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The individuals with disabilities education act makes available free appropriate public education to eligible children with disabilities throughout the nation.

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This group of disabilities affects a child’s ability to read, write, listen, speak, or to do math. For example dyslexia, dyscalculia and written expression disorder (dysgraphia). SLD is the most known of the 13 categories under IDEA. SLD affects about 5-15% among school age children from different cultures and languages. A teaching strategy could be breaking down learning tasks into smaller steps.

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IDEA’s definition of specific learning disability remains unchanged since 1975.

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This group covers conditions that limit a child’s strength, energy, or alertness due to health conditions and can impact education negatively as an effect. One example is ADHD, which influences attention and executive function. Other health impairments effects about 10% of students receiving special eduction under OHI. a teaching strategy could be

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Other Health Impairment | Center for Parent Information and Resources

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Sec. 300.8 (c) (1) - Individuals with Disabilities Education Act

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A developmental disability caused by differences in the brain that has a large number side effects, however it mainly influences a child’s social, relational abilities, or behavioral problems. Individuals with autism May require different approaches in learning, moving, or focus / paying attention. Autism spectrum disorder effects about 1 out 100 children b can be diagnosed by or before age 3 but early detection is always best. A teaching strategy could be avoiding sensory overload you could keep the class on task and at a good volume so your ASD student doesn’t get over whelmed.

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Individuals with Disabilities Education Act

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Sec. 300.8 (c) (1) - Individuals with Disabilities Education Act

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(1) (i) Autism means 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 engagement in repeti…

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Various mental health issues can fall under "emotional disturbance” such as anxiety disorder, schizophrenia, bipolar disorder, obsessive- compulsive disorder (OCD), and depression. Emotional disturbance effects at least 1 out of 10 people or about 6 million people have experienced emotional disturbance in their life. a teaching strategy could be allowing small breaks and not assign too much work because stress could send the child into a fit of rage.

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Links updated, November 2021
This information in Spanish

The mental health of our children is a natural and important concern for us all. The fact is, many mental disorders have their beginnings in childhood or adolescence, yet may go undiagnosed and untreated for years. ( 1)

We refer to mental disorders using different "umbrella" terms such as emotional disturbance, behavioral disorders, or mental illness. Beneath these umbrella terms, there is actually a wide range of specific conditions that differ from one another in their characteristics and treatment. These include (but are not limited to):

anxiety disorders;

bipolar disorder (sometimes called manic-depression);

conduct disorders;

eating disorders;

obsessive-compulsive disorder (OCD); and

psychotic disorders.

You may be reading this fact sheet with one of these specific disorders in mind, or you may be looking for information about emotional disturbances in general. In either case, keep reading to find out what different emotional distubances have in common, how they are defined in federal law, and where to find more detailed information on specific disorders.
Quick-Jump Menu
Definition
IDEA defines emotional disturbance as follows:
We've chosen to use the term "emotional disturbance" in this fact sheet because that is the term used in the nation's special education law, the Individuals with Disabilities Education Act (IDEA).

"...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:

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

(B) An inability to build or maintain satisfactory interpersonal relationships with peers and teachers.

(C) Inappropriate types of behavior or feelings under normal circumstances.

(D) A general pervasive mood of unhappiness or depression.

(E) A tendency to develop physical symptoms or fears associated with personal or school problems." ( 2)

As defined by IDEA, emotional disturbance includes schizophrenia but does not apply to children who are socially maladjusted, unless it is determined that they have an emotional disturbance. ( 3)

Characteristics

As is evident in IDEA's definition, emotional disturbances can affect an individual in areas beyond the emotional. Depending on the specific mental disorder involved, a person's physical, social, or cognitive skills may also be affected. The National Alliance on Mental Illness of Southern Arizona puts this very well:

Mental illnesses are medical conditions that disrupt a person's thinking, feeling, mood, ability to relate to others and daily functioning. Just as diabetes is a disorder of the pancreas, mental illnesses are medical conditions that often result in a diminished capacity for coping with the ordinary demands of life. ( 4)

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).

Children with the most serious emotional disturbances may exhibit distorted thinking, excessive anxiety, bizarre motor acts, and abnormal mood swings.

Many children who do not have emotional disturbance may display some of these same behaviors at various times during their development. However, when children have an emotional disturbance, these behaviors continue over long periods of time. Their behavior signals that they are not coping with their environment or peers.

Causes

No one knows the actual cause or causes of emotional disturbance, although several factors-heredity, brain disorder, diet, stress, and family functioning-have been suggested and vigorously researched. A great deal of research goes on every day, but to date, researchers have not found that any of these factors are the direct cause of behavioral or emotional problems.

According to NAMI, mental illnesses can affect persons of any age, race, religion, or income. Further:

Mental illnesses are not the result of personal weakness, lack of character, or poor upbringing. Mental illnesses are treatable. Most people diagnosed with a serious mental illness can experience relief from their symptoms by actively participating in an individual treatment plan. ( 5)

Frequency

Of the 74.5 million children in the United States, an estimated 17.1 million have or have had a psychiatric disorder. ( 6) Half of all psychiatric illness occurs before the age of 14, and 75% by the age of 24. The most common psychiatric disorders in childhood are anxiety disorders, AD/HD and disruptive behavior, depression and bipolar disorders, and eating disorders. ( 7)

Help for School-Aged Children

IDEA requires that special education and related services be made available free of charge to every eligible child with a disability, including preschoolers (ages 3-21). These services are specially designed to address the child's individual needs associated with the disability-in this case, emotional disturbance, as defined by IDEA (and further specified by states). In the 2016 school year, more than 349,000 children and youth with emotional disturbance received these services to address their individual needs related to emotional disturbance. ( 8)

Determining a child's eligibility for special education and related services begins with a full and individual evaluation of the child. Under IDEA, this evaluation is provided free of charge in public schools.
10 Basic Steps in Special Education Questions Often Asked by Parents about Special Education Services Evaluating Children for Disability Developing Your Child's IEP
There is a lot to know about the special education process, much of which you can learn here on the CPIR site. We invite you to read the wide range of publications we offer on the topic, especially:

A Look at Specific Emotional Disturbances

As we mentioned, emotional disturbance is a commonly used umbrella term for a number of different mental disorders. Let's take a brief look at some of the most common of these.

We all experience anxiety from time to time, but for many people, including children, anxiety can be excessive, persistent, seemingly uncontrollable, and overwhelming. An irrational fear of everyday situations may be involved. This high level of anxiety is a definite warning sign that a person may have an anxiety disorder.

The term "anxiety disorder" is a broad term covering several different disabilities that share the core symptom of irrational fear. These include such different disorders as generalized anxiety disorder, panic disorder, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), social anxiety disorder (also called social phobia), and specific phobias. ( 9)

According to the Anxiety Disorders Association of America, anxiety disorders are the most common psychiatric illnesses affecting children and adults. ( 10) They are also highly treatable. Unfortunately, only about 36.9% of those affected receive treatment. ( 11)

Also known as manic-depressive illness, bipolar disorder is a serious medical condition that causes dramatic mood swings from overly "high" and/or irritable to sad and hopeless, and then back again, often with periods of normal mood in between. Severe changes in energy and behavior go along with these changes in mood. ( 12)

For most people with bipolar disorder, these mood swings and related symptoms can be stabilized over time using an approach that combines medication and psychosocial treatment. ( 13)

Conduct Disorder

Conduct disorder refers to a group of behavioral and emotional problems in youngsters. Children and adolescents with this disorder have great difficulty following rules and behaving in a socially acceptable way. ( 14) This may include some of the following behaviors:

aggression to people and animals;

destruction of property;

deceitfulness, lying, or stealing; or

truancy or other serious violations of rules. (15)

Treatment will depend on the child's symptoms, age, and general health. It will also depend on how severe the condition is. Treatment may include:

helping the child learn how to better solve problems, communicate, and handle stress, as well as how to control impulses and anger (what's known as cognitive-behavioral therapy);

family therapy;

peer group therapy (to help better social and interpersonal skills); and

medications (although these are not typically used to treat conduct disorder). (16)

Eating disorders are characterized by extremes in eating behavior-either too much or too little-or feelings of extreme distress or concern about body weight or shape. Females are much more likely than males to develop an eating disorder. ( 17)

Anorexia nervosa and bulimia nervosa are the two most common types of eating disorders. Anorexia nervosa is characterized by self-starvation and dramatic loss of weight. Bulimia nervosa involves a cycle of binge eating, then self-induced vomiting or purging. Both of these disorders are potentially life-threatening. ( 18)

Binge eating is also considered an eating disorder. It's characterized by eating excessive amounts of food, while feeling unable to control how much or what is eaten. Unlike with bulimia, people who binge eat usually do not purge afterward by vomiting or using laxatives. ( 19)

According to the National Eating Disorders Association:

Treating an eating disorder generally involves a combination of psychological and nutritional counseling, along with medical and psychiatric monitoring. Treatment must address the eating disorder symptoms and medical consequences, as well as psychological, biological, interpersonal, and cultural forces that contribute to or maintain the eating disorder... Many people utilize a treatment team to treat the multi-faceted aspects of an eating disorder. ( 20)

Obsessive-Compulsive Disorder

Often referred to as OCD, obsessive-compulsive disorder is actually considered an anxiety disorder (which was discussed earlier in this fact sheet). OCD is characterized by recurrent, unwanted thoughts (obsessions) and/or repetitive behaviors (compulsions). Repetitive behaviors (handwashing, counting, checking, or cleaning) are often performed with the hope of preventing obsessive thoughts or making them go away. Performing these so-called "rituals," however, provides only temporary relief, and not performing them markedly increases anxiety. ( 21)

A large body of scientific evidence suggests that OCD results from a chemical imbalance in the brain. ( 22) Treatment for most people with OCD should include one or more of the following:

therapist trained in behavior therapy;

Cognitive Behavior Therapy (CBT);

medication (usually an antidepressant). (23)

"Psychotic disorders" is another umbrella term used to refer to severe mental disorders that cause abnormal thinking and perceptions. Two of the main symptoms are delusions and hallucinations. Delusions are false beliefs, such as thinking that someone is plotting against you. Hallucinations are false perceptions, such as hearing, seeing, or feeling something that is not there. Schizophrenia is one type of psychotic disorder. ( 24) There are others as well.

