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Educational professionals are aware of the requirements under IDEA that each child in special education will have “a full and individual initial evaluation, in accordance with §§300.532 and 300.533, before the initial provision of special education and related services to a child with a disability under Part B of the Act.” 

IDEA notes:

(b) A variety of assessment tools and strategies are used to gather relevant functional and developmental information about the child, including information provided by the parent, and information related to enabling the child to be involved in and progress in the general curriculum (or for a preschool child, to participate in appropriate activities), that may assist in determining—

(1) Whether the child is a child with a disability under §300.7; and

(2) The content of the child’s IEP.

Additionally: 

(g) The child is assessed in all areas related to the suspected disability, including, if appropriate, health, vision, hearing, social and emotional status, general intelligence, academic performance, communicative status, and motor abilities.

(h) In evaluating each child with a disability under §§300.531-300.536, the evaluation is sufficiently comprehensive to identify all of the child's special education and related services needs, whether or not commonly linked to the disability category in which the child has been classified.

It is important that we be sure about how both vision and hearing function in children who we know are deaf or hard of hearing or who are visually impaired or blind, if we want them to be successful in their educational settings.  Children with multiple disabilities certainly need the best possible functioning of their vision and hearing to help them overcome their physical and/or cognitive challenges.  We need to always be asking ourselves as educational professionals, how is this child using his/her vision?  How is he/she using his/her hearing? 

Sometimes we think that a child may have problems with hearing and vision, but for some reason we are not sure.  Perhaps the child has other additional disabilities that make it hard to test for vision and hearing loss, or maybe the child has been getting by okay and is suddenly starting to fall behind.  Whenever we suspect there is something wrong with either of these senses, we MUST follow-up and try to learn more.  Not only because the law requires that we do, but as caring professionals, we want to make sure the child has as few obstacles as possible to learning.  If he or she needs some special accommodations, modifications or instructional strategies, we want to make sure he/she receives them.

This manual was developed to help guide an educational team, especially the Teacher of the Deaf and Hard of Hearing and the Teacher of the Visually Impaired, through a process of checking on the student’s ability to use both of his distance senses so critical in classroom instruction.  These materials are intended as tools.  There is no requirement to use these forms or this process.  There may be other tools that work equally well or better than these.  Please feel free to copy these forms and use them as you like.  Let us know what was helpful and what needs changing. 

About the Development of This Document

This document was developed by a group of individuals over a period of two years between in 2000 and later field tested throughout Texas.  We would like to thank the individuals who gave their time to participate in this process:

Core Group

  • Robbie Blaha, Teacher Trainer, Texas DeafBlind Project
  • Leigh Crawshaw, Deaf Education Teacher/ Private Consultant
  • Tina Herzberg, Education Specialist, Education Service Center Region 12
  • Ann Johnson, Deaf Education Consultant for the Northeast Texas Cluster
  • Kate Moss, Teacher Trainer, Texas DeafBlind Project
  • Shelia Mosser, Teacher of the Visually Impaired, Killeen ISD

Other Contributors

  • Ann Adkins, Teacher Trainer, Texas School for the Blind and Visually Impaired, Visually Impaired Outreach
  • Gigi Brown, Early Childhood Specialist, Texas Deafblind Project
  • Janet Chlapek, Teacher of the Visually Impaired, Temple ISD
  • Ramona Egly, Deaf Education Teacher, Killeen ISD
  • hris Krasusky, Special Education Coordinator for AI/VI, Killeen ISD
  • Jenny Lace, Teacher Trainer, Texas Deafblind Project
  • Stacy Shafer, Early Childhood Specialist,
  • Texas School for the Blind and Visually Impaired, Visually Impaired Outreach
  • Heather Sullivan, Deaf Education Supervisor, Temple ISD
  • Amy Tange, COMS, Cypress-Fairbanks ISD
  • David Wiley, Transition Specialist, Texas Deafblind Project

 

Students who are Deaf or Hard of Hearing at Risk for Vision Loss

Students who are Blind or Visually Impaired at Risk for Hearing Loss

Hearing Quick Check

Vision Quick Check

Return to a Process for Identifying Students with Deafblindness (Birth-22)

As a Teacher of the Visually Impaired, you are aware of the importance of hearing for a child with a visual impairment. The Functional Vision Evaluation and the Learning Media Assessment both consider how the child uses his/her hearing for learning. Here are some things that you should try to determine through parent and staff interviews and/or the student's records. (Adapted from the Checklist for Deafblind Census of Texas)

