Lecture 9- Case Management & Planning Flashcards
What are factors that affect the audiologists role in case management/service delivery?
- Availability and qualifications of other service providers
- Characteristics and needs of individual students
- School Schedules
- Locations to be served (Role may not be the same for each student)
- Case management involves communication and coordination with multiple service providers
What does the AuD do as the service coordinator?
• Facilitate communication between service providers, family members, and students
• Facilitate decision making by anticipating future difficulties and helping to prevent them
• Advise &/or assist families with logistics of scheduling medical/clinical appointments
(e.g., schedule on teacher work days, assist with transportation resources)
How can the AuD facilitate effective case management?
• Clarification of Needs and Services
• Identification of Personnel
o Other providers who can address some of the needs of the student with HL when Ed AuD is not available (e.g., SLP, TOD, counselors, etc.)
• Arrangements for Effective Collaboration
o Due to changing schedules and caseloads, schedule and disseminate in writing how and when team members will communicate
• Efficient Written Communication (Should be simple, clear, and concise )
How can the AuD implement Aural (Re)hab?
• Ed AuD’s primary purpose on the team is to facilitate maximum use of auditory input during the learning process
Rehab includes:
o Involvement with equipment
o Involvement with teaching and learning strategies
o Knowledge of environmental acoustics in any situation where learning takes place (classroom or otherwise)
• Other service providers may address auditory input but only AuDs have audition as their primary focus
What direct services does the Ed AuD provide
- Management of amplification
- Development of listening/auditory skills
- Speechreading
- Communication repair training
- Development of skills to overcome environmental barriers
- Informational counseling
- Psychosocial development
How can the AuD manage amplification?
• Develop students’ independence in managing their own technology
o Insertion of earmolds
o Basic power and VC operation
o Battery care
o Identification of when unit is or in not providing amplification
o Troubleshooting techniques as appropriate for age-level
- Taking earmold impressions
- Electroacoustic analysis and/or real ear
How can listening/auditory skills be developed?
• May be provided by an Ed AuD, SLP, &/or TOD
• Auditory training should be included in any oral language and speech (re)hab
• May work in collaboration with other designated personnel to enhance the auditory focus when time for direct instruction is limited.
o E.g., Team teach a lesson with a TOD and/& the SLP to model the emphasis on auditory skill development within the classroom or therapy room
What is communication repair training?
- Students are often unaware of the communication breakdowns that occur during the school day
- Uncomfortable with or unaware of a variety of repair strategies
Steps to help students in a school environment
o Understanding basic communication processes
o Understanding communication breakdowns
o Message formulation
o Introduction of communication repair strategies
o Practice using communication repair strategies
• Helps students to acknowledge that communication breakdowns occur and assists them in developing appropriate ways to cope independently
What are some skills to overcome environmental barriers?
• Teachers and students with HL should be educated re the effects of noise, distance, reverberation, & poor lighting
Sample activities for students
o Identify noise sources in their classrooms (Drawing diagrams, SLMs)
o Identify solutions to noise problems
o Older students can actually reverberation time for their classrooms
o Schedule of noisy times/activities as well as strategies for use during those times
o Discussion about which classes require more energy for attending to instruction (visual and auditory)
What is informational counseling?
Student should have an understanding of his/her own HL
Helps students feel empowered
o Etiology
o Personalized hearing test results
o Equipment used for assessment
o Different types of amplification for different individuals and environments
o Current & future technology other than amplification
How can the AuD consider psychosocial development?
Counseling related to the impact of the HL
o Ed AuD is more of a resource than service provider
May bring in adults who are D/HH
Maintain and make available a file of news articles or stories concerning children and adults with HL
Encourage social connection with other students with HL
What are indirect services?
- Classroom amplification and other assistive technology
- Teacher collaboration regarding strategies for the classroom
- Selection of Classroom & Teacher
- Selection of auditory curricula and materials
- Facilitation of auditory skill development with sign language use
- Info concerning student HL and auditory function
How can the AuD collaborate with classroom teachers? (potential questions)
Define “preferential seating”
o Best location for student’s desk
o Best location for all teaching activities?
o When there is lighting glare from one direction and competing noise from another, how do you reconcile that for the student?
How well is the student following the instruction and discussion?
Does teacher alert the student with HL to changes in topic?
Does teacher supplement group instruction with individual checks to assess comprehension?
Would a student “buddy” be helpful?
Oral or ASL interpreter be helpful? Which classes?
Would note taking assistance be helpful?
Observation by an Ed AuD can provide valuable insight to alleviate academic problems before failure occurs
Describe the selection of auditory curricula and materials for students with HL.
Make recommendations based on auditory goals and objectives
Make suggestions re how to phase objectives into the regular or special education curriculum for use with specific students. Examples:
o Vocab lists for listening exercises
o Recording sounds around school facility for recognition of environmental sounds
o Use of classroom directions for auditory comprehension activities
Describe auditory skill development w/ ASL use.