Treatment for psychotic disorders will differ from person to person, depending on the specific disorder involved. Most are treated with a combination of medications and psychotherapy (a type of counseling). ( 25)

More about School

As mentioned, emotional disturbance is one of the categories of disability specified in IDEA. This means that a child with an emotional disturbance may be eligible for special education and related services in public school. These services can be of tremendous help to students who have an emotional disturbance.

Typically, educational programs for children with an emotional disturbance need to include attention to providing emotional and behavioral support as well as helping them to master academics, develop social skills, and increase self-awareness, self-control, and self-esteem. A large body of research exists regarding methods of providing students with positive behavioral support (PBS) in the school environment, so that problem behaviors are minimized and positive, appropriate behaviors are fostered. (See the resource section at the end of this fact sheet for more information on PBS.) It is also important to know that, within the school setting:

For a child whose behavior impedes learning (including the learning of others), the team developing the child's Individualized Education Program (IEP) needs to consider, if appropriate, strategies to address that behavior, including positive behavioral interventions, strategies, and supports.

Students eligible for special education services under the category of emotional disturbance may have IEPs that include psychological or counseling services. These are important related services available under IDEA and are to be provided by a qualified social worker, psychologist, guidance counselor, or other qualified personnel.

Recognizing and Addressing the Impact of COVID-19 | As young people return to in-person schooling in the 2021-2022 school year, they may bring with them the impact of the pandemic's trauma. This makes it essential that schools consider the possibility that many students will need to be re-evaluated to determine if they need additional services, especially behavioral support and mental health services, than they needed prior to COVID-19. Two resources of great relevance to reopening schools and returning students are the following:

Other Considerations

Children and adolescents with an emotional disturbance should receive services based on their individual needs, and everyone involved in their education or care needs to be well-informed about the care that they are receiving. It's important to coordinate services between home, school, and community, keeping the communication channels open between all parties involved.

The Importance of Support

Families often need help in understanding their child's disability and how to address the needs that arise from the disability. Help is available from psychiatrists, psychologists, and other mental health professionals that work in the public or private sector. There is also a network of mental health support operating in every state as well as locally.

To locate systems of support in your community or state, visit the organizations we've listed below. They can connect you with local resources, including support groups that provide connection and understanding, information, referral, and advocacy for those living with emotional disturbance.

There are also support groups available from organizations that address specific mental disorders under the umbrella term of emotional disturbance. See the resources at the end of this fact sheet to identify some of these groups.

Resources of More Information

AACAP | American Academy of Child and Adolescent Psychiatry | AACAP offers Facts for Families, a series in English, Spanish, and several other languages that includes many briefs on specific mental disorders, including the ones mentioned in this publication.

AACAP also operates different Resource Centers, which offer consumer-friendly definitions, answers to frequently asked questions, clinical resources, expert videos, Facts for Families, and much more. Visit the Resource Center home page if you are concerned with one of the following:

Anxiety Disorders

Autism

Bipolar Disorder

Conduct Disorder

Depression

Oppositional Defiant Disorder

NIMH | National Institute of Mental Health | NIMH is clearly a source of authoritative information on specific mental disorders. Phone: 1.866.615.6464. TTY: 1.866.415.8051

NAMI | National Alliance on Mental Illness | NAMI is an excellent source of information and connection on mental illness, including the individual disorders mentioned in this fact sheet. NAMI's website and toll-free helpline are available in English and Spanish.

SAMHSA is the Substance Abuse & Mental Health Services Administration. It offers many resources to consumers, including:.

Detailed information on specific emotional disturbances, or related issues such as positive behavior supports, is also available from these sources:

Anxiety Disorders Association of America | https://adaa.org/

Center on Positive Behavioral Interventions and Supports | The PBIS Center provides research-based information on how to provide behavioral supports to children who need them. | https://www.pbis.org

Conduct Disorders | A soft place to land for battle-weary parents
https://www.conductdisorders.com/community/

Encyclopedia of Mental Disorders | http://www.minddisorders.com/index.html

National Eating Disorders Association
1.800.931.2237 | www.nationaleatingdisorders.org

Something Fishy | (eating disorders)
https://www.something-fishy.org

**Highly Rated Resource! This resource was reviewed by 3-member panels of Parent Center staff working independently from one another to rate the quality, relevance, and usefulness of CPIR resources. This resource was found to be of "High Quality, High Relevance, High Usefulness" to Parent Centers.
________________________________________

References

2 | Code of Federal Regulations, Title 34, §300.8(c)(4)(i)

3 | Code of Federal Regulations, Title 34, §300.8(c)(4)(ii)

5 | Ibid.

7 | Ibid.

11 | Ibid.

13 | Ibid.

14 | American Academy of Adolescent and Child Psychiatry. (2013, August). Conduct disorder: Facts for families. Washington, DC: Author. Available online at:
http://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/Facts_for_Families_Pages/Conduct_Disorder_33.aspx

15 | Ibid.

16 | Johns Hopkins Medicine Health Library. (n.d.). Conduct disorder in children. Baltimore, MD: Author. Online at:
https://www.hopkinsmedicine.org/healthlibrary/conditions/mental_health_disorders/conduct_disorder_90,P02560

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Links updated, November 2021 This information in Spanish The mental health of our children is a natural and important concern for us all. The fact is, many mental disorders have their beginnings in childhood or adolescence, yet may go undiagnosed and untreated for years.

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This group covers problems with speech or language. The most common form of a speech impediment is a stutter, more examples are having problems pronouncing words or making the right sounds and it also covers children's ability to understand words or express them themselves. A teaching strategy could be giving the student a quiet environment so that the student can focus and hear themselves speak.

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Center for Parent Information and Resources

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Speech and Language Impairments - Center for Parent Information and Resources

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Your Central Hub for Parent Centers Serving Families of Children With Disabilities

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6. Visual impairments (including blindness)

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6. Visual impairments (including blindness)

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This category includes partial sight and blindness. A child who has eyesight is considered to visually impaired. If a child has eyewear and it corrects the vision problem they don't qualify for IDEA. Some characteristics of visual impairment are blindness like not being able to see objects in the distance like on a whiteboard or blackboard, having problems reading or learning to read, not being able to focus on objects or follow them, and they may chronic eye redness or extreme sensitivity to light. A teaching strategy could be using clear images and always making sure they can see things as clearly as possible.

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Links updated, April 2017
Table of Contents

Julian's Story

When Julian was almost two years old, he developed this adorable habit of closing one eye when he looked at you. It almost seemed as if he were winking. The possibility that Julian had a visual impairment didn't initially occur to his parents, but when Julian's left eye started crossing inward toward his nose...

Off they went to the eye doctor, who confirmed that, yes, Julian had a visual impairment-, often called "lazy eye." As the most common cause of vision problems in children, amblyopia is the medical term used when vision in one eye is reduced because that eye and the brain are not working together properly. ( 1) Julian was also very farsighted, especially in the eye he'd taken to closing.

Soon Julian had a brand-new pair of durable glasses suited to his active two-year-old self. The eye doctor also put an eyepatch over Julian's better eye, so that he would have to use the weaker eye and strengthen its communication with the brain. Otherwise, the eye doctor said, the brain would begin to ignore the images sent by the weaker eye, resulting in permanent vision problems in that eye.

Julian took good care of his glasses, but he didn't take well to the patch, unfortunately. He ripped it off every time his parents put it on...and back on... and back on again. So today his eye still turns inward if he doesn't wear his glasses.

Visual Impairments in Children

Vision is one of our five senses. Being able to see gives us tremendous access to learning about the world around us-people's faces and the subtleties of expression, what different things look like and how big they are, and the physical environments where we live and move, including approaching hazards.

When a child has a visual impairment, it is cause for immediate attention. That's because so much learning typically occurs visually. When vision loss goes undetected, children are delayed in developing a wide range of skills. While they can do virtually all the activities and tasks that sighted children take for granted, children who are visually impaired often need to learn to do them in a different way or using different tools or materials. ( 2) Central to their learning will be touching, listening, smelling, tasting, moving, and using whatever vision they have. ( 3) The assistance of parents, family members, friends, caregivers, and educators can be indispensable in that process. More will be said about this in a moment.

Types of Visual Impairment

Not all visual impairments are the same, although the umbrella term "visual impairment" may be used to describe generally the consequence of an eye condition or disorder.

The eye has different parts that work together to create our ability to see. When a part of the eye doesn't work right or communicate well with the brain, vision is impaired.

To understand the particular visual impairment a child has, it's helpful to understand the anatomy of the eye and the functions of its different parts. Rather than go into those details here, in this general fact sheet, we're pleased to refer you to the experts for easy-to-understand explanations and diagrams of the visual system.

National Eye Institute |
Visit the Institute online for a diagram of the eye, what different parts are called, and what aspect of vision each part is responsible for.
https://www.nei.nih.gov/health/eyediagram

Most of us are familiar with visual impairments such as near-sightedness and far-sightedness. Less familiar visual impairments include:

strabismus, where the eyes look in different directions and do not focus simultaneously on a single point;

congenital cataracts, where the lens of the eye is cloudy;

retinopathy of prematurity, which may occur in premature babies when the light-sensitive retina hasn't developed sufficiently before birth;

retinitis pigmentosa, a rare inherited disease that slowly destroys the retina;

coloboma, where a portion of the structure of the eye is missing;

optic nerve hypoplasia, which is caused by underdeveloped fibers in the optic nerve and which affects depth perception, sensitivity to light, and acuity of vision; and

cortical visual impairment (CVI), which is caused by damage to the part of the brain related to vision, not to the eyes themselves.

