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Communication for Children/Students Who are Deafblind: An Overview of Methods, Assessments, and Technology

[ROBIN SITTEN] Good afternoon everybody welcome to today's event from Perkins elearning we will get started in a few minutes. There is a chat box on your screen right now if you want to say hello, tell us where you are from , your interest in the top but , while we are waiting -- your interest in the topic, while we are waiting we will get started at the top of the hour.

Hi everybody as people are joining us, we will go ahead and get started with some of the preliminary information. I have got to say when the most enthusiastic audiences we have had in a long time so happy to see you communicating with each other through the chat window. I also see familiar names, that is nice. Thank you for joining us and particularly here so late into your summer season or as Angel has reminded me, some of you are back to school already said we are very excited to have you all take time with us today. The audio for today's event will be coming through your computer speakers, make sure they are turned on and you have your volume turned up. For most of you using audio we find you will have good luck using earbuds or headphones.

This is Perkins elearning webinar series today is Wednesday, August 13, 2014 my name is Robin, welcoming you to today's presentation, communication for children and students who are deafblind. Perkins elearning webinars are presented throughout the year and if this topic interests you, I would invite you to take a look at our most recent webinar amount last month's webinar about literacy adaptation for students who are deaf blind. Those of you who attended live there was audio trouble on that life events and the audio problem has been removed so do go back and take a look at that record of events. I would also plug a webinar we had a few months ago called, technology for us too, that touched on topics of communication independence and achieving dialogue with your students.

If you are interested in getting information about future webinars or other teaching resources, our content includes publications, newsletters, webcasts and workshops, both live, in person and online. Please visit our website, perkinselearning.org. Every month we are joined by new attendees so I would like to review a couple of things about the technology. You should now be seen a black slide on your screen and a steel frame of Angel Perez's video if you are only hearing my voice and not seeing this space your icon may have become minimized on your desktop, so look for that. One thing we do to keep noise levels under control is we have muted all of your lines. Shortly, we will remove the chat box and replace it with a question and answer space. We do encourage you to post your questions as they occur to you during the webinar. We will address them during Q&A but if you have questions go ahead and write them in. You may have seen a pop-up screen asking about how you want to choose to receive audio for the webinar. Quick the cancel button, removes the box from your screen.

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We are using the virtual meeting room for audio that has been set for you. You have individual controls for your screen, those of you using captioning you can see captioning in the bottom third of your screen. If you need to make that larger, you can do that on your own screen without interfering with anyone else's view. You also have individual audio controls for your computer. Part of this introduction is to give you time to make adjustments that you need. You may find sometimes that the video, of Angel, our presenter is not quite in sync with what you are hearing this has to do with bandwidth, quite frankly and connectivity. Some people find it a little distracting. If that is happening for you, you can always hide that video. The screen larger if that is distracting for you. It is not something we can manipulate on our end, unfortunately. A couple of last of things this is being recorded in the Commonwealth of Massachusetts, it will be available tomorrow on the Perkins website including a PDF version of the slides our presenter will bring to you.

So, thank you for joining us and know that we do our best to ensure you're getting the most out of this webinar. It is my pleasure to introduce today's speaker, Angel Perez, a doctoral student at the University of Alabama at Birmingham. Concentrating in the area of deaf blind studies and she is also a fellow at the national leadership Consortium in sensory disabilities as a recipient of a scholar grant through Salus University and was previously a 2010-2011 Helen Keller Fellow. Angel is currently affecting independent study concerning deaf students with dyslexia pursuing a certification in visual phonics and national braille certification. As I turn the floor over to Angel, I invite her to start her video and make sure her microphone is no longer muted. There we go, welcome to Perkins, Angel.

[ANGEL PEREZ] Thank you very much, it is very good to be here. I am so pleased and happy to see so many people interested in the subject of deafblindness and communication. It is nice to see everyone, meet everyone. If you are ready, we will get started with the PowerPoint and discussion. I want this to be a pretty laid-back forum, if you have questions I will be glad to address them at the end. So, let's get going.