If ASL is used, there is an inherent conflict during simultaneous communication
o Students in most ASL programs may not make use of auditory input during the majority of the school day
Auditory skill development may be very slow and laborious.
Must discuss thoroughly with parents, teachers, and student to see if auditory learning is a desired goal
o If yes, clear recommendations must be made regarding how to integrate use of audition into the student’s communication system
o Write into IEP and document
How is referral made to special ed and assessment?
Purpose is to determine how child is functioning to determine SpEd eligibility
- Specific disability areas require formal tests in certain areas (E.g., hearing disability requires hearing test, cognitive disability requires formal intelligence test)
Assessment requires parent permission and notification of parent rights
Referral paperwork should indicate specific areas of assessment
If parent refuses, team must decide if concerns are significant enough to pursue referral through legal channels.
How is disability and eligibility determined?
Disability–determined from the assessments that are completed and the resulting needs of the child
- Determination of primary disability
Eligibility–determined by ascertaining whether the disability adversely affects educational performance
For HL, question of “how much loss?” constitutes disability cannot be measured only by audiometric testing
How do you select special education or a 504 plan?
Can the student receive reasonable educational benefit from regular education alone?
o YES, the student doesn’t qualify for SpEd. May be referred for 504 consideration
o NO, ask…
Does the child have a disability which adversely affects educational performance (as defined by IDEA)?
o NO, SpEd meeting is terminated, 504 may be considered
o YES, proceed with development of goals and objectives for IEP
Eligibility for 504–does the disability substantially limit one or more major life activities? (function of regular education)
o Team may include teacher(s), parents, specialist(s)
o Most children with documented HL qualify for a 504 Plan
What are accommodations?
Accommodations: provisions in how a student accesses information and demonstrates learning
Do not substantially change the instructional level, content, and/or performance criteria
- Presentation and/or response format & procedures
- Instructional strategies
- Time & scheduling
- Attitudes
- Architectural features
- Environmental Features
- Equipment
What are modifications?
Modifications: substantial changes in what a student is expected to learn and demonstrate.
Changes are made to provide a student the opportunity to participate meaningfully and productively in learning experiences and environments
- Instructional level
- Content
- Performance Criteria
How is an individual plan developed?
Written, legally binding documents that define the content and parameters of appropriate educational services for each student
o Include legal rights and due process
o How often? By whom? Amount of time services are scheduled?
IDEA mandates Annual Review of goals and objectives and Triennial Re-evaluation
What are some academic issues for students with HL?
- Wide variations in academic performance
- Many factors to consider
- AuD is the expert in “hearing” and may be consulted. Depending on your background, may not be an expert in teaching and learning strategies
- Your input re HL will help teacher develop appropriate teaching strategies to meet the student’s needs
Describe reading/language instruction.
D/HH students sometimes enter school significantly behind other students in terms of pre-literacy skills
Pre-reading skills taught in preschool and kindergarten assume the ability to discriminate English sounds
- Printed English is a representation of the spoken sounds of English
Even with appropriate amplification, students are still listening with an impaired auditory system
Average 18-19 y/o deaf student reads no better than average 9-10 y/o hearing students
Educational AuD may need to discuss importance of access to visual info and consultation with SLP familiar with HL to address “processing” (perception and identification) and “language” issues (semantic and syntactic deficits, limited background knowledge)
Describe mathematics instruction.
Achievement gap in math is smaller than for reading for D/HH students; however, challenges remain
Educate teachers about factors that could impede math learning
Classroom acoustics
- Difficulty perceiving oral directions quickly (necessary for elementary oral math drills)
Vocabulary of math may be challenging
Syntactic complexity of written math problems
- Difficulty translating to ASL
- No standardized signs exist for many math concepts
- “Signing, counting, and language differences may limit the types of problems these students experience in their conceptual development of math” (Pagliaro, 2006, p. 34)
Teachers of the Deaf often do not have math certification–may need to enhance teacher preparation in this area
Describe science and social studies instruction.
- Difficulties with vocabulary and higher level syntax will present challenges
- Success depends a great deal on reading ability
- Textbooks increase in complexity quickly in elementary school
- By middle school, should be familiar with different voices in writing, and varying lexicons for each subject
- D/HH students may be putting so much energy into decoding surface structure that they never get to the deep structure where meaning is understood
- Importance of preteaching cannot be overemphasized
What is visual and multisensory learning?
Multisensory teaching methods are recommended. However, the use of these approaches may be different for a student with HL
- D/HH students may not be able to simultaneously listen and look effectively
Teacher must intentionally plan to appropriately use visual aids or other sensory activities
Teacher may need to direct attention to visual aids between explanations
- Depends on the circumstance
