Feb 27, 2009

Mainstreaming your child with a cochlear implant

As part of our blog site, the editorial team decided from time to time we would pick a topic of interest from the week on the discussion forum and discuss it here.

One of the major topics this week started off with a parent asking what other parents were doing with regards to their child with a cochlear implant in the mainstream setting - did the child have an aide working with them, or were they mainstreamed without any additional support?

A range of responses ensued, further highlighting other issues around mainstream settings.

Some students were mainstreamed with a school aide supporting them directly in the classroom. Other students were supported by a Teacher of the Deaf (TOD) who would visit the school and withdraw the child from the classroom to work with them one to one. In some instances the TOD may work in the class with the students.

For those that had an aide, there were varying amounts of time, some for a certain number of hours a week, and in some instances where a child is using ASL, they may use a combination of an interpreter for some lessons, and then an in class aide for those lessons in which the teacher is fluent in ASL. Some parents described having the aide in the classroom for some of the time as a way of improving the student to teacher ratio rather than using it for direct one to one time. Still other students spend time in the school "resource room".

When parents request an aide for their child as part of the Individual Education Plan (IEP) process, there are some things to be aware of. There are many very good teacher aides however the vast majority offered by schools are often untrained and inexperienced with working with a child with a hearing loss. School districts save money by hiring someone of a lower pay scale. That said there are certainly some outstanding aides, so don't dismiss the idea outright. Perhaps the issue that maybe isn't discussed often enough is "what is it that the aide is supposed to be doing with the child?" Is the aide going to spend time withdrawing the child one to one to teach the child unknown vocab, pre-teaching concepts? Is the aide going sit right alongside the child and even turn his/her page for them? (Don't laugh too loud, it has happened!!) Where the role of the aide is undefined, there is a minefield of potential problems. If the aide does not have clear direction, then they may feel they need to "do everything" for your child to justify their presence. This does not sit well when we are trying to raise independent children with a capacity to self-advocate. However if the aide is told to simply "shadow" the student and only intervene if necessary, then the aide will be comfortable sitting back and allowing the child to try, since they are directly following their role as defined in the IEP.

By and large school resource rooms should be for what we call curriculum support. A place where the staff know the school, know the program and can help the child with some additional time and support to reinforce concepts taught in the classroom. They may also even pre-teach some content so the child knows what is happening when a new topic is started in the class group. School teachers do not have the specialist training in deaf education that TODs have, and as such it is unfair to expect them to fulfil a role that expects that of them. TODs have an understanding of the kinds of speech gaps that students with a hearing loss may have. They also have an awareness of the specific areas of learning that are often more difficult for children with a hearing loss, for example double meanings.

Where students have a TOD visiting them, they are often withdrawn (or "pulled out") to work by themselves with the teacher in a separate room. TODs, because of their qualifications and training, will focus on more specific areas of language acquisition. Depending on the child's level, they may be doing very basic tasks for example pre-teaching or post-teaching, or for an older child, specific aspects of language, eg idioms, auditory memory for multiple tasks/requests. The much older teen may perhaps even be working on specific aspects of self advocacy and how to manage the multitude of teachers and classrooms in the middle and senior years of schooling. (For more information, you may wish to read one of our past blog posts, "What is a TOD"? written by a TOD.)

There are a vast range of options for supporting the child with a cochlear implant in the mainstream setting. This will depend on things like age at diagnosis, age at implantation, any language delays on starting school etc. The best way for parents to go about this process is to gather as much information as possible about what other parents & schools in their district and beyond, are doing and using that information to help plan what might best suit the needs of the child. However perhaps the issue that is as important as what that support might look like is what are the specific roles of the support personnel? Parents should be making sure that those roles and responsibilities are clearly defined in the IEP document so that everyone understands their part in the process. The other thing is that any goals set need to be reviewed at specific time points to see whether or not your child is meeting those goals. If they are not, perhaps the support services need to be re-evaluated to make sure your child is getting the support required. If by chance your child is meeting those goals, this is not a reason for the school to cut that support. They are meeting those goals because the support program is working the way it is supposed to!! BUT that might be a whole future blog!

If you would like more information including some helpful advice for teachers, like repeating instructions, seating, acoustics, check out this link, starting on page 8...click here