The first slide is on deafblindness. This particular slide is the example or definition of deafblindness according to the federal laws. Basically, breaking this down, deaf blindness is when you have someone who has both a vision and a hearing loss and the combination is severe enough that it causes a breakdown in communication, development, and education needs and they cannot be accommodated by basic special education programs.

Who all’s here? Let's take a webinar poll. If you will take a look at the poll and check if you are a teacher of the deaf, visually impaired, special education, let’s take a poll and see what we've got.

[SITTEN] Angel, I think everybody has had a chance to answer.

[PEREZ] Very interesting group of people. Quite a few folks from deaf Education and visually impaired so it is a great group of folks, and we are glad to have each one of

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you. So, thank you all again for coming out and that was a great poll, a good conglomeration of various types of people interested in deafblindness. So, let's talk about communication. Communication is extremely important. It is a vital topic for me, personally, as well as everyone in your environment. Communication is the way that we express what we need, what we want. It is our way of being able to share the knowledge that we have, our feelings and our wishes. Individuals with vision loss and hearing loss have a variety of ways that they can show those communication, those desires through communication. So, maybe forms of body movement, gestures, facial expressions, vocalizing, just pointing to objects and using picture communication, those types of things. There are even more formal systems than that. There is quite a few varieties of doing this, of people, children most especially, in communicating. But we have to understand their needs, their mode of communication that they have chosen and what they are trying to convey to us. So what is meaningful communication?

If you take a look at this picture of a mom and this little baby, this is one of the most fundamental aspects of communication and it is the beginning stages of bonding between a child and their caregiver. This mother and baby both are smiling, she is laying her head on the baby’s chest and the maybe is feeling warm and comforted and safe. So effective communication with children who are deafblind begins as emotional attachments of young and the developmentally young children, they begin to show references for particular people who are familiar to them, mother, father, someone who is a close caregiver to them that they are with on a daily basis. They will seek those caregivers and their proximity, especially when they are upset, distressed, frustrated. They have the ability to use familiar adults as a secure base so when they are ready to explore their environment, they feel safe and secure and they are not as frustrated or upset when it comes time to explore the environment around them.

Hearing and vision loss and communication. If you have a child that has a vision loss and hearing loss, it is going to be more difficult to understand what they are trying to tell you. We all know, if you have all had children, that in the baby stage, communication can be difficult anyway. When you have a baby or child who is deafblind, then it really does become very difficult for that child to communicate what it is they want, what it is they need.

I wanted us to take a look at the perspectives from professionals and families. These are some things that’s been pulled and input from various people in the field of deafblindness and families with children who are deafblind. We need to gain, as professionals, especially, gain an understanding of the various types of communication techniques, strategies, and modes that are available that we can give a child and individualize and appropriate communication system for that child, that reflects the child's assessed needs, and we have to remember the respect of the family.

Anything from cultural differences to just plain preferences, we have to understand that we have to respect that family's wishes. Continuing those perspectives, children should be provided multiple approaches. If you have a child who has vision and hearing loss, they may not be totally blind, as you probably all well know, or totally deaf, so we need

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to explore as many options as possible. Speech, if they have residual hearing, speech is an option. Total communication is an option and that is speaking along with sign language, sign language and or ASL, pictures, pictures of the PECS system which is the picture exchange system if you will look at the PowerPoint you can see an example of that, and that is pictures that express a particular word. So, a lot of times we will use those types of systems and calendar systems to help with routines and communication names. Augmentative communication device, that is a picture of, the one in the center, and that shows you a communication device that children that are nonverbal will use. A lot of your deaf blind children are nonverbal. However, we do have some with residual hearing and vision and have some ability to communicate in other modes, but for your nonverbal children, this is a very, very important device to introduce.

