From the Beginning (or not)

January 6, 2018

How is eligibility for special education services for students with hearing loss determined for school-aged children? 

I currently have a kindergartner for whom we signed the referral and permission to test paperwork just before Christmas break.  I would like to share what information I gather, how I interpret it and what the IEP and interventions will look like.  (My school district provides preschool services that are separate from the school-age services so I work with children in Grades K-12.)

With all students new to me, I start by assembling a Timeline of Information beginning at birth because hearing is tested at birth.  The critical things I am looking for is age of diagnosis, age of amplification and age when intervention began.  Other important factors are medical issues/health, assessments completed, language in the home and parental understanding.

baby-3031532_1920

After the paperwork is signed for testing, I collaborate with the SLP and we divvy up the testing so we each know what the other is doing.  For this kindergartner, the SLP will complete:

  • a speech-language screening
  • PLS-5
  • Montgomery Assessment of Vocabulary Acquisition (MAVA).

I will do:

  • Test of Narrative Language
  • auditory skills using the Auditory Learning Guide
  • Phonological Awareness Test-2
  •  spontaneous language sample
  • informal self-advocacy assessment
  • classroom observations.

The School Psychologist will do:

  • educational achievement testing
  • intellectual testing
  • adaptive behavior
  • classroom observations.

We have 90 days from the date that the referral was first made to the school to complete the testing, write narrative reports and have a formal meeting to discuss results and plan interventions.

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My perspective as a Teacher of the Deaf and Speech Language Pathologist is different from most of the members of school special education teams because factors surrounding hearing loss are so different than for disabilities schools typically see such as learning disabilities, speech-language impairments and other health impairments.  For those students it may make sense to provide regular education interventions or “exposure” to regular education to determine if that helps them “catch up”.

However, for kids born with hearing loss, the impact starts in the womb.  Research has shown that speech processing begins when the auditory system becomes functional at 25 weeks gestation.  For a baby failing a newborn hearing screening more delays may happen before appropriate evidence-based interventions are begun.  These delays may be due to other medical issues, lack of parental understanding, mental health issues of the parents, living a far distance from pediatric ENTs and audiologists and lack of knowledgeable professionals providing intervention.

synapse-formation

We know that the brain has the greatest ability to re-wire itself between the ages of birth to three years and that ability decreases as the child gets older.  Because of this fact, interventions with young kids with hearing loss should be characterized by a sense of urgency.  Hearing loss in children is frequently referred to as a neurological emergency.   So my perspective for young students who show delays in language and literacy is to give them as much intervention as possible at the youngest age possible to hopefully close the language and literacy gap between their current abilities and their potential abilities as soon as possible!

I will keep you posted about this student and the outcomes.

 

2 thoughts on “From the Beginning (or not)

  1. Thanks so much for sharing your insight and plan of action. I’ve been a DHH teacher for a number of years, and never realized that the auditory system becomes functional @ 25 weeks gestation.

    Like

    1. Thanks for your feedback, Denise. It’s amazing what research is able to tell us about babies and brains!

      Like

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