Supporting children with deaf-blindness in learning

Abstract. Every child has right to learn and to access the curriculum which is suitable for and can enhance their knowledge and skills. Children with deaf- blindness often deal with many difficulties in their learning. With the purpose of supporting these children, this article highlights different supports in term of curriculums, individual education plan, approaches to teaching, learning environment, assessing and reporting, technology, equipment and resources.

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HNUE JOURNAL OF SCIENCE DOI: 10.18173/2354-1075.2017-0141 Educational Sci., 2017, Vol. 62, Iss. 6, pp. 169-175 This paper is available online at SUPPORTING CHILDRENWITH DEAF-BLINDNESS IN LEARNING Nguyen Thi Tham1, Phan Thi Thuy2 1Faculty of Special Education, Hanoi National University of Education 2Faculty of Special Education, Ho Chi Minh National College of Education Abstract. Every child has right to learn and to access the curriculum which is suitable for and can enhance their knowledge and skills. Children with deaf- blindness often deal with many difficulties in their learning. With the purpose of supporting these children, this article highlights different supports in term of curriculums, individual education plan, approaches to teaching, learning environment, assessing and reporting, technology, equipment and resources. Keywords: Curriculum, children, deaf- blindness, learning, supporting. 1. Introduction It is the fact that children’s cognitive learning occurs mainly through vision and hearing. Palmer (2011) expressed that they were two distance senses, which contribute a major role to information gathering which supports children to learn in educational environments. Nevertheless, as Olson (1999) mentioned, children with deaf-blindness “have limited access to information and may lack necessary experiences to develop a language base, making communication and social skills a lifelong challenge” [1], because deaf-blindness was as a condition in which the combination of visual and hearing impairments caused severe communication, developmental and learning problems (Correa-Torres, 2008, cited in IDEA, 2004). Some aspects involving students with deaf-blindness are regarding definitions of deaf-blindness, curriculum, approaches teaching these students and modifications or management in the environment as well as other issues will be discussed in this paper. 2. Content 2.1. Definition There are some definitions of deaf-blindness. Kelley (1998) highlighted that “Deaf-blindness is as varied as the etiology, level of vision and/or hearing loss, and the age of onset of both the sensory disabilities” [2]. Following this definition, Vaughn, Bos and Schumm (2007, p.165) stated that:“Deaf-blindness means concomitant hearing and visual impairments, the combination of which causes such severe communication and other developmental and educational needs that they cannot be accommodated in special education programs solely for children with deafness or children with blindness”. Received date: 15/5/2017. Published date: 21/6/2017. Contact: Nguyen Thi Tham, e-mail: thamnguyencwd@gmail.com 169 Nguyen Thi Tham, Phan Thi Thuy In Australia, the prevalence rates were now estimated as 10:100,000 (Ward, 1994, cited in Kelley, 1998). Also, “there are over 70 known causes of deaf-blindness and these are usually split up into two main groups: acquire and congenital. Children with deaf-blindness may be identified as having many different etiologies” [2]. Thus, a child with deaf-blindness is who includes both hearing impairment and visual impairment and the combination of these impairments affects on child developments such as cognition, communication, language, motor, social skills, etc. The child with deaf-blindness needs special programmes which meet with abilities of him/her and are different from programmes for child who is only blindness or deafness. 2.2. Some guidelines to support for children with Deaf-Blindness in learning Curriculum It is crucial that each student with deaf-blindness needs individual curriculum. These children also need the expanded core curriculum (ECC) with respect to compensatory or functionally academic skills, including communication modes, orientation and mobility, social interaction skills, independent living skills, recreation and leisure skills, career education, technology and visual/hearing efficiency skills (Hatlen, 2000) [3]. However, as Farrell (2006) notes, “In general, the curriculum for children who are deaf-blindness should be content and structure which have regard to the National Curriculum, use the flexibilities of the National Curriculum (such as working at a low level than most children of the same age) and may draw on child developmental models, especially models of early communication” [4]. Hence, appropriate professionals can further use the ECC to address the educational issues facing these students (Hatlen, 2000). Additionally, Collins (1992) claims that these students “need a functional curriculum that is