Entendiendo las Dinámicas Familiares. Un Camino Hacia una Vida Mas Enriquecida
Understanding the Family Dynamics. A Path Towards a More Empowered Life

Fecha: Sept. 11, 2010
Hora: 9am-4pm
Lugar: El Sur de California (lugar exacto será anunciado próximamente)

Presentador:

• Myrna Medina, CDBS Especialista de Familia
• Gloria Rodriguez-Gil, CDBS Especialista de educatión

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Date: Sept. 11, 2010
Time: 9am-4pm
Location: Southern California (exact location to be announced)

Presenters:

• Myrna Medina, CDBS Family Specialist
• Gloria Rodriguez-Gil, CDBS Educational Specialist

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We've got a new videos section! Our first project is Who's Who on My Child's Team and What Are They For? The goal of the project is to clarify the roles of the members of a child's education team. We will be producing video interviews for eight roles and have the first one ready for viewing. Check it out below:

PART 1 OF 3

Too see all parts of the project, click HERE.

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When: Saturday, June 5, 2010  •  10:00 a.m. – 3:00 p.m.

Where: Kennedy Park, Hayward

This is a great opportunity to meet other families in a relaxed, fun atmpsophere. Kennedy Park has many attractions to keep children busy, including a carousel, petting zoo, train ride, and for the younger children pony rides. The park is close to I-880 and can also be reached by BART (COPE-DB can provide transportation between the Hayward BART station and the park). Watch this space for more information and an online RSVP system. We hope to see you there.

One of the main goals of this training session was discussing the critical importance of creating respectful alliances with families in order to better serve our students. 

For this training I invited parents to talk about their experiences from their very unique perspectives. One of these parents who came to talk to us had kept a diary about her son with special needs since he was born, and he is now twenty-years old. 

She shared the diary with me because I had been her son’s teacher many years back. After reading it, I asked her if I could share her diary with the participants of this training. She agreed and when she came to talk to us, the participants had already read it and had several questions for her in regards to the information she had written in it. 

At the end of her presentation she said she had a pressing question to all of us about something that was happening with her son now that he had transitioned out of the school system, and she felt she was at dead end.

In these parent-professional exchanges, several things happened that are worth pointing out: 

Her story brought us back to what is real: the struggles, the successes, the pain, the happiness, the challenges that these families go through.

It reminded us that we are working with people who are facing deep challenges and who need to be treated with respect and empathy.

It brought to us a perspective that it is not our own, which is critical if we want to do a good job.

In a nutshell, it grounded us.

When she asked her question to us, it was a tough and complex question. None of us with our experience and knowledge could answer it right away. There was a long silence, until someone broke the ice by asking a clarifying question.  From the professional contribution it is worth to point out the following:

The answer was collective. It started by someone asking a question, another person saying something that was not exactly the answer, but with an intent to move towards the answer. Finally, two or three people came up with ideas that the parent thought could help her, her son and her family. 

It was very interesting to analyze, after the fact, how the collective contribution in the quest for solutions to complex situations was so critical

The professionals brought an “outside perspective” of people who are outside of the challenge, and who have a wealth of experiences they had had with other students and families. 

In conclusion, the final analysis found that this successful collaboration between parent and professionals happened because the parent and the professionals were respectful, and open to share and listen to each other.

* * *

CDBS will offer one conference session on the topic of intervention. The session, titled "The Concept of Intervention: What is it? How does it work? Why is it important for children and youth who are deaf-blind?", is currently scheduled to occur on Saturday, March 27 from 8:00 - 9:30 a.m. This workshop will be an abbreivated version of the six-hour "on-ramp" training CDBS has conducted throughout the state and will be a great opportunity for teams who need basic information but may not have six hours to devote to the topic.

For a conference registration brochure, click here:

2010 para reg brochure.pdf (479,4 kB)

For more information about the conference session on interveners, contact CDBS Project Coordinator Maurice Belote at 800-822-7884 ext. 1.

It came from a real need. The family asked for this planning meeting because they felt they needed ideas and support from a large network of people.

Happened during a transition time. The student was about to graduate from high school. More people needed to be involved in her life and new ways of doing things needed to be figured out.

Participants were carefully selected by her parents. The family invited people who cared and knew their child well.

The student was already familiar with the MAPs process before the meeting. It helped the student think about who she was, her history, and some of the things she wanted; to understand at some level that her life was about to change; and when the meeting was held, to sit through the whole meeting calm and content. We met for three hours with a break of fifteen minutes.

The meeting was carefully planned. The parents and I had several conversations before the meeting. CDBS staff advised on things to prepare, and time was carefully tracked during the meeting.

Support for the facilitator. As a facilitator I had the help of two teachers who were also interns in the CDBS-San Francisco State University teacher training program. One summarized ideas and comments throughout the MAPs on chart paper and another documented everything. With this support I was able to concentrate all my attention on facilitating the discussion, as well as having a document ready to give to the family three days after the meeting was held.

The meeting focused on specific themes. There were four themes given as choices: Home, work, community life and social life. The parents decided they wanted the meeting to focus on community life and social life.

The level of caring and creativity from the participants was very high. It was evident they cared and wanted the meeting to be successful. They very insightful, and when the time came for the action plan, they came up with excellent ideas and many of them volunteered to be the person responsible for a particular activity in the action plan.

