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According to the Individuals with Disabilities Education Act (IDEA) the definition of emotional disturbance is:

“…a condition exhibiting one or more of the following characteristics over a long period of time and to a marked degree that adversely affects a child’s educational performance:

1. An inability to learn that cannot be explained by intellectual, sensory, or health factors.

2. An inability to build or maintain satisfactory interpersonal relationships with peers and teachers.

3. Inappropriate types of behavior or feelings under normal circumstances.

4. A general pervasive mood of unhappiness or depression.

5. A tendency to develop physical symptoms or fears associated with personal or school problems.”

Some of the characteristics and behaviors seen in children who have an emotional disturbance include:

Hyperactivity (short attention span, impulsiveness);

Aggression or self-injurious behavior (acting out, fighting);

Withdrawal (not interacting socially with others, excessive fear or anxiety);

Immaturity (inappropriate crying, temper tantrums, poor coping skills); and

Learning difficulties (academically performing below grade level).

https://sites.ed.gov/idea/regs/b/a/300.8/c/4
https://education.ohio.gov/Topics/Special-Education/Students-with-Disabilities/Emotional-Disturbances#:~:text=Definition%20of%20Emotional%20Disturbance&text=An%20inability%20to%20build%20or,mood%20of%20unhappiness%20or%20depression.
https://therapytravelers.com/wp-content/uploads/2018/02/ed2.jpg

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Interventions and Accommodations

Teachers will have to structure their classrooms to accommodate students with impairments. This is based on how much help the student needs.

Things to consider:
Making moving around the room easier for the students. So, seating arrangement, posture, and technology devices will need to be considered. Services are also available to assist students with severe disabilities.

Services

✭ occupational therapist

✭ speech/language pathologist

✭ physical therapist

✭ social worker

✭ orientation-and-mobility instructors

✭ recreation specialists

Assistive Technology

Assistive technology can be broken down into categories of devices to access information and devices for positioning and mobility.

Devices to Access Information

✼ software for speech recognition and reading

✼ alternative and augmentative communication devices

✼ academic software packages

Devices for Positioning and Mobility

✼ walkers, canes, crutches, wheelchairs, specialized furniture (chairs, desks, tables), and specialized exercise equipment

Low and high-tech Devices

·      Slant boards are low-tech and portable. It allows students to write at an adjustable angle.

·      iPads can be used to support the various needs of students. Some apps that are useful include text to speech, electronic games, speech to text, dice, and so on.

Other accommodations and devices teachers and parents can consider:

✭ Dycem non-slip rolls

✭ pencil grips

✭ specialized writing paper

✭ specialized keyboards such as IntelliKeys

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Sources

https://assistedtechnology.weebly.com/at-tools-for-physical-needs-meredith-chen.html

http://www.projectidealonline.org/v/orthopedic-impairments/

https://guidetoorthopedicimpairment.weebly.com/strategy--intervention.html

https://youtu.be/QsX_zrCMPEc

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Interventions: Includes early screening to identify who needs help with reading, writing, spelling and math. Identify students & focus on teaching decoding skills (phonology, letter-sound relationships, syllable patterns, etc.).

Accommodations: Students can receive extra time to complete classwork. Test questions can be recorded so that students don’t have to read them.

Assistive technology: Using word-processing programs or audio books.

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Interventions: Therapists can help to strengthen fine motor skills needed for writing. Body positioning can also be practiced with a therapist for the correct writing posture.

Accommodations: Teachers can offer oral exams, provide a note-taker or provide video/audio options for turning in assignments.

Assistive technology: Use an audio recorder instead of writing by hand.

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Interventions: Early intervention through daily practice and repetition of math can be very helpful down the line. Using a Multisensory approach to teaching math concepts - this means using sight, touch, hearing & movement in math.

Accommodations: Teachers can use pictures to represent math problems. Rhymes & music can be helpful in remembering math concepts.

Assistive technology: Computers can be used to practice math.

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https://www.ncld.org/news/state-of-learning-disabilities/understanding-learning-and-attention-issues/

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https://improvingliteracy.org/ask-an-expert/why-early-intervention-so-important-kids-dyslexia

https://www.nichd.nih.gov/health/topics/learning/conditioninfo/treatment#f5

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4538781/

https://www.understood.org/en/articles/treatment-options-for-dysgraphia

https://www.dyscalculia.me/dyscalculia-treatment

https://www.understood.org/en/articles/treatment-options-for-dyscalculia

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What is a speech or language impairment?

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What is a speech or language impairment?

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A student with a speech or language impairment means that they suffer from a communication disorder. This can come in many forms, such as stuttering, trouble with articulation or fluency, language difficulties, or an impairment of the voice. "SLI includes several types of communication disorders that affect different aspects of language: articulation, voice, fluency, and language." https://crsreports.congress.gov/product/pdf/R/R46566

Common accommodations for children with various types of communication disorders are communication boards and AAC Devices. The most basic AAC devices are non-electronic communication boards. These boards offer a few choices represented by images, words, and symbols, and are typically used to aid the child in making choices. "Electronic AAC devices range from very simple devices with few buttons (such as the Cheap Talk) to very elaborate systems that use a keyboard and synthesized speech (such as the Dyna Vox and Liberator)." http://www.projectidealonline.org/v/speech-language-impairments/

Resources:
https://crsreports.congress.gov/product/pdf/R/R46566
http://www.projectidealonline.org/v/speech-language-impairments/

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Articulation disorders may be caused by a structural issue with the mouth, or caused from motor-based issues.

Assistive Technologies are available to students struggling with articulation disorders. For example, the app called Speech Wizard helps students to practice their sounds, words, and phrases. Teachers can gather research + data from the app to track the progress the student is making.

Another accommodation that can be made for students with articulation disorders is utilizing text-to-speech technologies. The text automatically read can be used as an model for the student to hear the correct articulation of speech. Text-to-speech can also be used with older students needing to make a classroom presentation. This simple accommodation can save a student lots of embarrassment if they are struggling with their speech and articulation.

Resources:
https://www.thetechedvocate.org/assistive-technology-to-help-students-with-articulation-disorder-succeed-academically/

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Deaf-blindness is when hearing impairment is accompanied by visual impairment. According to IDEA it is a low-incidence disability, which means that it makes up 20% of disabilities among students. Low-incidence disabilities require a medical diagnosis together with an evaluation of educational needs.

Intervention include early identification and referral. The recommendation is that children with one sensory impairment, either hearing or visual, should also receive assessment in the remaining area. Timely referrals should be made to medical and educational services. Early intervention for children with deaf-blindness will improve education gains, as well as other things.

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National Center on Deaf-Blindness (NCDB): Deaf-Blindness Perspectives

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As deaf-blindness is the combination of hearing and visual impairment resulting in severe communication, other developmental, as well as educational needs, such students cannot be placed in special education programs for only hearing impairment or only visual impairment.

Different types of support can be provided for students. Such accommodations include:
Interpreters to communicate information to and from the student to others in the classroom,
Notetakers which provide and additional written, Brailled, or taped source or information, and
Readers that read text to students who can hear a little but have impaired vision.

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A considerable variety of assistive technology is available for students with deaf-blindness. These tools can increase communication, make information more accessible, and facilitate independence. Students with deaf-blindness  often have many assistive technology devices and require an intervener to support in the use of these devices.

Assistive technology includes low tech materials like reading stands or slanted workspaces, medium tech such as hand-held and video magnifiers, to high tech materials like computer hardware and software, tablets, and Braille devices.

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https://accessiblecampus.ca/tools-resources/educators-tool-kit/teaching-tips/teaching-students-with-deaf-blindness/

https://www.levelaccess.com/understanding-assistive-technology-how-do-deaf-blind-people-use-technology/

https://www.nationaldb.org/info-center/educational-practices/assistive-technology/

M12 LA3 Assistive Technology

https://webapps.ou.edu/ods/cds/MADTools/print/pdf/tpshtdb.pdf

https://crsreports.congress.gov/product/pdf/R/R46566

https://www.deafblindinformation.org.au/about-deafblindness/congenital-deafblindness/for-families-carers/early-intervention/

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Intellectual disability is classified as notable sub average intellectual functioning occurring together with a shortfall in adaptive behavior which impacts a student's educational abilities.
According to IDEA it is classified as a medium/high incidence disability. Medium incidence disabilities are not always visible but can be observed through characteristic behavior. Sometimes, to be classified as a student with a medium incidence disability, a medical diagnosis is needed. Medium/high incidence disabilities make up 80% of all disabilities among students.
Early and continuous intervention is vital in helping students with this condition to reach their full potential. Parents or caregivers who suspect intellectual disability should consult a physician as soon as possible. A specialist in diagnosing developmental conditions should referred by a doctor who observes continuing symptoms.
Other early intervention tips include contacting local schools to inquire and gain access to special education programs, as well as collaboration with teachers and support workers to facilitate the student's progress.

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Accommodations come in the form of additional support as well as modifying the environment and kind of activities. Accommodations which can assist students in learning include;
Creating a quiet work space that is solely for studying and introducing a studying routine,
Use functional activities that teach practical everyday useful things,
Repeating the instruction of the same concept in different ways, and
making use of all 5 senses to help them learn and remember better.

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Assistive technology devices are used to augment, sustain, and better students' abilities. It needs to be used with proper instruction to be most effective. Assistive technology comes in a variety of low to high tech. Classrooms that are equipped with assistive technology facilitate the diverse learning needs of intellectual disabled students.
This technology includes hearing aids, speech to text recognition tools, touch control devices, and computer communication tools.

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https://www.medicalnewstoday.com/articles/intellectual-disability#definition

https://www.therapytravelers.com/strategies-teaching-students-intellectual-disabilities/#:~:text=Accommodations%20are%20often%20made%20in,teacher%20notes%20or%20taped%20lectures

https://www.ldatschool.ca/assistive-technology/

https://numberdyslexia.com/assistive-technology-for-students-with-intellectual-disabilities/

https://crsreports.congress.gov/product/pdf/R/R46566

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Intellectual disability causes significant limitations to a person's intellectual functioning and adaptive behavior.

Intellectual disability is also sometimes known as cognitive disability. An outdated and now offensive term for this condition was "mental retardation."

Read on to learn more about the definition of intellectual disability, its common causes, its symptoms, and some tips for parents and caregivers. This article also covers diagnosis, treatment, and management.

Intellectual disability occurs when a person has difficulty with general mental abilities. This may impact their:

intellectual functioning, such as their learning, judgment, problem solving, abstract thinking, memory, reasoning, and academic skills

practical functioning, which refers to the ability to function and take care of oneself independently, such as performing personal care tasks, managing money, and performing work, school, or home tasks

social functioning, which refers to the ability to function normally in society by using skills such as social judgment, communication, understanding and following social rules and cues, understanding the consequences of one's actions, and making friends

According to the American Psychiatric Association, 1% of the population have intellectual disability. Around 85% of these people have mild cases.

In the United States, intellectual disability affects around 1 in 10 families.

Males are more likely to receive a diagnosis of intellectual disability.

In many cases, the precise cause of intellectual disability is unknown. Typically, however, the condition develops due to injury, disease, or certain brain conditions.

Any condition that impacts the brain and begins before the age of 18 years, even before birth, can cause intellectual disability. However, intellectual disability can also develop later in childhood or adolescence due to conditions that cause brain damage.

Some common causes of intellectual disability include:

certain genetic conditions, such as Down syndrome, phenylketonuria, or fragile X syndrome

fetal alcohol syndrome

congenital anomalies or brain malformations

some infections, such as meningitis, measles, or whooping cough

exposure to toxins such as mercury or lead

serious head injury

maternal disease, such as rubella, drug use, or infection during pregnancy

problems at birth, such as insufficient oxygenation

extreme malnutrition

insufficient medical care

People with more severe forms of intellectual disability usually experience more severe symptoms that are noticeable at a young age.

There are a variety of signs and symptoms that a person with intellectual disability might experience. Generally, people with this condition tend to take longer to learn and develop intellectually than other people.

They also tend to have difficulty with adaptive behaviors. Adaptive behaviors are the conceptual, social, and practical skills that people learn and use in everyday life to function.

