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Who’s Who on the DB Team – It Takes a BIG Village!

Parents and family:

Because we do not see them every day, the parents and family members of DB students are sometimes the last to be considered as members of the team. Especially in light of the fact that DB students often function very differently at home than they do at school, therapists who serve DB students owe it to themselves, and to the students they serve, to get to know the child’s parents and significant family members. This can be as simple as a yearly home visit followed up with monthly communication, or as complex as a daily log or notebook that documents more detail. Whatever way you choose, don’t miss the opportunity to round out your understanding of the DB child on your caseload by sharing information with parents and family.

Classroom teacher:

The DB child you serve may be integrated into regular education classes, or may be in an alternative classroom setting with a Special Education teacher. As a therapist, you’ll need to know whether or not the teacher’s background is in general education or special education so that you can decide how to best communicate your ideas and elicit her's.

Teacher of Students with Visual Impairments (TVI):

The TVI is a collaborator with the classroom teacher and all of the other professionals who interface with the student, including OT and PT. In successful teams, the OT and PT exchange information about students with the TVI on a regular basis. For instance, it is sometimes difficult for therapists to determine what, precisely, a child can see and how best to present materials for the child to be able to maximize use of available vision. The TVI can provide that information. Conversely, there are times when the TVI may be unsure what is appropriate to ask a student to do in terms of motor control or positioning supports, and the school therapist can determine what tasks are appropriate considering the child’s strength, range of motion and coordination. With this kind of information exchange, the student experiences consistency of expectation and approach from person to person. 

TVI s are responsible for:

  1. LMA: Learning Media Assessment. This assessment gives the whole staff information about how the child learns best. Some DB students learn best through tactile experience, others have enough vision that they can be visual learners. Others are primarily auditory learners. It is absolutely essential that you, as a therapist, know what the child’s best learning medium is. If you work with a student who has multiple disabilities without knowing what the LMA has identified as the primary learning medium, you may waste both your time and the student’s time.
  2. FVE: Functional Vision Evaluation. This evaluation tells you what and how the child can see. It will give you an idea what the near vision is (up to 14 inches from the face) and how the child’s distance vision (seeing objects up to 20 feet away) functions. The FVE will give educational implications for the student’s visual etiology, with recommendations for programming. All therapists should ask about the FVE results for DB students they serve in order to work with the child’s strengths, recognize limitations and adapt appropriately for maximum function.
  3. Instruction in Braille or other alternative written communication forms: TVIs support literacy in DB students by introducing Braille as both a reading and a writing medium when that’s appropriate. They are often directly involved in providing other alternatives for literacy, including optical devices and/or large print reading aids, as well as tactile and object symbols as tangible representational systems.
  4. Coordinating services with other professionals: It is not uncommon for the TVI to take on the role of coordinating services for the DB child. Precisely because there are so many people involved, it is critical to have one professional who looks at the total program of the child, and insures that it is meaningful to the student.

Teacher of the Deaf and Hard of Hearing:

Eligibility for the designation of “hearing impaired” relies on an ENT’s examination of the structures of the ear. Students are also referred to an audiologist who determines the level of audiological processing, identifies type and extent of hearing loss, provides information on whether the loss is progressive or stable, and suggests amplification or other remediations. In essence, eligibility rests on three points: medical assessment of ears, results of audiological consult, and ARD committee decision. Once eligibility is established, a teacher of the deaf is assigned to the team. The teacher of the deaf takes information from the student’s ENT and audiologist regarding the child’s hearing and translates that information into strategies in the classroom. These strategies could include determining what type of evaluation is most appropriate for the child, selecting the kind of amplification the student might best benefit from and providing the support needed for the child to use an amplification device. It might include determining how best to use tactile sign, how much to emphasize fingerspelling for children whose vision limits their ability to read it, etc. All therapists working with DB students need to know what the child can hear, and what kind of communication system – both receptive and expressive – is in place.

Deafblind Specialists:

We weren’t kidding about “It takes a big village” to teach a DB student. In addition to the teachers identified above, there are a number of other players on the DB team in most public schools in Texas.

  1. Regional Service Center Deafblind Specialist: Every Regional Service Center in the state now has a person on staff who is designated as the DB Specialist. Often this is a TVI, though it varies from region to region. Deafblind specialists are available for on-site consultation in programming, and serve as an information and referral source for families and school districts. They also help to provide technical assistance and professional development for people working with DB students in their region, and help direct information to families with DB children.
  2. TSBVI Outreach Specialist: The Texas School for the Blind and Visually Impaired Outreach Programs collaborate with regional education service centers (ESCs) to offer support and training to families and professionals serving blind and deafblind students throughout the state. Outreach Specialists are available to consult directly with school programs to develop programming for students with deafblindness from the ages of birth to twenty-two. One of these staff members is a Family specialist and is available to consult directly with families about any issue related to parenting a child with deafblindness. In addition, TSBVI Outreach Specialists provide training for staff and families in local school districts, develop materials about deafblindness, and network with schools, agencies, organizations and individualsaround developing supports to school-aged individuals with deafblindness.
  3. DARS DB Specialist: The Division of Blind Services employees four staff members to support DARS-DBS caseworkers and counselors working with a client who is deafblind. They focus primarily on finding and developing jobs for deafblind individuals. However, they also provide information to families ofchildren and youthwith deafblindness, lend support in identifying and advocating for services (including school services and services in the home) for deafblind individuals, and collaborate with other agencies who might serve individuals with deafblindness of all ages.

Classroom Paraprofessional:

Because they require such specific kinds of supports (alternative reading and writing media, sign or other representational system for communication, behavioral supports, etc.), DB students often have a classroom paraprofessional whose primary job is to help the student access the educational programming available. If you work with a DB student, you will need to get to know this person, and also observe the relationship between the paraprofessional and the classroom teacher so that you can support both of them as effectively as possible.


Some DB students have an aide called an “Intervener.” An intervener is an instructional aide who has specific training in deaf-blindness. Intervener training would include the information needed to implement the IEP objectives and individual modifications for a child with deaf-blindness. Interveners are specifically designated to work with a child with deaf-blindness for all or part of the instructional day based on the current need of the child. As a therapist, you’ll need to know what an intervener does because the intervener can give you very valuable information about how the child learns, what kind of a day the student is having, and much more.

Intervener References:

Orientation and Mobility Specialist (O&M):

Orientation and mobility training

O & M helps a blind or visually impaired child know where he is in space and where he wants to go (orientation). It also helps him be able to carry out a plan to get there (mobility). Orientation and mobility skills should begin to be developed in infancy starting with basic body awareness and movement, and continuing into adulthood as the individual learns skills that allow her to navigate her world efficiently, effectively, and safely.

O & M specialists work on these issues:

This list of skills makes it easy to understand why it is ALWAYS important for therapists to work in dialogue with O & M. See: Orientation and Mobility Training: The Way to Go

For students with deafblindness and other disabilities, including physical motor problems that result in mobility challenges, O & M can be challenging.

For a Comprehensive Look at Wheelchair Mobility for DB and VI students, please click to see the original pdf file: Orientation and Mobility Strategies for Low Vision Wheelchair Users PDF document (88k)