  1. Does the student have a documented auditory impairment meeting Texas eligibility requirements as cited in the Commissioner's Rules?
  2. Does the student have a documented unilateral hearing impairment (conductive, sensorineural, or mixed) of at least 15 dB?
  3. Does the student have a documented bilateral hearing impairment (conductive, sensorineural, or mixed) of at least 15 dB?
  4. Does the student have a documented syndrome, disease or disorder associated with hearing loss?
    • Bacterial meningitis
    • Cytomegalovirus (CMV)
    • CHARGE
    • Usher Syndrome
    • Down Syndrome
    • Microcephaly
    • Rubella
  5. Does the student have a documented syndrome/disorder associated with a progressive hearing loss?
    • Cytomegalovirus (CMV)
    • Norrie Syndrome
    • Goldenhar Syndrome
    • Hurler Syndrome
  6. Does the student have a diagnosis of a central auditory processing disorder (CAPD) by a speech language pathologist or an audiologist? May also be called central auditory processing problem, central auditory processing dysfunction, auditory neuropathy. ORDoes the family or staff report the child having difficulty understanding what he is hearing?
  7. Is the student at risk for hearing loss? Factors to alert to include:
    • Documented chronic/persistent otitis media
    • Caregivers/professionals who know the child suspect impaired hearing based on:
      • significant and otherwise unanticipated delay in receptive and/or expressive speech-language skills or
      • Responses to full range of auditory stimuli in the environment is less than anticipated
      • Ototoxic medications such as those given for cancer, serious infections, etc.
      • Prematurity
      • Balance problems
      • Family history of hearing loss

Other risk factors include:

  • Drug or alcohol consumption during pregnancy
  • APGAR scores lower than 4 at one minute and below 6 at five minutes (APGAR scores measure newborn vital signs at birth)
  • Low birth weight (below 3.5 pounds)
  • Neonatal jaundice at birth requiring transfusion
  • Craniofacial anomalies
  • Visible malformations of the head, neck or ears including middle and/or inner ear structures
  • Family history of permanent or progressive hearing loss in childhood
  • Childhood injuries (especially skull fracture, sharp blow to the head or ears, loud noise exposure, and items accidentally inserted into ears resulting in damage)

Speech and language development are impacted greatly by hearing impairment. Even mild to moderate impairment can have dramatic consequences, especially if the child also has some type of vision loss. Below are typical milestones for a child with normal hearing according to the Alexander Graham Bell Association for the Deaf and Hearing Impaired. Be sure to visit their website at www.agbell.org for more detailed information.

Average Speech and Hearing Behavior by Age Level

Birth-3 Months

  • Startled by loud sounds
  • Soothed by caretakers' voices

3-6 Months

  • Reacts to the sound of your voice
  • Turns eyes and head in the direction of the source of sounds
  • Enjoys rattles and noisy toys

7-10 Months

  • Responds to his/her own name
  • Understands "mama," "dada," "no," "bye bye" and other common words
  • Turns head toward familiar sounds, even when he/she cannot see what is happening: e.g., dog barking or paper rustling, familiar footsteps, telephone, person's voice

11-15 Months

  • Imitates and matches sounds with own speech production (though frequently unintelligible), especially in response to human voices or loud noises
  • Locates or points to familiar objects when asked
  • Understands words by making appropriate responses or behavior: "Where's the dog?" "Find the truck."

15-18 Months

  • Identifies things in response to questions, such as parts of the body
  • Uses a few single words; while not complete or perfectly pronounced, the words should be clearly meaningful
  • Follows simple spoken directions

2 Years

  • Understands yes/no questions
  • Uses everyday words heard at home or at daycare/school
  • Enjoys being read to and shown pictures in books; points out pictures upon request
  • Interested in radio/television as shown by word or action
  • Puts words together to make simple sentences, although they are not complete or grammatically correct: "Juice all gone" "Go bye-bye car"
  • Follows simple commands without visual clues from the speaker: "Bring me that ball." "Get your book and give it to Daddy."

2 ½ Years

  • Says or sings short rhymes and songs; enjoys music
  • Vocabulary approximately 270 words
  • Investigates noises or tells others when interesting sounds are heard: Car door slamming, Telephone ringing

3 Years

  • Understands and uses simple verbs, pronouns and adjectives: Go, come, run, sing, me, you, him, her, big, green, sweet
  • Locates the source of a sound automatically
  • Often uses complete sentences
  • Vocabulary approximately 1000 words

4 Years

  • Gives connected account of some recent experiences
  • Can carry out a sequence of two simple directions: "Find your shoe and bring it here." "Get the ball and throw it to the dog."

5 Years

  • Speech should be intelligible, although some sounds may still be mispronouncedsuch as the /s/ sound, particularly in blends with other consonants (e.g., "street", "sleep", "ask").
  • Neighbors and people outside the family can understand most of what your child says and her grammatical patterns should match theirs most of the time.
  • Child carries on conversations, although vocabulary may be limited
  • Pronouns should be used correctly: "I" instead of "me" "He" instead of "him"

 

The Assessment of Deafblind Access to Manual Language Systems (ADAMLS) is a re­source for educational teams who are responsible for developing appropriate adaptations and strategies for children who are deafblind who are candidates for learning manual lan­guage systems. Our scope here is intentionally narrow; however we want the reader to remember how complex the approach to instructional strategies for children with deafblindness can be and we encourage you to refer to the resources listed.