Some common symptoms of intellectual disability include:

reaching developmental milestones - such as sitting up, crawling, walking, or talking - later than other children

difficulty speaking or reading

difficulty understanding or following social rules or cues

difficulty understanding the results or consequences of their actions

difficulty solving problems, thinking logically, or thinking abstractly

difficulty planning or following schedules or routines

difficulty remembering things

difficulty letting others know their needs

difficulty understanding systems such as the need to pay for things, time, or how to use a phone

difficulty with social skills

a reduced ability to perform regular personal care, such as eating, getting dressed, or completing household tasks

limited functioning in one or more daily activities

reduced judgment and decision making skills

difficulty learning from experience

communicating using nonverbal means, such as expressions and gestures

difficulty regulating emotions and behaviors

In most cases, the symptoms of intellectual disability start in early childhood or adolescence. In particular, difficulty with language and motor skills may occur by the age of 2 years.

People with mild intellectual disability may not show any obvious signs until they begin to have difficulty with schoolwork.

To diagnose intellectual disability, a doctor will perform several tests to assess the person's intellectual and adaptive functioning.

These tests may include:

an IQ test (a score of 70-75 may indicate intellectual disability)

interviews with the individual and others who have observed their adaptive functioning - that is, their conceptual, social, and practical functioning - such as family members or teachers

whether or not someone has the skills necessary to live independently

general medical tests

neurological tests

psychological tests

special education tests

hearing, speech, and vision tests

physical therapy evaluations

Intellectual disability tends to develop and cause noticeable symptoms before the age of 18 years.

Intellectual disability is a lifelong condition.

Although there is currently no cure, most people can learn to improve their functioning over time. Receiving early, ongoing interventions can often improve functioning, thereby allowing someone to thrive.

Most treatment plans for intellectual disability focus on the person's:

strengths

needs

support needed to function

additional conditions

Many services exist to help people with intellectual disability and their families get the support they need. Most of these services allow someone with intellectual disability to function normally in society.

Someone's diagnosis typically determines which services and protection of rights, such as special education or home or community services, they are eligible to receive under federal or national law. It also usually helps determine which supportive services they may need.

Supportive services include:

early interventions that work to identify intellectual disability in infants and toddlers

special education and academic support, such as individual education plans, which are available in the U.S. under federal law for free to every child with intellectual disability

transition services that help people with intellectual disability transition to adulthood after high school

day programs

vocational programs, such as job coaching or skill learning

housing options

case managers to help coordinate services and ensure that the individual receives proper care

psychological or psychiatric services

speech and language pathology or audiology services

therapeutic recreation

rehabilitation counseling

adapted equipment or assistive technology

Family members, caregivers, friends, co-workers, and community members can also provide additional support to people with intellectual disability.

With proper support and treatment, most people with intellectual disability are capable of achieving successful, production roles in their communities.

However, how well someone is able to cope and function with intellectual disability is also dependent on the severity of their condition and any other underlying genetic or medical conditions they have.

Parents and caregivers who think that their child may have intellectual disability should talk with their child's doctor or nurse as soon as possible. Receiving early, ongoing intervention is very important in ensuring that someone with this condition can reach their full potential.

If the doctor suspects intellectual disability or the child continues to experience symptoms, they should visit a pediatrician who specializes in diagnosing developmental conditions.

To find local specialists, click here.

Other tips for parents and caregivers include the following:

Learn the specifics about the child's intellectual disability, including their limitations, strengths, needs, and other individual factors.

Connect with other parents who have children with intellectual disability.

Encourage activities that support independence and responsibility, such as chores, dressing, feeding, or bathing.

Seek support from community, medical, or other supportive services.

Be patient, kind, hopeful, and understanding.

Get involved with social, recreation, sports, or other activities.

Try to avoid negative thinking, projections, or words.

Work with early intervention services to develop an Individualized Family Services Plan that focuses on the child's and family's needs.

Contact local school systems or elementary schools to get access to special education and related services.

Practice social and communication skills.

Recognize that parents and caregivers can help improve the functioning of someone with intellectual disability.

Be as clear as possible, using demonstrations such as a picture or hands-on materials rather than verbal directions.

Break longer and new tasks into simpler steps.

Work with teachers and academic support workers to assess the child's progress at school and at home.

Work with adolescent or child psychiatrists to set appropriate expectations for the individual.

People with intellectual disability have varying limits to their ability to learn and function in society, and they often learn slower than others.

However, receiving early, ongoing treatment in the form of supportive services can often help people with intellectual disability function normally or independently.

Contact a doctor as soon as possible if a child has any signs or symptoms of intellectual disability.

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Intellectual disability: Definition, symptoms, treatment, and more

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Intellectual disability causes significant limitations to a person's intellectual functioning and adaptive behavior. Intellectual disability is also sometimes known as cognitive disability. An outdated and now offensive term for this condition was "mental retardation." Read on to learn more about the definition of intellectual disability, its common causes, its symptoms, and some tips for parents and caregivers.

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The Individuals with Disabilities Education Act (IDEA) defines hearing impairment (HI) as "any decrease in hearing, whether fluctuatin or permanent...," that is not include under the term "deafness." In terms of education, it"... interferes with a child's ability to perform in an educational setting."

https://www.webmd.com/connect-to-care/hearing-loss/what-is-hearing-impairment
http://sinche.uom.gr/sites/default/files/14_disability_categories_under_idea.pdf

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Taken from WEBMD

Mild: Soft sounds are difficult to hear.

Moderate: Very little speech is heard when someone is talking at a normal level.

Severe: No speech is heard at normal levels and only some loud sounds are heard.

Profound: No speech is heard, and only very loud sounds are perceived.

https://www.youtube.com/watch?v=PbBZjT7nuoA
https://www.webmd.com/connect-to-care/hearing-loss/what-is-hearing-impairment

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Hearing Loss Simulation - What's It Like?

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Incidences of Hearing Impairment in School-age children.

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Incidences of Hearing Impairment in School-age children.

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According to the National Center for Education Statistics (NCES), hearing impairmant has been classidied as a low-incidence disability among school-age children between the ages of 3-21, with an incidence rate around 1%.

https://nces.ed.gov/programs/coe/indicator/cgg

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If a child is categorized as having ‘other health impairments’ this means that the child has:

limited strength, vitality and alertness due to chronic health issues and

their academic performance is negatively affected due to this issue

Other health impairments include a variety of disabilities including:

- ADD, ADHD, diabetes, epilepsy, heart conditions, hemophilia, lead poisoning, leukemia, nephritis, rheumatic fever, sickle cell anemia, Tourette syndrome and many more.

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There are 2 main interventions offered depending on age. Early intervention is for children under the age of 3. At this stage, children are evaluated to see what the problem is and to identify their needs going forward. The second stage of intervention happens between 3 and 21. These services include specially designed instruction and a wide range of support to help students with their disability.

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To accommodate students with other health impairments, schools will need to offer specialized instruction and even medical care.

Specialized instruction will vary depending on the needs of the student. Some students will have academic goals, some will have behavioral goals and others will have life skills goals.

Schools will need to accommodate students with regards to medical care. Schools will need to have school nurses and other qualified individuals available on site. Schools will also have to be understanding if students are missing a lot of school time due to being in medical care or seeing doctors/specialists.

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For children with asthma, there are many apps and gadgets that can be used to track and make monthly reports. These apps look out for when you use your inhaler and it tries to find out whether there are common triggers that cause you to have asthma. With continued use, these gadgets can look at the environmental factors and can send you alerts for when to be more careful.

For students with ADHD, there are many apps that can help students to organise their time and use their time more productively. They can set to-do lists and make sure that they get everything done that needs to get done.

Other health impairments include so many disabilities that it will take a long time to cover all of the assistive technology available. Above are just 2 examples of the many options out there.

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Video for more information on other health impairments:

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Video for more information on other health impairments:

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Other Health Impairment: Students wit Disabilities

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https://granite.pressbooks.pub/understanding-and-supporting-learners-with-disabilities/chapter/other-health-impairments/

https://www.parentcenterhub.org/ohi/

https://www.everydayhealth.com/asthma/asthma-tech-to-watch/

https://disabilitycreditcanada.com/10-best-assistive-technologies-add-adhd/

https://www.clevelandmetroschools.org/Page/7455

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The effects of hearing impairment on the learner.

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The effects of hearing impairment on the learner.

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Some of the effects of hearing impairment on child development include:
1. It can impact speech development. Both sound production and intonation.
2. It can slow a child's rate of phonological (speech sound) awareness, for example the ability to articulate vowel and consonant sounds.  This reduces a child's speech intelligibility.
3. It has often led to reduced vocabulary and grammatical knowledge.
4. A hearing impairment makes it very difficult to understand speech and/or to localize sound. It has often been described as hearing underwater.
5. It can also lead to educational difficulties. Because of the slowed cognitive development and lack of understanding of what is being spoken, and therefore going, on around them students with hearing impairment suffer academically as well. They are more likely to fail a grade which, according to hattie's influences on students' achievement has a profound negative impact on future learning. (-0.32)

https://www.ncbi.nlm.nih.gov/books/NBK207837/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6105119/
https://visible-learning.org/wp-content/uploads/2018/03/VLPLUS-252-Influences-Hattie-ranking-DEC-2017.pdf

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When hearing loss is identified in infants or toddlers, hearing aids can and should be fitted as soon the degree and type of hearing loss is known in each ear. Hearing aids can be adjusted or programmed to provide a frequency response that is appropriate for the hearing loss of the individual and to provide the appropriate amount of amplification based on the degree of loss for sounds of specific frequency. The amount of amplification and maximum power can also be adjusted in most aids to be appropriate for the hearing loss and the acoustic environment. The characteristics of the hearing aids are selected or programmed to match the severity and frequency response of the child's hearing loss. Consequently, any hearing aid fitting begins with the diagnostic audiological assessment discussed earlier.

Outcomes of Hearing Aid Use

For linguistically sophisticated adults, the goal of amplification use is the enhanced perception of speech in a variety of listening environments. For infants or young children, for whom speech has not yet acquired meaning, the audibility of sounds in a wide frequency range is the initial primary goal. Consistent exposure to sounds in environmental context is the basis for development of auditory neural networks that will ultimately be responsible for the organization of auditory information and learning about complex patterns of sounds including speech. If the infant or toddler with hearing loss can be provided with consistently audible speech through amplification, he or she should be able to learn to recognize speech, distinguish voices, and develop spoken vocabulary. Children with significant hearing loss will not be able to monitor their own voice and speech sounds unless these are audible to them. Other more rudimentary skills also are developed through auditory experience, such as awareness and recognition of environmental sounds and development of the ability to find sound-emitting objects in space (sound localization). As children develop, speech perception ability is monitored as a metric of aided performance.

Stelmachowicz (1999, p. 16) describes the most common outcome measures used in children who use amplification as "auditory awareness, audibility of speech, speech intelligibility, accuracy of speech production, rate of language acquisition, loudness discomfort and social development." Normal developmental time-courses exist for many of these skills in all children, as discussed earlier in this chapter. Such skills can be assessed only after they are expected to be present, regardless of the hearing status. For example, there are few measures of speech recognition for children under 3 years of age. For older children, it is important to distinguish the effects of amplification on outcome measures from normal developmental patterns and from the effects of the therapy and early intervention that necessarily accompany the fitting of amplification.

Surveys and Inventories for Pediatric Hearing Outcome Measures. Hearing loss is now often identified in very young infants due to the advent of newborn hearing screening. Few outcome measures can be used directly with these children. Consequently, it is increasingly common for professionals to use questionnaires or surveys of parents, caregivers, or teachers to gain insights into the early development of auditory behaviors. As children age, more direct objective measures can be taken if allowances for normal developmental patterns of ability are taken into account. However, questionnaires and inventories can be very useful for pre- and postintervention assessment over time, for example in assessing the use of amplification or devices such as FM systems.

Among parent-teacher survey tests is the Screening Instrument for Targeting Educational Risk (SIFTER) (Anderson, 1989), used by educators for school-age children. A preschool version is also available (Anderson and Matkin, 1996). The Meaningful Auditory Integration Scale (Robbins, Renshaw, and Gerry, 1991) and the IT-MAIS infant-toddler version (Zimmerman-Phillips et al., 2000) are parent inventories used generally with children who demonstrate severe to profound hearing loss. These scales probe for hearing aid use, acceptance, and basic auditory development.

The Listening Inventories for Education (LIFE) (Smaldino and Anderson, 1997) is a classroom inventory that includes student and teacher appraisals of listening difficulty and a teacher opinion and observation list.