at appropriate age, as well as language purpose, sensory development activities, teaching strategies that consider preferred learning styles, mobility training, cognitive skill expansion through adaptation of sensory inputs, increased opportunities for social interaction, and reading and writing, where appropriate” (cited in Kelley, 1998, p. 258). In support, Olson (1999) points out that the two primary areas, namely orientation and mobility (O & M) should be focused. More importantly, Alsop, Blaha and Kloos (2006) stress the student’s emotional state or behaviors toward people, hence emotional and social skills should be considered carefully [5]. Other aspects of the curriculum are everyday activities (eating and drinking and dressing), sex education, challenging behavior, physical changes, emotional changes, human reproduction, personal hygiene, residential education, mobility, and religious education (Clark, 2000). The Individual Education Plan The individual education plan (IEP) plays an extremely important role in education for students with deaf-blindness. As Alsop, Blaha and Kloos (2006, p. 5) noted that “individual with deaf-blindness is a diverse group with a continuum of needs, which varies and depends upon the age of onset of deaf-blindness, degree of sensory loss, presence of concurrent disabilities, and environmental conditions” [5]. For this reason, as Kelley (1998, p. 255) mentioned, “students with deaf-blindness are learners who have differences in their abilities to receive and interpret visual and auditory information. They require modifications in their IEP to accommodate their sensory differences” [2]. The IEP team should include family members, the student, deaf-blind specialists, and teacher of student with visual impairments, teacher of students with hearing impairments, O & M specialist, intervention specialist, paraprofessionals and interpreter. On the one hand, the IEP must contain information on the student’s primary and any secondary disabilities and include present levels of educational performance, measurably annual goals and short term objectives. On the other hand, the IEP should focus on the student’s potentials. The IEP must also include the 170 Supporting children with deaf-blindness in learning date for the beginning of services, the duration and location of services and who are responsible for implementing each service [6]. Approaches to teach Numerous authors have studied about strategies to teach children who are deaf-blindness. Clearly, to interact with a student who is deaf-blind, educator should use all the sense and involve the child in the whole process of every activity (Olson, 1999). Furthermore, it is important to remember that using communication modes and techniques are good methods to educate these children. - Communication strategies If educators use effective communication strategies, children with deaf-blindness will possibly learn and integrate more easily in the community. As Vaughn, Bos and Schumm (2007, p. 213) highlighted, “because of the unique nature of each individual who is deaf-blind, there is not one standardized method of communication and therefore schools and centre need to be highly skilled, knowledgeable and flexible in responding to individual differences. In addition, as Kelley (1998, p.258) noted, “Communication methods and teaching strategies used with children who are deaf-blind are diverse as are the individuals and may vary according to: the levels of vision and hearing, the ability to integrate sensory information with experiences, social, personal, and behavior development, previous experiences, and the presence or absence of additional disabilities” [2]. There are some modes of communication for children with deaf-blindness, which can include gross sign gestures, voice, tactile, combinations of sign and finger spelling, hand on hand, note writing, print on palm, large print, signed English, Braille, computers, regular print and so on. - Touch cues and object cues One of communication strategies is the use of touch cues and object cues. According to Prickett and Welch (1998, p.146), “children who are deaf-blind do not learn to communicate in the way that typical individuals do with full auditory and visual information and cues, alternative communication strategies are vital”. Also, these children have less access to such communication forms as spoken language, nonverbal linguistic cues (eye contact, tone of voice), therefore, touch cues and object cues are extremely useful with children who are deaf-blind. He explained that the use of touch cues made with the speaker’s hand touching the receiver’s body [7]. In some cases, educators could use some touch cues to inform the children when an activity was over or when they were leaving by developing a special “good bye” touch signal or sign (Kelley, 1998) [2]. - Tangible symbols As Prickett and Welch (1998) highlighted, tangible symbols are objects, pictures, partial objects, or textured materials which can be used as beginning symbols for children who do not use spoken or signed