 
A few days after the meeting the parents of this student emailed me and said that the meeting gave their whole family a completely different way of perceiving and thinking about their child’s needs and their role in supporting her.

* * *

Vengan por comida, diversión, regalos y tiempo para compartir con otras familias y profesionales.

FECHA:  Domingo 13 de Diciembre del 2009
HORA:  10:00am – 3:00pm
LUGAR: 

Residencia de los De la Torre
2408 Heather Ave.
Long Beach, CA 90815

COPE DB proveerá el café y los refrescos.  Por favor traiga un platillo para compartir con 12-15 personas.

Para registrarse en línea porfavor presione el botón de abajo.

DATE: Sunday, December 13, 2009                                         
TIME: 10:00am to 3:00pm
PLACE:

De la Torre Residence
2408 Heather Ave.
Long Beach, CA 90815

COPE-DB will provide coffee and soft drinks. Please bring a dish to share, enough to serve 12-15 people.

To register online, please click the button below.

1. It is not important.
2. I will tell you later.
3. Never mind.
4. It was just small talk.
5. It is all settled.

How often do we communicate these ideas to children who are deaf-blind, whether we mean to or not? How often have I said or signed “later”, only to forget—more often than not—to ever revisit the issue? And how might we communicate these phrases through our own behavior in a way that might confuse and frustrate the children we serve? Consider the following situations. Spilled milk? Nevermind because I’m in a hurry so I’ll just mop it up. Your dad coming to the classroom door unexpectedly? It’s not important because he just stopped by to ask about an upcoming meeting. The fire truck that just passed with its lights flashing and sirens blaring? I will tell you later because the city bus is coming and we have to be ready. What’s for lunch? There was a disagreement whether we should have pizza or burgers but now it is all settled so you don’t need to know how we decided on pizza.

Maybe we’re in a hurry and don’t have time to explain. Perhaps we think trying to explain something is just too complicated, or that the explanation might be beyond the ability of the child to understand. And these aren’t just phrases that bother people who are deaf-blind, or for that matter people who are just hard of hearing. They’re responses that would bother anyone, especially if they were used often enough.

Hopefully you get the idea. I’d love to hear your thoughts on this. Feel free to post your comments here on our website for others to read.

Authors: Linda Alsop, Cindy Robinson, Karen Goehl, Jenny Lace, Maurice Belote, Gloria Rodriguez-Gil. Published by SKI-HI Institute, Utah State University. (2007)

This booklet provides detailed guidelines in a checklist format for interveners, teachers, administrators, and parents to assist in their understanding of the roles and responsibilities of interveners in educational settings. An intervener code of ethics is included. The cost is approximately $10.00. Available from Linda Alsop at Utah State University. Phone: 435-797-5598. E-mail: lalsop@cc.usu.edu.

Join us for the annual COPE-DB northern California picnic! This is a great opportunity to meet other families and enjoy a day in the sun.

Sponsored by the Coalition of Parents and Educators Deaf-Blind in collaboration with California Deaf-Blind Services.

• Saturday, June 13, 2009
• 10:00 a.m. to 3:00 p.m.
• Kennedy Park (Peaceful Pines Group Picnic Area near the northwest corner of the park)
• Hesperian Blvd. at Golf Course Rd. (just north of West A Street) Hayward, California
• For information about the park and to download a park map that shows the location of Peaceful Pines visit: http://www.haywardrec.org/kennedy.html

Kennedy Park is centrally located and has plenty of parking. In addition to a large play structure, the park features a petting zoo, carousel, narrow-gauge train ride, and pony rides. COPE-DB will provide lunch. Bring a blanket to spread out on and lawn games if you’d like.

If an individual (birth through age 21) has combined hearing and vision problems that are significant enough to require considerations (such as specialized adaptations, modifications, and strategies) when presenting information or interacting with the child, then that child, along with family members and service providers, is eligible to receive services from CDBS.

You’ll note that here at CDBS, we don’t use our functional definition to label children as having deaf-blindness. That is a process best left to families and local education agencies. The functional definition simply states that if the definition is applicable to a child, then CDBS can provide services to assist the family and educational team to better meet that child’s unique, specialized needs.

Deaf-blindness is a confusing and scary term, and I know this is particularly true for families of children who have recently been diagnosed with vision and hearing issues. For this reason, I hear family members say that their children aren’t deaf-blind, but rather that their children have hearing and vision problems. Others ask us why we use the term at all. I would give two main reasons for continuing its use. The first is that, when a new child is entering a program, the term alerts teachers and administrators that there are critical sensory issues for the child that must be addressed if he or she is going to be fully integrated into the instructional day and the school community. Secondly, the term “deaf-blind” represents a community of children, youths, and adults throughout the world with a rich and proud history of success, innovation, creativity, courage, and undaunted spirit.

Maurice Belote, CDBS Project Coordinator

Edited by Marianne Riggio and Barbara McLetchie and published in 2008 by Perkins School for the Blind.

From the book’s Foreword by Joe McNulty of the National Coalition on Deafblindness:

Deafblindness: Educational Service Guidelines offers state and local education agencies a framework from which meaningful, appropriate programming for students who are deafblind can be developed. These guidelines identify the knowledge and skills educators need to assist their students who are deafblind reach their full potential and become successful, contributing members of our society.