Kopun and Stelmachowicz (1998) have used an adapted version of the Abbreviated Profile of Hearing Aid Benefit (APHAB) (Cox and Alexander, 1995) successfully with children ages 10-15 with hearing loss as well as with their parents. Discrepancies were found between the children's assessments and those of their parents, which points out the need for development and validation of tools that can be used with children.

Many other functional assessments based on report of behaviors are being developed for assessing outcomes in children with hearing loss. For example, the Functional Auditory Performance Indicators (FAPI), from Stredler-Brown and Johnson (2001), address many functional areas, including localization, discrimination, and short-term auditory memory. It can be used over time to map a given child's progress. Each of these inventories has strengths in evaluating certain aspects of auditory development and may best be suited to a particular environment or degree of hearing loss.

Direct Measures for Toddlers and Young Children. To be appropriate for infants and toddlers, measures of speech perception ability that can be used to evaluate adequacy of amplification must be modified to be age appropriate for both the task and the perceptual skills of the children. If speech stimuli are used, the influence of the children's linguistic capacity on speech perception must be considered carefully. For example, it is easier to perceive words in one's vocabulary or to perceive a sentence when one has the grammatical capacity to construct such a sentence. Eisenberg and Dirks (1995) looked at children's ability to judge speech clarity using paired comparison and category rating tasks. They found that by 5 years of age, children could make reliable clarity judgments of distorted speech, especially with the paired comparison method. Dawson, Nott, Clark, and Cowan (1998) evaluated a test procedure using a play paradigm for assessing the ability of young children to discriminate between pairs of speech sounds. They found that 82 percent of 3- and 4-year-old children and 50 percent of 2-year-old children could perform this task and would reliably indicate when two stimuli were discriminated. Boothroyd and colleagues have developed an imitative speech perception test that allows for evaluation of speech feature perception in toddlers and has the added attraction of allowing a comparison of visual, auditory, and auditory + visual perception ability (Kosky and Boothroyd, 2003). This simple task (IMSPAC) can be used with toddlers as young as 3 years of age. To date, we know of no studies that have used these measures to evaluate the outcome of amplification in children.

Age at Amplification. Both Yoshinaga-Itano et al. (1998) and Moeller (2000) have found that language outcomes in children with hearing loss are significantly related to age at intervention. Specifically, both studies found that if infants are enrolled in an early-intervention program for deaf and hard-of-hearing children before 1 year of age (Yoshinaga-Itano found 6 months to be critical and Moeller found 11 months), there is a significant positive effect on the child's later language ability. Conversely, delayed intervention leads to poorer language outcomes in children. However, in neither study was the intervention necessarily tied to amplification fitting. Consequently, although conventional wisdom based on consistent widespread clinical observations supports the value of fitting amplification as soon as a hearing loss is diagnosed (Joint Committee on Infant Hearing, 2000; Pediatric Working Group, 1996), published data on communication outcomes (language, speech perception, speech production) that confirm the utility of early amplification are not currently available.

Device Efficacy and Features in Children-Audibility. The outcomes of children using amplification can be measured in many ways. At the most basic are tests that evaluate the audibility of sounds when using a device. The most important factor is the audibility of sounds within the frequency range that comprises speech signals. In addition, Stelmachowicz, Pittman, Hoover, and Lewis (2002) emphasize that infants and children may have specific additional needs for adequate audibility of frequencies considered to be high in the speech spectrum (above 3000 Hz). She points out that children who are learning language need to be able to hear and perceive these very high frequency sounds that include "s" because of its importance in denoting possession, plurality, and verb tense. Also, infants and children are often listening to female speech, which is higher in frequency content than male speech.

Assessing the audibility of sounds has become a routine procedure in the process of fitting and evaluating amplification for infants and children (Pediatric Working Group, 1996; American Academy of Audiology, 2003). Procedures such as the desired sensation level input/output (DSL i/o) (Cornelisse, Seewald, and Jamison, 1995) or NAL NL1 (Dillon, Birtles, and Lovegrove, 1999) allow comparison of amplified signals to target prescription levels. Appropriate signals, such as speech or speech-shaped noise, are directed to the hearing aid, and the amplified output is measured in the ear canal of the infants or children under optimal conditions, or in a standard hearing aid coupler with corrections appropriate for estimating sound levels that would occur in infants' or toddlers' ears. Applied stimulus type and level can be manipulated to simulate real listening conditions, and the characteristics of the amplification can be adjusted to maximize the response in a particular infant's ear and to document the audibility of the signal, based on the hearing loss of each child. Scollie et al. (2000) have provided support for the 4.1 version of the DSL by demonstrating that the DSL target levels for amplified speech are very similar to the preferred listening levels of children with hearing loss.

Aided audibility can be also be quantified by the articulation index (American National Standards Institute, 1969). The articulation index is a number from 0 to 1 which approximates the percentage of the speech spectrum that is audible. Stelmachowicz and colleagues have developed a system to provide a visual display of the audibility of speech at various input levels and to take into account the amplification and output-limiting characteristics of the hearing aid. This system is known as the situational hearing aid response profile (SHARP) (Stelmachowicz, Lewis, Kalberer, and Cruetz, 1994). Presently, the above measures of audibility in an aided situation are used clinically as initial indicators of aided performance in infants and children, or a sort of early outcome measure.

Measuring Outcomes of Hearing Aids and Features. Standard measures of hearing aid fitting often include determining speech recognition scores for words or sentences with the speech presented in the context of background noise. Often the level of the noise that can be tolerated relative to the level of the speech is the metric of performance. These measures can be used only with older children (over about age 7). Pettersson (1987) demonstrated that children with hearing loss ages 8 to 20 performed better on speech perception when using their own amplification devices than when evaluated with amplified speech presented through an audiometer. She attributes much of this finding to the fact that the children had accommodated to their amplification and were familiar with the amplification characteristics.

School-age children with all degrees of hearing loss have been shown to have an advantage in listening through hearing aids while using a directional microphone (Gravel and Hood, 1999; Hawkins, 1984; Kuk, Kollofski, Brown, Melum, and Rosenthal, 1999). Gravel et al. (1999) noted that the directional advantage is greatest for older children with more advanced language skills.

FM Systems. Several studies have shown that a significant advantage is afforded to children with hearing loss for perceiving speech in real-life situations when an FM transmission system is used. These advantages have been demonstrated in the classroom (Boothroyd and Iglehart, 1998; Hawkins, 1984; Pittman, Lewis, Hoover, and Stemachowicz, 1999) and to a lesser degree in the home (Moeller, Donaghy, Beauchaine, Lewis, and Stelmachowicz, 1996). Most studies point out that while speech perceived from a distance may be enhanced using FM systems, the need for local microphones must be addressed in order to allow children to monitor their own voices and speech as well as to interact with classmates.

Outcomes with Minimal and Unilateral Hearing Loss. There is clear evidence that children with even unilateral or mild hearing loss are at a significant disadvantage when listening in noisy situations, such as classrooms (Crandell, 1993). However, there are few outcome data on the use of amplification with these children. Kenworthy, Klee, and Tharpe (1990) compared the use of a CROS hearing aid and personal FM devices on children with unilateral hearing loss in a variety of listening conditions. They found an advantage to the CROS aid but only in limited conditions, whereas the personal FM provided uniform advantage for speech perception in these children. However, device fitting for children with unilateral hearing loss is not universally accepted as a clinical procedure. English and Church (1999) reported that only 27 percent of children with unilateral hearing loss are using amplification in the classroom.

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Spoken communication is uniquely human. If the sense of hearing is damaged or absent, individuals with the loss are denied the opportunity to sample an important feature of their environment, the sounds emitted by nature and by humans themselves. People who are deaf or hard-of-hearing will have diminished enjoyment for music or the sound of a babbling brook.

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https://docs.google.com/document/d/1JbJQZ0PSLfQWNxunMdY-m9YZ2E_qzK2SDnjoScHB74c/edit?usp=sharing

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-Teacher should always face forward when speaking, staying in one position so it is easier for the hearing impaired student's speechreading.
-Get the HI student's attention before speaking. and use a focusing phrase, such as: "listen to this question." Also, the teacher may want to learn and use "Makaton," a simplified form of sign language.
-Teacher could use an FM system that tranmits the teachers voice directly in the child's hearing aid or other device. Or other soundfield apmplification system. With these the teacher should mirror the speech of other students who are not mic'd up.
-Environmental factors that might help, set up better acoustics in the classroom and good lighting so the student has a better view of speakers' lips. Teacher can also change or be more flexible with the seating arrangement to be more inclusive, keeping the student with the hearing impairment closer to or farther from speakers depending on their needs.
-Individual Assitive Technology devices such as a hearing aid, cochlear implants, bone-anchored hearing aids, brainstem implants, or something as basic as a speech to text device.
-Caption videos.
-Provide more visual aids and tactile cues when presenting material. And pre-provide vocaulary of each lesson.
-More flexibility in resources available to the HI student: Sign language alongside videos or presentations, or written resources instead of audible ones.
-It may be possible for students with severe HI to be suppoorted with an interpreter.
-provide the HI studnet with a peer-buddy to work with them.
-Keep unnecessary background noise to a minimum.
-Maintain continual communication with the HI learner's parents. They can reinforce what you are teaching, and you can help them make sure that they can continually improve their communication with their child.

https://do2learn.com/disabilities/CharacteristicsAndStrategies/SpeechLanguageImpairment_Strategies.html
https://www.youtube.com/watch?v=RBrnvGKLF_Q
https://mediaaccess.org.au/latest_news/education/five-tips-for-teachers-of-students-with-hearing-impairment
https://www.deafnessforum.org.au/factsheet-adjustments-for-students-with-a-hearing-impairment/
https://ttaconline.org/differentiated-instructional-strategies-deaf-history
https://engage-education.com/blog/how-to-support-a-child-with-a-hearing-impairment-in-school/#!

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How to tell if a student is potentially suffering from Hearing Impairment.

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How to tell if a student is potentially suffering from Hearing Impairment.

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Taken directly from Engage Education

Not responding when their name is called

Problems with concentration, excessive tiredness and frustration with work that starts to affect their behaviour

Watching your lips intently as you speak

Speaking too loudly or too quietly

Watching others do something before attempting it themselves

Becoming increasingly withdrawn from others in the classroom

Delayed speech and communication development

Mishearing or mispronouncing words

Not being able to hear what’s happening if there is any background noise

Making minimal contributions to classroom discussion

Difficulty with reading and linking it to speech

https://engage-education.com/blog/how-to-support-a-child-with-a-hearing-impairment-in-school/#!

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Going through school with a hearing impairment or deafness can be a frustrating, isolating and ultimately unproductive experience for a child without the right support. As a teacher, it can be equally challenging to teach a hearing-impaired child effectively without adequate tools or training. For both it can sometimes feel like there's an imaginary pane of glass keeping each from communicating effectively with the other. The ideal environment for many hearing-impaired children to learn is one in which they are not singled out as different, but instead benefit from the kind of adjustments which go unnoticed by others but are truly transformative for the child. At Engage Education we want to provide the information you need to handle hearing impairments with confidence.

What is a hearing impairment?

Hearing impairment and deafness are not necessarily the same thing. Hearing loss greater than 90 decibels is generally categorised as deafness, but any impediment to hearing - whether temporary, permanent or fluctuating - impacts not only a child's experience in the classroom but their social and emotional development, literacy skills and speech and language abilities.

What types of hearing impairment are there?

According to the National Deaf Children's Society there are over 50,000 children and young people in the UK with hearing impairments, but this does not mean that they all have the same conditions or needs. There are three main types of hearing impairment that you may come across in children:

Sensorineural deafness (nerve deafness)
A permanent hearing loss in the inner ear usually caused by the cochlea not working effectively

Auditory Neuropathy Spectrum Disorder (ANSD)
A problem occuring more deeply within the ear, where sounds are received normally by the cochlea, then become disrupted as they travel to the brain

Conductive deafness
Usually temporary, sometimes permanent. Sound can't pass effectively through the outer and middle ear to the inner ear. Caused by blockages such as wax or fluid. The latter is known as - can last for up to three months and very common in pre-school children

How can I spot signs of hearing impairment in a child?

