Cochlear Implant Assessment and Planning for Deaf Children

1. IEP Considerations for the Child with a Cochlear Implant Darcy Beaver Teacher of the Deaf/Hard of Hearing

2. Pragmatics vs. Academics

4. Where are we going? • Family’s goals? • Education goals? Keeping this in mind creates your road map!

5. Observations • In class • Out of class • Discussions with teachers • Checklists • www.cde.com

6. Assessments • Language levels may be age appropriate due to early programming and therapy • Scores may indicate that the student doesn’t “qualify” for special education services since a discrepancy is not present

7. Assessments Recommended • Cottage Acquisition Scales for Listening, Language & Speech (CASLLS) • Preschool Language Scale-4 • Preschool-Clinical Evaluation of Language Fundamentals (CELF-P) • Rosetti Infant Toddler Language Scale • MacArthur Communication Development Inventory: Words, Gestures, and Sentences • Test of Auditory Comprehension of Language- Third Edition (TACL-3) • The Screening Instrument for Targeting Educational Risk (S.I.F.T.E.R) • The Reynell Development Language Scales III (RDLS III), 3rd ed. • SKI-HI Language Development Scale • Oral and Written Language Scales (OWLS) • Grammatical Analysis of Elicited Language, Pre-Sentence Level (GAEL-P) • Early Speech Perception Test (ESP) for Profoundly Hearing Impaired Children • Functional Auditory Performance Indicators (FAPI) • Meaningful Auditory Integration Scale (MAIS)/ Infant-Toddler: Meaningful Auditory Integration Scale (IT-MAIS) • The Listening Inventory for Education: an Efficacy Tool (LIFE)

8. Assessments cont. • The Arizona Articulation Proficiency Scale –Third Edition • The Goldman Fristoe: Test of Articulation 2 • Identifying Early Phonological Needs in Children with Hearing Impairment • Peabody Picture Vocabulary Test (PPVT-3) • Expressive One-Word Picture Vocabulary Test • Receptive One-Word Picture Vocabulary Test • Test of Early Reading Ability-3rd Ed. (TERA-3) • Boehm Test of Basic Concepts – Revised (BTBC-R) • Bracken Basic Concept Scale- Revised • Checklist of Emerging ASL Skills • ASL Development Observation Record • The American Sign Language Proficiency Assessment (ASL-PA) • Test of American Sign Language (TASL) • www.nasde.org/Portals/O/Documents /AssessmentTools.pdf

9. A New Approach: • We need to use a prevention and surveillance model rather than a failure model to manage this generation of children with hearing loss. Beware of being seduced by how much these children seem to know at a young age. • They still need enrichment! Carol Flexer, 2010

10. Pragmatics • Think of what the student is doing with the information that they have • Social skills – are they accurately interpreting situations with peers? • Applying information- they can spell, they understand grammar- what happens when they put it into writing?

11. Things to Consider in the Mainstream Classroom

12. What do we need to know? • What are the standards expected at each grade level? • How are they measured? • Content, Content and More Content! • What district and state tests occur at each grade level? • What accommodations are needed? Standards Things to consider

13. Whoa! That pace is fast!

14. What did you say?

15. Consider all of the domains • Involve the family at all times • No cookbook approach • Keep assessing the child’s needs

16. Goals • Listen, Listen, and Listen some more • Resources: • www.hearingjourney.com CLIX Word Association Syllable Perceptions (WASP) SPICE (CID) Cottage Scales Spelling Tests Cochlear Implant Center HOME!!!!

17. Listen in and out of the classroom • Early listeners need to have listening goals in a quiet environment • As their listening skills advance, then goals can move into more controlled noise situations • Lastly, listening goals can be monitored in the classroom – children spend over ½ of their school day listening

18. Words, Words, Words • Must read everyday to learn vocabulary! Read out loud! • A student needs to know 10,000 words by first grade • A student needs to know approximately 100,000 words by 12th grade TV stays within 10,000 words!

19. Tell Me More….. • Phonics • Sequencing • Retell

20. Reading • Geers (2003) • Large numbers of 8-9 yr. olds implanted before 5 years • Reading levels within the normal range • Geers (2008) • When tested again at 15-16 years of age- significant numbers had not progressed

21. Articulation • Choose targets carefully with eye toward practicing consonants with a variety of vowels • Listen for sounds that are present and absent- it will guide us on how well the implant is or isn’t working Muddy In/Muddy Out (Carol Flexer) • Be aware of normal speech development but don’t always feel like that is what needs to be followed • Only 25% of speech sounds are visible so keep that in mind when presenting sounds

22. Thoughts? • Conclusions: Early cochlear implantation had a long term positive impact on auditory and verbal development but did not result in age-appropriate reading levels in high school for the majority of students. • Carol Flexor stated that the reading material for adolescents demands skills in word knowledge, complex vocabulary, making inferences, pragmatic skills of language.

23. Comprehension skills • Answer questions-verbally and written • Understanding age appropriate skills can be the best guide

24. Write it Down • Understand expectations of each grade level • The student may have great language skills but writing it down is a different ballgame!

25. Keep communicating • Team members • Family • Cochlear Implant center

26. Enjoy the ride! The journey is full of challenges and many joys!

27. Resources • www.agbell.org • www.cochlear.com/HOPE • www.hearingjourney.com • www.asha.org • www.avli.org • www.cochlearamericas.org • www.advancebionics.com