A child who is deaf or hard of hearing depends heavily on the visual channel to access information and interaction. Sign language, fingerspelling and speechreading are visual by definition, and vision loss can greatly affect the ability of the child who is deafblind to access these modes of communication. Because little or no attention has been focused on this problem, it is typically not addressed in evaluations. As a result, many qualified students are considered incapable of learning these language systems, and educators may be so unfamiliar with adaptations and strategies to teach them that the child fails to show progress. Effective teaching practice requires that the influence of vision loss on the acquisition and use of manual communication forms be fully considered so that appropriate adaptations can be implemented.

The assessment tool should be used for all children with a dual vision and hearing sen­sory loss (deafblindness) in educational settings that use a form of manual communica­tion. Communication is the means by which a child gains access to the curriculum and to education generally. Therefore, if there is a breakdown in this critical exchange, the child is essentially denied the right to a free and appropriate education. We hope the ADAMLS provides unique and important information in a user­friendly manner to fulfill a need that exists in the field of deafblindness.

Download the assessment.

Return to a Process for Identifying Students with Deafblindness (Birth-22)

As a teacher of the deaf and hard of hearing, you are aware of the importance of vision for the child with a hearing impairment or deafness. Here are some things that you should investigate through parent and staff interviews and/or the student's records. (Adapted from the Deafblind Census of Texas Checklist)

  1. Does the student have a documented visual impairment meeting Texas eligibility requirements as cited in the Commissioner's Rules?
  2. Does the student have a vision loss in one eye only?
  3. Does the student have a documented syndrome, disease or disorder associated with vision loss?
    • Congenital Rubella Syndrome
    • CHARGE
    • Down Syndrome
    • Cerebral Palsy
    • Prematurity
    • Meningitis
    • Congenital cataracts
    • Prematurity
    • Hydrocephaly
  4. Does the student have a documented syndrome/disorder associated with a progressive vision loss?
    • Usher Syndrome
    • Leber's Congenital Amaurosis
    • Hurler's Syndrome
    • Glaucoma
  5. Does the student have a diagnosis of cortical visual impairment, which results in difficulties in processing visual information, from an ophthalmologist and/or neurologist?
  6. Does the student have a documented visual impairment of 20/70 or greater after correction in better eye or a loss in visual field?
  7. Is the student at risk for vision loss? Factors to alert to include:
    • Diagnosis of nystagmus (an involuntary rapid movement of the eye)
    • Diagnosis of untreated amblyopia (uncorrectable blurred vision due to disuse of the eye) after the age of 6 years?
    • History of untreated eye condition, such as cataracts (a clouding of the lens of the eye), during the first three years of life
    • Impaired occulomotor functioning resulting from strabismus (a deviation of the eyes so they are not simultaneously directed to the same object) or cerebral palsy or other neurological impairments
    • Prematurity
    • Caregivers/professionals who know the child suspect visual impairments because visual attending and/or visual examining behaviors are less than anticipated
    • Family history of vision loss
    • Childhood injuries especially blows to the head
    • Craniofacial anomalies
    • Drug or alcohol abuse of parent during pregnancy
    • Low birth weight

ABC CHECKLIST FOR VISION OBSERVATION AND HISTORY

It's as simple as A, B, C!

There are three common areas to look for when determining whether a child has a vision problem. A simple A, B, C Checklist can help you along the way! Your job is to be a good observer of the child's eyes and activities. If you have any questions about the vision of a child, please talk to a teacher, a school nurse, or a doctor. Many vision problems can be corrected, if caught early. Be a vision detective and identify vision problems early!

A = APPEARANCE

Do eyes look normal?

  • Eyes turn in or out
  • Crusty or red eyelids
  • Different size pupils or eyes
  • Swelling of eyelids
  • Conjunctivitis (Pink eye)
  • Drooping lid(s)
  • Any other observation about "eyes that just don't "look right"?

B = BEHAVIOR

Teacher/Parent Observation

  • *Tilts head, covers or closes one eyes for critical seeing
  • Difficulty in keeping place while reading -a "finger" reader
  • Disinterested in activities involving critical seeing
  • *Excessive stumbling, awkwardness or daydreaming
  • *Holds printed material in unusual position
  • *Has (reported) difficulty seeing at night or in the dark.
  • Other behaviors the child does that seem to indicate vision problems.