There are also numerous other eye conditions that can cause visual impairment. For a more comprehensive glossary of conditions, here are two resource pages you'll find helpful:

Because there are many different causes of visual impairment, the degree of impairment a child experiences can range from mild to severe (up to, and including, blindness). The degree of impairment will depend on:

the particular eye condition a child has;

what aspect of the visual system is affected (e.g., ability to detect light, shape, or color; ability to see things at a distance, up close, or peripherally); and

how much correction is possible through glasses, contacts, medicine, or surgery.

The term "blindness" does not necessarily mean that a child cannot see anything at all. A child who is considered legally blind may very well be able to see light, shapes, colors, and objects (albeit indistinctly). Having such residual vision can be a valuable asset for the child in learning, movement, and life.

Signs of a Visual Impairment

It's very important to diagnose and address visual impairment in children as soon as possible. Some vision screening may occur at birth, especially if the baby is born prematurely or there's a family history of vision problems, but baby wellness visits as early as six months should also include basic vision screening to ensure that a little one's eyes are developing and functioning as might be expected.

That said, common signs that a child may have a visual impairment include the following.

Eyes that don't move together when following an object or a face

Crossed eyes, eyes that turn out or in, eyes that flutter from side to side or up and down, or eyes that do not seem to focus

Eyes that bulge, dance, or bounce in rapid rhythmic movements

Pupils that are unequal in size or that appear white instead of black

Repeated shutting or covering of one eye (as noticed with Julian)

Unusual degree of clumsiness, such as frequent bumping into things or knocking things over

Frequent squinting, blinking, eye-rubbing, or face crunching, especially when there's no bright light present

Sitting too close to the TV or holding toys and books too close to the face

Avoiding tasks and activities that require good vision ( 4)

If any of these symptoms are present, parents will want to have their child's eyes professionally examined. Early detection and treatment are very important to the child's development.

How Common are Visual Impairments?

Very common, especially as we grow older. But there are many causes of visual impairments that have nothing to do with the aging process, and children certainly can be-and are-affected. In the U.S., there are approximately:

455,462 children with vision difficulty (the term "vision difficulty" refers only to children who have serious difficulty seeing even when wearing glasses and those who are blind.) (5)

42,000 children with a severe vision impairment (unable to see words and letters in ordinary newsprint) (6)

61,739 children in educational settings who are legally blind (7)

Each year States must report to the U.S. Department of Education how many children with visual impairments received special education and related services in our schools under the Individuals with Disabilities Education Act (IDEA), the nation's special education law. Data for the school year 2015-16 indicate that the following numbers of children were served in the U.S. and its outlying areas:

2,799 children (ages 3-5) with visual impairment (8)

24,944 children (ages 6-21) with visual impairment (9)

Understanding How Children with Visual Impairments Learn

Children with visual impairments can certainly learn and do learn well, but they lack the easy access to visual learning that sighted children have. The enormous amount of learning that takes place via vision must now be achieved using other senses and methods.

are a primary information-gathering tool for children with visual impairments. So are the senses of smell, touch, taste, and hearing. Until the child holds the "thing" to be learned and explores its dimensions-let us say, a stuffed animal, a dog, a salt shaker, or a CD player -he or she cannot grasp its details. That is why sensory learning is so powerful for children with visual impairment and why they need to have as many opportunities as possible to experience objects directly and sensorially.

Families, friends, and others can support sensorial learning in many ways.

"Mmmm. Do you smell dinner?" appeals to the child's sense of smell.

"Listen to that bird singing outside" calls to the child's hearing. You might also say, "That's a robin," which gives the child a name for the bird that sings the song he or she is hearing.

"Your clothes are so soft today" speaks to the child's sense of touch and helps the child build a picture of the "whole" from the many details. ( 10)

Being able to see enables us to capture the "whole" of an object immediately. This isn't so for children with a visual impairment. They cannot see the "whole," they have to work from the details up to build an understanding of the whole.

The Help Available under IDEA

If you suspect (or know) that your child has a visual impairment, you'll be pleased to know there's a lot of help available under IDEA-beginning with a free evaluation of your child. IDEA requires that all children suspected of having a disability be evaluated without cost to their parents to determine if they do have a disability and, because of the disability, need special services under IDEA. Those special services are:

Early intervention | A system of services to support infants and toddlers with disabilities (before their 3rd birthday) and their families.

Special education and related services | Services available through the public school system for school-aged children, including preschoolers (ages 3-21).

Visual impairment, including blindness, is one of the disabilities specifically mentioned and defined in IDEA. If a child meets the definition of visual impairment in IDEA as well as the State's criteria (if any), then he or she is eligible to receive early intervention services or special education and related services under IDEA (depending on his or her age).

To identify the EI program in your neighborhood
Ask your child's pediatrician for a referral. You can also call the local hospital's maternity ward or pediatric ward, and ask for the contact information of the local early intervention program.

Accessing special education and related services
If your child is between 3 and 21 years of age, we recommend that you get in touch with your local public school system. Calling the public school in your neighborhood is an excellent place to start. The school should be able to tell you the next steps to having your child evaluated free of charge. If found eligible, your child can begin receiving services specially designed to address his or her educational needs and other needs associated with the disability.

Developing a written plan of services
In both cases-in early intervention for a baby or toddler with a visual impairment and in special education for a school-aged child, parents work together with program professionals to develop a plan of services the child will receive based on his or her needs. In early intervention, that plan is called theIFSP (individualized family service plan). In special education, the plan is called the IEP (individualized education program). Parents are part of the team that develops their child's IFSP or IEP.

There's a lot to know about early intervention for infants and toddlers with disabilities and about special education and related services for school-aged children. Find out more about these crucial services for eligible children with visual impairments, beginning at:

How IDEA Defines Visual Impairment

IDEA provides the nation with definitions of many disabilities that can make children eligible for special education and related services in schools. Visual impairment is one such disability the law defines-as follows:
Visual impairment including blindness...
...means an impairment in vision that, even with correction, adversely affects a child's educational performance. The term includes both partial sight and blindness. [§300.8(c)(13)]

Working with the Medical Community

If you have a child with a visual impairment, you'll probably find yourself dealing with a variety of eye care professionals who become involved to diagnose and address your child's specific disability or eye condition. Wondering who these professionals might be, what qualifications they should have, and what kind of expertise they can bring to your child's care?

Family Connect is an excellent source of this information. Family Connect is an online, multimedia community created by the American Foundation for the Blind (AFB) and the National Association for Parents of Children with Visual Impairments (NAPVI). We suggest you download (or read online) Family Connect's toolkit called Working with Medical Professionals. The toolkit is available online in English and Spanish, at:
http://www.familyconnect.org/info/after-the-diagnosis/working-with-medical-professionals/13

Need a glossary? |Becoming familiar with medical terminology relating to the visual system may also prove helpful, especially when talking to medical professionals and reading about your child's impairment. If you're baffled by the terms you hear, visit the Glossary of Eye Terminology, which lists common terms that eye doctors use when discussing symptoms, tests, treatments, surgery, diseases and conditions, and the anatomy of the eye. The glossary's online at: http://www.eyeglossary.net/

Adapting the Environment

Making adaptations to the environment where a child with a visual impairment lives, works, or plays makes evident sense, but it may be difficult for families, daycare providers, or school personnel to decide what kinds of adaptations are necessary to ensure the child's safety while also encouraging his or her ability to do things independently.

Two resources you can consult, depending on your role in the child's life, are:

Family Connect | Adapting Your Home
http://www.familyconnect.org/info/browse-by-age/infants-and-toddlers/parenting-and-family-life-iandt/adapting-your-home/1235

IRIS Center | Offers a professional development module for teachers called Accommodations to the Physical Environment: Setting up a Classroom for Students with Visual Disabilities.
https://iris.peabody.vanderbilt.edu/module/v01-clearview/

Educational Considerations

Children with visual impairments need to learn the same subjects and academic skills as their sighted peers, although they will probably do so in adapted ways. They must also learn an expanded set of skills that are distinctly vision-related, including learning how to:

move about safely and independently, which is known as orientation and mobility (O&M);

use assistive technologies designed for children with visual impairments;

use what residual vision they have effectively and efficiently; and

read and write in Braille, if determined appropriate by the IEP team of the child after a thorough evaluation. (11)

These are just some of the skills that need to be discussed by the student's IEP team and included in the IEP, if the team decides that's appropriate. Each of the above skill areas-and more-can be addressed under the umbrella of special education and related services for a child with a visual impairment.

Tips for Teachers

-Learn as much as you can about the student's specific visual impairment. What aspects of vision are affected, and how does that affect the student's ability to move about the classroom, see the board, or read a textbook? Parents (and the student!) can be an excellent source of this information.

- Learn about the many instructional and classroom accommodations that truly help students with visual impairments learn. We've listed a few in the resource section. Strongly support the student by making sure that needed accommodations are provided for classwork, homework, and testing. These will help the student learn successfully.

-If you are not part of the student's IEP team, ask for a copy of his or her IEP. The student's educational goals will be listed there, as well as the services and classroom accommodations he or she is to receive.

- Consult with others (e.g., special educators, the O&M specialist) who can help you identify strategies for teaching and supporting this student, ways to adapt the curriculum, and how to address the student's IEP goals in your classroom.

-Find out if your state or school district has materials or resources available to help educators address the learning needs of children with visual impairments. It's amazing how many do!

-Communicate with the student's parents. Regularly share information about how the student is doing at school and at home.

Tips for Parents

- Learn as much as you can about your child's specific visual impairment. The more you know, the more you can help yourself and your child.

-Understand that your child is receiving small bits of information at a time, not all at once through vision. Help your child explore new things with his or her senses and build up a concept of the "whole." For example, your child might need to be shown a banana, help you peel it, feel the banana without its skin, have a bite of it, and then help you mash it in her bowl to understand the qualities of bananas and that bananas can be eaten in different ways. ( 12)

- Encourage curiosity and explore new things and places often with your child. Give lots of opportunity to touch and investigate objects, ask questions, and hear explanations of what something is, where it comes from, and so on.

