Guidelines for Evaluating Placement for Children with Cochlear Implants (Part 2) by Deborah Pergament

In this posting, my colleague Deborah Pergament will detail the factors to allow parents to determine if a placement is indeed an aural/oral setting for a child with a cochlear implant, and the necessary criteria to determine the appropriateness of a placement.

IS IT REALLY AN ORAL CLASSROOM?

Despite due process decisions in support of oral programs and research demonstrating the effectiveness of oral/aural education, the use of sign language in the education of the deaf is still heavily debated.  Some teachers of the deaf, influenced in large part by the Deaf culture movement, will still claim that the “natural language” of all  deaf/hearing impaired children is sign.  They will argue that the use of sign does not interfere with language acquisition but actually enhances the ability to learn spoken language.  The proponents of sign language also argue that not all children with cochlear implants can learn to speak and to hear and that the use of sign language prevents these children from emotional distress or loss of academic benefit.   While  age of implantation and other disabiling conditions may interfere with the development of spoken language skills, we believe that children with implants deserve the opportunity to develop these abilities fully.  Unless a child requires sign language to communicate and to learn spoken language, an oral/aural approach should be the sole means of communication in the classroom.

Some school districts argue that they offer an oral program when, in fact, total communication is still what is being used.   The Districts will use terms like “oral with sign support” or “oral with visual support” to describe their program.   The best source of information about the use of sign is speaking with parents of children already in the program or therapists who treat those children.   If you are considering a program in a district that you have heard uses sign in supposedly “oral” classes, it is important to investigate by asking other parents, making multiple visits, and speaking with treatment providers in the area.  You may also ask your child’s treatment providers to visit the programs to independently assess the situation.

Use of Sign Language

1) Observe the class for as long as possible.  Does anyone sign?  Do the kids appear to be aware of your presence?  Do they appear to be having trouble making their needs known/answering questions without repeated attempts/do they look like they are struggling not to sign/point?  Does anyone tell you they have been told not to sign?

2) Does it appear the teacher makes a special effort to ensure that the kids can speech read at all time or is the use of hearing stressed?

3) Does the teacher over-articulate?  Or, does she appear to speak naturally and encourage the children to use their hearing to understand?

4) Does the teacher rely on visual materials to convey concepts in a manner that seems artificial and designed to ensure kids are receiving significant visual input?

5) If possible, ask the kids: do they know/use sign language?  Try to talk to the kids to see how good their articulation is and how comfortable they are using their voices?

6) Ask the teaching staff about their educational background and training.

a) Where did they go to school?  Is it a school that is known for emphasizing Deaf culture and the use of sign?
b) Why did they become a teacher of the hard of hearing/deaf? Are they proponents of Deaf culture?
c) Are they fluent signers?
d) Are they fluent in cued speech?
e) Have they every taught in total communication classrooms?
f) How long have they taught in oral classrooms?
g) Do they belong to AG Bell?
h) What seminars have they attended on cochlear implants? When, Where, How Long Ago?
i) Do they feel positive about cochlear implants?  Do they appear knowledgeable about the differences between working with a deaf child without an implant and children with implants?
j) Do they appear open to working with parents and outside treatment providers?
k) Do they make efforts to address the children’s emotional concerns around being deaf/hard of hearing and using a cochlear implant?

Speech/Audition Therapy

1) If possible, try to see if any of the kids can hear/interpret spoken language with someone talking behind their backs.

2) Ask to speak to the slp providers.
a) What is their experience with kids with cochlear implants?
b) Have they attended any seminars on kids with cochlear implants? When, Where, How Long Ago?

3) Is the speech therapy individual or group?
What is the “mix” of kids in the group? All with implants?

4) What service is offered for audition therapy?

Specials/Co-curriculars?

1) What is done to maximize value of the experience?

2) Does the music program focus on pitch?  Does it incorporate limitations of cochlear implants in hearing music/distinguishing instruments?

3) How is the noise handled in P.E.?  Art?  Lunch/recess?

4) Are FM systems used during these classes?

Safety Issues

1)What precautions are taken to ensure against static discharge?

2) Plastic Slides?

3) Plastic Mats?

4) Computer Screens?

5) Missing External Implant Pieces?

6) What safety precautions are used when an activity involves water?  (e.g., swimming?).

Audiology

What is the protocol for contacting parents if there is an audiological emergency?
Where are extra cords/batteries kept in the classroom?
How are parents informed that supplies are needed?
What happens if a child is “off air” for a period of time?
How often is the audiologist in the building?
Does the teacher test each child using the Ling sounds?  How often during the day? 
Does the teacher report to parents if a child is not receiving benefit from the implant?  How?  How often?
How is preferential seating decided?  Is this reassessed regularly?

Conclusion

    It is important to keep your individual child’s needs in mind when evaluating any program.  Although parents of children with cochlear implants have unique and special considerations, all children deserve to attend schools that will provide them an appropriate education.  Ultimately, the most important question is whether your child will learn, grow, develop academically and socially and be welcomed as a member of a community of young learners.