C = COMPLAINTS

Child's Statements or Your Observations that the Child Might be Experiencing Discomfort During Visual Tasks

  • Eyes hurt or blur while reading
  • Headaches when reading
  • Words move or jump about when reading
  • Double vision
  • Eye problem following a blow to the head
  • Cannot see the chalkboard
  • *Cannot see well at night or in dark situations
  • *Eyes hurt or bother child when in bright lighting
  • Other complaints or observations that might mean a child is experiencing discomfort during visual tasks

*Underlined items may be an indication of problems with field loss.

Reprinted from Vibrations Newsletter of Colorado Services for Children who are Deafblind, Winter 2000 Edition with adaptations by Region 12 Deafblind Stakeholder Committee.

Download form in RTF (75k)

Direct Service
CATEGORYLOW NEEDS - 1AVERAGE NEEDS - 3HIGH NEEDS - 5SCORE
VISION
  • No "severe vision loss" noted on eye report, but ability to attend to visual stimuli is questionable
  • Uses vision very well in a variety of settings
  • Very sure of functional vision
  • Visual diagnosis made over 1 year ago
  • Vision is not expected to change in the next 6 months
  • Able to attend to visual stimuli
  • New visual skills being developed
  • Visual diagnosis made 1 year ago
  • Unsure of functional vision
  • Difficulty attending to visual stimuli
  • Vision fluctuates
  • Severe vision loss or totally blind
  • Prognosis for improved visual functioning appears to be good (CVI, ROP)
  • Progressive loss of vision expected in next 6 months
  • Visual diagnosis made less than 1 year ago
DIRECT SCORE
HEALTH
  • Very Medically Fragile
  • No health concerns
  • Some health concerns (nutrition, etc.)
  • Chronic ear infections
  • Very premature/low birth weight
  • Significant time spent in hospital
DIRECT SCORE
OTHER IMPAIRMENTS
  • No additional impairment
  • Additional impairment
Two or more additional impairments DIRECT SCORE
DEVELOPMENTAL
  • No developmental delays
  • Very slight developmental delays
  • Vision loss may be contributing to developmental delays
  • Modifications needed
DIRECT SCORE
FAMILY MEMBERS/PRIMARY CAREGIVER
  • Does not want additional professionals making weekly home visits
  • Understands about their child's vision
  • Distressed about issues other than this child (Financial, Marital, etc.)
  • Does not readily participate in parent child trng.
  • Needs help learning about the educational systems
  • Want additional resource info
  • Need information about getting the most out of ophthalmological appointments and interpreting reports
  • Has lots of vision related concerns
  • Needs lots of info about their child's vision
  • Needs additional support
  • Grief issues about vision
  • Needs help bonding with child
  • Needs help reading child's communicative cues
DIRECT SCORE

 

Consulting Service
CATEGORYLOW NEEDS - 1AVERAGE NEEDS - 3HIGH NEEDS - 5SCORE
PROFESSIONALS ON TEAM
  • All have experience working with babies with similar vision
  • No questions about ECI or ISD procedures
  • Few questions about ECI or ISD procedures
  • Few questions about assessment, stategies, etc.
  • Have no experience working with child with visual impairment
  • Need training in implications, modifications, strategies, communicative cues, etc. for child with VI
CONSULT SCORE
VI TEACHER (Activities in Support of Instruction)
  • Has significant experience working with babies, babies with visual impairments, and babies with multiple impairments
  • Has moderate experience working with babies, babies with visual impairments, and babies with multiple impairments
  • Has little or no experience with babies
  • Needs time to learn from other professionals on team (Motor, Handling, Communication, Infant Development, Working with Families, etc.)
  • Suspected or diagnosed auditory impairment
ACTIVITIES IN SUPPORT OF INSTRUCTION SCORE
OTHER    
  • Child actively explores environment
  • Needs adaptations to learn basic concepts
  • Needs help to generalize skills
  • Needs more exposure to concrete experiences to develop language skills
  • Body imaging, spatial awareness
DIRECT OR CONSULT SCORE
*PROFESSIONAL JUDGEMENT FACTORS (POSITIVE OR NEGATIVE)       DIRECT OR CONSULT SCORE
TOTAL SCORES DIRECT SCORE CONSULTING SCORE ACTIVITIES IN SUPPORT OF INSTRUCTION SCORE  

*PROFESSIONAL JUDGEMENT FACTORS:

(THESE CAN BE POSITIVE OR NEGATIVE)

SCORE FACTORS BRIEF DESCRIPTION
  Age of Student  
  Transition Issues  
  Parent Concern/Issues  
  Attendance  
  Home Environment  
  VI Teacher Issues  
  Other Professional's Issues  
  Child Issues  
  Other  
  TOTAL  

 