The Guidelines were developed by a group of educators and family members in collaboration with the National Association of State Directors of Special Education. While the primary target audience is administrators and state education agency staff (i.e., the California Department of Education), families, classroom teachers and specialists will find the guidelines useful in guiding program development and implementation. The guidelines are divided into five main sections: 1) foundations, 2) educational personnel, 3) assessment, 4) services and placement options, and 5) supportive structure and administration.

As of this writing, the Deafblindness: Educational Service Guidelines document is available from Perkins School for the Blind for the cost of $25. For information about ordering, visit:
(secure2.convio.net/psb/site/Ecommerce/1847536043?VIEW_PRODUCT=true&product_id=3101&store_id=1101).

Cristi then went on to write about her own observations of the student:

She is starting to chew tiny pieces of food. I watched her as she took the smallest bites possible and daintily chewed them. It was pretty cute to see her do this. She initiated taking her cup and drinking from it. She is also MUCH better at using her object calendar. She carries each object one at a time, attached with Velcro to the outside of her little fanny pack. She knows to pull them off when it’s time. It’s still a tiny bit hard for her but she does initiate it herself.

Cristi ends her email by writing, “It’s all pretty cool stuff. Muy bien!!!”

I think it is very important to celebrate the accomplishments of the children we serve. It’s also important to recognize the efforts of the children, and the efforts of the families, and service providers that have and continue to support the child over the years.

Of course we know that in our work, doing our best everyday is the right thing to do. But when working with children with complex specialized needs, we may not see the point of the enormous effort we put in. We don’t always see the light at the end of the tunnel but, as this story demonstrates, there is light at the end of the tunnel.

I want to acknowledge this child’s educational team. She has been served by one of the best educational teams I have ever worked with. They work with a sense of joy and pride in what they do. They care about and respect the child, and work as closely as they can with this child’s family.

Kudos to All!

Gloria Rodriguez-Gil, CDBS Educational Specialist

Los Servicios de California para la Sordo-Ceguera en colaboración con El Centro de Recursos Familiares del Hospital Miller Children's en Long Beach Memorial presenta un Taller en Español:

“Cómo Adquirir Servicios para Niños con Necesidades Especiales en Tiempos de una Economía Dificil"
Presentador: Matthew M. Pope, Abogado de Derechos a la Discapacidad

• Para: Miembros de familia y profesionales de niños y jóvenes con problemas de visión y/o audición incluyendo discapacidades adicionales.
• Los participantes aprenderán: Información básica de las principales agencias que proveen servicios y apoyos a familias y a sus hijos con necesidades especiales.
• Específicamente el presentador compartirá: Información acerca de varias agencias incluyendo sus diferentes culturas, criterio de eligibilidad y el language especializado que usa cada una de estas agencias.

Logística:

• Lugar: Millers Children’s Hospital en Long Beach Memorial
• Dirección: 2801 Atlantic Ave., Long Beach, CA  90806
• Cuarto: Board Room (planta baja)
• Fecha: Sábado 12 de Septiembre del 2009
• Horario: 9:00am – 3:00pm

Para mas información por favor contáctese con:

• Myrna Medina: Especialista en Familias - medinam66@sbcglobal.net
• Gloria Rodriguez-Gil: Especialista en Educación - gloriagil@vzavenue.net
• O llame al teléfono: 1-800-822-7884

Se proveerá cuidado de niños básico. Este taller se proveerá sin ningún costo a los participantes. Por favor regístrese lo mas pronto posible. El espacio para el cuidado de niños es limitado.

[view English version]

* Por favor registrese por internet apretando el boton de abajo.*

California Deaf-Blind Services in collaboration with Miller Children's Hospital Family Resource Center at Long beach Memorial present a Spanish workshop:

“How to Access Services for Children with Special Needs in Tough Economic Times
Presenter:  Matthew M. Pope, Disability Rights Attorney

• For: Family members and professionals of children and young adults with visual and/or hearing problems and who may also have additional disabilities
• Participants will learn: Basic information about the main agencies that provide services and supports to families and their children with special needs.
• Specifically presenter will share:  Information about several agencies including their different cultures, eligibility criteria and specialized language

Logistics:

• Place: Millers Children’s Hospital at Long Beach Memorial
• Address: 2801 Atlantic Ave., Long Beach, CA  90806
• Room: Board Room (ground floor)
• Date: Saturday, September 12, 2009
• Time: 9:00 a.m. – 3:00 p.m.

For information contact:

• Myrna Medina: Family Specialist - medinam66@sbcglobal.net
• Gloria Rodriguez-Gil: Educational Specialist - gloriagil@vzavenue.net
• or you can call them at 1-800-822-7884

Basic childcare will be provided. This training is provided at no cost to participants. Please register ASAP. Childcare services are limited.

[view Spanish version]

* Please register online by clicking on the button below. *

• Fecha:  Sábado 22 de Agosto del 2009
• Hora:   10:00am a 3:00pm
• Lugar:  Junior Blind of America – 5300 Angeles Vista Blvd., Los Angeles, CA   Tel:  (323) 295-4555
• Direcciones:  Si viaja por el freeway 10 Santa Monica hacia el Este, salga en Crenshaw Blvd., viaje sur en Crenshaw, haga una derecha en Vernon e imediatamente  cambie al carril izquierdo Angeles Vista.  Si viaja en  el freeway 405 San Diego, salga en Slauson y haga una izquierda en Angeles Vista maneje  ½  milla.  JBA estará  a su lado izquierdo.
• Preguntas:  Por favor llame a Gloria Rodriguez-Gil al (310) 823-5824 o Myrna Medina al (323) 363-7499.

