Download An Ongoing Challenge to Our Systems

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An Ongoing Challenge to our
Systems:
Students and Adults
Identified as Low Functioning
and Deaf or Hard of Hearing
As A Deafness Professional,
Most Likely, Some of the
People You Serve Are NOT
Able To . . .
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Participate fully in their educational program
Take advantage of new technologies
Understand the certified NAD/RID interpreter; or
Participate in post-secondary and vocational
training opportunities
WHY?
Graduation Rates
(RRTC-31 in 1980s)
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7,800 deaf & hard of hearing students graduate or
exit school each year
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2,300 have 6th to 12th grade literacy skills
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3,500 have 2nd to 4th grade literacy skills
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Benefit from post-secondary training through accommodations
provided in colleges & universities
Benefit from vocational training through accommodations
provided in technical schools and other training programs
2,000 have less than 2nd grade literacy skills
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Accommodations and environmental supports are usually not
available to this population
More on Graduation Rates
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1996 study indicates that:
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48% of students left school without a diploma
40% of students received high school diploma
Number to receive diplomas are declining as
a result of accountability requirements in No
Child Left Behind Act
National Longitudinal Transition
Study (1987 – 1993)
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Reported on deaf students who had been out
of secondary school for up to three years as
of 1990.
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28% enrolled in postsecondary programs
20% enrolled in vocational programs
25% employed in competitive settings
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Where’s the other 27%?
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Gallaudet Research Institute 2007
Other Student Characteristics
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English Language Learners
Economically Disadvantaged
Pre-lingual Deaf
Second Disability
Three or More Disabilities
23%
37%
56%
40%
15%
What does this mean for
Students?
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Each year, about 30% of “hearing impaired” students
actually graduate
About 30% receive certificate of completion
Many who don’t receive a certificate of completion, have
2nd grade or less literacy skills
27% of the students who left high school, are NOT
working, in college or in voc training
What does this mean for
Adults?
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60% of people, who are deaf or
hard of hearing, are between 21
and 65; i.e., working age
60% of the working age group are
not in the labor force – they are
unemployed
Description
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Group of individuals within the general
population of persons who are Deaf or Hard of
Hearing, whose skills and competencies are
significantly below average
No precise “epidemiological” description of this
group
Individual is a person with a significant disability
Labels
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Under Achieving
Multiply Handicapped
Severely Disabled
Minimal Language Skills
Traditionally Underserved
Hard to Serve
Low Functioning
Most At Risk
Deaf with Special Needs
Definitions
Federal Definition: Low Functioning
 Individual is Deaf or Hard of Hearing
 Individual may have other disabilities
 Functioning level prohibits participation in
post-secondary education or training
 Language and communication are extremely
limited
 Limited work skills and poor employment
history
COED Definition
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Low functioning adults who are deaf or hard of
hearing are an un-served subgroup within the
population…due to communication barriers
these persons are not able to benefit from
conventional rehabilitation training programs.