DIRECT SCORE FREQUENCY AND AMOUNT: DIRECT SERVICES CONSULTING SCORE FREQUENCY AND AMOUNT: CONSULTING SERVICES ESTIMATED TIME FOR ACTIVITIES IN SUPPORT OF INSTUCTION
1-5 2 HOURS PER MONTH 1-2 2 HOURS PER MONTH PLANNING
6-20 1 HOUR PER WEEK OR 2 30 MIN. SESSIONS/WEEK 3-4 1 HOUR PER WEEK PREP
21-25 2 HOURS PER WEEK 5-9 2 HOURS PER WEEK LIAISON
26-30 3 HOURS PER WEEK 10+ 3 HOURS PER WEEK EVALUATIONS
30+ 3+ HOURS PER WEEK     IFSP
        MEETINGS
        OTHER

____ DIRECT SERVICE TIME

____ CONSULTING TIME

____ TRAVEL TIME

____ ACTIVITIES IN SUPPORT OF INSTRUCTION

____ TOTAL NUMBER OF HOURS

Teacher of the Visually Impaired

NOTE: To be used with: "GUIDELINES FOR AMOUNT OF SERVICE TO STUDENTS WITH VISUAL IMPAIRMENTS: SAMPLE" (Developed by the VI staff of Denton ISD, Revised by D. Leff and O.F. Morris), Found on pages B-57-58 of the Quality Programs For Students With Visual Impairments Manual

Adapted by Stacy Shafer from:

Michigan's Vision Severity Rating Scale
1996
Printed by the Office of Special Education Services, Michigan Department of Education 

 

  1. Name:
  2. Date:
  3. Information on My Etiology
  4. Access to Distance Tasks in School Settings
    1. Examples of tasks:
    2. Strategies and tools I use to accomplish these:
    3. My challenges:
  5. Access to Near and Medial Tasks in School Settings
    1. Examples of tasks:
    2. Strategies and tools I use to accomplish these:
    3. My challenges:
  6. Access to Distance Tasks in Community Settings
    1. Examples of tasks:
    2. Strategies and tools I use to accomplish these:
    3. My challenges:
  7. Access to Near and Medial Tasks in Community Settings
    1. Examples of tasks:
    2. Strategies and tools I used to accomplish these:
    3. My challenges:
  8. Access to Near and Medial Tasks at Home
    1. Examples of tasks:
    2. Strategies and tools I used to accomplish these:
    3. My challenges:

Use with How Does My Vision Affect My Access to Information? Self-Determination Lesson 7:  Grades 3-12

Think about the following tasks that require use of vision.  Is the item very easy or very hard to complete, or somewhere in between?  Please circle the number that best describes your ability to comfortably complete each task. If you use assistive technology (for example: braille device, telescope, magnifier) to complete the task, please check “A.T.” next to the task. (Visual Tasks Survey downloadable pdf)


Visual Tasks in School

Read print in books or magazines
1 very hard 2 somewhat hard 3 neither hard nor easy 4 somewhat easy 5 very easy A.T.
Read very small print such as math symbols, tables, charts, graphs
1 very hard 2 somewhat hard 3 neither hard nor easy 4 somewhat easy 5 very easy A.T.
Read information on the board or on signs at school
1 very hard 2 somewhat hard 3 neither hard nor easy 4 somewhat easy 5 very easy A.T.
Read my own handwritten notes
1 very hard 2 somewhat hard 3 neither hard nor easy 4 somewhat easy 5 very easy A.T.
Read things projected on a screen (such as a PowerPoint)
1 very hard 2 somewhat hard 3 neither hard nor easy 4 somewhat easy 5 very easy A.T.
Read a computer monitor
1 very hard 2 somewhat hard 3 neither hard nor easy 4 somewhat easy 5 very easy A.T.
Watch a speaker in class, at an assembly, or in a large lecture hall
1 very hard 2 somewhat hard 3 neither hard nor easy 4 somewhat easy 5 very easy A.T.
Using audio books along with print books for classwork
1 very hard 2 somewhat hard 3 neither hard nor easy 4 somewhat easy 5 very easy A.T.

Visual Tasks in the Community

Read price tags or label information on items in a store
1 very hard 2 somewhat hard 3 neither hard nor easy 4 somewhat easy 5 very easy A.T.
Look at scenery or watch wildlife
1 very hard 2 somewhat hard 3 neither hard nor easy 4 somewhat easy 5 very easy A.T.
See small video displays such as on a cell phone, MP3 player, thermometer, and credit card scanner in grocery store
1 very hard 2 somewhat hard 3 neither hard nor easy 4 somewhat easy 5 very easy A.T.
See activity in the distance such as a football game or concert
1 very hard 2 somewhat hard 3 neither hard nor easy 4 somewhat easy very easy A.T.
Find information on outdoor signs or buildings
1 very hard 2 somewhat hard 3 neither hard nor easy 4 somewhat easy 5 very easy A.T.
Read paper menus in restaurants
1 very hard 2 somewhat hard 3 neither hard nor easy 4 somewhat easy 5 very easy A.T.
Read overhead menus at fast food restaurants
1 very hard 2 somewhat hard 3 neither hard nor easy 4 somewhat easy 5 very easy A.T.