-Learn how to adapt your home, given the range and degree of your child's visual impairment. Help your son or daughter explore the house and learn to navigate it safely.

-Encourage your child's independence by letting him or her do things, rather than you doing them. Teach how to do a chore by using hands-on guidance, give lots of practice opportunities with feedback. Now, your child knows the skill, too.

- Work with the early interventionists or school staff (depending on your child's age) to build a solid individualized plan of services and supports that address your child's unique developmental and educational needs.

- Talk to other parents of children who have visual impairments similar to your child's. They can be a great source of support and insight in the challenges and joys of raising a child with vision problems. Many of the organizations we've listed in the Resources section have state or local chapters you can contact. You can also visit Parent to Parent, which specializes in teaming new parents up with veteran parents of children with similar disabilities. P2P is online at: http://www.p2pusa.org/p2pusa/sitepages/p2p-home.aspx

- Keep in touch with the professionals working with your child. Offer support. Demonstrate any assistive technology your child uses and provide any information teachers will need. Find out how you can augment your child's learning at home.

Resources of More Information

In alphabetical order, here's a starter list of organizations providing info on visual impairments, including blindness. Explore the sites below and the wealth of material they offer to families, services providers, and educators. We also include helpful resources and accessible materials for those with visual impairments.
Organizations to Consult
American Council of the Blind
800.424.8666 | http://www.acb.org

American Foundation for the Blind
Find services in your state at the link below.
http://www.afb.org/directory.aspx

American Printing House for the Blind
800.223.1839 | http://www.aph.org/

Family Connect
http://www.familyconnect.org/parentsitehome.asp (English)
http://www.familyconnect.org/parentsitehome.asp?lang=esp (Spanish)

Foundation Fighting Blindness
800.683.5555 | 800.683.5551 (TTY)
Find your local chapter | http://www.blindness.org/local-chapters
http://www.blindness.org/ (English)
http://www.blindness.org/en-espanol (Spanish)

Lighthouse Guild
800.284.4422 | http://www.lighthouseguild.org/

National Braille Association
http://www.nationalbraille.org/

National Braille Press
888.965.8965 | http://www.nbp.org

National Federation of the Blind
http://www.nfb.org/

National Library Service for the Blind and Physically Handicapped, Library of Congress
http://www.loc.gov/nls/

National Eye Institute, National Institutes of Health
http://www.nei.nih.gov/ (English)
https://www.nei.nih.gov/health/espanol (Spanish)

Prevent Blindness America
800.331.2020 | http://www.preventblindness.org
Accessible Materials Other Helpful Resources
Are You the Parent of a Blind Child?
http://www.acb.org/node/392

AEM Navigator
The AEM Navigator is an interactive tool that facilitates the process of decision-making around accessible instructional materials for an individual student.
http://aem.cast.org/navigating/aem-navigator.html#.WOPpYzvyuUk

References

1 | Centers for Disease Control and Prevention (CDC). (2015, September). Common eye disorders: Amblyopia. Atlanta, GA: Author. Online at:
https://www.cdc.gov/visionhealth/basics/ced/index.html

2 | American Foundation for the Blind. (n.d.). Accommodations and modifications at a glance: Educational accommodations for students who are blind or visually impaired. Retrieved April 4, 2017 from the Family Connect website:
http://www.familyconnect.org/info/education/know-your-rights/accommodations-and-modifications-at-a-glance/235

3 | American Foundation for the Blind. (n.d.). What's different about the way visually impaired children learn? Retrieved April 4, 2017 from the Family Connect website: http://www.familyconnect.org/info/browse-by-age/infants-and-toddlers/education-iandt/whats-different-about-the-way-visually-impaired-children-learn/1235

4 | American Optometric Association. (n.d.). Preschool vision: 2 to 5 years of age. St. Louis, MO: Author. Online at: http://www.aoa.org/patients-and-public/good-vision-throughout-life/childrens-vision/preschool-vision-2-to-5-years-of-age?sso=y

5 | American Foundation for the Blind. (2017, January). Children and youth with vision loss. New York: Author. Online at: http://www.afb.org/info/blindness-statistics/children-and-youth/children-and-youth-with-vision-loss/235

6 | Lighthouse International. (n.d.). Prevalence of visual impairment. No longer available online.

7 | American Foundation for the Blind. (2017, January). Children and youth with vision loss. New York: Author. Online at: http://www.afb.org/info/blindness-statistics/children-and-youth/children-and-youth-with-vision-loss/235

8 | U.S. Department of Education, Office of Special Education Programs. (2016, July). Table 1-2. Number of children ages 3 through 5 served under IDEA, Part B, by disability category and state: 2015-2016. Online at: https://www2.ed.gov/programs/osepidea/618-data/static-tables/2015-2016/part-b/child-count-and-educational-environment/1516-bchildcountandedenvironment-2.xlsx

9 | U.S. Department of Education, Office of Special Education Programs. (2016, July). Table 1-3. Number of students ages 6 through 21 served under IDEA, Part B, by disability category and state:2015-2016. Online at: https://www2.ed.gov/programs/osepidea/618-data/static-tables/2015-2016/part-b/child-count-and-educational-environment/1516-bchildcountandedenvironment-3.xlsx

10 | American Foundation for the Blind. (n.d.). Promoting your baby's growth and development. Retrieved April 4, 2017 from the Family Connect website: http://www.familyconnect.org/info/browse-by-age/infants-and-toddlers/growth-and-development-iandt/promoting-your-babys-growth-and-development/1235

11 | American Foundation for the Blind. (n.d.). The expanded core curriculum. Retrieved April 4, 2017 from the Family Connect website:
http://www.familyconnect.org/info/education/know-your-rights/expanded-core-curriculum/235

12 | American Foundation for the Blind. (2011). What's different about the way visually impaired children learn? Retrieved April 4, 2017 from the Family Connect website:
http://www.familyconnect.org/info/browse-by-age/infants-and-toddlers/education-iandt/whats-different-about-the-way-visually-impaired-children-learn/1235

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Links updated, April 2017 Table of Contents When Julian was almost two years old, he developed this adorable habit of closing one eye when he looked at you. It almost seemed as if he were winking. The possibility that Julian had a visual impairment didn't initially occur to his parents, but when Julian's left eye started crossing inward toward his nose...

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This category is for children who Can't hear most or all sound with a hearing aid. Common characteristics of are difficulty with oral expression, following verbal directions, social emotional problems, and interpersonal skills. Deafness effects every one out of people who are 12 and older. A teaching strategy could be closed captions or making the appropriate assistive technology available.

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Disability Fact Sheet 3 (FS3)
Links updated, May 2015
In This Publication:
Caroline's Story

Caroline is six years old, with bright brown eyes and, at the moment, no front teeth, like so many other first graders. She also wears a hearing aid in each ear-and has done so since she was three, when she was diagnosed with a moderate hearing loss.

For Caroline's parents, there were many clues along the way. Caroline often didn't respond to her name if her back was turned. She didn't startle at noises that made other people jump. She liked the TV on loud. But it was the preschool she started attending when she was three that first put the clues together and suggested to Caroline's parents that they have her hearing checked. The most significant clue to the preschool was Caroline's unclear speech, especially the lack of consonants like "d" and "t" at the end of words.

So Caroline's parents took her to an audiologist, who collected a full medical history, examined the little girl's ears inside and out, ran a battery of hearing tests and other assessments, and eventually diagnosed that Caroline's inner ear (the cochlea) was damaged. The audiologist said she had sensorineural hearing loss.

Caroline was immediately fitted with hearing aids. She also began receiving special education and related services through the public school system. Now in the first grade, she regularly gets speech therapy and other services, and her speech has improved dramatically. So has her vocabulary and her attentiveness. She sits in the front row in class, an accommodation that helps her hear the teacher clearly. She's back on track, soaking up new information like a sponge, and eager for more.

About Hearing Loss in Children

Hearing is one of our five senses. Hearing gives us access to sounds in the world around us-people's voices, their words, a car horn blown in warning or as hello!

When a child has a hearing loss, it is cause for immediate attention. That's because language and communication skills develop most rapidly in childhood, especially before the age of 3. When hearing loss goes undetected, children are delayed in developing these skills ( March of Dimes, 2010).

Recognizing the importance of early detection, the Centers for Disease Control and Prevention (the CDC) recommends that every newborn be screened for hearing loss as early as possible, usually before they leave the hospital. Catching a hearing loss early means that treatment can start early as well and "help the child develop communication and language skills that will last a lifetime" ( CDC, 2013).

Types of Hearing Loss

Before we describe the types of hearing loss a person may have, it's useful to know that sound is measured by:

its loudness or intensity (measured in units called decibels, dB); and

its frequency or pitch (measured in units called hertz, Hz).

Hearing loss is generally described as slight, mild, moderate, severe, or profound, depending upon how well a person can hear the intensities or frequencies most strongly associated with speech. Impairments in hearing can occur in either or both areas, and may exist in only one ear or in both ears. Generally, only children whose hearing loss is greater than 90 decibels (dB) are considered deaf.

There are four types of hearing loss, as follows ( eHealthMD, 2013):

Conductive hearing losses are caused by diseases or obstructions in the outer or middle ear (the pathways for sound to reach the inner ear). Conductive hearing losses usually affect all frequencies of hearing evenly and do not result in severe losses. A person with a conductive hearing loss usually is able to use a hearing aid well or can be helped medically or surgically.

Sensorineural hearing losses result from damage to the delicate sensory hair cells of the inner ear or the nerves that supply it. These hearing losses can range from mild to profound. They often affect the person's ability to hear certain frequencies more than others. Thus, even with amplification to increase the sound level, a person with a sensorineural hearing loss may perceive distorted sounds, sometimes making the successful use of a hearing aid impossible.

A mixed hearing loss refers to a combination of conductive and sensorineural loss and means that a problem occurs in both the outer or middle and the inner ear.

A central hearing loss results from damage or impairment to the nerves or nuclei of the central nervous system, either in the pathways to the brain or in the brain itself.

