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School Based Therapy Training Module

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ASL:  American Sign Language. 
A note about ASL, identity and the Deaf community. There are two main types of deafness in American culture.  Those people who use ASL as their primary communication mode and who factor deafness into their identities often refer to themselves as Deaf  with a capital D.  People who have hearing impairments, but who can pass as hearing, and who have multiple forms of expressive communication (they may use ASL and spoken English, or signed English -depending on where they are) are often referred to as deaf  with a lower case d.  People with hearing deficits who function in the hearing world without relying on alternative communication devices, but who often use augmentation, are referred to as hard of hearing.
a surgically implanted electronic device that directly stimulates functioning auditory nerves links to another website inside the cochlea links to another website with electrical impulses so that severely Deaf people can receive and recognize sound. A cochlear implant is not a cure for deafness, it is a technological mediation. Sound is picked up by a microphone and a speech processor then filters the sound and prioritizes audible speech, which it sends to the transmitter via a thin cable. The transmitter (held in place by a magnet that is located behind the external ear) moves the sound to the internal receiver and stimulator.  The receiver converts the sound signals into electronic impulses that are sent to an array of implanted electrodes in the cochlear. From there, the sensory information travels to the scala tympani and on to the brain through the auditory nerve.  Cochlear implants are highly successful in terms of relaying sound to the nervous system, but that is only part of the process of hearing.  In the DB population, the results vary widely because the success of the cochlear implant relies on the students ability to meaningfully recognize and decode the sounds. 
USDA - Information on Cochlear Implants links to another website
National Institute on Deafness and Other Communication Disorders Information on Cochlear Implants links to another website
Vision for objects that are 20 feet or more from the viewer
The Expanded Core Curriculum (ECC) is the body of knowledge and skills that are needed by students with visual impairments due to their unique disability-specific needs. If you work with a DB student in a public school, you will likely hear discussions about the expanded core curriculum, especially when its time to write IEPs. Students with visual impairments need the expanded core curriculum in addition to the core academic curriculum of general education. The ECC should be used as a framework for assessing students, planning individual goals and providing instruction (From AFB links to another website ).

The Existing Core Curriculum

  • English language arts other languages, to the extent possible
  • mathematics science
  • health physical education
  • fine arts social studies
  • economics business education
  • vocational education history

The Expanded Core Curriculum

  • compensatory or functional academic skills, including communication modes
  • orientation and mobility
  • social interaction skills
  • independent living skills
  • recreation and leisure skills
  • career education
  • use of assistive technology
  • sensory efficiency skills
  • self-determination
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. BrokenXXLinkOutreach/seehear/winter04/intervener.htm
The primary, and most effective, means through which a student learns. DB students go through a Learning Medium Assessment that gathers three types of information:
  • The efficiency with which the student gathers information from various sensory channels: visual, tactual, and auditory
  • The types of general learning media the student uses, or will use, to accomplish learning tasks
  • The literacy media the student will use for reading and writing
Close range vision, typically 2 feet or less from the face
Some educators use signed English in the classroom instead of ASL.  Signed English is literal translation of words into sign.  American Sign Language is not direct literal translation of English into sign, but rather a complete language made of signs, which has its own syntax (patterns of word order).  Children who learn signed English may or may not be able to communicate with other children who use ASL.  In order to communicate effectively and avoid confusing the student with whom you work, school therapists need to know whether ASL or signed English is the preferred choice.