Visual Tasks at Home & Neighborhood

Read cooking directions on food packages or recipes
1 very hard 2 somewhat hard 3 neither hard nor easy 4 somewhat easy 5 very easy A.T.
Read numbers/letters on oven or microwave
1 very hard 2 somewhat hard 3 neither hard nor easy 4 somewhat easy 5 very easy A.T.
Read numbers on measuring spoons/cups
1 very hard 2 somewhat hard 3 neither hard nor easy 4 somewhat easy 5 very easy A.T.
Read directions for appliances
1 very hard 2 somewhat hard 3 neither hard nor easy 4 somewhat easy 5 very easy A.T.
Read expiration dates on food packaging
1 very hard 2 somewhat hard 3 neither hard nor easy 4 somewhat easy 5 very easy A.T.
Read dosage instructions on medicine bottles
1 very hard 2 somewhat hard 3 neither hard nor easy 4 somewhat easy 5 very easy A.T.
Walk independently to a neighborhood house and/or store
1 very hard 2 somewhat hard 3 neither hard nor easy 4 somewhat easy 5 very easy A.T.

When you are finished, total your score.

  • Between 88-110 = You are good to go!
  • Between 66-88 = Perhaps you could develop some more strategies to complete these tasks more easily.
  • Between 22-66 = Work with your TVI to develop strategies that would enable you to access more visual tasks.
Total Score:  

Use with How Does My Vision Affect My Access to Information Self-Determination Lesson 7: Grades 3-12

Ideas for Using Tools in the Home

Snack and Meal Preparation

  • Use a magnifier to follow recipes to prepare a snack or simple meal. Recipes can be found on packages (e.g., taco seasoning, pudding, rice), in cook books, or printed from a web site.
  • Use a magnifier to look at food labels, particularly salt, sugar, and fat content. Discuss the affect these have on health, and what constitutes a healthy diet.
  • Use a magnifier to read numbers on keypads and dials for the oven, stove, and microwave when cooking.
  • Use a magnifier to read food expiration dates on items stored in the pantry and refrigerator. Combine this with the “sniff” test and discuss discarding food that is turning bad.
  • Use voiceover on an iOS device to follow/prepare a simple recipe.

Health and Appearance

  • Use a magnifier to read medicine packaging, including dosage instructions, expiration dates, and refills for prescription medications. Discuss steps to take if you feel you have taken too much of any medication (poison hotline).
  • Use magnifier to read a thermometer, or a talking thermometer. Discuss what constitutes a fever, and how this information is used.
  • Use a magnifying mirror to check skin, teeth, and hair, or to look closely at eyes for applying eye makeup.

Recreation and Entertainment

  • Use a magnifier to read instructions for games, as well as print on game cards and boards.
  • Use print enlargement software to read information on a computer monitor (email, internet searches, Facebook, articles).
  • Use a telescope to watch TV and/or follow action while playing with a Wii.
  • Use a magnifier to read parts of a favorite magazine/newspaper. Discuss a selected topic.
  • Use a magnifier for hobbies such as scrapbooking, coin/card/stamp/rock collecting.
  • Use a telescope to follow the action of pets in the neighborhood, and/or birds and squirrels in the yard.
  • Use a magnifier to read a book to a younger sibling.

Ideas for Using Tools in the Community

  • Use a telescope to locate stores and read signs in the mall.
  • Use both a telescope and magnifier to complete a scavenger hunt in a grocery store, using a list of things to find along with their prices.
  • Use a telescope to order from overhead menus in fast food restaurants.
  • Use a magnifier to order from table menus.
  • Visit a zoo, rodeo, or stock show to watch the action and observe animals.
  • Plan a trip in the community, using public transportation. Use a magnifier to read bus routes, and a telescope to watch for bus numbers.
  • Use a telescope at a sporting event. Keep track of the score on the scoreboard, relate action as it occurs, and locate people in the crowd.
  • Attend a museum, using the telescope to stand back and view the art work.

Ideas for Using Tools in the School

For Middle School and High School Students

Start with a conversation with the student about each class, and the kinds of visual tasks the student is required to complete. Create a chart, writing in how the student currently accesses school assignments. A completed chart might look like this:

SUBJECTTEXTBOOKSHANDOUTSOVERHEADBOARDINTERNET
English Large Print Reg./Lg. Print Print copy Print copy Zoomtext
Math Reg. Print Large Print “can see fine” Walk to Board n/a
Science Reg. Print Large Print Can’t see “can see fine” Pretty hard to read units

Use this information as a starting point for increasing independence in the student.