How Common is Hearing Loss?

Each year in the United States, more than 12,000 babies are born with a hearing loss; often, the cause is unknown ( Centers for Disease Control and Prevention, 2010). Profound deafness occurs in 4-11 per 10,000 children; in at least 50% of these cases, the cause is genetic ( American Speech-Language-Hearing Association, n.d.). Through the Universal Newborn Hearing Screening program, many states now mandate that all newborns be screened for hearing loss within hours of birth ( National Center for Hearing Assessment & Management, n.d.).

Signs of a Hearing Loss or Deafness

Just as with Caroline, our first grader, there will be signs that a child may not be hearing normally. Parents may notice that their child:

does not respond consistently to sounds or to his or her own name;

asks for things to be repeated or often says "huh?"

is delayed in developing speech or has unclear speech;

turns the volume up loud on the TV and other electronic devices. (CDC, 2012)

Causes of Hearing Loss and Deafness

Hearing loss and deafness can be either:

acquired, meaning that the loss occurred after birth, due to illness or injury; or

congenital, meaning that the hearing loss or deafness was present at birth.

The most common cause of acquired hearing loss is exposure to noise ( Merck Manual's Online Medical Library, 2012). Other causes can include:

build up of fluid behind the eardrum;

ear infections (known as otitis media);

childhood diseases, such as mumps, measles, or chicken pox; and

head trauma.

Congenital causes of hearing loss and deafness include:

a family history of hearing loss or deafness;

infections during pregnancy (such as rubella);

complications during pregnancy (such as the Rh factor, maternal diabetes, or toxicity).

A child's hearing loss or deafness may also be a characteristic of another disability such as Down syndrome, Usher syndrome, Treacher Collins syndrome, Crouzon syndrome, and Alport syndrome ( American Speech-Language-Hearing Association, n.d.).

In all cases, early detection and treatment are very important to the child's development.

Is There Help Available?

Yes, there's a lot of help available, beginning with the free evaluation of the child. The nation's special education law, the Individuals with Disabilities Education Act (IDEA), requires that all children suspected of having a disability be evaluated without cost to their parents to determine if they do have a disability and, because of the disability, need special services under IDEA. Those special services are:

Early intervention | A system of services to support infants and toddlers with disabilities (before their 3rd birthday) and their families.

Special education and related services | Services available through the public school system for school-aged children, including preschoolers (ages 3-21).

To access early intervention: To identify the EI program in your neighborhood, visit the Early Childhood Technical Assistance Center, at: http://ectacenter.org/contact/ptccoord.asp

To access special education and related services: We recommend that you get in touch with your local public school system. Calling the elementary school in your neighborhood is an excellent place to start. The school should be able to tell you the next steps to having your child evaluated free of charge and, if found eligible, he or she can begin receiving services specially designed to address your child's needs.

There are also special services available to low-income children through the Early Periodic Screening, Diagnosis, and Treatment (EPSDT) program, the child health component of Medicaid. To learn more about the EPSDT program, visit: http://www.hrsa.gov/epsdt/

Definition in IDEA

It's helpful to know that, while the terms "hearing impairment" and "hearing loss" are often used to describe a wide range of hearing losses, including deafness, IDEA actually defines the two terms separately, as follows:

Hearing impairment is defined by IDEA as "an impairment in hearing, whether permanent or fluctuating, that adversely affects a child's educational performance."

Deafness is defined as "a hearing impairment that is so severe that the child is impaired in processing linguistic information through hearing, with or without amplification."

Thus, deafness is viewed as a condition that prevents an individual from receiving sound in all or most of its forms. In contrast, a child with a hearing loss can generally respond to auditory stimuli, including speech.

Educational Implications

Hearing loss or deafness does not affect a person's intellectual capacity or ability to learn. However, children who are hard of hearing or deaf generally require some form of special education services in order to receive an adequate education. Such services may include:

regular speech, language, and auditory training from a specialist;

amplification systems;

services of an interpreter for those students who use sign language;

favorable seating in the class to facilitate lip reading;

captioned films/videos;

assistance of a notetaker, who takes notes for the student with a hearing loss, so that the student can fully attend to instruction;

instruction for the teacher and peers in alternate communication methods, such as sign language; and
counseling.

Children who are hard of hearing will find it much more difficult than children who have normal hearing to learn vocabulary, grammar, word order, idiomatic expressions, and other aspects of verbal communication. For children who are deaf or have severe hearing losses, early, consistent, and conscious use of visible communication modes (such as sign language, fingerspelling, and Cued Speech) and/or amplification and aural/oral training can help reduce this language delay.

By age four or five, most children who are deaf are enrolled in school on a full-day basis and do special work on communication and language development. Parents work with school personnel to develop an individualized education program (IEP) that details the child's special needs and the services and supports that will be provided to meet those needs. IDEA requires that the IEP team address the communication needs of a child who is deaf or hard of hearing.

Read more about communication needs as one of IDEA's "special factors"
https://www.parentcenterhub.org/special-factors/#deaf
https://www.parentcenterhub.org/considering-hearingloss/
It is important for teachers and audiologists to work together to teach the child to use his or her residual hearing to the maximum extent possible, even if the preferred means of communication is manual. Since the great majority of deaf children (over 90%) are born to hearing parents, programs should provide instruction for parents on implications of deafness within the family.

People with hearing loss use oral or manual means of communication or a combination of the two. Oral communication includes speech, lip reading, and the use of residual hearing. Manual communication involves signs and fingerspelling. Total Communication, as a method of instruction, is a combination of the oral method plus signing and fingerspelling.

Using the Relay Service

Individuals with hearing loss, including those who are deaf, now have many helpful devices available to them. Text telephones (known as TTs, TTYs, or TDDs) enable persons to type phone messages over the telephone network.

The Telecommunications Relay Service (TRS) makes it possible for TT users to communicate with virtually anyone (and vice versa) via telephone through a communications assistant. Dial 711 to access all telecommunications relay services anywhere in the United States. The relay service is free.

Resources

In alphabetical order, here's a starter list of organizations providing info and guidance on deafness and hearing loss. Explore the sites below and the wealth of material they offer on types of hearing loss, newborn and early childhood screening, the EHDI program for early detection of hearing loss, guidance for parents, suggestions for educators working with children who are deaf or hard of hearing, and much more.

Alexander Graham Bell Association for the Deaf and Hard of Hearing | www.agbell.org

American Hearing Research Foundation | www.american-hearing.org

American Society for Deaf Children |1.800.942.2732 | www.deafchildren.org/

ASHA | American Speech-Language-Hearing Association | 1.800.638.8255 | www.asha.org/public/hearing/

Beginnings | For parents of children who are deaf or hard of hearing | http://www.ncbegin.org/index.php

Better Hearing Institute | 1.800.327.9355 | http://www.betterhearing.org

CDC | Centers for Disease Control and Prevention | 1.800.CDC.INFO
www.cdc.gov/ncbddd/dd/ddhi.htm

Deaf Children and Parents | http://www.deafchildrenandsigning.com/index.html

Deaf Culture Online | http://www.deaf-culture-online.com/index.html

Hands and Voices | http://www.handsandvoices.org/

Hearing Loss Association of America | http://www.hearingloss.org/

How's Your Hearing? | http://www.howsyourhearing.com/

Info to Go | Laurent Clerc National Deaf Education Center | 202.651.5051
http://clerccenter.gallaudet.edu/Clerc_Center/Information_and_Resources/Info_To_Go.html

Listen Up! | http://www.listen-up.org

Medline Plus | http://www.nlm.nih.gov/medlineplus/hearingdisordersanddeafness.html

National Association of the Deaf | http://www.nad.org

National Center for Hearing Assessment & Management | 435.797.3584 |
http://www.infanthearing.org/

NIDCD | National Institute | on Deafness and Other Communication Disorders | 1.800.241.1044
http://www.nidcd.nih.gov/health/hearing/

PEPNET | Regional postsecondary education centers to increase access to postsecondary education for persons who are deaf.
http://www.pepnet.org
Helpful Readings on Specific Subjects
Your Baby's Hearing and Communicative Development Checklist |
http://www.nidcd.nih.gov/health/hearing/pages/silence.aspx

To Parents of Deaf Children |
http://www.deaf-culture-online.com/parents-of-deaf-children.html

Early Intervention
http://www.infanthearing.org/earlyintervention/index.html

Assistive Technology for Hearing
http://www.asha.org/public/hearing/treatment/assist_tech.htm

Communications Considerations A-Z |
http://www.handsandvoices.org/comcon/index.html

Communication Plan for a Child Who is Deaf or Hard of Hearing
http://www.handsandvoices.org/pdf/communication_plan.pdf

Cochlear Implants | www.nidcd.nih.gov/health/hearing/coch.asp

How to set up closed captioning on Netflix, HBO, Hulu. Amazon Instant Video, and more
http://exstreamist.com/streaming-television-solutions-for-the-deaf-and-hard-of-hearing/

Resources for People Who Can't Afford Hearing Aids and Cochlear Implants
http://www.hearingexchange.com/articles/paulas-110601.htm

Strategies for Teachers
https://www.parentcenterhub.org/speced/#deaf

Tips for Teachers | http://deafness.about.com/od/schooling/a/inclassroom.htm

References

American Speech-Language-Hearing Association. (n.d.). Causes of hearing loss. Available online at: www.asha.org/public/hearing/disorders/causes.htm

American Speech-Language-Hearing Association. (n.d.). The prevalence and incidence of hearing loss in children. Available online at: http://www.asha.org/public/hearing/disorders/children.htm

Centers for Disease Control and Prevention. (2012). Facts. Available online at:
http://www.cdc.gov/ncbddd/hearingloss/facts.html

Centers for Disease Control and Prevention. (2013). Hearing loss in children. Available online at: http://www.cdc.gov/ncbddd/hearingloss/about.html

eHealthMD. (2013). Different types of hearing loss. Available online at:
http://ehealthmd.com/content/different-types-hearing-loss#axzz2zvvrz36Q

Merck Manual's Online Medical Library. (2012). Hearing loss. Available online at:
http://www.merckmanuals.com/home/ear_nose_and_throat_disorders/hearing_loss_and_deafness/hearing_loss.html

March of Dimes. (2010). Hearing impairment. Available online at:
http://www.marchofdimes.com/baby/hearing-impairment.aspx

Michigan Department of Community Health. (2004). A diagram of the ear. Available online at: www.michigan.gov/documents/mdch/DCH0519A_201145_7.pdf

National Center for Hearing Assessment & Management. (n.d.). Status of early hearing detection and intervention in the United States. Available online at: www.infanthearing.org/status/index.html

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Disability Fact Sheet 3 (FS3) Links updated, May 2015 In This Publication: Caroline is six years old, with bright brown eyes and, at the moment, no front teeth, like so many other first graders. She also wears a hearing aid in each ear-and has done so since she was three, when she was diagnosed with a moderate hearing loss.

