An Ongoing Challenge to our Systems: Students and Adults

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 . . .

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)

7,800 deaf & hard of hearing students graduate or exit school each year 2,300 have 6th to 12th grade literacy skills

Benefit from post-secondary training through accommodations provided in colleges & universities

3,500 have 2nd to 4th grade literacy skills Benefit from vocational training through

accommodations provided in technical schools and other training programs

2,000 have less than 2nd grade literacy skills Accommodations and environmental supports are

usually not available to this population

More on Graduation Rates

1996 study indicates that: 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)

Reported on deaf students who had been out of secondary school for up to three years as of 1990. 28% enrolled in postsecondary programs 20% enrolled in vocational programs 25% employed in competitive settings Where’s the other 27%?

Gallaudet Research Institute 2007 Other Student Characteristics English Language Learners 23% Economically Disadvantaged 37% Pre-lingual Deaf 56% Second Disability 40% Three or More Disabilities 15%

What does this mean for Students?

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?

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

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 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

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

Incorporated the COED - underserved

Introduction of Risk Factors

Risk Factors

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

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

Limited communication abilities Difficulty in maintaining

employment Poor social and emotional skills Need support and/or training to

live independently

Dual “Pathway” to Identification

Medical/Secondary Disability Based

Environmental- Deprivation /Risk Based

Diagnosis Errors

Failure to Identify Hearing Difficulty

Identification of Hearing Difficulty as a Developmental Disability

Delayed Identification of Hearing Difficulty

Medical / Disability Based Etiology

Undiagnosed Cognitive Barrier Progressive Sensory Disability Acquired Physical Barrier Undiagnosed Developmental Issue

Prevalence of Persons with

Additional Disabilities 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 Inadequate environmental

opportunity Barriers to language acquisition Barriers to skill acquisition and

development Cumulative impact of lack of

opportunity to develop skills

Educational Deprivation Language Development Reading Achievement Writing Achievement Math Achievement Results from inappropriate

placement and lack of resources Primary Disability Focus

Other Deprivation Factors Inadequate Social

Opportunity/Isolation Inadequate Community Interaction Inadequate Economic Opportunity Inadequate Vocational Exposure Language Deprivation Inadequate Service Access

CRITICAL BARRIER--

COMMUNICATION

Language and Communication

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

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

Understanding communicative intentions

Convey information Express attitude/emotion Regulation of social interaction Turn taking Topic Maintenance Presupposition and Narrative Skills

Language & Communication “Impairments”

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

Certified Interpreters Certified Deaf Interpreters Communication Interveners/Support

Support Service Providers Professionals with ASL Skills Paraprofessionals with ASL Skills Family Members

Communication Standard

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

Assessment Model Assessment Principles Assessment Strategies Assessment Adjustments Risk Analysis Functional Process

Bio-psycho-social Model Of Disability

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

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

Field Sensitive Style Field Independent Style Ability To Generalize Need for Learning Support

Assessment Considerations: Cultural Awareness

Recognize Cultural Influence Learn about that influence Clarify values Develop fluency in the culture

Assessment Considerations: Family Interaction 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

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

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

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

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 RiskPoor or no work historySubstance abuseFamily involvement w/ protective servicesParent incarcerated or w/ arrest recordInvolvement with social welfare agencyReceives public assistance

Functional Assessments

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

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

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

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

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

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 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

Psychological Challenges Cognitive Challenges Family Support and Integration

Issues Misdiagnosis Inadequate or Inappropriate

Treatment

Employment Issues

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

Supports are needed for: 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?

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