Lessons to consider:

  • Read smaller print size of an assignment currently completed with large print, using a magnifier to enlarge the print instead. This takes practice!
  • Use a magnifier to read information on maps, charts, and graphs, particularly in the student’s math, science, and social studies/history books, including information printed from the internet.
  • Access the board/overhead using a telescope. Practice reading and copying from the board, increasing the number of words copied per view. The goal is to read/remember/write down as many as 10 words at a time, checking for accuracy.
  • Access the board/overhead using a video magnifier. Practice locating information, focusing, and taking notes.
  • Access the board/overhead using a tablet. Practice locating, saving, and storing information.
  • Use a magnifier to read notations on measurement devices (linear, as well as volume).

For Pre-Primer through Elementary Students

  • For 3-5 year olds, explore the properties of magnifiers by looking at bugs, leaves, shells, and other 3-dimensional objects.
  • For 4-5 year olds, explore the properties of a telescope outside, locating play equipment, friends, moving vehicles, etc. Inside, use the telescope to watch as the teacher conducts a story time or demonstrates a lesson.
  • For 1st-6th graders, teach students how to use a telescope to view and copy information placed at a distance.
  • For 1st-6th graders, teach students how to use a magnifier to increase reading fluency on smaller print sizes.
  • Practice telescope skills on field trips.
  • For students who require larger print on computer monitors, provide instruction with enlargement software (e.g., Zoomtext).
  • Teach accessibility options for computers, cell phones, and tablets.
  • Use a monocular in games (e.g., Battleship game graphic posted to a wall; mazes placed on a wall)
  • Use magnifier to read game cards and game instructions.

A baby with a visual impairment and wearing a hearing aid plays with a toy.As a Teacher of the Visually Impaired, you are aware of the importance of hearing for a child with a visual impairment.  The Functional Vision Evaluation and the Learning Media Assessment both consider how the child uses his/her hearing for learning.  Here are some things that you should try to determine through parent and staff interviews and/or the student’s records.  (Adapted from the Checklist for Deafblind Census of Texas)

Does the student have a documented auditory impairment meeting Texas eligibility requirements as cited in the Commissioner’s Rules?

Does the student have a documented unilateral hearing impairment (conductive, sensorineural, or mixed) of at least 15 dB?

Does the student have a documented bilateral hearing impairment (conductive, sensorineural, or mixed) of at least 15 dB?

Does the student have a documented syndrome, disease or disorder associated with hearing loss?

  • Bacterial meningitis
  • Cytomegalovirus (CMV)
  • CHARGE
  • Usher Syndrome
  • Down Syndrome
  • Microcephaly
  • Rubella

 Does the student have a documented syndrome/disorder associated with a progressive hearing loss?

  • Cytomegalovirus (CMV)
  • Norrie Syndrome
  • Goldenhar Syndrome
  • Hurler Syndrome

Does the student have a diagnosis of a central auditory processing disorder (CAPD) by a speech language pathologist or an audiologist? 

May also be called central auditory processing problem, central auditory processing dysfunction, auditory neuropathy. 

OR

Does the family or staff report the child having difficulty understanding what he is hearing?

Is the student at risk for hearing loss? 

Factors to alert to include:

  • Documented chronic/persistent otitis media
  • Caregivers/professionals who know the child suspect impaired hearing based on:
    • significant and otherwise unanticipated delay in receptive and/or expressive speech-language skills or
    • Responses to full range of auditory stimuli in the environment is less than anticipated
    • Ototoxic medications such as those given for cancer, serious infections, etc.
    • Prematurity
    • Balance problems
    • Family history of hearing loss

Other risk factors include:

  • Drug or alcohol consumption during pregnancy
  • APGAR scores lower than 4 at one minute and below 6 at five minutes (APGAR scores measure newborn vital signs at birth)
  • Low birth weight (below 3.5 pounds)
  • Neonatal jaundice at birth requiring transfusion
  • Craniofacial anomalies 
  • Visible malformations of the head, neck or ears including middle and/or inner ear structures
  • Family history of permanent or progressive hearing loss in childhood
  • Childhood injuries (especially skull fracture, sharp blow to the head or ears, loud noise exposure, and items accidentally inserted into ears resulting in damage)

 Average Speech and Hearing Behavior by Age Level

Speech and language development are impacted greatly by hearing impairment.  Even mild to moderate impairment can have dramatic consequences, especially if the child also has some type of vision loss.  Below are typical milestones for a child with normal hearing according to the Alexander Graham Bell Association for the Deaf and Hearing Impaired.  Be sure to visit their website at www.agbell.org for more detailed information.   