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What is a Hearing Impairment? Special Education Guide

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This category is hearing loss that is not covered under deafness, this can change and can become worse over time. Being hard of hearing is not the same as having trouble with auditory or language processing issues. Characteristics of hearing impairments are speech and sound delays, frequent or re-occurring ear infections, A family history of hearing impairments, and difficulties attending. Hearing impairments affect one out of eight people 12 and older. A teaching stratgey could be closed captions and making sure unnecessary noise to a minimum.

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Definition

Hearing impairment as a disability category is similar to the category of deafness, but it is not the same. The official definition of a hearing impairment by the Individuals with Disabilities Education Act (IDEA) is "an impairment in hearing, whether permanent or fluctuating, that adversely affects a child's educational performance but is not included under the definition of 'deafness.'" Thus, knowing the definition of deafness is necessary to understand what sort of disabilities are considered hearing impairments. A hearing loss above 90 decibels is generally considered deafness, which means that a hearing loss below 90 decibels is classified as a hearing impairment.

Common Traits

The National Dissemination Center for Children with Disabilities (NICHCY) explains that hearing loss falls into four subcategories: conductive, sensorineural, mixed and central. These identify the location in the body in which the hearing impairment occurs. Hearing aids and other sound amplifying assistive technologies (AT) often work for students with conductive hearing loss, as their impairments stem from the outer or middle ear. Such does not hold true with sensorineural, mixed and central hearing losses, as these impairments stem from the inner ear, the central nervous system or a combination of the two. Typically, hearing loss is categorized as slight, mild, moderate, severe or profound, depending on how well an individual can hear the frequencies that are commonly associated with speech.

Educational Challenges

Educational obstacles related to hearing impairments stem around communication. A student with a hearing impairment may experience difficulty in:

the subjects of grammar, spelling and vocabulary

taking notes while listening to lectures

participating in classroom discussions

watching educational videos

presenting oral reports

Underscoring the difficulty that students with hearing impairments may have in presenting oral reports are the potential language development problems linked to hearing impairments. Arizona's Department of Education's Parent Information Network notes that, "Since children with hearing impairments are unable to receive some sounds accurately, they often cannot articulate words clearly."

Tips for Teachers and Parents

The National Institute on Deafness and Other Communication Disorders (NIDCD) strongly endorses early intervention. This can limit communication hurdles. Typically, both oral (speech, lip reading and use of residual hearing) and manual (sign language) communication are used with and taught to children with hearing impairments. Voice and articulation training is often recommended to help students learn to form the sounds which they cannot hear.

Designating a note taker can allow a student with a hearing impairment to concentrate fully on listening to a lecture. A combination of traditional communication, lip reading, sign language and assistive technology can compensate for issues which make listening to lectures and participating in class discussions challenging. Children who read lips often need to sit close to the teacher, while those who use sign language may use an interpreter. Turning on captions during a video can reiterate what a student may pick up from his or her amplifying device.

Finally, it's important that parents and teachers don't underestimate a child's intelligence based on a hearing impairment. Arizona's Department of Education's Parent Information Network warns, "For most children with hearing impairments, language acquisition and language development are significantly delayed. As a result, some may incorrectly estimate the child's intelligence as low." Avoid this mistake!

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What is a Hearing Impairment? Special Education Guide

# data[].attributes.attachment_link.description
Hearing impairment as a disability category is similar to the category of deafness, but it is not the same. The official definition of a hearing impairment by the Individuals with Disabilities Education Act (IDEA) is "an impairment in hearing, whether permanent or fluctuating, that adversely affects a child's educational performance but is not included under the definition of 'deafness.'" Thus, knowing the definition of deafness is necessary to understand what sort of disabilities are considered hearing impairments.

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This category is for kids who have severe hearing and vision loss. Their needs are so unique that the other categories don't accommodate their needs. Characteristics include difficulty following conversations, not hearing noises, trouble bonding with caregiver, trouble with object permanence, trouble perceiving time, and overactive startle response. Deaf-blindness affects about .1% of the population 40 and younger. A teaching strategy could be using hand under hand to guide students hand to teach them new items by there feelings.

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Links updated, September 2020
In This Publication...
About Deaf-Blindness

There are approximately roughly 45,000 to 50,000 individuals in the U.S who are deaf-blind. [ 1] According to the 2018 National Deaf-Blind Child Count, over 11,000 are children under the age of 21.

The word "deaf-blindness" may seem as if a person cannot hear or see at all. The term actually describes a person who has some degree of loss in both vision and hearing. The amount of loss in either vision or hearing will vary from person to person.

Our nation's special education law, the IDEA, defines "deaf-blindness" as:

...concomitant [simultaneous] hearing and visual impairments, the combination of which causes such severe communication and other developmental and educational needs that they cannot be accommodated in special education programs solely for children with deafness or children with blindness. [§300.8(c)(2)]

The National Center on Deaf-Blindness observes that the "key feature of deaf-blindness is that the combination of losses limits access to auditory and visual information." [ 3] This can severely limit an individual's natural opportunities to learn and communicate with others.

Finding Help for Children with Deaf-Blindness

Children birth to age 3 | Very young children (birth up to age 3) who are deaf-blind are typically eligible for early intervention services under the Infants and Toddlers with Disabilities program of IDEA (also called Part C). These services are extremely important to children with deaf-blindness and their families, for the services are designed to address the child's developmental and learning needs. Parents are involved in deciding what services their child and family need to address the challenges of deaf-blindness. Services are either provided free of charge to families or on a sliding cost scale based on the family's income.

To find the early intervention program in your area, ask your pediatrician or get in touch with the pediatric unit of a nearby hospital. Say that you're looking for a referral to early intervention or Child Find for a baby or toddler. They'll put you in touch with a program near you.

School-age children, including preschoolers | When children with deaf-blindness reach the age of 3, they transition into special education services under Part B of IDEA. Special education services are provided free through the public school system. Even if a child with deaf-blindness is not in school yet (for example, a four-year-old), the school system is still responsible for making sure that special education and related services are available to the child.

Because deaf-blindness causes severe communication and other developmental and educational needs, it's very important for children with deaf-blindness to receive special education and related services to address their individual needs. You can find out more about these services and how to access them by contacting the local elementary school in your area.

Rather than duplicate the excellent work of others, the Center for Parent Information and Resources (CPIR) is pleased to connect you with an array of information and assistance already available on deaf-blindness. What's listed below is not exhaustive, but will certainly lead you to the founts of experience and knowledge that will be very helpful in addressing the challenges associated with deaf-blindness.

Resource Section

We've divided the resource section into several parts to speed you to information relevant to your concerns. Browse all the resources or jump to the type of resources you're looking for.

About deaf-blindness

FAQs about deaf-blindness.
http://www.aadb.org/FAQ/faq_DeafBlindness.html

What is deaf blindness?
https://nationaldb.org/library/list/3

How many children are we talking about?
https://nationaldb.org/library/list/7

Information about deaf-blindness. Personal insights and information from an individual with deaf-blindness.
http://www.deafblind.com/info-db.html

How do deaf-blind people communicate?
http://www.aadb.org/factsheets/db_communications.html

The Deafblind Manual Alphabet.
http://www.deafblind.com/card.html

Finding Services in Your State

Visit the American Association of the Deaf-Blind.
AADB provides a listing of state and local organizations for deaf-blind people and also a listing of service and rehabilitation agencies around the country. http://www.aadb.org/resources/resources.html

The Experts on Deaf-Blindness

National Center on Deaf-Blindness (NCDB)
http://www.nationaldb.org

Helen Keller National Center for Deaf-Blind Youths and Adults (HKNC)
http://www.hknc.org

American Association of the Deaf-Blind (AADB)
http://www.aadb.org

Deafblind International
http://www.deafblindinternational.org/

In Children's Early Years

How to engage your child in the early years.
https://www.nationaldb.org/for-families/learning-resources/family-topics/engage-your-child-early-years/

Early interactions with children who are deaf-blind.
https://nationaldb.org/library/page/2062
Also available in Spanish and in Indonesian.

Communication fact sheets for parents.
https://nationaldb.org/library/list/14

School Matters

Considerations when teaching students who are deaf-blind (NETAC Teacher Tipsheet).
https://webapps.ou.edu/ods/cds/MADTools/print/pdf/tpshtdb.pdf

Deaf-blindness: Educational service guidelines.
This best practice guide is designed to help states, districts, schools and practitioners in supporting students who are deafblind and their families. Available in English and Spanish from the Perkins School for the Blind.