Por favor registrese por internet apretando el boton de abajo.

- Cristi Mercedes Saylor, DHH itinerant teacher, East San Diego County

In my work as an itinerant teacher I have had the opportunity to work with several children or young people who are deaf-blind or who are deaf and have multiple handicaps. I also was fortunate to have attended several trainings offered by CDBS in the past – you know those olden golden days when people actually had money to fund such things. As I work with various teams who serve my students I have found myself wishing that they, too, could have attended all those trainings.

Recently CDBS offered a one day training and discussion on interveners to which four of the teams I work with attended. It was great for us to have the opportunity to sit and discuss what interveners are all about and the unique needs of each team. One thing that came out of the training was that people wanted more training and they wanted more time to discuss their students and compare notes with other professionals. So I said why don’t we just create our own trainings and support each other? Seems logical enough. After all we have a veritable plethora of talent, skills and knowledge – plus one of the assistants has decided to get the Utah intervener certificate – think of all the new things we can pick from her brain!

So I decided to “test the waters” and see if people really would come if I offered to facilitate this type of group. And, many people have said, yes, they’d like to come, and they don’t have the time to come often. Hmmm… what to do? I decided to set it up so that we will meet quarterly, discuss topics, ask questions and share what has worked and offer each other support in this journey. I’ve also started sending out emails and links with things of interest for people to read at their leisure. This way they can get training without having to go any place.

Our first meeting will take place in October. The plan is to keep it informal and somewhat collegiate. You know - round table discussions over food and drink? Perhaps start with an article to read and discuss, show videos and discuss them – there are some good ones out there that really are worth a thousand words – and pick one student to discuss as a group. I’d also like us to share emails and build relationships so that in between our meetings we can still offer support and information to one another. So I guess what I’m really saying is that I’d like to build a little community of people who serve children and young people who are deaf-blind and/or deaf with multiple handicaps.

And one never knows where such a thing will lead. Already it has sparked a discussion with one of our schools that serves infants to pre-schoolers who have various disabilities to start setting up a team that is always the team that serves the children who are deaf-blind. Imagine that? We would have one team that would learn how to work with these young children and instead of constantly training teams over and over with the same concepts we could train a team once and then – hold onto your socks – build on that training over time! And who knows where that might lead?! Anyway, I’m excited to be starting a new idea and I’ll keep you all posted on the progress and growth of our little community.

For those of you who’d like to join us, either in cyberspace or real space, feel free to email me at cmsaylor@sdcoe.net. The more the merrier!

Edited by Charity Rowland, Ph.D. and published in 2009 by Design to Learn Projects of Oregon Health & Science University.

This is an invaluable resource for any educator, therapist, or family member who needs clear and concise information about assessment—one of the most challenging aspects of designing high quality educational programs for children and youth who are deaf-blind. The content of the manual is divided into three sections: getting started, gathering information, and interpreting and applying results. Sample questions are included to guide the assessment process towards the identification of functional and usable assessment information. The manual also includes two appendices. The first is a set of four special notes regarding assessment, targeted to special educators, psychologists, speech-language pathologists, and family members. The second appendix contains a one-page summary for each of twelve assessment instruments commonly used to assess children who are deaf-blind, including the strengths and weaknesses of each.

This product and the two assessment forms included in it may be downloaded as pdf files at no cost from:

http://www.ohsu.edu/oidd/d2l/com_pro/db_assess_ab.cfm

In addition, printed coil-bound copies are available at no cost from DB-LINK at the National Consortium on Deaf-Blindness. DB-LINK can be reached at info@nationaldb.org or at 800-438-9376.

Edited by Linda Alsop and published in 2002 by Hope, Inc.

Understanding Deafblindness represents an outstanding overview of all major issues related to deaf-blindness.  The easy-to-use format includes plenty of illustrations, diagrams, and “points to remember” sidebars.  The two-volume binder set is divided into the following chapters: psychosocial aspects; concept development; intervention; vision; hearing; touch; sensory integration; neurological issues; health; communication basics; early communication; communication and interactive relationships; calendar systems; the van Dyke perspective; family issues; self-determination; behavior; gross motor; fine motor and play; O&M for infants and young children; O&M for adolescents and young adults; daily care and self help; IFSP/IEP; physical activity, PE, sport and recreation; social/sex education; transition; and community support.  As of this writing, the cost for the set is $175 and is available through Hope, Inc. (http://hopepubl.com)

Two new features:

1. CDBS now provides online technical assistance through its new Ask the Expert feature. It's also readily accessible through a permanent shortcut area in the lower-left hand corner of the front page.

2. Check out our new Staff Picks section which will be a section of must-have publications related to deaf-blindness selected by the CDBS staff.

Enjoy!

- Ty

Think about this common classroom-setting scenario: A student is doing a task, and the person who is working with him is observing him carefully to make sure he is doing it correctly. This person only intervenes when she sees the student needing help to finish the task or when he is taking too long. The only times when this student and the person teaching or supporting him have physical contact is when the student needs help. When he is doing things well he is left alone, isolated, in what other people may perceive as “independence”. Imagine that this student is deaf-blind with very limited vision and hearing or totally blind with a profound hearing loss.