language effectively for daily interaction. Farrell (2006, p. 52) claimed that “symbolic communication involves something standing for a concept, such as an object, a picture, a manual sign or a spoken word, allowing the child to refer to things other than the here and now” [4]. - Gestures, body language, and vocalizations Gestures, body language and vocalizations can be used for interaction with children who are deaf-blind. Prickett and Welch (1998) explained that “language-based communication, spoken language like speech, speech reading or lip reading, and the use of any hearing that an individual have been often important to children who are deaf-blind and have useful hearing” [7]. - Use calendar systems In order to operate and develop in a sequence of routines, using calendar systems is a 171 Nguyen Thi Tham, Phan Thi Thuy strategy to teach children with deaf-blindness. In support, Kelley (1998) expressed that the use of calendar systems of anticipation and communication is useful and teachers can let the child be as independent as possible [2]. Also, teaching routines for children with deaf-blindness requires numerous repetitions until these children can begin to anticipate what comes next. Furthermore, Prickett and Welch (1998, p. 150) claimed that children who are deaf-blind may use either print or Braille to read and write and this depends on the remaining vision and functional vision of each student. Management of the learning environment Obviously, due to the lack of visual and auditory sensory inputs, it is crucial that students with deaf-blindness need a vast of modifications of the environment. According to Horvath, Kampfer – Bohach and Keamrns (2005), accommodations for these children are vast and varied. They need accommodations for vision, such as Braille, large print, or special lighting, as well as accommodations for the hearing, which may include an interpreter or an auditory amplification device (Prickett & Welch, 1998) or modifications of location of furniture or materials, size, contrast, angle, distance and complexity may be necessary as Kelley (1998) mentioned. In some instances, the child who is deaf-blind may need accommodations for both hearing and vision combined with its for motor response (for example additional time, in-booklet responding) [7]. In addition, Prickett and Welch (1998) noted that, some modifications in the environment, materials, and activities can make children more accessible and information more meaningful to them. Olson, (1999, p. 260) agreedwith this view and adds that “the environment can be adapted with the use of tactile, visual, verbal, gestural, and object cues that facilitate comprehension, as well as consistency in presentation of cues and choices help establish routines within instructional sequences (Gothelf et al, 1995). However, Kelley (1998) expanded that for those with severely limited vision and hearing, it may be necessary to use more specialized materials, such as objects or texture boards, or some other tactile modality and especially size and speed of signs and gestures need to be adapted to the individual student [2]. Furthermore, Vaughn, Boss and Schumm (2007, p. 166) stated that, there are some environmental accommodations for students with dual sensory impairments such as developing a tactile schedule, for example, each activity of the day has an object that represents (mathematic – calculator, lunch-spoon, reading- book); using objects according to the tactile schedule to enable student to make choices, get information from the environment or convey a message. Nevertheless, these authors noted that tactual or visual identification should be consistent and meaningful symbols (cited in Palmer, 2011). Moreover, the pathways should be clear with objects or some consistent cues or landmarks in order to help promote independence in mobility of the student. If child has useful vision or hearing, teachers can add light, color, sound or interesting textures to objects so he/she can use the remaining senses effectively [8]. With similar view, Prickett and Welch (1998) recommended that, educators need to check carefully with “assistive technology specialists or vocational rehabilitation specialists who have experience with clients who are deaf-blind for the most current technological options and adaptations that are appropriate for a specific individual” to ensure these devices work well. For children with deaf-blindness who need additional time than their peers to gather information and interpret the information and then develop a response [8]. Therefore, they often need more time to learn new skills and implement those already acquired. Assessment and reporting Assessment and reporting are vital parts to build IEP for children with deaf-blindness. In the process of assessment of these students, Farrell (2006) stated that, two specialists, namely audiologist and the ophthalmologist will assess the degree of deaf-blindness. Also, contributing to 172 Supporting children with deaf-blindness in learning the assessment is the child, parents, speech