While hearing impairments are often identified in babies, they may not develop or make themselves known for several years. This means that it's important to keep an eye out for the signs of hearing impairment in the classroom, particularly in young children - as at some point in your career you could find that you are teaching a child with an undiagnosed hearing impairment.

Here are some of the common signs of hearing impairments that you can look for in young children:

Not responding when their name is called

Problems with concentration, excessive tiredness and frustration with work that starts to affect their behaviour

Watching your lips intently as you speak

Speaking too loudly or too quietly

Watching others do something before attempting it themselves

Becoming increasingly withdrawn from others in the classroom

Delayed speech and communication development

Mishearing or mispronouncing words

Not being able to hear what's happening if there is any background noise

Making minimal contributions to classroom discussion

Difficulty with reading and linking it to speech

How does hearing impairment affect learning?

Hearing-impaired children struggle at every stage of their education , with only 44% leaving school with two or more A Levels, and 43% reaching the expected standard for reading, writing and maths at key stage 2 (KS2) when finishing primary school. Hearing and learning go hand-in-hand, so the impairment of this function means much more for a child than simply struggling to hear. Any hearing impairment which is not handled effectively has an adverse effect on a child's development, preventing them not only from taking in new information but learning to interact, relating to others and making friends.

A child whose hearing impairment negatively affects their learning is likely to withdraw further into themselves throughout their education, which has a knock-on effect throughout the rest of their life. The frustration of being unable to express themselves and communicate both inwardly and outwardly is highly damaging and can impact future employment and their relationships with both others and themselves.

Everyday frustrations in the classroom are not as simple as an absence of individual attention from the teacher. A child with a hearing impairment does not necessarily require constant additional help but rather a mindful and sensitive approach to teaching the whole class - not facing the whiteboard to speak, minimising background noise and using visual aids as much as possible.

Strategies for supporting a child with a hearing impairment in school

It's vital that children with hearing impairments are given the right support from as early a stage as possible. If you have a child with a hearing impairment in your class, teaching in a way that fully supports them may seem a daunting prospect, but there is plenty of support and many ideas available.

Classroom equipment

A radio aid is a microphone worn by the teacher that connects to a hearing aid, and can also be passed to other pupils during activities such as group reading. This will help the child to feel part of the class and ensure that they don't miss any important information.

Dedicated staff

For schools that have the budget to employ one, a communication support worker or learning support assistant can provide hugely valuable help. Whether in the classroom all or some of the time, they can ensure the child is supported while you are able to give proportionate attention to other pupils.

Make sure that you don't turn away from the class while talking and ensure that the child has understood every task or instruction (and they aren't automatically looking to copy others after you have spoken). You can also sit the child right at the front of the class to give them the best possible chance of learning as hearing technologies only have an optimal range of one to three metres.

Meet with parents regularly

Having an open line of communication with the child's parents will help to ensure that the child has consistent support both at school and home. Meeting with the parents face-to-face will enable you both to discuss any concerns you may have and track the child's progress. Often the child may be confiding in the parents about issues that they are struggling with which they are too embarrassed to bring up in the classroom.

A 'hearing buddy'

If the child has to take off their hearing aid at any point during the day (for example during a sports lesson) you can allocate them a 'hearing buddy' (perhaps their closest friend) who can help to repeat any information that the child may have missed.

Preventing bullying

Although being bullied can happen to any child, children who are considered different in some way can be targeted by bullies. This can be because the hearing-impaired child's teaching arrangements are different, because they look different due to wearing a hearing aid, or because they are less able to pick up on social cues from their peers. The child could also find it harder to make friends and have a reduced ability to stand up for themselves. Childline has lots of advice and support available for children who are deaf or hard of hearing in their 'Deaf Zone' which you can refer children to who are old enough to use the website.

There are also ways in which a teacher can prevent bullying:

Raising awareness in the school - empathy and kindness can be taught. For example celebrating Deaf Awareness Week at school will open up discussions about the challenges faced by hard of hearing children and increase understanding. Your class could hold a school assembly in mime to the rest of the school. Your students could also put themselves in the child with hearing impairments shoes by learning to sign their names or by taking part in a sponsored silence.

Foster a sense of community in the classroom - in this way, other students will watch out for bullying and make a stand against it. You could have class morning meetings where students are encouraged to share their experiences and you can establish any class rules together including anti-bullying ideas.

Be aware of 'gateway behaviours' and nip them in the bud - things like eye rolling and ignoring, cruel laughter, excluding or staring can signal bullying or lead to escalated bullying. The child laughing cruelly may not realise the deep and lasting psychological impact they could be having on the child they are laughing at (especially if the child who is being bullied is pretending to laugh back) so class discussion, rather than focusing on one child's behaviour, can be helpful.

Using Makaton

is a simplified form of sign language, incorporating symbols and gestures, and is normally used with children with additional needs.

Makaton is usually taught at Nursery, Reception and Year 1 level. The actions are fun so that it helps shy children as well as those with special educational needs. Children who have trouble communicating can often be moody, quick to anger or simply retreat into themselves, so Makaton allows them to better communicate and relieves any stress they may be feeling. Given the importance of ensuring that deaf children have access to a rich language environment, Makaton should not be seen as an alternative or substitute for British Sign Language (BSL) or Sign Supported English .

Helpful links:

NHS hearing loss - https://www.nhs.uk/conditions/hearing-loss/symptoms/

British Sign website - https://www.british-sign.co.uk/

The Makaton Charity - https://www.makaton.org/

National Deaf Children's Society - https://www.ndcs.org.uk/

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How to support a child with a hearing impairment in school | Engage

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Going through school with a hearing impairment or deafness can be a frustrating, isolating and ultimately unproductive experience for a child without the right support. As a teacher, it can be equally challenging to teach a hearing-impaired child effectively without adequate tools or training.

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The earlier hearing loss is diagnosed and intervened with the better the chances of the student to more easily develop the speech, language, cognitive, and social skills needed to reach their full potential.
https://www.cdc.gov/ncbddd/hearingloss/treatment.html

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Centers for Disease Control and Prevention

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No single treatment or intervention is the answer for every child or family. Good intervention plans will include close monitoring, follow-ups and any changes needed along the way. There are many different options for children with hearing loss and their families.

Some of the treatment and intervention options include:

Working with a professional (or team) who can help a child and family learn to communicate.

Getting a hearing device, such as a hearing aid.

Joining support groups.

Taking advantage of other resources available to children with a hearing loss and their families.

Early Intervention and Special Education

Early Intervention (0-3 years)

Hearing loss can affect a child's ability to develop speech, language, and social skills. The earlier a child who is deaf or hard-of-hearing starts getting services, the more likely the child's speech, language, and social skills will reach their full potential.

Early intervention program services help young children with hearing loss learn language skills and other important skills. Research shows that early intervention services can greatly improve a child's development.

Babies that are diagnosed with hearing loss should begin to get intervention services as soon as possible, but no later than 6 months of age.

There are many services available through the Individuals with Disabilities Education Improvement Act 2004 (IDEA 2004). Services for children from birth through 36 months of age are called Early Intervention or Part C services. Even if your child has not been diagnosed with a hearing loss, he or she may be eligible for early intervention treatment services. The IDEA 2004 says that children under the age of 3 years (36 months) who are at risk of having developmental delays may be eligible for services. These services are provided through an early intervention system in your state. Through this system, you can ask for an evaluation.

Special Education (3-22 years)

Special education is instruction specifically designed to address the educational and related developmental needs of older children with disabilities, or those who are experiencing developmental delays. Services for these children are provided through the public school system. These services are available through the Individuals with Disabilities Education Improvement Act 2004 (IDEA 2004), Part B.

Early Hearing Detection and Intervention (EHDI) Program

Every state has an Early Hearing Detection and Intervention (EHDI) program. EHDI works to identify infants and children with hearing loss. EHDI also promotes timely follow-up testing and services or interventions for any family whose child has a hearing loss. If your child has a hearing loss or if you have any concerns about your child's hearing, call toll free 1-800-CDC-INFO or contact your local EHDI Program coordinator to find available services in your state.

Technology

Many people who are deaf or hard-of-hearing have some hearing. The amount of hearing a deaf or hard-of-hearing person has is called "residual hearing". Technology does not "cure" hearing loss, but may help a child with hearing loss to make the most of their residual hearing. For those parents who choose to have their child use technology, there are many options, including:

Hearing aids

Cochlear or brainstem implants

Bone-anchored hearing aids

Other assistive devices

Hearing Aids

Hearing aids make sounds louder. They can be worn by people of any age, including infants. Babies with hearing loss may understand sounds better using hearing aids. This may give them the chance to learn speech skills at a young age.

There are many styles of hearing aids. They can help many types of hearing losses. A young child is usually fitted with behind-the-ear style hearing aids because they are better suited to growing ears.

Cochlear and Auditory Brainstem Implants

A cochlear implant may help many children with severe to profound hearing loss - even very young children. It gives that child a way to hear when a hearing aid is not enough. Unlike a hearing aid, cochlear implants do not make sounds louder. A cochlear implant sends sound signals directly to the hearing nerve.

Persons with severe to profound hearing loss due to an absent or very small hearing nerve or severely abnormal inner ear (cochlea), may not benefit from a hearing aid or cochlear implant. Instead an auditory brainstem implant may provide some hearing. An auditory brainstem implant directly stimulates the hearing pathways in the brainstem, bypassing the inner ear and hearing nerve.

Both cochlear and brainstem implants have two main parts. There are the parts that are placed inside the inner ear, the cochlea, or base of the brain, the brainstem during surgery; and the parts outside the ear that send sounds to the parts inside the ear.

Bone-Anchored Hearing Aids

This type of hearing aid can be considered when a child has either a conductive, mixed or unilateral hearing loss and is specifically suitable for children who cannot otherwise wear 'in the ear' or 'behind the ear' hearing aids.

Other Assistive Devices

Besides hearing aids, there are other devices that help people with hearing loss. Following are some examples of other assistive devices:

FM System
An FM system is a kind of device that helps people with hearing loss hear in background noise. FM stands forfrequency modulation. It is the same type of signal used for radios. FM systems send sound from a microphone used by someone speaking to a person wearing the receiver. This system is sometimes used with hearing aids. An extra piece is attached to the hearing aid that works with the FM system.

Captioning
Many television programs, videos, and DVDs are captioned. Television sets made after 1993 are made to show the captioning. You don't have to buy anything special. Captions show the conversation spoken in soundtrack of a program on the bottom of the television screen.

Other devices
There are many other devices available for children with hearing loss. Some of these include:

Text messaging

Telephone amplifiers

Flashing and vibrating alarms

Audio loop systems

Infrared listening devices

Portable sound amplifiers

TTY (Text Telephone or teletypewriter)

Medical and Surgical

Medications or surgery may also help make the most of a person's hearing. This is especially true for a conductive hearing loss, or one that involves a part of the outer or middle ear that is not working in the usual way.

One type of conductive hearing loss can be caused by a chronic ear infection. A chronic ear infection is a build-up of fluid behind the eardrum in the middle ear space. Most ear infections are managed with medication or careful monitoring. Infections that don't go away with medication can be treated with a simple surgery that involves putting a tiny tube into the eardrum to drain the fluid out.

Another type of conductive hearing loss is caused by either the outer and or middle ear not forming correctly while the baby was growing in the mother's womb. Both the outer and middle ear need to work together in order for sound to be sent correctly to the inner ear. If any of these parts did not form correctly, there might be a hearing loss in that ear. This problem may be improved and perhaps even corrected with surgery. An ear, nose, and throat doctor (otolaryngologist) is the health care professional who usually takes care of this problem.

Placing a cochlear implant, auditory brainstem implant, or bone-anchored hearing aid will also require a surgery.

Learning Language

Without extra help, children with hearing loss have problems learning language. These children can then be at risk for other delays. Families who have children with hearing loss often need to change their communication habits or learn special skills (such as sign language) to help their children learn language. These skills can be used together with hearing aids, cochlear or auditory brainstem implants, and other devices that help children hear.
Read about learning language
Family Support Services

For many parents, their child's hearing loss is unexpected. Parents sometimes need time and support to adapt to the child's hearing loss.

Parents of children with recently identified hearing loss can seek different kinds of support. Support is anything that helps a family and may include advice, information, having the chance to get to know other parents that have a child with hearing loss, locating a deaf mentor, finding childcare or transportation, giving parents time for personal relaxation or just a supportive listener.