In a scenario like this, it is very likely that the student who is deaf-blind may be reticent to become independent, because it will mean very limited human contact.

This scenario reminds me of a student who was totally blind and had a moderate to severe hearing loss, and who loved to ride the swings at school. The people working with him knew that the student could independently walk to the swings because he had been doing it for several years, and had shown on some occasions that he could do it on his own. When he walked independently to his destination, it meant walking alone with his cane because the person walking with him would be looking at him at a distance. So what usually happened is that this student stopped several times on the way to the swings waiting for some kind of touch before resuming the walk. Was this only prompt-dependency, or was he looking for some kind for human contact? Sometimes when he was prompted with a touch cue on his arm, he even looked for the adult’s arm asking to walk with her using her as a guide. 

These are some things that you can do that may help lessen this kind of situation: 

• Be aware that the child or youth who is deaf-blind who has very limited vision and hearing is isolated from others when there is no physical contact.
• This student or youth may be stopping in a middle of a task that he already knows because he may want to interact or have contact with another person. This may be the way he had learned to communicate with others: I stop, and then they will touch me, and perhaps tell me something.
• Do not limit your interactions to only supervision: “I observe you and I intervene only when you need help, otherwise I leave you alone.” This would be an incomplete approach.

The relationship and in consequence - the interactions - should mostly be about sharing an activity where both parties are engaged and even have fun while doing it together; having parallel activities where both parties share what they are doing; showing an object or a place; introducing another person; having a conversation based on an object, with signs.

- Gloria Rodriguez-Gil, CDBS Education Specialist

The student may communicate through facial expression, body movement, posture, vocalization, crying, tantrums, etc. These reactions are frequently seen by parents and/or professionals as behaviors that need to be eliminated, when in fact the student is trying to communicate and becomes more and more frustrated when their communication is misunderstood. If, instead, the student's attempt to communicate can be acknowledged and expanded, difficult behaviors may begin to decrease.

Points to Remember:

1. Look at all of the student's behavior as an attempt to communicate.

2. Be sure the student has had medical problems eliminated.

3. Attempt to understand the student's communication effort.

4. Teach the student a more acceptable way to communicate what he has to say, after showing you understand the effort.

Fact sheets from California Deaf-Blind Services are to be used by both families and professionals serving individuals who are deaf-blind. The information applies to students 0-22 years of age. The purpose of the fact sheet is to give general information on a specific topic. More specific information for an individual student can be provided through individualized technical assistance available from CDBS. The fact sheet is a starting point for further information.

What It Is, What Causes It,

Its Effects, and Treatment

What it is:

Otitis media is one of the most common problems for which a child is seen by a physician. It is an inflammation of the middle ear space and is usually accompanied by fluid build-up. This fluid may or may not be infected. This build up of fluid in the middle ear space restricts the movement of the ear drum. If the ear drum does not move freely, a hearing loss occurs. This can be compared to plugging your ear with your finger. The child with otitis media does not always show signs such as fever, irritability, tender ears, reddened ears, etc.

There are three general categories of otitis media: 1. otitis media without effusion (fluid); 2. otitis media with effusion; 3. otitis media with perforation (hole in ear drum).

What causes it:

The eustachian tube is the tube connecting the middle ear and the upper part of the nasal passages. Eustachian tube dysfunction is a significant factor in the development of otitis media. The purpose of the Eustachian tube is to equalize the pressure on both sides of the ear drum and provide ventilation to the middle ear space. When it does not work properly, the air is trapped in the middle ear space. This air is absorbed and fluid results.

Age plays a factor in the development of otitis media. At birth, the eustachian tube is in a horizontal position and it is wider and shorter. During the first few years of life it begins to extend downward allowing for easier drainage. Therefore, otitis media is most common during the first 2 years of life. Inflammation of the nasal end of the eustachian tube may produce swelling, thus impairing its function. Such inflammation may result from viral or bacterial infection (a cold) or chemical irritation (tobacco smoke, chlorinated pool water).

Allergies have also been known to cause otitis media. Some foods that commonly cause allergic reactions in young children include milk, wheat, eggs, corn, yeast, peanuts, soybean, sugar and citrus. Skeletal changes play an important part in the development of otitis media. Children with Down syndrome, cranial base anomalies (cleft palate, atresia, adenoid problems, etc.) and craniofacial syndromes (Treacher-Collins, Crouzon's or CHARGE) have a high incidence of otitis media. Children with upper respiratory problems are also more prone to develop otitis media. Family history, climate, and dietary reasons have also been linked to recurring otitis media.

What the effects are:

Recurring otitis media has been shown to have a direct impact on a child's speech, language, and academic development. If a hearing loss is present due to otitis media, a child will experience difficulties in attending and following both formal communication (classroom instruction), and incidental communication (conversation that is on-going throughout the day).

Amplification is not prescribed for the child with otitis media because in the majority of cases, the child's hearing returns to normal after the otitis media is cleared. However, more severe cases, especially when prolonged or left untreated, may result in a perforated ear drum, scar tissue on the ear drum and even a permanent hearing loss. Other, more serious, complications that could occur include facial nerve paralysis, meningitis, encephalitis or brain abscess.