  1. DB-Link links to another website : Perhaps your most valuable source for all kinds of information on DB!
  2. Overview of Deafblindness links to another website . By Barbara Miles, a communication specialist and teacher who is considered a primary theorist in the field of deaf-blindness. Her overview includes discussion of strategies for relating to and teaching DB students.
  3. Effects of an Intervention Program To Foster Harmonious Interactions between Deaf-Blind Children and Their Educators.
    Authors:Janssen, Marleen J.; Riksen-Walraven, J. Marianne; Van Dijk, Jan P. M.
    Publication Date:2003-00-00
    Pub Types:Journal Articles; Reports - Evaluative
    Journal Name:Journal of Visual Impairment & Blindness
    Journal Citation:v97 n4 p215-29 Apr 2003
    Descriptors:Children; Communication Skills; Congenital Impairments; Deaf Blind; Elementary Secondary Education; Inservice Teacher Education; Interaction Process Analysis; Interpersonal Communication; Interpersonal Relationship; Intervention; Parent Child Relationship; Parent Education; Program Effectiveness; Staff Development; Teacher Student Relationship; Videotape Recordings
  4. Understanding and Preventing Learned Helplessness in Children Who Are Congenitally Deaf-Blind.
    Authors:Marks, S. B.
    Publication Date:1998-00-00
    Pub Types:Guides - Non-Classroom; Journal Articles
    Journal Name: Journal of Visual Impairment & Blindness
    Journal Citation:v92 n3 p200-11 Mar 1998
    Descriptors:Child Development; Communication Skills; Congenital Impairments; Daily Living Skills; Deaf Blind; Educational Practices; Elementary Secondary Education; Helplessness; Infants; Mastery Learning; Motivation; Personal Autonomy; Preschool Education; Skill Development; Training Methods; Visually Impaired Mobility
  5. Promoting Learning through Active Interaction. Project PLAI. Final Report. links to another website
    Authors:Chen, Deborah; Haney, Michele
    Publication Date:1999-06-10
    Pub Types:Reports - Research
    Descriptors: Child Development; Child Rearing; Communication Skills; Curriculum Development; Deaf Blind; Early Intervention; Infant Care; Infants; Interpersonal Communication; Parent Child Relationship; Parent Education; Parent Role; Parenting Skills; Theory Practice Relationship; Toddlers
  6. The Impact of Congenital Deafblindness on the Struggle to Symbolism
    Authors:Bruce, Susan M.
    Publication Date:2005-09-00
    Pub Types:Information Analyses; Journal Articles; Reports - Evaluative
    Journal Name:International Journal of Disability Development and Education
    Journal Citation:v52 n3 p233-251 Sep 2005
    Descriptors:Symbolic Learning; Cues; Object Permanence; Communication Disorders; Abstract Reasoning; Associative Learning; Visual Learning; Deaf Blind; Play; Child Development; Attention
  7. An Analysis of Communicative Functions of Teachers and Their Students Who Are Congenitally Deafblind
    Authors:Bruce, Susan; Godbold, Emily; Naponelli-Gold, Sarah
    Publication Date:2004-06-22
    Pub Types:Journal Articles; Reports - Research
    Journal Name: RE:view: Rehabilitation Education for Blindness and Visual Impairment
    Journal Citation:v36 n2 p81 Sum 2004
    Descriptors:Special Education Teachers; Deaf Blind; Nonverbal Communication; Verbal Communication; Interpersonal Communication; Communication Skills; Teacher Student Relationship; Models; Intervention
  8. Use of Activity Boxes with Young Children Who Are Blind, Deaf-Blind, or Have Severe Learning Disabilities and Visual Impairments.
    Authors:Dunnett, Jenefer
    Publication Date:1999-00-00
    Pub Types:Journal Articles; Reports - Research
    Journal Name:Journal of Visual Impairment & Blindness
    Journal Citation:v93 n4 p225-32 Apr 1999
    Descriptors:Deaf Blind; Experiential Learning; Foreign Countries; Infants; Intellectual Development; Learning Activities; Learning Disabilities; Motor Development; Multiple Disabilities; Preschool Children; Psychomotor Skills; Toddlers; Visual Impairments; Young Children
  9. Creating Classroom Environments That Nurture Independence for Children Who Are Deafblind links to another website. Final Report.
