Teaching Students with Lower-Incidence

Disabilities

Chapter 11

Dr. Julie Esparza Brown

SPED 518: Survey of the Exceptional Learner

Focus Questions• How are visual impairments defined? How can you

provide accommodations for students with visual impairments in your classroom?

• How are hearing impairments defined? How can you provide accommodations for students with hearing impairments in your classroom?

• How are physical disabilities, health impairments, and traumatic brain injury defined? What are some areas to consider when developing an education plan for these students?

Definition and Types of Visual Impairments

• Legal definitions:• Legal blindness – defined as a visual acuity of 20/200 with best

correction in the best eye or a visual field loss in a visual field of 20 degrees or less. The legally blind person can see at 20 feet what the average person can see at 200 feet. Only 2% of people with vision impairments are totally blind.

• Low Vision – limited or diminished vision that cannot be corrected with standard lenses

• Partial Sight – the field of vision is impaired because of an illness, a degenerative syndrome, or trauma. Individuals who have a visual acuity in the range of 20/70 to 20/200.

• Visual acuity – the ability to see detail clearly• Visual field – how well a person can see using peripheral or side

vision

Definition and Types of Visual Impairments

Educational definition:• Emphasizes academic tasks, particularly reading

more and visual acuity less.• Visual impairment including blindness – means an

impairment in vision that even with correction, adversely affects a child’s educational performance (IDEA 300.8 [c][13].

Causes of Visual Impairments

• Structural impairments• Damage to one or more parts of the visual

system

• Refractive errors• Inability of the eye to focus the light rays onto the

retina correctly

• Cortical visual impairments• Problem with the neurological pathways

Characteristics of Students with Visual Impairments

• Possible delays in development include:• Concept development• Communication• Motor skills and mobility• Self-help• Social skills

Prevalence of Visual Impairments

• Visual impairments are a low-incidence disability• During 2005-2006 school year 25,855 school-age

students (ages 6-21) with vision impairments were served under IDEIA

• 1,310 deaf-blind students also received services• 25% of visual impaired students are visual readers• 7% of visual impaired students auditory readers• The remaining visual impaired students are prereaders

or nonreaders.

Identification and Assessment of Students with Visual Impairments

• Common physical characteristics that indicate visual impairments include:

Red-rimmed, swollen, or encrusted eyesExcessive blinkingItchy eyesEyes that are tearingEye(s) turn inward, outward, upward, or downwardExtreme sensitivity to light tilting or turning head to see objects

SquintingCover one eye to view objectsThrust head forward to view objectHeadache, fatigue, dizziness after doing close workTripping, bumping into objects, or appearing disorientedRecurring sties

Identification and Assessment of Students with Visual Impairments

• Assessments used by visual impairments teacher include:• Functional vision assessment• Learning media assessment• Compensatory skills

Instructional Guidelines and Accommodations for Students with VI

• Some of the accommodations include:• General accommodations• Use of Braille and Braille devices• Orientation and mobility skills• Optical, nonoptical, and instructional aids• Testing accommodations

Examples of Nonoptical Aids

• Nonoptical aids include:• Lamp• Reading stand• Bold-line paper• Hats and visors• Color acetate• Cranmer abacus• Raised-line paper• Writing guides• Measurement tools

Some Considerations

• Some students use canes or guide dogs for mobility purposes. If the guide dog has a harness, it is working and should not be petted.

• When speaking to a student with a vision impairment, speak in a normal voice.

• Identify yourself when entering a room.• When giving directions (e.g., right, left) convert

directions to the student’s perspective. Offer your arm and let students take it.

Instructional Considerations• Most students in primary years can access their school

materials with minimal aides. As they process, however, the prints in texts become smaller and some form of magnification may become necessary.

• Enlarged print is a less desirable option than standard print with the use of a low vision device. As students progress through the grades, the large amount of reading materials makes the use of enlarged print inefficient.

• Enlarged print can result in inefficient reading because the reading rate is slower and this impacts comprehension.

Braille• Braille is a good option for many

children, even those with good functional vision.

• A good Braille reader may be preferable to a poor print reader.

• Braille texts can now be stored electronically and there are now portable embossers.

Assistive Technology

• Assistive technology is an integral part of a students with a vision impairment’s world.

• They can range from low tech, non-optical devices like a reading stand, to a high tech piece of equipment like the Braille Note.

• Structured instruction must be provided on the use of assistive technology.

Orientation and Mobility• Orientation is knowing where one is in relation to

the environment and where one wants to go.• Acquiring orientation skills allows an individual to

be an independent traveler. They may need to learn to read maps and directions and public transportation guides.

• Mobility is the ability to move to one’s target location in the safest and most efficient way.

• Students may need to use the white cane, protective techniques and the use of guide dogs.

Daily/Independent Living Skills

• A child with a vision impairment may need to learn self-help skills such as eating, brushing teeth and choosing clothes.

• Students may require direction instruction in skills that are at their developmental level.

Social Skills• Much of what children know about social

behavior is learned through imitation and modeling.

• Children with vision impairments are unable to learn these skills through incidental learning.

• They must be taught through structured experiences.

• Remember that merely placing students into regular classes does not automatically result in social inclusion.

Testing Accommodations

• Modifications may include:• Assigning alternative items• Orally reading sections of the test • Using large-print or braille answer sheets• Providing real objects for items shown in

pictures• Coloring pictures to make them easier to

see

What’s It Like to Have a Vision Impairment?