Language limitations may preclude the use of
Interpreters…the cost from extended service
needs tends to discourage the provision of these
services
RRTC-1993 Revisions
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Incorporated the
COED - underserved
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Introduction of Risk
Factors
Risk Factors
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Low socioeconomic status
Inappropriate diagnosis
Foreign born or English as 2nd language
Lack of access to services
Lack of family support
Substance abuse
Secondary disabilities
Minority status
Residence in rural/low income urban
settings
Characteristics of
the Population
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Inadequate communication skills
Vocational deficiencies
Deficiencies in behavioral, emotional &
social adjustment
Independent living skills deficiencies
Educational & transitional deficiencies
Health, mental, and physical limitations
Consequential
Difficulties
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Limited communication abilities
Difficulty in maintaining employment
Poor social and emotional skills
Need support and/or training to live
independently
Dual “Pathway” to
Identification
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Medical/Secondary
Disability Based
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EnvironmentalDeprivation /Risk
Based
Diagnosis Errors
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Failure to Identify Hearing Difficulty
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Identification of Hearing Difficulty as a
Developmental Disability
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Delayed Identification of Hearing
Difficulty
Medical / Disability Based
Etiology
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Undiagnosed Cognitive Barrier
Progressive Sensory Disability
Acquired Physical Barrier
Undiagnosed Developmental Issue
Prevalence of Persons with
Additional Disabilities
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Approximately 6,047,910 of the 20,295,000 who are
Hard of Hearing have an additional disability
Approximately 164,496 of the 552,000 who are Deaf
have an additional disability
School age data suggest 40% have a second
disability
Additional Disabilities Affect Skill Development
Deprivation as an Etiology
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Inadequate environmental opportunity
Barriers to language acquisition
Barriers to skill acquisition and
development
Cumulative impact of lack of opportunity
to develop skills
Educational Deprivation
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Language Development
Reading Achievement
Writing Achievement
Math Achievement
Results from inappropriate placement
and lack of resources
Primary Disability Focus
Other Deprivation Factors
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Inadequate Social Opportunity/Isolation
Inadequate Community Interaction
Inadequate Economic Opportunity
Inadequate Vocational Exposure
Language Deprivation
Inadequate Service Access
CRITICAL BARRIER--
COMMUNICATION
Language and Communication
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Internal: Language is a means of
thinking or reasoning
External: Language is a means of
communication
Language uses structure/system,
rules/grammar and symbols/vocabulary
to accomplish internal and external tasks
Language Assessment
Considerations
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Language is symbolic and generative and not
easy to assess
Language is synergistic: measurement of one
part does not measure the whole
Language is part of the total experience of the
individual-difficult to assess in isolation
Language use (quality and quantity) varies
according to the setting, inter-actors and topic.
Communication and Language
Assessment Content
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Understanding communicative intentions
Convey information
Express attitude/emotion
Regulation of social interaction
Turn taking
Topic Maintenance
Presupposition and Narrative Skills
Language & Communication
“Impairments”
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ASL: Individual has ASL Signs but lacks
understanding of grammar and structure
Communication: Individual has limited
pragmatic skills
Lacks “Mother Tongue”: Individual did
not have the opportunity to develop a
first language and as a consequence is in
a state of “language deprivation”
Strategies for Communication
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Certified Interpreters
Certified Deaf Interpreters
Communication Interveners/Support
Support Service Providers
Professionals with ASL Skills
Paraprofessionals with ASL Skills
Family Members
Communication Standard
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Direct communication is the most
effective method between the person
who is labeled as either low functioning
and deaf or at risk of being low
functioning and the service provider.
A DISCUSSION OF
ASSESSMENT PRINCIPLES
AND STRATEGIES
(That is, what environmental and social
supports does this individual need?)
Assessment Of Persons At
Risk
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Assessment Model
Assessment Principles
Assessment Strategies
Assessment Adjustments
Risk Analysis
Functional Process
Bio-psycho-social Model
Of Disability
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International Classification of Functioning,
Disability and Health (ICF)
Replaces Medical Focus
Emphasis on Interaction with Environment NOT
Cause and Treatment
Focus on Enhancing Functioning
Focus on Participation
Focus on Environmental Modification
Assessment Principles
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The ultimate goal is to focus on the
interaction of the individual with the
environment where he/she is expected to
function.
The interaction with the environment will
identify the needs for ongoing supports
or adaptations to reduce the barriers to
optimal functioning.