Transition to Adulthood for Students Who Are Deaf-Blind

Transition toolkit: Enhancing self-determination for young adults who are deaf-blind.
https://nationaldb.org/library/page/2297

And more on self-determination. https://nationaldb.org/library/list/66

For Administrators

DB 101.
Working with students who are deaf-blind? Need to train staff and paraprofessionals? Consult these two sections at the National Center on Deaf-Blindness for a wealth of information for both teachers and administrators:

Educational Practices
https://www.nationaldb.org/info-center/educational-practices/

Interveners and Qualified Personnel
https://www.nationaldb.org/national-initiatives/iqp/

Resources in Spanish

Visit the National Center on Deaf-Blindness, where you'll find a wealth of information in Spanish on deaf-blindness.
https://www.nationaldb.org/for-families/learning-resources/recursos-para-familias/

English/Spanish Specialized Deaf-Blind Glossary/Espanol Glosario Especializado En Sordoceguera.
https://documents.nationaldb.org/products/esgloss.pdf

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1 | Gallaudet University Library. (2010). American deaf-blind population. Retrieved October 28, 2011, from: http://libguides.gallaudet.edu/content.php?pid=119476&sid=1029203

2 | National Center on Deaf-Blindness. (2019, December). The 2018 national child count of children and youth who are deaf-blind. Retrieved September 10, 2020, from:
https://www.nationaldb.org/media/doc/2018_National_Deaf-Blind_Child_Count_Report_FINAL_a.pdf

3 | National Center on Deaf-Blindness. (2007, November). Children who are deaf-blind. Retrieved September 10, 2020, from: https://www.nationaldb.org/media/doc/Children_Who_Are_Deaf-Blind_a.pdf
See fact sheets on other disabilities

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Links updated, September 2020 In This Publication... There are approximately roughly 45,000 to 50,000 individuals in the U.S who are deaf-blind. [ 1] According to the 2018 National Deaf-Blind Child Count, over 11,000 are children under the age of 21. The word "deaf-blindness" may seem as if a person cannot hear or see at all.

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This category is for children lack function or ability in their bodies. There are three classifications neuromotor impairments, degenerative diseases, musculoskeletal disorders. Neuromotor impairments like cerebral palsy, spinal cord injuries, spinal bifida, and seizure disorders. Degenerative diseases such as muscular dystrophy and ehlers- danlos syndrome. Musculoskeletal disorders include scoliosis and disformed limbs. Orthopedic impairments affect 1.1% or 68,188 students. A teaching strategy could be focusing on fine gross motor skills to improve mobility.

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This category is for children with below average intellectual abilities. Down syndrome is an example of disability that falls under intellectual disabilities. Some characteristics of intellectual disability crawling and walking later than most children, learning to talk late, finding it hard to remembering things, problems seeing the results of their actions, and troubles problem solving. A teaching strategy could be taking small steps and shifting to more hands on to allow independence.

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Intellectual Disability | Center for Parent Information and Resources

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Link checked and current as of June 2017

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This category is a brain injury caused by an accident or some kind of physical force. Some characteristics are bothered by light or noise, dizziness or balance, vision problems, attention or concentration problems, difficulty short and long term memory, trouble thinking clearly, and trouble sleeping or staying awake. Traumatic brain injury affects 180 100,000 children under age 15. A teaching strategy could be providing visual instructions for easy remembering

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Links updated, July 2015
In This Publication:
______________________

Susan's Story

Susan was 7 years old when she was hit by a car while riding her bike. She broke her arm and leg. She also hit her head very hard. The doctors say she sustained a traumatic brain injury. When she came home from the hospital, she needed lots of help, but now she looks fine.

In fact, that's part of the problem, especially at school. Her friends and teachers think her brain has healed because her broken bones have. But there are changes in Susan that are hard to understand. It takes Susan longer to do things. She has trouble remembering things. She can't always find the words she wants to use. Reading is hard for her now. It's going to take time before people really understand the changes they see in her.

What is Traumatic Brain Injury?

A traumatic brain injury (TBI) is an injury to the brain caused by the head being hit by something or shaken violently. (The exact definition of TBI, according to special education law, is given below.) This injury can change how the person acts, moves, and thinks. A traumatic brain injury can also change how a student learns and acts in school. The term TBI is used for head injuries that can cause changes in one or more areas, such as:

thinking and reasoning,

understanding words,

remembering things,

paying attention,

solving problems,

thinking abstractly,

talking,

behaving,

walking and other physical activities,

seeing and/or hearing, and

learning.

The term TBI is not used for a person who is born with a brain injury. It also is not used for brain injuries that happen during birth.

How is TBI Defined?

The definition of TBI below comes from the Individuals with Disabilities Education Act (IDEA). The IDEA is the federal law that guides how schools provide special education and related services to children and youth with disabilities.

IDEA's Definition of "Traumatic Brain Injury"
Our nation's special education law, the Individuals with Disabilities Education Act (IDEA) defines traumatic brain injury as...
"...an acquired injury to the brain caused by an external physical force, resulting in total or partial functional disability or psychosocial impairment, or both, that adversely affects a child's educational performance. The term applies to open or closed head injuries resulting in impairments in one or more areas, such as cognition; language; memory; attention; reasoning; abstract thinking; judgment; problem-solving; sensory, perceptual, and motor abilities; psycho-social behavior; physical functions; information processing; and speech. The term does not apply to brain injuries that are congenital or degenerative, or to brain injuries induced by birth trauma." [34 Code of Federal Regulations §300.8(c)(12)]

How Common is Traumatic Brain Injury?

Approximately 1.7 million people receive traumatic brain injuries every year. ( 1) Of children 0-19 years old, TBI results in 631,146 trips to the emergency room annually, 35,994 hospitalizations, and nearly 6,169 deaths. ( 2)

What Are the Signs of Traumatic Brain Injury?

The signs of brain injury can be very different depending on where the brain is injured and how severely. Children with TBI may have one or more difficulties, including:

Physical disabilities: Individuals with TBI may have problems speaking, seeing, hearing, and using their other senses. They may have headaches and feel tired a lot. They may also have trouble with skills such as writing or drawing. Their muscles may suddenly contract or tighten (this is called spasticity). They may also have seizures. Their balance and walking may also be affected. They may be partly or completely paralyzed on one side of the body, or both sides.

Difficulties with thinking: Because the brain has been injured, it is common that the person's ability to use the brain changes. For example, children with TBI may have trouble with short-term memory (being able to remember something from one minute to the next, like what the teacher just said). They may also have trouble with their long-term memory (being able to remember information from a while ago, like facts learned last month). People with TBI may have trouble concentrating and only be able to focus their attention for a short time. They may think slowly. They may have trouble talking and listening to others. They may also have difficulty with reading and writing, planning, understanding the order in which events happen (called sequencing), and judgment.

Social, behavioral, or emotional problems: These difficulties may include sudden changes in mood, anxiety, and depression. Children with TBI may have trouble relating to others. They may be restless and may laugh or cry a lot. They may not have much motivation or much control over their emotions.

A child with TBI may not have all of the above difficulties. Brain injuries can range from mild to severe, and so can the changes that result from the injury. This means that it's hard to predict how an individual will recover from the injury. Early and ongoing help can make a big difference in how the child recovers. This help can include physical or occupational therapy, counseling, and special education.

It's also important to know that, as the child grows and develops, parents and teachers may notice new problems. This is because, as students grow, they are expected to use their brain in new and different ways. The damage to the brain from the earlier injury can make it hard for the student to learn new skills that come with getting older. Sometimes parents and educators may not even realize that the student's difficulty comes from the earlier injury.

Is There Help Available?

Yes, there's a lot of help available, beginning with the free evaluation of the child. The nation's special education law, IDEA, requires that all children suspected of having a disability be evaluated without cost to their parents to determine if they do have a disability and, because of the disability, need special services under IDEA. Those special services are:

Early intervention | A system of services to support infants and toddlers with disabilities (before their 3rd birthday) and their families.

Special education and related services | Services available through the public school system for school-aged children, including preschoolers (ages 3-21).

To access early intervention: To identify the EI program in your neighborhood, ask your child's pediatrician for a referral. You can also call the local hospital's maternity ward or pediatric ward, and ask for the contact information of the local early intervention program. There, you can have your child evaluated free of charge and, if found eligible, your child can begin receiving early intervention services.

To access special education and related services: We recommend that you get in touch with your local public school system. Calling the elementary school in your neighborhood is an excellent place to start. The school should be able to tell you the next steps to having your child evaluated free of charge. If found eligible, he or she can begin receiving services specially designed to address your child's needs.

In the fall of 2011, nearly 26,000 school-aged children (ages 3-21) received special education and related services in our public schools under the category of "traumatic brain injury." ( 3)

What About School?

Although TBI is very common, many medical and education professionals may not realize that some difficulties can be caused by a childhood brain injury. Often, students with TBI are thought to have a learning disability, emotional disturbance, or an intellectual disability. As a result, they don't receive the type of educational help and support they really need.

When children with TBI return to school, their educational and emotional needs are often very different than before the injury. Their disability has happened suddenly and traumatically. They can often remember how they were before the brain injury. This can bring on many emotional and social changes. The child's family, friends, and teachers also recall what the child was like before the injury. These other people in the child's life may have trouble changing or adjusting their expectations of the child.

Therefore, it is extremely important to plan carefully for the child's return to school. Parents will want to find out ahead of time about special education services at the school. This information is usually available from the school's principal or special education teacher. The school will need to evaluate the child thoroughly. This evaluation will let the school and parents know what the student's educational needs are. The school and parents will then develop an Individualized Education Program (IEP) that addresses those educational needs.

It's important to remember that the IEP is a flexible plan. It can be changed as the parents, the school, and the student learn more about what the student needs at school.

Tips for Parents

Learn about TBI. The more you know, the more you can help yourself and your child. The resources and organizations listed below will connect you with a great deal of information about TBI.

Work with the medical team to understand your child's injury and treatment plan. Don't be shy about asking questions. Tell them what you know or think. Make suggestions.

Keep track of your child's treatment. A 3-ring binder or a box can help you store this history. As your child recovers, you may meet with many doctors, nurses, and others. Write down what they say. Put any paperwork they give you in the notebook or throw it in the box. You can't remember all this! Also, if you need to share any of this paperwork with someone else, make a copy. Don't give away your original!

Talk to other parents whose children have TBI. There are parent groups all over the U.S. Parents can share practical advice and emotional support. To locate parent groups near you, including your Parent Training and Information Center, have a look at our short brief, Parent Groups.