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early hearing detection and intervention

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Hearing Loss Treatment and Intervention Services | CDC

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No single treatment or intervention is the answer for every child or family. Good intervention plans will include close monitoring, follow-ups and any changes needed along the way.

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According to IDEA deafness is defined as a hearing impairment so severe that a child is impaired in processing linguistic information through hearing, with or without amplification, that adversely affects a child's educational performance

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1. Opportunities for making choices

Use a three-step method for choice-making:
Give the learner up to three options and ask them to select only one; Let them know the time they have to make a decision and wait for their response ;, reinforce the option they chose so that they’re fully aware of the benefits and drawbacks of their choice.

2. Adjust task difficulty

Adjust the difficulty of math problems to suit your learners’ capabilities.

In fact, prompt your students to voice the math problems aloud before solving them.

3. Personalized system of instruction

Come up with specific objectives with your students.

Break down the course into smaller units.

Stick to writing content over dictating.

Allow the student to move at their own pace throughout the curriculum in relevant areas like writing term papers.

Give immediate feedback for exams.

Assign student tutors where necessary for the more challenging concepts.

4. Individual curricular modification

Regularly administer behavioral assessments and use the results to determine the best instructional and curricular variables for different students when it comes to, for instance, assignment completion.

https://www.yourtherapysource.com/blog1/2022/03/11/accommodations-for-students-with-emotional-and-behavioral-disorders/
https://www.positiveaction.net/blog/teaching-strategies-for-emotional-and-behavioral-disorders
https://study.com/academy/lesson/accommodations-for-students-with-emotional-disturbance.html

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If you're a special education teacher working with students who have emotional and behavioral disorders, you know that accommodations are key to helping them succeed. But what accommodations are best for these students? In this blog post, you will learn about accommodations for students with emotional and behavioral disorders (EBD) that have proven to be effective for students.

Remember, it is extremely important to collect data on what accommodations are suitable for each student. It is oftentimes trial and error to determine what are the most effective strategies for each student. This is not an exhaustive list but rather ideas and suggestions for the first phase of the process in deciding how to help students succeed.

ENCOURAGE POSITIVE BEHAVIORS

One of the most important accommodations for students with EBD is to provide them with a positive and structured environment. This means discouraging negative behavior while rewarding appropriate behavior. Some ways to do this include setting clear rules and expectations, providing positive reinforcement when students display good behavior, and using a token economy system to reward positive behaviors.

ACCOMMODATIONS FOR STUDENTS WITH EMOTIONAL AND BEHAVIORAL DISORDERS-PARTICIPATING IN CLASS

Another important accommodation for students with EBD is to encourage them to participate in class. This means giving them opportunities to answer questions, offer their opinions, work with their peers, and complete assignments.

Examples of accommodations and modifications are:

providing clear instructions

breaking down tasks into smaller steps

offer choices when able

give students extra time to complete assignments.

Making class participation an effective part of normal circumstances, will shift students' focus off their disability, and increase their tendency to strive for better grades.

PROVIDE PROPER ASSIGNMENTS

It's important to give students with EBD assignments that are within their abilities and that match their educational level. Additionally, the types of accommodations in their IEP and individualized education program can be provided to help these students succeed.

Some examples of accommodations that have been found to be effective for students with EBD include:

- Testing accommodations such as extended time on tests, and small group testing environment

-Use of a calculator on math tests and homework

-Extended time on assignments that are in the general education curriculum

- Movement breaks as needed: use a pass system for breaks

- Offer choices: for example, students can demonstrate comprehension of a subject by handing in a traditional paper, video, or poster, etc.

- Preferential seating arrangements

- Frequent check-ins with the teacher

- Alternative seating such as wiggle cushions or exercise ball seating

ENSURE ACCOUNTABILITY - ACCOMMODATIONS FOR STUDENTS WITH EMOTIONAL AND BEHAVIORAL DISORDERS

It's important for students with EBD to be held accountable for their behavior and actions. This means making sure they understand the consequences of their choices. Some ways to do this include:

- Having clear rules and expectations in place

- Providing immediate feedback to the student

-Use non-verbal cues or a code word to communicate inappropriate behavior

- Encouraging the student to take ownership of their actions

- Imposing consequences for severe inappropriate types of behavior

ENCOURAGE STUDENTS WITH EMOTIONAL AND BEHAVIORAL DISORDERS TO PARTICIPATE IN SOCIAL ACTIVITIES

Many students with EBD struggle with social interactions. It can be helpful to encourage them to participate in social activities, such as lunchtime groups, class discussions, or extracurricular activities. This can help them to develop their social skills and make friends. With satisfactory interpersonal relationships in hand, students can hope to avoid a general pervasive mood of unhappiness.

Accommodations or modifications for social skills could possibly include:

small group work

lunch time with small number of peers

Seat the student close to a positive role model

provide additional personal space between desks

partnering with a peer to encourage social skills.

WORK WITH COLLEAGUES, COUNSELORS, OR PSYCHOLOGISTS

If you are having difficulty managing a student with EBD, don't hesitate to ask for help from your colleagues or school administration. There are many resources available to help educators support students with EBD. If a student's emotional or behavioral problems are causing intense difficulty in the classroom, it may be necessary to seek help from a counselor or school psychologist.

Counselors or psychologists can provide interventions, therapy, and guidance to help the student deal with their emotions and behavior. They might also be able to give students the peace of mind they need to focus on their academic subjects.

ACCOMMODATIONS FOR STUDENTS WITH EMOTIONAL AND BEHAVIORAL DISORDERS-CALM ENVIRONMENT AND SCHOOL ROUTINES

There are a few things that can be done in the classroom to help accommodate students with emotional and behavioral disorders. One of the most important is to create a calm and organized environment cutting down on emotional disturbances. This can be done by:

- Putting up calming decorations, such as pictures of nature or peaceful scenes

-Providing a calm classroom environment - Keep the classroom quiet during higher-level learning.

-Offering a calming corner in the classroom or hallway

- Keeping noise levels down

- Having a predictable schedule

-Noise cancelling headphones

-Dim lighting

- Having clear rules and expectations

- Providing structure and routine

-Use visual supports to reinforce the predictability of the routine

ACCOMMODATIONS FOR STUDENTS WITH ANXIETY DISORDERS

Students with anxiety disorders can often find it difficult to focus in the classroom. Accommodations that may be helpful for students with this diagnosis include:

- Allowing them to take breaks as needed

- Giving them more time to complete tasks

-Weight daily work higher than tests of test anxiety is present

- Helping them prepare for tests and assignments

- Encouraging them to participate in social activities

- Putting them in a designated seat away from distractions

-Provide organizers for lockers/desk to help with predictability

- Using calming decorations, such as pictures of nature or peaceful scenes.

Read more about writing and students with anxiety here.

ACCOMMODATIONS FOR STUDENTS WITH EMOTIONAL AND BEHAVIORAL DISORDERS-AUTISM SPECTRUM

Students with autism spectrum disorders often have difficulty with communication and social interaction. This is by no means an extensive list but help to provide basic suggestions. Accommodations that may be helpful for these students include:

- Preferential seating

- Allowing them to take breaks as needed

- Encouraging them to be social with their peers

-Helping them learn and identify their sensory needs

- Using visual supports to aid with communication, directions, and routine.

Read more on accommodations and students with autism.

ACCOMMODATIONS FOR STUDENTS WITH DEPRESSION

Students with depression often have low energy levels and difficulty concentrating. It can have a profound effect on a person's thoughts, emotions, and behavior. Accommodations that may be helpful for these students include:

- Allowing them to take downtime when necessary

- Encouraging them to talk and interact with peers

- Helping them with schoolwork and studying for tests

- Giving them longer periods of time to complete tasks

- Breaking assignments down into simpler steps

-Recognizing when health factors or physical symptoms may be causing an inability to focus.

- Self-monitoring checklists to stay on task

ACCOMMODATIONS FOR STUDENTS WITH EMOTIONAL AND BEHAVIORAL DISORDERS- BIPOLAR DISORDER

Students with bipolar disorder can experience extreme mood swings, from mania to depression that can cause many school problems and conduct disorders. Students may feel intensely happy, and then quickly feel very depressed. Accommodations that may be helpful for these students include:

- Preferential seating

-Reduced workload during difficult times

- Allowing them to take a pause if the classroom environment is too much

-Encouraging positive behavior and social activities with peers

- Breaking tasks down into small, manageable steps

-Organizational supports

- Monitoring the variables in their moods and adjusting their accommodations as needed.

Accommodations can be an important tool in helping students with emotional and behavioral disorders succeed in the classroom. By understanding the condition and implementing appropriate accommodations, it is possible to create a learning environment that meets the student's needs.

LEARNING TO KNOW WHICH ACCOMMODATIONS TO CHOOSE

Learn more about the difference between accommodations and modifications here.
5 Different Ways to Use Accommodations in the Classroom 504 Accommodations for ADHD
Most importantly, teach your students how to learn about their strengths, challenges and accommodations to empower them to live a more independent life at school, home and the workplace. You can follow this 10 step process starting today with the Self-Advocacy for Students Workbook.

It is critical to determine what accommodations work for each student using data collection and feedback. Research indicates that this is often highly imprecise. The information can be presented differently, responses can change, the environment can be altered, time constraints can be eliminated and specialized tools/technology can help! Take the time to determine what is the best options for each individual student.

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Accommodations for Students with Emotional and Behavioral Disorders

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Learn about accommodations for students with emotional and behavioral disorders (EBD) that have proven to be effective for students.

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Assistive technology could be the the solution that educators need to support learners with behavioral disabilities flourish in the classroom setting.

Text-to-Speech Software

Reading can be one of these tasks that prove to be too much for their frustration tolerance and would trigger negative behaviors. A text-to-speech software such as that found within the Microsoft programs could be an ideal solution. Students can sit back and listen while the computer or tablet reads to them, preventing them from trying to engage too many brain systems at one time.

Reminder Devices

Students with behavioral disturbances are easily distracted, and their mind may wander during lessons. A reminder device might be a good way to get their attention back. This quietly motivates them to refocus on the task at hand without teacher intervention. As a result, they can feel significantly more independent when teachers have fewer reasons to chastise them.

Voice Recognition Software

If a student struggles with the physical act of writing or translating their thoughts onto paper, teachers may need to consider allowing them to use this software. This gives them an opportunity to say what they would like to put on paper while the computer handles the rest. This can avoid the frustration that comes from a lack of fine motor skills or the inability to concentrate.

Talk Light

Assistive technology can help you to monitor class volume, which can trigger negative behaviors from certain students, is Talk Light. This provides educators with a tangible way to realize when volumes are reaching unacceptable levels for sensitive students. By preventing this situation, you might be able to ward off some of the negative behaviors.

https://www.theedadvocate.org/assistive-technology-to-help-students-with-behavioral-disabilities-succeed-academically/
https://www.ssdmo.org/Page/892
https://classroom.synonym.com/assistive-technology-students-behavior-disorders-7219566.html

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There are lots of ways deaf students can be supported in the classroom.

Speech to Text Services: These devices or apps can take speech and translate it into text in real time.

Note Takers: Deaf students can benefit from receiving notes from another not taker who can hear the lecture/discussions.

Translation Services: Allow the words of a speaker to be transcribed, by a trained individual using a keyboard, into text displayed on a monitor, screen, or laptop computer, used by the students who are hard of hearing or deaf.

Captioned Media: Video resources can utilize closed captioning to allow deaf students to read along the information being presented.

Audio-visual FM Systems: Facilitate speech-reading for students who are oral-deaf or hard of hearing. An example would be the AudiSee which includes a microphone transmitter and a headset-camera worn by the teacher. The student has a small monitor-receiver on the desk allowing the student to hear the teacher’s voice and see the teacher’s face.

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http://sinche.uom.gr/sites/default/files/14_disability_categories_under_idea.pdf

https://cid.edu/wp-content/uploads/2013/10/Assistive-Technology-in-the-Classroom.pdf

https://www.nationaldeafcenter.org/accommodations-101

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What is visual impairment?