and language therapist, physiotherapist, occupational therapist, educational psychologist and others. According to Quality Standards in Education, Support Services include standards relating to assessment, emphasizing that it should always be concerned with the child as a whole, taking account of the views of the family, the child and professionals. Furthermore, “a functional assessment is likely to provide much useful information because it is contextual, can structure the environment to offer opportunities for observing skills in practical use. Additionally, senses of touch, taste, smell and proprioception will be assessed. Assessing cognitive abilities may include the student’s awareness, attention, memory, imitation, classification, symbolic understanding and number concepts [9]. Eyre (2000, p. 133) noted that “Communication will be assessed and may be considered in terms of functional communication (the way the child show interest, any form of two-way interactions and whether the child associates any gestures, signs, pictures, objects or words) and linguistic communication (the forms of communication used, for example assessing how the child can express wants and needs)” [3]. Moreover, speech and language therapists and teachers can use the pre-verbal communication schedule (Keirnan & Reid, 1987) to assess the communication skill of those who cannot speak or who use a few words, signs or symbols. Technology, equipment and resources Thanks to the development of technology, students with disabilities in general and especially, students with deaf-blindness can access different resources and information. As Palmer (2011) highlighted, some portable devices that may help people who are deaf-blindness such as handheld electronic travel aids, canes and wheelchairs [8]. Also, Parker (2009) noted that “there are some evidences showing that person with deaf-blindness and cognitive disabilities can learn to use assistive technology for increase O & M”. According to some high tech devices like a freedom scientific PDA device, Pac Mate, GPS are extremely useful for children with deaf-blindness [10]. Also, Balaha and Moss (2002) noted that children with deaf-blindness need to have access to a variety of adaptive/assistive devices such as personal hearing aids and glasses, low vision devices such as CCTV, monocular, assistive listening device such as FM systems, auditory loops, computer aided real time (CART), lamps or spotlights on interpreter to help the child in visually accessing the information that is being signed and so on [11]. Other support It is obvious that, to educate children with deaf-blindness, supports from teamwork are necessary. As Palmer (2011) suggested, children who are deaf-blindness present a unique challenge to professionals. They represent one of the lowest incidence, yet most diverse group of learners receiving early intervention and special education services [8]. Additionally, Prickett and Welch (1998) stated that these, children need to participate in early intervention in which intervention specialist can assist them to gather information for daily living. In order to enhance effective participation, they explain that these children need “assistance to communicate with peers, teachers, or others in the school and the community”. Besides, in the work of Cloniger and Giangreco (1995), they demonstrated that if the child was engaged in independent activities or working one –on – one with either the teacher or a paraprofessional, they can be enhanced more social interactions and communication opportunities as well as gaining more playing and direct instructions. Moreover, due to the limitation in both auditory and visual information, and dual sensory disabilities affect social interactions, students with deaf-blindness may face many unique challenges in building and keeping relationships with others, especially with their peers [12]. Thus, 173 Nguyen Thi Tham, Phan Thi Thuy educators or intervention specialists can support these students through program modifications in order to involve them to interact with peers or teachers effectively. Also, Horvath, Kampfer -Bohach and Keamrns (2005, p. 178) expressed that “the IEP team plays a significant role in the determination of the accommodations that will be used during assessment and instruction”. This is because with those assistances, the student can learn to take in and use information (all available information channels, that is all sensory information, help child use of other senses, especially touch, try a multisensory approach-using the various sensory modes in support of one another) [7]. Furthermore, Palmer expressed the contribution of parents and caregivers in education for children with deaf-blindness. She notes that “Parents and caregivers can interact with a baby who is deaf-blind through sound, touch and rewarding responses from their child such as mutual gaze, smiling and turning towards the sound [8]. Therefore, it can be concluded that intervention and services fo
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