Birth-3 Months

  • Startled by loud sounds
  • Soothed by caretakers’ voices

3-6 Months

  • Reacts to the sound of your voice
  • Turns eyes and head in the direction of the source of sounds
  • Enjoys rattles and noisy toys

7-10 Months

  • Responds to his/her own name
  • Understands “mama,” “dada,” “no,” “bye bye” and other common words
  • Turns head toward familiar sounds, even when he/she cannot see what is happening: e.g., dog barking or paper rustling, familiar footsteps, telephone, person’s voice

11-15 Months

  • Imitates and matches sounds with own speech production (though frequently unintelligible), especially in response to human voices or loud noises
  • Locates or points to familiar objects when asked
  • Understands words by making appropriate responses or behavior: “Where’s the dog?” “Find the truck.”

15-18 Months

  • Identifies things in response to questions, such as parts of the body
  • Uses a few single words; while not complete or perfectly pronounced, the words should be clearly meaningful
  • Follows simple spoken directions

2 Years

  • Understands yes/no questions
  • Uses everyday words heard at home or at daycare/school
  • Enjoys being read to and shown pictures in books; points out pictures upon request
  •  Interested in radio/television as shown by word or action
  • Puts words together to make simple sentences, although they are not complete or grammatically correct: “Juice all gone” “Go bye-bye car”
  • Follows simple commands without visual clues from the speaker: “Bring me that ball.” “Get your book and give it to Daddy.”

2 ½ Years

  • Says or sings short rhymes and songs; enjoys music
  • Vocabulary approximately 270 words
  • Investigates noises or tells others when interesting sounds are heard:  Car door slamming, Telephone ringing

3 Years

  • Understands and uses simple verbs, pronouns and adjectives: Go, come, run, sing, me, you, him, her, big, green, sweet
  • Locates the source of a sound automatically
  • Often uses complete sentences
  • Vocabulary approximately 1000 words

4 Years

  • Gives connected account of some recent experiences
  • Can carry out a sequence of two simple directions: “Find your shoe and bring it here.” “Get the ball and throw it to the dog.”

5 Years

  • Speech should be intelligible, although some sounds may still be mispronounced—such as the /s/ sound, particularly in blends with other consonants (e.g., “street”, “sleep”, “ask”).
  • Neighbors and people outside the family can understand most of what your child says and her grammatical patterns should match theirs most of the time.
  • Child carries on conversations, although vocabulary may be limited
  • Pronouns should be used correctly: “I” instead of “me” “He” instead of “him”

Self-Determination Units and Lessons

Use this with Strategies for Communicating with Others about Access, Self-Determination Lesson 13: Creating a Product to Communicate Visual Strategies/Tools with Teachers

Monocular or telescope- I use this for reading and copying from the board, watching assemblies, looking at things that are more than 8 feet away from me (e.g., a ball game, signs across the road, overhead menus). Sometimes I use it to see things in a middle range (3-5 ft.) such as items on a store’s top shelf.

Magnifier- for reading smaller print on school handouts, in textbooks, on food packages, etc.

Reading glasses- for reading longer sections of text where my hands are free to hold the material. These may be called microscope glasses or high ADD glasses.

Corrective Lenses (glasses)- may be prescribed for some students to correct additional refractive errors such as myopia, hyperopia, and/or astigmatism. Some lenses are transitional, or change tint to reduce light. Not all students benefit from corrective lenses.

Sunglasses- protect the eyes from excessive light and harmful UV rays. Some students wear these indoors, but most will likely wear them outside.   

Audio App for iDevices or computer- This app allows me to listen to audible textbooks that I get from agencies such as Learning Ally or Bookshare.

ZoomText- screen enlarging software installed on a computer to increase the image size of what’s shown on the screen.

JAWS- screen reading software installed on a computer to help access documents or websites (this program will read aloud what is shown on the screen).

TI Graphing Calculator View Screen- This enlarges the readout on my graphing calculator.

Tablet (e.g. iPad)- This lets me download assignments so I can change print size, take a snapshot of something at a distance and then enlarge it, take notes in class, complete written assignments, and send these back to teachers, and/or load auditory books.  

Portable video magnifier- This has a built-in camera and lets me adjust both font and contrast in print material.  It’s good for spot viewing but not for lengthy assignments. Some models can freeze an image and let me store it such as a business card or information on a food package.

Portable video magnifier and distance viewer- This has a screen, a camera, and a materials tray. The camera swivels so I can view the board, or I can use it with books and other print materials. Some models can hook up to a laptop.

Braille notetaker– This is a portable device with a braille keyboard for entering information. It has a speech synthesizer or braille display for output. I can enter information on the braille keyboard and have the option of transferring it to a larger computer with more memory, reviewing it using the built in speech synthesizer or braille display, or printing it on a braille or inkprint printer.

Perkins brailler– This is like a braille typewriter.

Cranmer abacus- This is a calculation tool I use in math classes.