Assessment Considerations:
Individual Learning Styles
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Field Sensitive Style
Field Independent Style
Ability To Generalize
Need for Learning Support
Assessment Considerations:
Cultural Awareness
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Recognize Cultural Influence
Learn about that influence
Clarify values
Develop fluency in the culture
Assessment Considerations:
Family Interaction
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Improve Competence with Families
Identify Perspective: Needs, Strengths,
Priorities and Values
Family and Individual Help Define the
Nature of the Assessment
Diversity WITHIN a Culture is Respected
Identification / “Assessment”
of Persons “AT RISK” of LFD
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Hearing Loss/ Deafness is Documented
Secondary Disability is Documented
Screening for Risk Factors in the
Individual History
Assessments of Abilities in Functional
Domains
Risk Factor Screening and
Assessment
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Low SES-Income < 200% Poverty
Late Diagnosis-Individual > 5 years
Inappropriate Diagnosis- Developmental
Disability
Poor Service Access- Lack of
medical/social services for adjusting to
deafness
Risk Factor Screening/
Assessment
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Lack of Appropriate Education- No
specialized services, education as person
with Developmental Disability, began
education after age 6 or did not complete
at least 12 years of education
Foreign Born- Immigration from a
country that lacks appropriate education/
social, medical services
Risk Factor Screening/
Assessment
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Family Language- English not spoken at
home
Minority Status- Risk of lack of access to
services because of discrimination
Rural- Low income, limited health
education and social services
Risk Factor Screening/
Assessment
Family Risk
Poor or no work history
Substance abuse
Family involvement w/ protective services
Parent incarcerated or w/ arrest record
Involvement with social welfare agency
Receives public assistance
Functional Assessments
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Self Care – Situational assessment
Language – Assess grammar and
pragmatic use of first language
Communication – Standard assessment
of common communication disorders or
assessment of a consistent system used
for pragmatic purposes
Functional Assessments
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Literacy – Educational achievement (less
than second grade level)
Social Skills – Deficit in interacting in
varied settings; poor understanding /
differentiation of social role of self and
others
Functional Assessments
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Employment – Interest, aptitude, ability
with ecological and situational
assessment
Daily Living – Understanding “life
routine” of home, money, food, medical
Self-direction – Capacity within the range
of choice and preference to decision
making
Emphasis on Interaction with
Environment
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The ultimate goal is to focus on the
interaction of the individual with the
environment where he/she is expected to
function.
The interaction with the environment will
identify the needs for ongoing supports or
adaptations to reduce the barriers for optimal
functioning
Unmet Needs of
Individuals Identified As...
At Risk of Being
“Low Functioning Deaf”
Educational Issues
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Personnel shortages and requirement that IDEA
service have certified providers
Resource limitations and the establishment of
“benefit” for auditory intervention services to be
provided
Primary “Disability” identification does not fully
describe the complexity of the educational
needs
Limitation of Resources that often requires a
forced choice between language intervention
and auditory intervention services
Transition Issues
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Family Involvement
Timing and Quality of Transition Plans
Indicator 13: Student Led IEP Challenges
Dispersion of Students into Mainstream
Programs-Challenge to Identification
Reduced Resources in the Vocational
Rehabilitation Program
Emphasis of Services for high achieving students
Residential Services and wait lists
Service Issues
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Poor epidemiological Information
Interaction of language and learning:
limited research
Poor correlation of diagnosis (needs) with
treatment (program plan) and outcomes
Limited funding
Personnel shortage
Systems barriers
Mental Health Issues
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Psychological Challenges
Cognitive Challenges
Family Support and Integration Issues
Misdiagnosis
Inadequate or Inappropriate Treatment
Employment Issues
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Limited non-college bound training
programs
Current high rates of unemployment in
the general population
Limited long-term support resources for
those needing supported employment
Inadequate numbers of trained staff
Impact of Service Issues
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Supports are needed for:
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Employment settings
Independence at home and in the community
Access to appropriate educational and vocational
training opportunities
Socialization and recreational opportunities
Health care
Behavioral adjustment and mental health
counseling
Accommodations to secondary disabilities
What can we do?
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Identify shared values and goals
Advocate for and with students, families and adults
Collaborate within the educational system
Increase coordination between pre- educational systems,
educational and adult systems
Improve our understanding of the multiple and complex
services and systems of support needed by the individual
Improve collaboration of services and systems across
adult services systems