    Authors:Rowland, Charity; Schweigert, Philip
    Publication Date:2000-12-31
    Pub Types:Reports - Descriptive
    Available in Full Text format throught ERIC,
    Descriptors:Child Development; Classroom Environment; Cognitive Development; Communication Skills; Deaf Blind; Early Intervention; Multiple Disabilities; Outcomes of Treatment; Personal Autonomy; Physical Disabilities; Preschool Education; Severe Disabilities; Student Evaluation; Teaching Models. The project produced an inventory and manual to help teachers identify natural cues for certain behaviors and arrange the social and physical environment to facilitate learning.
  10. Overview on Deaf-Blindness. DB-LINK Fact Sheet. Revised.
    Authors:Miles, Barbara
    Publication Date:1998-12-00
    Pub Types:Guides - Non-Classroom
    Journal Name:
    Journal Citation:
    Descriptors:Adults; Adventitious Impairments; Caregiver Role; Children; Communication Skills; Congenital Impairments; Coping; Deaf Blind; Etiology; Individual Development; Interpersonal Communication; Language Acquisition; Physical Mobility; Quality of Life; Social Integration
  11. Educational and Behavioral Implications of Missing Balance Sense in CHARGE Syndrome links to another website, by David Brown
  12. Understanding Balance Problems in Children with CHARGE Syndrome. links to another website George Williams and Timothy Hartshorne.
  13. Sensory integration dysfunction in deafblind children links to another website. Gail Deuce.
  14. Developing Concepts With Children Who Are Deaf-Blind links to another website. Barbara Miles,
  15. What a Concept! --Durkel, Jim, CCC-SPL/A. Texas School for the Blind and Visually Impaired, Outreach. SEE/HEAR, vol. 5, #2, Spring 2000, pp. 10-14. (2000) This article addresses the importance of concept acquisition in developing communication skills for children with deafblindness. It stresses the importance of teaching a child the concepts in place with meanings for words that are readily understood by the child in the first two years of life. This may be done through varied "hands-on" experiences in which the child can learn to develop concepts for different environments, and opportunities for exploration and play. Available in Spanish.
  16. Admiraal RJC, Huygen PLM. 1997. Vestibular Areflexia as a cause of delayed motor skill development in children with the CHARGE association. International Journal 0f Pediatric Otorhinolaryngology, 39, 205-222
  17. Brody J. Occupational Therapy For Young Children With Visual Impairments and Additional Disabilities.
  18. Brown D. in press. CHARGE Syndrome Behaviors  Challenges or Adaptations? American Journal of Medical Genetics
  19. Colby Trott M, Laurel MK, Windeck SL. 1993. SenseAbilities: Understanding Sensory Integration. Tucson, Arizona: Therapy Skill Builders.
  20. Forney PE. Wolff Heller K. 2004. Sensorimotor Development: Implications for the Educational Team. In: Orelove FP, Sobsey D, Silbermann RK editors. Educating Children with Multiple Disabilities: A Collaborative Approach. Baltimore: Paul H Brookes.
  21. Gregory BB. 1999. Physical Therapy and Occupational Therapy in CHARGE Syndrome. In: Hefner M, Davenport SLH, editors. CHARGE Syndrome: A management manual for parents. Columbia, MO: CHARGE Syndrome Foundation.
  22. Liefert FK. 2003. Expanded Core Curriculum: Orientation and Mobility. In: Goodman SA, Wittenstein SH, editors. Collaborative Assessment: Working with Students Who Are Blind or Visually Impaired, Including Those with Additional Disabilities. New York: American Foundation for the Blind.
  23. Maynard S. 1999. The Impact of Sensory Integration Dysfunction in CHARGE. In: Hefner M, Davenport SLH, editors. CHARGE Syndrome: A management manual for parents. Columbia, MO: CHARGE Syndrome Foundation.
  24. Stock Kranowitz C. 1997. The Vestibular System and Auditory-Language Process links to another website.
  25. Stock Kranowitz C. 1998. The Out of Synch Child: Recognizing and Coping with Sensory Integration Dysfunction. New York: Berkley Publishing Group, Skylight Press.

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