Children that have a known sensorineural hearing loss may experience a decrease in their usable hearing and in some cases, these children may not be able to wear their hearing aids during an episode of otitis media. The ear must be allowed to breathe and drain. If an earmold or hearing aid is in the ear, increased condensation may occur or the fluid may drain into the hearing aid causing internal damage to the amplifier. Some children may experience such pain that they cannot tolerate the earmold or hearing aid in their ear.

Treatment:

Treatment for otitis media varies according to the severity, the occurrence, and the age of the child. If the otitis media is found to be infectious, antibiotics are usually recommended. Clearance of the liquid is imperative. If the child has a history of recurring otitis media the doctor may choose to perform a myringotomy and place a tympanostomy tube in the ear drum. This is a common procedure in young children which entails the doctor making an incision in the ear drum to drain the fluid. A small tube is then placed in the incision. This tube allows for the air pressure to be equalized on both sides. It also assists in keeping the middle ear space well ventilated.

IF YOU SUSPECT YOUR CHILD MAY BE PRONE TO OTITIS MEDIA, CONSULT YOUR PHYSICIAN, PEDIATRICIAN, OR EAR, NOSE AND THROAT SPECIALIST (ENT). CDBS IS ALWAYS HERE TO ANSWER YOUR QUESTIONS.

Glossary:

effusion - The escape of fluid into the middle ear cavity.

perforation - A hole or tear.

cranial base anomalies - Pertaining to or involving both the braincase and face.

cleft palate - Nonclosure of all or part of the roof of the mouth.

atresia - Absence of the ear canal.

myringotomy - A small cut in the ear drum.

facial paralysis - A paralyzed face muscles.

meningitis - Inflammation of the membranes covering the brain and spinal cord.

encephalitis - Inflammation of the brain.

brain abscess - A collection of puss surrounded by inflamed tissue on the brain.

tympanostomy tube - A small tube that is placed in the ear drum to allow
air to enter the middle ear.

Fact sheets from California Deaf-Blind Services are to be used by both families and professionals serving individuals who are deaf-blind. The information applies to students 0-22 years of age. The purpose of the fact sheet is to give general information on a specific topic. More specific information for an individual student can be provided through individualized technical assistance available from CDBS. The fact sheet is a starting point for further information.

Fact sheets from California Deaf-Blind Services are to be used by both families and professionals serving individuals with dual sensory impairments. The information applies to students 0-22 years of age. The purpose of the fact sheet is to give general information on a specific topic. More specific information for an individual student can be provided through individualized technical assistance available from CDBS. The fact sheet is a starting point for further information.

Children who are deaf-blind but have a significant amount of vision can be assisted in using their vision to the greatest extent possible by adapting the environment and materials, or by teaching them strategies to meet the demands of the environment. Not all adaptations are appropriate for all children. Each child's visual needs are different according to a variety of factors. These include their visual diagnosis, the presence of other disabilities, their visual abilities, and environmental factors. Two factors to keep in mind when considering adaptations for a child are: Student or material/environmental adaptation, necessity, and level of demand on the student.

Student adaptations can be more effective because they are less intrusive and more flexible. This approach is best when the student is capable of generalizing the learned skill to a variety of environments. This is not always the case and the skill that the student has learned may have to be taught in each environment where it would be helpful.

Materials adaptation should be used when the student has difficulty adapting in the way required by the task. Material adaptations take a number of different forms: Lighting, color and contrast, size and format, and changes in workspace. Material adaptations should be made with forethought and only when required by the student. They should be made as minimal as possible while still allowing the student to complete the task effectively.

You do not want to make the student dependent on an adaptation when it is not necessary. In some situations it may be better to make small adaptations at first in order to place higher demands on the student to help them to learn to adapt. Once they have done so the task can be further adapted to increase efficiency. It is also important to remember that when all visual adaptations are ineffective non visual (tactual) adaptations must be considered.

1. Students should be taught techniques in a variety of settings to encourage independence and generalization of the skill.

2. Students benefit from good positioning. The less energy they expend on holding themselves up the more they can put into using their vision. This is a skill that they can be taught to self monitor.

3. Limiting fatigue will help students perform better. Break tasks up into shorter time periods to give their eyes a rest and limit visual fatigue. Extended time may also be necessary for a child to complete a task.

4. Children can and need to be taught to wait for their eyes to adjust to changes in lighting. This is most true if going from outdoors to indoors and visa versa.

5. Children can learn to view in different ways to maximize their residual vision. The most obvious is distance. Getting closer to or farther away from the object or person to be seen may make it easier. Some children tilt their heads to get the visual material at an ideal angle. They may also do this by moving the material.

1. Lighting interacts with many other factors but most importantly with contrast. Lighting can increase or decrease the contrast of visual materials. In a dark environment increased lighting will increase contrast but in a bright environment it will reduce it. Natural light is good but it needs to be controlled due to glare. Light that comes from behind the individual is best as it minimizes glare and does not strike the person directly in the eyes. A lamp with an adjustable level of light is useful for this. Children who have trouble attending to material may benefit from shining light directly on it. This may help attract their attention.

