagnosis of untreated amblyopia after the age of 6 years

or

*9. History of untreated eye condition, such as cataracts, during the first three years of life

or

*10. Visual perceptual problems

or

*11. Impaired visual-motor functioning resulting from strabismus or cerebral palsy

or

12. Prematurity

or

13. Caregivers/professionals who know the child suspect visual impairments because visual attending and/or visual examining behaviors are less than anticipated

Examples for Vision

3. Some examples of syndromes or disorders associated with loss of vision include:

• Congenital cataracts
• Retinopathy of Prematurity
• Retinal Blastomas
• Noonan Syndrome
• Morquio Syndrome
• Marfan Syndrome

4. Some examples of disorders associated with progressive or fluctuating vision loss include:

• Retinitis Pigmentosa
• Usher Syndrome
• Glaucoma

5. Cortical visual impairment results in difficulties in processing visual information.

7. Nystagmus is an involuntary rapid movement of the eye.

8. Amblyopia is uncorrectable blurred vision due to disuse of the eye.

9. Cataracts are a clouding of the lens of the eye.

10. Examples of visual perception problems:

• Child may be observed to overreach or underreach for objects
• Child may misjudge where the food is on a plate
• Child may be confused by color or texture of walking surface

11. Strabismus is a deviation of the eyes so they are not simultaneously directed to the same object.

Developmental Concerns

1. At least one year delay on developmental assessments or one standard deviation from score expected on the basis of chronological age on standardized assessments in one or more of the following areas:

• communication skills (including speech and language)
• social skills
• spatial awareness and orientation
• basic concepts
• academic achievement
• visual and/or auditory guided movement
• self-help

or

2. At risk for problems with independent living and/or competitive employment upon graduation from high school

or

3. At risk for problems with integration into family life/community activities

or

4. At risk of getting hurt when walking/moving around independently

or

5. Under the age of 5 years