If your child was in school before the injury, plan for his or her return to school. Get in touch with the school. Ask the principal about special education services. Have the medical team share information with the school.

When your child returns to school, ask the school to test your child as soon as possible to identify his or her special education needs. Meet with the school and help develop a plan for your child called an Individualized Education Program (IEP).

Keep in touch with your child's teacher. Tell the teacher about how your child is doing at home. Ask how your child is doing in school.

Tips for Teachers

Find out as much as you can about the child's injury and his or her present needs. Find out more about TBI through the resources and organizations listed below. These can help you identify specific techniques and strategies to support the student educationally.

Give the student more time to finish schoolwork and tests.

Give directions one step at a time. For tasks with many steps, it helps to give the student written directions.

Show the student how to perform new tasks. Give examples to go with new ideas and concepts.

Have consistent routines. This helps the student know what to expect. If the routine is going to change, let the student know ahead of time.

Check to make sure that the student has actually learned the new skill. Give the student lots of opportunities to practice the new skill.

Show the student how to use an assignment book and a daily schedule. This helps the student get organized.

Realize that the student may get tired quickly. Let the student rest as needed. Reduce distractions.

Keep in touch with the student's parents. Share information about how the student is doing at home and at school.

Be flexible about expectations. Be patient. Maximize the student's chances for success.

Resources of More Information

American Academy of Family Physicians. (2010). Traumatic brain injury. Online at: http://familydoctor.org/familydoctor/en/diseases-conditions/traumatic-brain-injury.html

CDC | Centers for Disease Control and Prevention. (2010). Traumatic brain injury. Online at: www.cdc.gov/TraumaticBrainInjury/

Center on Brain Injury Research and Training. (n.d.). Traumatic brain injury: An overview (interactive learning module). Online at: http://www.cbirt.org/resources/interactive-learning-modules/

National Institute of Neurological Disorders and Stroke. (2014, July). NINDS traumatic brain injury information page. Online at: http://www.ninds.nih.gov/disorders/tbi/tbi.htm
Organizations Brain Injury Association of America
Main website: http://www.biausa.org/

Find your state BIA affiliate: http://www.biausa.org/state-affiliates.htm

National Brain Injury Information Center: 1.800.444.6443 (brain injury information only)

National Resource Center for Traumatic Brain Injury (NRCTBI)
http://www.tbinrc.com/

TBI Educators
http://cbirt.org/resources/educators/

Brainline
Information available in English and Spanish.
info@BrainLine.org
http://www.brainline.org/

Center on Brain Injury Research and Training
http://cbirt.org/

Family Caregiver Alliance
Information in English, Spanish, Chinese, Korean, and Vietnamese.
https://caregiver.org/

TBI Recovery Center
http://www.tbirecoverycenter.org/

References

1 | National Center for Injury Prevention and Control. (2012). Traumatic brain injury. Available online at the Centers for Disease Prevention and Control (CDC) website: http://www.cdc.gov/TraumaticBrainInjury/index.html

2 | CDC. (2010). Traumatic brain injury in the United States: Emergency department visits, hospitalizations and deaths, 2002-2006. Available online at: http://www.cdc.gov/traumaticbraininjury/pdf/blue_book.pdf

3 | Data Accountability Center. (2012). Data tables for OSEP state reported data. No longer available online.

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Links updated, July 2015 In This Publication: ______________________ Susan was 7 years old when she was hit by a car while riding her bike. She broke her arm and leg. She also hit her head very hard. The doctors say she sustained a traumatic brain injury.

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Sec. 300.8 Child with a disability - Individuals with Disabilities Education Act

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A child in this category has more than one of the other 12 disabilities. Having multiple issues creates educational needs that cannot be met under just one category. Some characteristics would be limited speech, trouble communicating, difficulty in basic mobility, trouble generalizing one situation from another, and may need support for major life activities. Multiple disabilities affects 2 % of special needs students. A teaching strategy could be working in groups with other students and working directly.

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Individuals with Disabilities Education Act

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300.8 Child with a disability.

(1) Child with a disability means a child evaluated in accordance with §§300.304 through 300.311 as having an intellectual disability, a hearing impairment (including deafness), a speech or language impairment, a visual impairment (including blindness), a serious emotional disturbance (referred to in this part as "emotional disturbance"), an orthopedic impairment, autism, traumatic brain injury, an other health impairment, a specific learning disability, deaf-blindness, or multiple disabilities, and who, by reason thereof, needs special education and related services.

(i) Subject to paragraph (a)(2)(ii) of this section, if it is determined, through an appropriate evaluation under §§300.304 through 300.311, that a child has one of the disabilities identified in paragraph (a)(1) of this section, but only needs a related service and not special education, the child is not a child with a disability under this part.

(ii) If, consistent with §300.39(a)(2), the related service required by the child is considered special education rather than a related service under State standards, the child would be determined to be a child with a disability under paragraph (a)(1) of this section.

(b) Children aged three through nine experiencing developmental delays. Child with a disability for children aged three through nine (or any subset of that age range, including ages three through five), may, subject to the conditions described in §300.111(b), include a child-

(1) Who is experiencing developmental delays, as defined by the State and as measured by appropriate diagnostic instruments and procedures, in one or more of the following areas: Physical development, cognitive development, communication development, social or emotional development, or adaptive development; and

(2) Who, by reason thereof, needs special education and related services.

(c) Definitions of disability terms. The terms used in this definition of a child with a disability are defined as follows:

(i) Autism means 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 engagement in repetitive activities and stereotyped movements, resistance to environmental change or change in daily routines, and unusual responses to sensory experiences.

(ii) Autism does not apply if a child's educational performance is adversely affected primarily because the child has an emotional disturbance, as defined in paragraph (c)(4) of this section.

(iii) A child who manifests the characteristics of autism after age three could be identified as having autism if the criteria in paragraph (c)(1)(i) of this section are satisfied.

(2) Deaf-blindness means concomitant hearing and visual impairments, the combination of which causes such severe communication and other developmental and educational needs that they cannot be accommodated in special education programs solely for children with deafness or children with blindness.

(3) Deafness means a hearing impairment that is so severe that the child is impaired in processing linguistic information through hearing, with or without amplification, that adversely affects a child's educational performance.

(i) Emotional disturbance means 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:

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

(B) An inability to build or maintain satisfactory interpersonal relationships with peers and teachers.

(C) Inappropriate types of behavior or feelings under normal circumstances.

(D) A general pervasive mood of unhappiness or depression.

(E) A tendency to develop physical symptoms or fears associated with personal or school problems.

(ii) Emotional disturbance includes schizophrenia. The term does not apply to children who are socially maladjusted, unless it is determined that they have an emotional disturbance under paragraph (c)(4)(i) of this section.

(5) Hearing impairment means an impairment in hearing, whether permanent or fluctuating, that adversely affects a child's educational performance but that is not included under the definition of deafness in this section.

(6) Intellectual disability means significantly subaverage general intellectual functioning, existing concurrently with deficits in adaptive behavior and manifested during the developmental period, that adversely affects a child's educational performance. The term "intellectual disability" was formerly termed "mental retardation."

(7) 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. Multiple disabilities does not include deaf-blindness.

(8) Orthopedic impairment means a severe orthopedic impairment that adversely affects a child's educational performance. The term includes impairments caused by a congenital anomaly, impairments caused by disease (e.g., poliomyelitis, bone tuberculosis), and impairments from other causes (e.g., cerebral palsy, amputations, and fractures or burns that cause contractures).

(9) Other health impairment means having limited strength, vitality, or alertness, including a heightened alertness to environmental stimuli, that results in limited alertness with respect to the educational environment, that-

(i) Is due to chronic or acute health problems such as asthma, attention deficit disorder or attention deficit hyperactivity disorder, diabetes, epilepsy, a heart condition, hemophilia, lead poisoning, leukemia, nephritis, rheumatic fever, sickle cell anemia, and Tourette syndrome; and

(ii) Adversely affects a child's educational performance.

(10) Specific learning disability-

(i) General. Specific learning disability means a disorder in one or more of the basic psychological processes involved in understanding or in using language, spoken or written, that may manifest itself in the imperfect ability to listen, think, speak, read, write, spell, or to do mathematical calculations, including conditions such as perceptual disabilities, brain injury, minimal brain dysfunction, dyslexia, and developmental aphasia.

(ii) Disorders not included. Specific learning disability does not include learning problems that are primarily the result of visual, hearing, or motor disabilities, of intellectual disability, of emotional disturbance, or of environmental, cultural, or economic disadvantage.

(11) Speech or language impairment means a communication disorder, such as stuttering, impaired articulation, a language impairment, or a voice impairment, that adversely affects a child's educational performance.

(12) Traumatic brain injury means an acquired injury to the brain caused by an external physical force, resulting in total or partial functional disability or psychosocial impairment, or both, that adversely affects a child's educational performance. Traumatic brain injury applies to open or closed head injuries resulting in impairments in one or more areas, such as cognition; language; memory; attention; reasoning; abstract thinking; judgment; problem-solving; sensory, perceptual, and motor abilities; psychosocial behavior; physical functions; information processing; and speech. Traumatic brain injury does not apply to brain injuries that are congenital or degenerative, or to brain injuries induced by birth trauma.

(13) Visual impairment including blindness means an impairment in vision that, even with correction, adversely affects a child's educational performance. The term includes both partial sight and blindness.

[71 FR 46753, Aug. 14, 2006, as amended at 72 FR 61306, Oct. 30, 2007; 82 FR 31912, July 11, 2017]

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Sec. 300.8 Child with a disability - Individuals with Disabilities Education Act

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300.8 Child with a disability. (a) General. (1) Child with a disability means a child evaluated in accordance with §§300.304 through 300.311 as having an intellectual disability, a hearing impairment (including deafness), a speech or language impairment, a visual impairment (including blindness), a serious emotional disturbance (referred to in this part as "emotional disturbance"), an...