2. As stated before contrast is effected by lighting but it is also effected by the materials them selves. Visual materials should be a different color from the background and backgrounds should be plain not patterned. For example if you want the child to see some red blocks put them against a blue or black background instead of an orange one. For print or pictures they should be as dark as possible on a clean background. A photocopy where the letters are gray and the background is also darker is not ideal for a child who needs good contrast.

3. Pictures need to have good contrast and be simple in format. Cluttered pictures will not be easy for the child to see. Also having many pictures on a page causes the same type of visual clutter.

4. Color can be an effective visual cue. It can be used to organize and classify or bring attention to important visual material.

5. Pictures or print should be spaced well. It is helpful if there is a good amount of space between pictures or words as it makes them stand out better. More space between lines can make tracking easier.

6. A student's workspace can also be changed to assist them in using their vision. An example of this would be to create visual boundaries by putting colored borders on a desk can be effective in focusing a child's attention. Using a tray can have the same effect, it also creates a tactual boundary to reinforce the idea of space. Materials can also be made more accessible by bringing them closer to the student. This can be done by using a reading stand and by adjusting the height of the desk or table.

7. This same concept is also true of the layout of a room. Areas of a classroom should be visually unique. This can be accomplished by using different colored carpet or by arranging the furniture to separate areas/activity centers from each other.

8. Enlarging materials is useful for children who have reduced acuity. This could be enlarging of pictures or print that the child needs to see. However enlarging materials is not necessarily the best adaptation for children with a field loss as they will see less of what has been enlarged instead of more.

Corn, A.L. (1983). Visual Functioning: A theoretical Model for Individuals with Low Vision. Journal of Visual Impairment and Blindness, 77, 373-377.

Hall, A., & Bailey I.L. (1989). A Model for Training Vision Functioning. Journal of Visual Impairment and Blindness, 82,390-396.

Levack, N. (1991 ). Low Vision: A Resource Guide with Adaptations for Students with Visual Impairments. Austin: Texas School for the Blind.

Stratton, J.M. (1990). The Principal of Least Restrictive Materials. Journal of Visual Impairment and Blindness, 84, 3-5.

Fact sheets from California Deaf-Blind Services are to be used by both families and professionals serving individuals who are deaf-blind. The information applies to students 0-22 years of age. The purpose of the fact sheet is to give general information on a specific topic. More specific information for an individual student can be provided through individualized technical assistance available from CDBS. The fact sheet is a starting point for further information.

Supported Education

Traditionally individuals with deaf-blindness have been educated in separate and specialized environments. Recently research and successful experiences have opened the doors to less restrictive educational programs for these students.

Including students with their non-disabled peers in integrated environments provides individuals with disabilities the opportunity to interact with and learn from students with other abilities. Non-disabled peers model appropriate communication and behavior and provide opportunities for social interaction. Shared experiences between peers allows friendships to develop. These friendships often continue to provide support individuals need in future environments.

Supported education is an option chosen by the educational team, including the family as the primary member. The least restrictive environment (LRE) mandate states that the educational placement of an individual must be based on the IEP and located as close as possible to the student's home.

Supported education is the process of providing support, assistance and information to ensure the successful inclusion of students with disabilities within the general education classroom. This support is most generally provided by a team of general education teacher, special education staff, the individual and his/her family and peers. Supported education is not a way to abolish special education, nor a strategy to decrease services to individual students. It is, however, a means to deliver educational services to students with diverse needs within the general education system. It often results in an increase of services to both individuals with disabilities and their non-disabled peers.

Supported education can benefit students with varying disabilities. While recognizing the unique learning needs of individuals, modifications and adaptations can be made to accommodate individuals with dual sensory impairments within a variety of educational settings. However, successful programming requires that the supports and supplemental services required by the IEP are provided and managed appropriately, and all involved work in a collaborative manner. Personnel specially trained in sensory impairments must work in a team approach to provide related services.

Supported education is an option that should be available to every individual with dual sensory impairments. Careful planning and collaborative efforts will ensure the successful inclusion of individuals in their school, community and work environments.

Strategies for developing supported educaton programs are identified in the following chart. For more information, or to obtain technical assistance on this or other topics related to individuals with deaf-blindness, contact California Deaf-Blind Services.



Fact sheets from California Deaf-Blind Services are to be used by both families and professionals serving individuals with dual sensory impairments. The information applies to students 0-22 years of age. The purpose of the fact sheet is to give general information on a specific topic. More specific information for an individual student can be provided through individualized technical assistance available from CDBS. The fact sheet is a starting point for further information.

ADD .......................................Attention Deficit Disorder
APE .......................................Adapted Physical Education
CAC .....................................Community Advisory Committee
CCS ....................................California Children's Service
CDBS ..................................California Deaf-Blind Services
CDE ...............................California Department of Education
CNS ...........................................Central Nervous System
COE .......................................County Office of Education
DIS ..............................Designated Instruction and Services
DD ..........................................Developmentally Disabled
DHH .........................................Deaf and Hard of Hearing
HKNC ....................................Helen Keller National Center
ICSM ................................Individual Critical Skills Model
IEP .................................Individualized Education Program
IFSP . Individual Family Service Plan (implemented by infant programs)
IHE ...................................Institute of Higher Education
IPP ........ Individual Program Plan (implemented by regional center)
ITP .......................................Individual Transition Plan
LD ................................................Learning Disabled
LRE ..................................Least Restrictive Environment
MH ..............................................Multiple Handicaps
OT .............................................Occupational Therapy
PEERS ............ Providing Education to Everyone in Regular Schools
PNS .......................................Peripheral Nervous System
PT .................................................Physical Therapy
SDC ...............................................Special Day Class
SED ......................................Special Education Division
SED ....................................Severe Emotional Disturbance
SELPA ..........................Special Education Local Planning Area
SH ............................................ Severely Handicapped
SLD .........................................Severe Language Disorder
SLD ....................................Specific Learning Disability
TRCCI . Training and Resources for Community and Curriculum Integration
USD .........................................Unified School District
VI................................................ Visually Impaired