According to the Individuals with Disabilities Education Act (IDEA) the visual impairment is described as “ an impairment in vision that, even with correction, adversely affects a child’s educational performance.” There are many eye diseases that can cause loss of vision if not treated properly and timely. It ranges from mild to severe. Blindness is the most severe form of visual impairment.  Thus, only a small percentage of visually impaired people are considered blind.  Most visually impaired can see the world around them.
Some signs of vision loss have been identified by Centers for Disease Control and Prevention (CDCP).  Children often times complain about their vision. They touch, cover, or squint their eyes, struggle reading, continuously hold objects close to eyes and so on.

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Voice disorders are noticed when the sound, quality, or use of one's voice is impaired. Voice disorders are typically caused from issues with the larynx. Our voice can be impacted in a variety of ways: pitch, loudness, resonance, and quality of voice can each be impaired when struggling with a voice disorder. Abnormal production or vocal absence can also be issues.

Assistive technology for individuals with voice disorders can range from low tech to high tech. A low tech modality to accommodate someone struggling with a voice disorder could be a picture or communication board. This would aid the student in making choices + effectively communicating their response. A simple audio recorder could be used to replay the voice to a student, aiding them in hearing where the disorder presents. A higher tech option for someone with a voice disorder would be a Frequency Altered Feedback (FAF).  Frequency Altered Feedback devices change the pitch of the voice spoken, acting as a guide for someone struggling with pitch or intonation. Modalities like this can not only help in therapy, but with overall morale as well.

Resources:

http://www.projectidealonline.org/v/speech-language-impairments/
https://www.ldatschool.ca/assistive-technology/

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Fluency disorders are defined as "difficulties with the rhythm and timing of speech characterized by hesitations, repetitions, or prolongations of sounds, syllables, words, or phrases."  http://www.projectidealonline.org/v/speech-language-impairments/

Common fluency disorders are stuttering and cluttering.

Using an accommodating tool such as text-to-speech modalities can aid children with fluency disorders. There is also a phone application called Stamuri, which has been created to help individuals with stammer/stutter issues through the use of activities and games.

Assistive technology, such as electronic fluency devices, are also used to improve the fluency of people with stutters. With an EFD, individuals are played back the sound of their own voice, just slightly altered. One example of this is a DAF- Delayed Auditory Feedback Device. This mechanism delays the feedback by just a fraction of a second, enabling the user to hear their voice at an uninterrupted rate.

Resources:
http://www.projectidealonline.org/v/speech-language-impairments/
https://guides.library.illinois.edu/c.php?g=613892&p=4265891
https://play.google.com/store/apps/details?id=com.stamurai.stamurai&hl=en_US

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According to Project Ideal, "There are five basic areas of language impairments: phonological disorders, morphological disorders, semantic disorders, syntactical deficits, and pragmatic difficulties."  http://www.projectidealonline.org/v/speech-language-impairments/

In order to assist students with various language impairments, there are a few technologies and accommodations that we can utilize as educators.

There are multiple computer software packages available to help develop speech and language skills, such as First Words. First Words is an application which uses graphics + speech to help develop language skills.

As mentioned previously in the section regarding communication disorders, AAC devices, or augmentative and alternative communication devices, are commonly used to assist individuals with language difficulties. AAC's can utilize symbols, images, and strategies to enhance + create ease within the communication process. AAC devices include but are not limited to sign + body language, picture and communication boards, and electronic devices such as smartphone applications, electronic communication boards, and keyboards. Some speech therapists will also use Speech Generating Devices, which can produce speech digitally when the user types or selects an image or text.

Cue Cards are an example of low tech assistance available to students struggling with language disorders. Cue cards can provide helpful hints for speaking, as well as aid with the mental organization + planning involved in communication.

Resources:

http://www.projectidealonline.org/v/speech-language-impairments/
https://guides.library.illinois.edu/c.php?g=613892&p=4265891
https://www.ldatschool.ca/assistive-technology/

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Prepared by Gabrielle Young, Ph.D., Assistant Professor, Memorial University of Newfoundland and Jeffrey MacCormack, M.Ed., Doctoral Student, Queen's University
Assistive technology refers to the devices and services that are used to increase, maintain, or improve the capabilities of a student with a disability (Dell, Newton, & Petroff, 2012). While the phrase assistive technology may make us think of computers and computerized devices, assistive technology can also be very low-tech. For example, pencil-grips (the molded plastic grips that slip over a pencil) are considered assistive technology. Assistive technology that helps students with learning disabilities includes computer programs and tablet applications that provide text-to-speech (e.g., Kurzweil 3000), speech-to-text (e.g., Dragon Naturally Speaking), word prediction capabilities (e.g., WordQ), and graphic organizers (e.g., Inspiration).

In comparison to other interventions, assistive technology may have a significant effect in helping students with disabilities progress towards the goals outlined on their Individual Education Plans (Watson, Ito, Smith, & Andersen, 2010). Assistive technology helps in two ways: it can help the student learn how to complete the task and it can help to bypass an area of difficulty. For example, when a student decides to listen to a digital version of a book, they are bypassing an area of difficulty. However, if the student focuses on the computer screen as highlighted words are read aloud, they can learn unfamiliar words.

Assistive Technology Summary Points

1. Assistive technology ranges from low- to high-tech.

2. Assistive technology can be used in two ways: to support learning and to bypass a challenging task such as handwriting.

3. In order to be effective, assistive technology needs to be embedded within quality instruction.

Laptop Computers and Computerized Devices: Benefits of Assistive Technology

Laptop computers and tablet devices are beneficial for students with learning disabilities because they are portable and lightweight. For students with handwriting difficulties, being able to take notes on a laptop or computerized device (such as an iPad) can improve the quantity and quality of the notes (Vaughn & Bos, 2009). Using a word processor can help students to complete work that is more organized and includes less spelling errors than handwritten work (Hetzroni & Shrieber, 2004). In addition, students may identify and correct more errors when using spell check than when editing by hand (MacArthur, Graham, Haynes, & De La Paz, 1996; McNaughton, Hughes, & Ofiesh, 1997). However, obtaining personal access to laptops and computerized devices does not ensure engagement and increased academic success (Donovan, Green, & Hartley, 2010). For many students, laptop computers and computerized devices can be too distracting. Teachers and students need to be trained in how to meaningfully integrate technology into academic contexts so that the devices don't detract from learning (Dell, Newton, & Petroff, 2012).

Computer-assisted Instruction

Computer-assisted instruction refers to software and applications that have been designed to provide instruction and practice opportunities on a wide range of devices (e.g., computer, laptop, iPad, mobile technology). Computer-assisted instruction provides immediate and dynamic feedback and students with learning disabilities can benefit from this nonjudgmental computerized drill and practice (Stetter & Hughes, 2010). Computer-assisted instruction has been shown to be helpful for students with learning disabilities in spelling and expressive writing skills (Wanzek et al., 2006) as this software can reduce distractibility (Hecker, Burns, Elkind, Elkind, & Katz, 2002), and can help students learn to read (Lee & Vail, 2005) and achieve other academic outcomes (Chiang & Jacobs, 2009). Computer-assisted instruction is also an effective way for students with learning disabilities to practice math drills (Bouck & Flanagan, 2009), as students who used computer-assisted instruction to practice math skills were able to memorize math facts more easily, and developed a more positive attitude towards math than students who did not use computer-assisted instruction (Adcock et al., 2010).
Computer-assisted Instruction Summary Points Figure 1: Helping students through assistive technology

1. Computer-assisted instruction provides students with dynamic feedback.

2. Computer-assisted instruction can help students practice spelling and multiplication drills.

3. In order to prevent the technology from being a distraction, students need to be taught how to use technology to support their learning

Software Functions

Assistive technology can improve the writing skills of students with learning disabilities (Batorowicz, Missiuna, & Pollock, 2012). Assistive technology can help students to bypass the mechanical aspects of writing. Using spell check and grammar features can help students focus on communicating their ideas and students can write with confidence knowing that they can easily make changes. In addition, being able to submit a final assignment that is neater and better organized supports positive self-esteem. Text-to-speech (e.g., Kurzweil 3000), speech-to-text (e.g., Dragon Naturally Speaking), word prediction (e.g., WordQ) and graphic organizers (e.g., Inspiration) are four useful software functions for students who struggle with language-based learning disabilities.

We may not consider the default functions of word processors to be ground breaking, but for students with learning disabilities, functions such as spell check and text-to-speech can be a tremendous help when composing and decoding words.

Text-to-speech - Text-to-speech software, such as Kurzweil 3000, can read aloud digital or printed text. This is beneficial as students are more likely to understand text when unfamiliar words are read to them (MacArthur, Ferreti, Okolo, & Cavalier, 2001). Text-to-speech can have a positive effect on decoding and word recognition (Raskind & Higgins, 1999), as well as reading fluency and reading comprehension (Izzo, Yurick, & McArrell, 2009; Montali & Lewandowski, 1996; Stodden, Roberts, Takahishi, Park, & Stodden, 2012). Text-to-speech software can be especially helpful for students who retain more information through listening than reading. This software can assist students with monitoring and revising their typed work, as hearing the text read aloud may assist students in catching grammatical errors that may have otherwise gone unnoticed (Raskind & Higgins, 1995; Rao, Dowrick, Yuen, & Boisvert, 2009; Zhang, 2000).

After reviewing the literature, Strangman and Dalton (2005) reported that the use of text-to-speech software can improve students' sight reading and decoding abilities. In addition, text-to-speech software can improve the reading comprehension of individuals with specific deficits in phonological processing (difficulty hearing letter-sounds) as students can learn to decode new words when they are highlighted as they are read aloud (Fasting & Halaas Lyster, 2005; Holmes & Silvestri, 2009). Kurzweil 3000 provides reading, writing, studying, and organizational support for students who have difficulty reading or writing (e.g., Elkind, 1998). The use of Kurweil 3000 software also improves students' perception of their work and their ability to write expressively (Chiang & Jacobs, 2009). Programs such as Kurzweil 3000 may decrease the negative emotions students associate with reading and provide students with a more complete comprehension of the text (Young, 2012), and as a result, text-to-speech programs are recommended for use along with research-supported reading intervention practices.

Speech-to-text - Writing involves low-level transcription skills (e.g., handwriting, spelling, punctuation, and grammar), as well as high-level composition skills (e.g., planning, generating content, and revising). Speech-to-text software transcribes spoken word into computer text, allowing the student to bypass the demands of typing or handwriting; freed from these effortful tasks, students may compose stories that are longer, more complex, and contain fewer errors (Graham, 1999). Speech recognition accuracy improves with use; however, new users can become frustrated with the training process, and they may lack the ability to efficiently edit the program's text output. Titles such as XpressLab are licensed by the Ministry of Education and can be used to improve expressive oral language for students in grade 7-12.
Software Summary Point
Voice recognition software can improve word recognition, spelling, and reading comprehension skills for students with learning disabilities (Higgins & Raskind, 2000). MacArthur and Cavalier (2004) found that for students with learning disabilities, essays dictated using Dragon Naturally Speaking were better than handwritten essays, but essays dictated to a scribe were even better. These authors found a differential impact on students with and without disabilities, providing evidence that this technology removes a barrier based on disability.
Click here to access a list of Ministry of Education approved software titles.
Word Prediction - Word prediction software was originally designed for students with physical disabilities who experienced difficulty typing. However, word prediction with text-to-speech is also effective for students with learning disabilities because it reduces the need for handwriting, and improves students' spelling accuracy and writing skills (Cullen, Richards, & Frank, 2008; Evmenova, Graff, Jerome & Behrman, 2010; Handley-More, Dietz, Billingsley & Coggins, 2003; Lewis, Graves, Ashton, & Kieley, 1998; Silió & Barbetta, 2010). In addition, students may find it enjoyable to have the words recommended through word prediction and be able to form sentences without having to worry about spelling and word-choice (Evmenova et al., 2010).

An analysis of 25 years of research found that word prediction increases transcription accuracy and may also increase word fluency and compositional quality of writing for students with learning and academic difficulties (Peterson-Karlan, 2011). In one particular study, children and their families generally found WordQ to be helpful, and reported improved vocabulary use and increased independence, productivity, and motivation to write (Tam, Archer, Mays, & Skidmore, 2005). While there are potential benefits to the use of WordQ, a basic foundation of phonological awareness is required as students who are unable to identify the beginning sound of words will not benefit from using word prediction software because the user has to provide the first letters of the word (MacArthur, 1999). In addition, word prediction demands a fairly high level of attention to make use of the suggested words (MacArthur, 1998); and as a result, each child must be considered on an individual basis in order to select the appropriate technology for his or her learning needs.