•http://www.youtube.com/watch?v=v9CawJSUy2c

Definitions and Types of Hearing Loss

• Hearing loss can result from several factors:• Heredity• Illness or disease• Excessive prolonged exposure to loud noises

• Prelingually deaf – children who lose hearing prior to learning language

• U.S. federal government definition of hearing loss

Definitions and Types of Hearing Loss

Type of Hearing Loss

Unilateral

Bilateral

Conductive

Sensorineural

Mixed

Definition

Loss of hearing in one ear

Loss of hearing in both ears

Outer and middle ears do not transfer enough acoustic energy to inner ear fluids

When there is damage to the cochlea or auditory nerve

Loss is both sensorineural and conductive

Characteristics of Students with Hearing Loss

• Normal hearing falls within the range 0-15 dB.

Degrees of Hearing Loss

16 – 25 dB = minimal loss25 – 40 dB = mild hearing loss

40 – 65 dB = moderate hearing loss65 – 90 dB =severe hearing loss

Greater than 90 dB = profound hearing loss

Characteristics of Students with Hearing Loss

• Hard of hearing – person with a mild to moderate loss

• Deaf – person with severe or profound loss• Residual hearing – amount of hearing remaining

after a hearing loss• American Sign Language (ASL) – primary mode

of communication for deaf students• Finger spelling – system for representing the

English alphabet manually

Prevalence of Hearing Loss

• In a survey of 37,352 hard of hearing students: • 42.4% received instruction in the general education

setting, and • 12.1% received instruction in a resource setting. • The remainder received services in self-contained,

special schools or were home-schooled

• In the 2005-2006 school year 71,332 students with hearing impairments received special education services.

Identification and Assessment of Students with Hearing Loss

• Mild to moderate loss detected during kindergarten screening or by teacher

• Moderate, severe, and profound losses detected prior to school

• Identification and intervention are key to development of language and learning

• Infants should be screened for hearing loss before hospital discharge

Identification and Assessment of Students with Hearing Loss

• Warning signs to look for in classroom:

Day-dreaming

Lethargy Articulation errors

Inappro-priate response to questions

Mouth breathing

Inatten-tion

Failure to follow simple verbal commands

Limited speech or vocabulary

Difficulty decoding phoneti-cally

Persistent colds

Behavior problems and frustration

Verbal expressions of misunder-standing (“Huh?”)

Difficulty with verbal tasks

Unusual voice quality

Watching other students for instructional cues

Instructional Guidelines and Accommodations for Students with Hearing Loss

• Use of amplification• Hearing aids• Implants

• Make classroom accommodations• Use of assistive technologies

• Personal FM system• Sound field FM system

• Use of interpreters and note takers

Instructional Guidelines and Accommodations for Students with Hearing Loss

• Use a circular seating arrangement. This offers deaf or hard of hearing students the best advantage for seeing all class participants.

• When desks are arranged in rows, keep front seats open for students who are deaf or hard of hearing and their interpreters.

• Repeat the comments and questions of other students, acknowledge who has made the comment so the deaf or hard of hearing student can focus on the speaker.

• When appropriate, ask for a hearing volunteer to team up with a deaf or hard of hearing student for in-class assignments.

• Assist the student with finding an effective notetaker or lab assistant from the class

• If possible, provide transcripts of audio information.

Instructional Guidelines and Accommodations for Students with Hearing Loss

• Face the class while speaking; if an interpreter is present, make sure the student can see both you and the interpreter

• If there is an interruption in the class, get the deaf or hard of hearing student's attention before resuming teaching.

• Use visuals frequently. Because visual information is a deaf student's primary means of receiving information, films, overheads, diagrams, and other visual aids are useful instructional tools.

• Be flexible: allow a deaf student to work with audiovisual material independently and for a longer period of time.

• Don't assume. When in doubt about how to assist the student, ask him or her.

• Allow the student the same anonymity as other students (i.e., avoid pointing out the student or the alternative arrangements to the rest of the class).

Instructional Guidelines and Accommodations for Students with Hearing Loss

• When using films, videos, or other forms of visual media make sure that captioning is used so the student can read what is being said in the film or video.

• When student is working in a group, have classmates sit in a horseshoe shape so that the student can see everyone.

• Allow extra time for students to process questions and allow them to participate in answering questions aloud.

• Have a plan ready in case of emergencies, such as fire.

•http://www.youtube.com/watch?v=ln8NHzVfJkQ

Definitions and Types of Physical Disabilities, Health Impairments, and Traumatic Brain Injury

• IDEIA Categories• Orthopedic impairment or physical disabilities• Other health impairment• Traumatic brain injury

• Neuromotor Impairment• Muscular dystrophy, polio, multiple sclerosis

• Neurological Impairment• Seizure disorders, cerebral palsy, spina bifida

• Other Health Impairments• Medically fragile• Technologically dependent

• Traumatic Brain Injury

Characteristics of Students with Physical Disabilities, Health Impairments, and TBI

• Types of disabilities include:• Asthma• Cerebral Palsy• Spinal Bifida• Epilepsy• Muscular Dystrophy• HIV and AIDS• Traumatic Brain Injury

Prevalence of Physical Disabilities, Health Impairments, and TBI

• Prevalence figures on the rise• Chronic health conditions vary from .22% to

44% of children in the U.S.• During 2005-2006 school year 60,100

students had orthopedic impairments and 625,187 with health impairments.

• 23,805 students with TBI received special education services.

Identification and Assessment• Students are assessed in the following areas:

• Activities of daily living• Attention, concentration, initiation, or sustained

effort• Adaptations for learning• Communication• Mobility• Physical abilities and limitations• Psychosocial development• Transition skills

Instructional Guidelines and Accommodations

• Transdisciplinary teaming • Use assistive technology• Make environmental modifications• Provide instruction for motor skills• Promote literacy development• Educate classmates• Deal with chronic illness and death

Great Website for TBI

•http://www.cbirt.org/tbi-education/

Closing Thought“Great teachers empathize with kids, respect them, and believe that each one has something special that can be built upon.”

Ann Lieberman