Fact sheets from California Deaf-Blind Services are to be used by both families and professionals serving individuals with dual sensory impairments. The information applies to students 0-22 years of age. The purpose of the fact sheet is to give general information on a specific topic. More specific information for an individual student can be provided through individualized technical assistance available from CDBS. The fact sheet is a starting point for further information.

Individuals with dual sensory impairments may show beginning communication skills in many ways. This communication may take the form of body movement, gestures, facial expressions, vocalizing, use of objects or people, pointing to pictures, or more formal systems. As these skills begin to develop, it may be helpful to create a need for increasing the use of these new communication forms.

1. You may do movements together with the individual which the person really enjoys (e.g., rocking, dancing or stirring batter). You can stop your movement, pause for a few seconds, and see if the individual indicates he wants to continue. He may indicate he wants to continue by his body movement, facial expression, gestures, vocalizing, etc. This is the beginning of communicating needs and wants.

2. As the individual becomes familiar with various routines, you can watch to see if he anticipates each step of the routine. As you do the familiar routine, pause before moving on to the next step of the activity. During the waiting period of a few seconds, watch for movement, body posture, facial expression, gestures, vocalizing, etc., which indicates that the individual wants to complete the activity. (For example, you may assist the individual with dressing and may pause after the socks are placed on his toes. The individual may wiggle his toes to indicate he wants to finish dressing.)

3. Many times a person with dual sensory impairments learns a variety of tasks well which do not require the need to communicate. You can create a need to communicate within the routine/task by "forgetting" to put out all materials he will need for finishing the task (e.g., putting out a can of soup without the pan, putting out the toothpaste without the toothbrush, or placing a desired object just out of reach). The individual will then need to

ask for the missing item in whatever way he can. You should not, however, interrupt his independence by removing materials he is currently using. It is also not recommended to insist he describe what he is doing in order to continue his task (e.g., the teacher removes the child's cookie for each bite until the child says/signs/gestures, "I want the cookie"). If you interrupt by removing materials he already has, the individual may feel punished and may not wish to communicate. If you block his independence by requesting a description of what he is doing, he may stop functioning independently and may always wait to be prompted to continue actions.

4. After the individual expresses his desire to continue these activities, it is very important to let him know that you understood his attempts to communicate. You may say "Oh, you need the toothbrush!" or "You want your socks on?", etc. Your movements as you speak can be an imitation of his movement. Your statements should tell him that you "heard" what he was saying and that you respect his wishes. Be sure that your facial expression, body language, vocalizations, and speech all give a message of positive feelings about his communication.


Fact sheets from California Deaf-Blind Services are to be used by both families and professionals serving individuals with dual sensory impairments. The information applies to students 0-22 years of age. The purpose of the fact sheet is to give general information on a specific topic. More specific information for an individual student can be provided through individualized technical assistance available from CDBS. The fact sheet is a starting point for further information.

Adapted from Deaf-Blindness: A Fact Sheet, Gallaudet University.

Fact sheets from California Deaf-Blind Services are to be used by both families and professionals serving individuals with dual sensory impairments. The information applies to students 0-22 years of age. The purpose of the fact sheet is to give general information on a specific topic. More specific information for an individual student can be provided through individualized technical assistance available from CDBS. The fact sheet is a starting point for further information.

Fact sheets from California Deaf-Blind Services are to be used by both families and professionals serving individuals with dual sensory impairments. The information applies to students 0-22 years of age. The purpose of the fact sheet is to give general information on a specific topic. More specific information for an individual student can be provided through individualized technical assistance available from CDBS. The fact sheet is a starting point for further information.

Adapted from Sternberg-White, S., Chen D., Watts, J., 1992,
Developing Social-Emotional Skills, INSITE, Utah State University, Logan, Utah

Fact sheets from California Deaf-Blind Services are to be used by both families and professionals serving individuals with dual sensory impairments. The information applies to students 0-22 years of age. The purpose of the fact sheet is to give general information on a specific topic. More specific information for an individual student can be provided through individualized technical assistance available from CDBS. The fact sheet is a starting point for further information.

Theme: Instructional Strategies
In This Issue:
CDBS Receives 5-Year Funding Award
Rethinking Circle Time
Sharing Information to Improve Your Children's Learning Experiences at School
News & Events: CDBS Welcomes New Staff
News & Events: The Concept of Intervention: What is it? How does it work? Why is it important for youth who are deaf blind?

Most CDBS fact sheets are available as PDF files. To view and print these documents, you need to have a PDF viewer such as Adobe Reader® installed on your computer. If a particular fact sheet is not available online, please contact our office to obtain a printed copy (free of charge): call 800-822-7884 ext. 1 from within California, 415-405-7560 ext. 1 from outside California, or send an email request.