1. Text-to-speech software helps students to bypass the task of decoding words. Seeing individual words highlighted as the text is read aloud may help to improve students' sight word vocabulary.

2. Speech-to-text software bypasses the tasks of handwriting and spelling, allowing the student to concentrate on developing their ideas and planning their work.

3. Speech-to-text software bypasses the tasks of handwriting and spelling, allowing the student to concentrate on developing their ideas and planning their work.

Mid-tech Devices

Mid-tech devices such as audio recorders, portable note takers, mp3 players, calculators, and pentop computers (such as LiveScribe smartpen) can be useful without the cost associated with high-tech devices. For example, the AlphaSmart is a note-taking device that can provide basic word-processing, without the cost related to the purchase and maintenance of a laptop. AlphaSmart devices were discontinued in 2013, but NEO Direct still provides support for users.

Figure 2: Exploring technology for students with learning disabilities
While assistive technology can be low or high-tech, most of the assistive technology for students with learning disabilities is high-tech (Lewis, 1998). Teachers should become familiar with assistive technology and understand how it can be incorporated within their teaching to support an inclusive learning environment.

Graphic Organizers - Graphic organizers benefit individuals who experience difficulty expressing their thoughts on paper as well as visual learners who need to see their ideas mapped out. While graphic organizers completed without technology can help students with learning disabilities to improve the quality of writing (Institute for the Advancement of Research in Education, 2003), electronic versions, such as Inspiration, allow students to arrange their thoughts on the computer screen without worrying about order, level of importance or categories because the text can be easily manipulated. Graphic organizers provide an organizational framework to help writers generate topics and content for writing projects and can assist with the planning and organizational stages of writing, and using concept mapping software can increase the quality and quantity of writing (Sturm & Rankin-Erickson, 2002). Using a web-based graphic organizer with procedural prompts enabled students to produce better organized and higher quality papers, than they could produce with handwritten organizers (Englert, Wu & Zhao, 2005; Englert, Zhao, Dunsmore, Collings, & Woblers, 2007). Being taught a strategy to plan and organize writing can improve the compositions of students with learning disabilities (MacArthur, 2009).

Pentop computers - Pentop computers, such as LiveScribe smart pens, are cheaper than high-tech devices like iPads but can provide text-to-speech, strategy feedback, and other organizational functions. As cost-effective and self-regulated reading aides, pentop computers may be a useful tool for students with reading disabilities (Schmitt, McCallum, Hennessey, Lovelace, & Hawkins, 2012). Pentop computers are also useful because they utilize instruction strategies such as providing auditory feedback during composition or math work. Handheld computerized devices that provide feedback have shown to be helpful for students with learning disabilities for essay composition (Bouck, Bassette, Taber-Doughty, Flanagan, & Szwed, 2009), and receptive note-taking and multiplication skills (Bouck, Flanagan, Miller, & Bassette, 2009). For example, pentop computers are able to provide reminders such as "don't forget to carry" during multiplication questions (Doughty, Bouck, Bassette, Szwed, & Flanagan, 2013).

Calculators and math software - Students with learning disabilities may have a history of academic failure, which contributed to their development of learned helplessness in math. For some students, a fear of failure and low academic self-concept can lead to math related anxiety. While the use of calculators can level the playing field for students with learning disabilities, some research has shown that calculators may provide unfair advantage (Bouck & Flanagan, 2009). Graphing calculators may be particularly effective because they provide visual conformation of the graph-shape. The added advantage of visual data can be highly motivating for students with learning disabilities (Bethell & Miller, 1998). Math drill programs can be an effective way for students to learn to mentally solve math questions (Adcock et al., 2010), they are also effective in increasing motivation and the addition and subtraction skills of students with dyscalculia (Amiripour, Bijan-zadeh, Pezeshki, & Najafi, 2011). Math Trek 1,2,3 is an example of software licensed by the Ministry of Education for use in classroom. Click here to find the full list of approved software titles.

1. Concept organizers, whether completed electronically or by hand, may contribute to better writing in students with learning disabilities.

2. Pentop computers can be used for reading (text-to-speech), writing (digitizing written words), and math (strategy feedback).

3. Calculators can help students with learning disabilities demonstrate their understanding of mathematical computations. Graphing calculators can provide additional support as they verify graph shapes and help solve algebraic equations.

Considerations

Much needs to be done to improve the quality of special education technology research (Edyburn, 2009). Little research has been conducted on the use of assistive technology in inclusive schools (Watson, Ito, Smith, & Andersen, 2010), and only a few researchers are conducting systematic, well-designed research that can lead to confident conclusions on how the use of assistive technology affects learning (Edyburn & Gersten, 2007; MacArthur, Ferretti, Okolo, & Cavalier, 2001; Wanzek et al., 2006). In addition, research cannot be produced quickly enough to match the rate of technological innovations, and as a result, educators tend to rely on the claims of the producers of the technologies rather than evidence-based research (Blackhurst, 2005).

Despite the enthusiasm that may surround the application of assistive technology in the classroom, assistive technology is not a panacea. Lack of common vision, limited training, access to support services, insufficient funding, and lack of teacher time are commonly cited problems in regards to the implementation of assistive technology (Ault, Bausch, & McLaren, 2013; Flanagan, Bouck, & Richardson, 2013; Morrison, 2007; Okolo & Diedrich, 2014). Researchers have noted that there is still an enormous gap between the potential of assistive technology and how much it actually helps (Burne, Knafelc, Melonis, & Heyn, 2011).

Assistive technology can reduce students' dependence on others to read, write, and organize their work (MacArthur, Ferretti, Okolo, & Cavalier, 2001; Mull & Sitlington, 2003). When provided with effective strategy instruction, outlining programs and concept mapping software can help with planning, and word processing, spell check, word prediction, and speech recognition can offer support for transcription and revision (MacArthur, 2009). While assistive technology can support struggling learners, MacArthur (2009) cautions that technology by itself has little impact on learning. In order for students to benefit from the technology, educators must have an understanding of assistive technology and how to embedded it within quality instruction (Batorowicz, Missiuana, & Pollock, 2012; Lee & Vega, 2005; Marino, Marino, & Shaw, 2006; Michaels & McDermott, 2003).

Staff Training

In a large scale survey study nearly three-quarters of respondents indicated that improved staff training and knowledge were the most important actions that could be taken to promote technology use (Okolo & Diedrich, 2014). Assistive technology devices and services have to be coupled with context-appropriate instruction from trained teachers (Specht, Howell, & Young, 2007), as students' successful implementation of assistive technology is directly related to the knowledge, skills, and dispositions of special education teachers (Michaels & McDermott, 2003). While educators acknowledge the potential of assistive technology, they may feel overwhelmed by the responsibility of understanding and using this technology with their students (Lee & Vega, 2005; Ludlow, 2001). Many teachers feel that they lack the knowledge and support to more fully integrate assistive technology into the curriculum (Okolo & Diedrich, 2014). This is not surprizing given that only a third of special education programs surveyed by Judge and Simms (2009) addressed assistive technology, and few workshops or professional development opportunities exist to continually support teachers' use of assistive technology during instruction (Lee & Vega, 2005; Ludlow, 2001; Michaels & McDermott, 2003). Teachers' use and understanding of assistive technology may increase when provided with effective instruction during pre-service education or professional development opportunities (Flanagan, Bouck, & Richardson, 2013; Lee & Vega, 2005). General educators and special educators need to become familiar with assistive and instructional technology so that they can embed this technology within their instruction to meet the needs of all their students (Chmiliar, 2007; Chmiliar & Cheung, 2007; Flanagan, Bouck, & Richardson, 2013).

When recommending the use of assistive technology, one must consider how training can be provided for students, parents, and teachers to become competent with the technology, as well as environmental factors that will continue to support the child in using technology (Specht, Howell, & Young, 2007). Funding should be allotted for the training of teachers to effectively facilitate assistive technology use (Burne, Knafelc, Melonis, & Heyn, 2011), and all educators who support an individual student should be knowledgeable about that child's assistive technology and be able to embed the use of the technology within instruction (Nelson, 2006; Okolo & Diedrich, 2014). Computers shouldn't be restricted to a specific subject area, and the use of technology should not solely occur within a computer lab; rather, assistive and instructional technology should be an integral part of all subjects and the use of these tools should be built into the curriculum. Schools should encourage teaching staff to assume the role of technology co-ordinators as they understand the demands of the curriculum and may be best equipped to find free or low cost educational solutions to help students meet curricular expectations.

1. Due to the limited evidence-based research, teachers tend to make decision about assistive technology based on claims from the software companies.

2. In order to be effective, assistive technology has to be coupled with quality instruction.

3. Teachers require training to support their implementation of assistive technology.

Examples of Assistive Technology by Domain

Receptive
Notepad - Notepads are an excellent way to record information. Students with learning disabilities (LDs) may appreciate having the information colour-coded based on the purpose, topic, or function of the information.

Audiobooks - Provides a simple way to listen to many of the best classic books and modern titles .

Speaking
Cue cards - Cue cards provide helpful hints for the oral presentation of information, and the process of composing cue cards can help organize the information before-hand.

Prezi - A free 3D graphic organizer which can be used to create presentations. Prezis can be collaborative as students can comment and build upon other Prezis.

ShowMe Interactive Whiteboard -In order to reduce anxiety, students may opt to record presentations on their iPad beforehand. Video recordings can be uploaded on YouTube or a more private domain.

Reading
Highlighter strips - Translucent rectangles of colour can help eliminate extra visual clutter by blocking out the rest of the text. Sticky notes - Students with LDs may find it useful to summarize the main ideas of the text with sticky notes which can be stuck directly on the page.

Kurzweil 3000 - Text-to-speech software, such as Kurzweil 3000, can read aloud digital or printed text.

Storyline Online - A free online streaming video program featuring books read aloud. Each book includes accompanying activities and lesson ideas.

Project Gutenberg - Over 45,000 free e-books.

Wikipedia - The Simple English function on Wikipedia allows content to be "translated" into plain English which is easier to read.

Writing
Pencil grips - For students who struggle with handwriting, pencil grips can provide a surface that is easier to manipulate.

Computerized pens - These pens can automatically transmit handwriting into digital text. Some computerized pens have audio-recording functions that allow the writer to listen to specific sections of the audio file by tapping on the written notes.

Word processing - Functions such as spell check, dictionary options, synonym support, and word-prediction features are helpful for students with learning disabilities.

Reasoning
Graphic organizers - Organizing ideas visually allows students with LDs to see the connections between ideas. Audio recorders - Many students with LD experience difficulty translating oral language into written text. Recording ideas early in the thinking process can provide a record for later recall and clarification.

SimpleMind+ - This app allows you to brainstorm and organize your ideas. Completed concept maps can be automatically converted to an outline.

Math
4-function calculator - Depending on the type of work being done, a 4-function calculator can be a great help without providing disproportionate advantage to students with LDs.

Graphing calculator - Graphing computers can solve complex equations, and the dynamic display screen allows the student to verify the results before solving on paper.

Math Dictionary for Kids - An animated, interactive online math dictionary that explains over 600 common mathematical terms in simple language.

Braiing Camp - Animated lessons and interactive activities to assess student understanding.

IXL Math - IXL's math practice skills are aligned with pre-K through Grade 8 provincial curricula, and students' performance is assessed on each objective.

Sumdog - Sumdog's learning engine adapts its math questions to each student's ability. Covering number operations through to simple algebra, it is designed for students age 6 to 14.

ShowMe and ScreenChomp - These apps provide an interactive whiteboard interface to solve problems. The actions on the screen and audio can be recorded and shared as a video file.

References

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Dr. Gabrielle Young is an Assistant Professor at Memorial University of Newfoundland where she teaches undergraduate courses such as the Nature and Characteristics of Learning Disabilities and Inclusive Practices for Students with Learning Disabilities, as well as graduate courses such as the Nature and Assessment of Learning Disabilities. While completing her doctoral studies at Western University, Gabrielle was also actively involved with the Learning Disabilities Association - London Region, where she was Vice-President of the Board. Gabrielle's research interests include: the use of assistive technology by students with special learning needs; learners' self-beliefs and the self-esteem of individuals with learning disabilities; and the use of universal design for learning and differentiated instruction to support the inclusion of students with exceptionalities in the general education classroom. Jeffrey MacCormack is a PhD student at the Faculty of Education, Queen's University, with a focus on cognition. He is a teacher certified by the Ontario College of Teachers with 9 years of experience teaching elementary school. He worked as an instructor at Queen's University and has taught and authored online courses for educators. He is currently conducting research on several topics including: learning disabilities, autism, emotional well-being, and youth development.
Young, G. (2012). Examining assistive technology use, self-concept, and motivation, as students with learning disabilities transition from a demonstration school into inclusive classrooms. Unpublished Doctoral thesis, Western University, London, Ontario, Canada. Retrieved from http://ir.lib.uwo.ca/cgi/viewcontent.cgi?article=2316&context=etd

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Assistive Technology for Students with Learning Disabilities

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Prepared by Gabrielle Young, Ph.D., Assistant Professor, Memorial University of Newfoundland and Jeffrey MacCormack, M.Ed., Doctoral Student, Queen's University Assistive technology refers to the devices and services that are used to increase, maintain, or improve the capabilities of a student with a disability (Dell, Newton, & Petroff, 2012).

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Traumatic Brain Injury (TBI) is a condition that stems from a person suffering from a severe head injury post-birth. This is only from an external force, not a disease or condition.

Because the brain is the command center for the entire body, brain damage can have widespread and long-lasting effects. Cognition, memory and language are some of the effects that first come to thought, however, they spread from there. For instance, emotions, social behaviors, and reasoning also suffer. In fact, over half of the homeless population have experienced an occurrence of TBI in their life and 25% of the population suffer from long-term and lifelong effects.

TBI is also prevalent inside the classroom with more than 1 million students suffering an occurrence annually. TBI's effects are especially tough for students to deal with as they are able to remember their ability level previous to the injury, and might not be able to process the new changes in their lives. This frustration can manifest in many different ways including lashing out at teachers and peers, social withdrawals, and personality changes.

Students suffering from TBI should be given special consideration to their surrounds.  Limiting distractions and noises can help their concentration.  Some students may benefit from lower light levels as well.  Students with memory loss may have a difficult time staying on schedule or reacting to changes in routines.  Printed note cards with the daily tasks can help them feel centered and in control.  Praise for completing these tasks can help motivate and provide a push to continue to check off the rest of the daily boxes.

Technology can also help students suffering from TBI. However, because TBI occurs suddenly during a student's educational career, they may not recognize the need for it. This means that the technology needs to both have meaning to the student as well as be minimally intrusive into their lives. Earplugs and noise-cancelling headphones can help drown out audible distractions. To keep students on track, calendar and checklist apps can help remind students who have a hard time remembering assignments. Technology implementation is more important than the actual aid for TBI students. Unfortunately, a device/solution will quickly become abandoned if it is cumbersome or a burden, and statistically a vast majority of TBI tech solutions are.

https://www.parentingspecialneeds.org/article/what-is-traumatic-brain-injury/

https://journals.lww.com/neurotodayonline/fulltext/2020/02060/traumatic_brain_injury_in_homeless_people_is.4.aspx

https://www.brainline.org/article/classroom-interventions-students-traumatic-brain-injuries

https://tbiresources.partnership.vcu.edu/media/tbi-resources/AssistiveTechnologyStrategiesforStudentswithTBI2017.pdf

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According to IDEA (Individuals with Disabilities Education Act)Autism is a developmental disability significantly affecting verbal and nonverbal communication and social interaction, generally evident before age three, that adversely affects a child’s educational performance. Other characteristics often associated with autism are engaging in repetitive activities and stereotyped movements, resistance to environmental change or change in daily routines, and unusual responses to sensory experiences.

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These are some simple accommodation's for students with autism that can be used inside the classroom.

A low distraction work area. Students with Autism can be easily distracted and can't tune distractions out, so it is best to find a work area with little to no distractions.

Printed out schedule. Students with Autism sometimes have a hard time with change of spontaneity, you can eliminate this with giving them a printed out schedule and keeping a good routine.

Sensory corner or retreat space. Sometimes students with autism can experience sensory overload so it is good to have a quiet place for them to hide and calm down.

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There are several low and high tech assistive technologies that can be utilized for a student with autism.

Some examples of low tech (AT) would be anything that does not require electricity. Sensory balls, picture boards any thing that the student can engage with.

Some medium tech (AT) could include battery operated sensory toys or timers.

There are also apps out there that can help assist students with autism such as Aut2Speak and Autism iHelp.

You may be able to combine several of these assistive technologies to really help elevate an autistic students learning.

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https://www.elemy.com/studio/autism-and-education/accommodations/

https://www.elemy.com/studio/autism-treatment/assistive-technologies/

https://www.verywellhealth.com/assistive-technology-for-autism-5076159#:~:text=Examples%20include%20battery%2Doperated%20sensory,in%20children%20on%20the%20spectrum.

http://sinche.uom.gr/sites/default/files/14_disability_categories_under_idea.pdf

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7 Helpful Accommodations for Autistic Students

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Use these suggestions to alter your classroom, your teaching style, or both to ensure that your autistic students learn all they can.

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Interventions: include detecting and referring to appropriate channels. Early intervention is the key because vision heavily affects a child's learning. Detecting a problem with vision may prevent children from getting visually impaired if treated in a timely manner. Even if the eye disease is not treatable but teaching the children how to socialize with their peers and others is very crucial early on, too.

Accommodations: Teachers have to make changes in the seating arrangement, classroom environment, preparation of lesson materials and tests in order to assist blind or visually impaired student. Each student's accommodation might look differently according to their IEP.

Teachers have to make a habit of describing what is happening in details and model it to the entire class on how to do it. This includes the blind or visually impaired student and creates awareness for other students. This way, other students working with visually impaired students are able to help them in class, too.  Students might need extra time to complete tasks, lessons translated into Braille or materials in LARGE print. They might also need assistive technology for note-taking or recording and even one-on-one assistance from a special education specialist.

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Assistive technology: Smart phone, tablets, and computers with reading magnifying and speech-to text  software, screen readers, Braille readers, and Portable magnifiers.

Sources:
https://www.miusa.org/resource/tipsheet/assistivetechnologyforblind

https://www.teachingvisuallyimpaired.com/accommodations--modifications.html

https://sites.ed.gov/idea/regs/b/a/300.8/c

https://owlcation.com/academia/Effective-Classroom-Accommodations-for-Visually-Impaired-Students

https://www.sess.ie/categories/sensory-impairments/visual-impairment/tips-learning-and-teaching

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Assistive Technology for Visual Impairments or Blindess

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“Multiple disabilities means concomitant impairments (such as intellectual disability-blindness or intellectual disability-orthopedic impairment), the combination of which causes such severe educational needs that they cannot be accommodated in special education programs solely for one of the impairments.”
https://www.google.com/search?q=multiple+disabilities&rlz=1C1CHZN_zh-TWTW983TW983&oq=multiple+disabilities&aqs=chrome..69i57j0i512l9.7190j0j15&sourceid=chrome&ie=UTF-8

The exception to this is deafness and blindness which has its own classification under IDEA.
https://www.specialeducationguide.com/disability-profiles/multiple-disabilities/

Multiple disabilities aren't all the same. They can differ in for each child in how many disabilities, which disabilities, and how severe the disabilities are. In order to provide an effective education for a child with multiple disabilities, it is important to understand which disabilities are involved, how severe each one is, and how each one can affect learning and daily living. However, because different disabilities can have a combined affect, it is also important to understand how the combination of these disabilities affect the child.
https://www.parentcenterhub.org/multiple/#not

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It is not always clear what has caused the disabilities. However, some known causes are

Chromosomal abnormalities

Premature birth

Difficulties after birth

Poor development of the brain or spinal cord

Infections

Genetic disorders

Injuries from accidents

lack of oxygen at birth

https://www.parentcenterhub.org/multiple/#not

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What is the Incidence of Multiple Disabilities?

"The U.S. Department of Education reports 5,971,495 students receiving special education services in the 2003-2004 school year. Of that number, roughly 2.2%, or 132,333 students, received special education services based on a classification of multiple disabilities."
http://www.projectidealonline.org/v/multiple-disabilities/

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It is important to first understand the nature of a child's disability as the types of disabilities and the severity can be different from case to case. Here are some ways to best help support a student with multiple disabilities:
1. Early intervention is crucial:

Many schools offer pre-kindergarten child development resources to help students with disabilities

These services help with mobility, adaptive learning methods, and more.

2. Often a team of professionals is necessary to meet the needs of the child:

This team will include speech pathologists, physical and occupational therapists, music and art therapists, and others.

Regular communication with the team can help assess the student's progress and help in pinpointing effective teaching methods.

3. Communication between home, the school, and any other involved parties which work with the child is important.

4. Inclusion in general education classrooms is important for social and cognitive development:

The degree with which a student is integrated into general education classroom can vary, with some students learning in a general classroom with some assistance and others requiring a special education classroom with limited integration into general classrooms.

Integration into general classrooms is helpful not only for the disabled child's social and cognitive development  but also for other students as well.

5. Special equipment may be required in the classroom (particularly, although not exclusively, related to mobility):

These may include wheelchairs, gait trainers, standers, and changing tables.

6.  Special education teachers, with the help of the team of professionals, need to prepare an Individual Education Plan (IEP):

These plans map out a series of goals to work toward throughout the school year, taking into account the abilities of the students.

It is a guide for best supporting the student's individual needs.

7.  Adaptive technology has the potential to benefit children with multiple disabilities greatly (discussed in the next section on Assistive technologies).
https://www.educationcorner.com/multiple-disabilities.html

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Learn how to best support children with multiple disabilities such as intellectual disability, mobility issues, visual or auditory deficits, language delay, brain injury.

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"AT includes any technological device aimed at enabling children with multiple disabilities with crucial minimal responses allowing them to favorably cope with the outside contexts."

Ideally, schools should have an Assistive Technology team put in place, responsible for each child's assistive technology needs based on the current state of their disability (those students with degenerative disabilities may find their needs changing year to year).

https://clinmedjournals.org/articles/ijpp/ijpp-1-001e.php?jid=ijpp
https://fisherpub.sjfc.edu/cgi/viewcontent.cgi?article=1300&context=education_ETD_masters

Possible AT options for MD students:

switches or  microswitches: enhance the students active role by providing access to preferred stimuli through the use of the microswitch.

Speech generated device (SGD): Allows students to ask for social contact with caregivers (can be paired with a microswitch).

Computer-based program (CBP): There are so many ways CBP could be used to help out MD students. One way would be to design a CBP that could give the target student the opportunity of choice between preferred items or access to literacy.

Assistive listening systems, or hearing assistive technology, can help students who are deaf or hard of hearing, as well as those with other auditory and learning problems.

Sip-and-puff systems are used by students who have mobility challenges, such as paralysis and fine motor skill disabilities. These systems allow for control of a computer, mobile device or some other technological application by the child moving the device with his or her mouth.

Speech recognition software programs for math can help students with a range of disabilities. From prealgebra to Ph.D. level mathematics, students can perform math problems by speaking into a microphone on their computer.

Object or tactile schedules: Allows students to communicate with teachers or parents and to make choices about things they want to do throughout their day.

Eye-gaze tracking device: Allows students to make choices with their eyes for those who have limited mobility.

https://clinmedjournals.org/articles/ijpp/ijpp-1-001e.php?jid=ijpp

https://www.teachthought.com/technology/assistive-technology/
https://youtu.be/4p3a0pC4nLM

Barriers to AT's effective integration within schools

lack of appropriate staff training and support

negative staff attitudes

inadequate assessment and planning processes

insufficient funding

difficulties procuring and managing equipment

time constraints

https://pubmed.ncbi.nlm.nih.gov/15771212/#:~:text=Abstract,coordinated%20assessment%20and%20implementation%20process.

Overcoming Barriers

a multi-faceted approach to the training and supporting of families and service providers that cover a variety of needs

More effective ways of determining students' needs, matching these with appropriate AT, and allowing more careful selection of equipment that is guided by forward planning of the student's future needs.

https://onlinelibrary.wiley.com/doi/epdf/10.1002/oti.213

# data[].attributes.attachment_link.title
How to Use Assistive Technology with Students Diagnosed with Multiple Disabilitiesn-Stephanie Renaud