How do we understand what works? Professional service providers have to understand that behavior, this is an issue, a pretty big issue, and there has been several research projects done on this, but behavior has a communication function. Not necessarily that that person is oppositional or that they are aggressive; this child is trying to let you know that they have a need, a want, a desire or they want to share something with you and they are trying to communicate that to you. Children who are deaf blind should be given the opportunity to express those needs and frustrations, without us labeling or pairing them with words like oppositional or aggressive.

Communication facilitation is very important. Each child who is deafblind, should be provided with a communication facilitator. If you have a child in the school system, if you work in the school system and you have a deafblind child, a facilitator can be a certified interpreter, trained intervener, teacher assistant, and I am not sure how familiar all of you are with the intervener process, but we can, if you have any questions about that I am more than happy to address that. However, those are some people that would you would want on your IEP team working with the child for facilitating communication. Training is a very important component to working with children who are deafblind. Here is an example in the PowerPoint of some folks getting some training and it should be provided to ensure a variety of people the ability to communicate with the child who is deafblind. If you are in the school setting, sometimes there is more than one person working with a child who is deafblind throughout the day, so you need proper training to understand what the modes are, techniques are, strategies and how to introduce that child into its environment and its world through communication.

Response time - this is a good one. Children and adults who are deafblind should be given the time to communicate, they should be given the time to listen to and have adequate time to respond. One of the things that I have experienced before, is I have been in collaborative classrooms, if any of you are familiar with that, due to inclusion, I have gone into collaborative classrooms and a teacher might ask a question to a student and call on that student and immediately want an answer, want an answer right then. Sometimes children with disabilities have to have a process of thinking, they have to have a moment to process what is being said and then determine how they want to respond to that. Children and adults who are deafblind are no different. They need time to process what they understood you to say or communicate, and need time to respond

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to that in their communication mode in a way they are comfortable with. That is a God-given right for them to be able to do that without being criticized or rushed because rushing a student like that or a child is going to be extremely frustrating in what you are going to do is build on bad behavior.

Some ways to develop some effective communication. As we saw earlier, touch is very important. The very beginning of communication with all children, with all babies, it doesn't matter if they have a hearing and vision loss, or if they do, or any other sensory issues, that is an important component to communication. A child needs the opportunity to feel safe and loved and cared for and not have to fear their environment in any way. This is something that this type of communication builds an intimate bonding relationship between you and that child. If you see the picture, you can see the mother or the caregiver and it looks like they are giving a baby massage, a child massage.

Back to behaviors - we will talk a little bit about behaviors. Behaviors can be physical movements, sounds, facial expressions, eye gazes. As you can see here this little boy is such an adorable little boy, that he is making all kinds of faces. He is looking confused, he’s laughing, he’s making funny faces, angry faces. He is communicating a variety of feelings through those communications. Sometimes when a child is deaf blind, their behavior comes off a little bit different. They’re expressions may be the same, but because they are unable to communicate with you in the mode that you are most comfortable with, sometimes you get more frustration than anything. Those frustrated looks and grunts and groaning.

Some areas of communication. You have pre-symbolic. As the child moves from infancy, behaviors intensify as a means of communication. If you look at the picture we have here, we have a child who is obviously crying his heart out. It is sad, it’s upset, but why is it sad and upset? Is it hungry? Does it need a diaper change? Is it angry? Are its feelings hurt? What is going on with this child that is causing it to have this kind of emotional expression and you have the child in the middle who is both smiling and waving, what is she trying to tell you? Is she trying to tell you hello, goodbye? What is it she is trying to let you know? And the child on the other side with the blue tobagan is smiling. He looks comfortable, happy, cozy on a cool day and comfortable, safe. He feels safe in his environment.

As the child grows, communication is obviously going to change and we are going to have to change our ways of doing things to communicate with the child. We want to start using some concrete symbols, pictures, drawings, objects, parts of objects, anything like that that will convey a message to a child and let them know what you are needing from them. Object cues are wonderful. If you look there is a roll of toilet paper. If you show a child a roll of toilet paper or a picture of a roll of toilet paper this is going to signify they need to take a bathroom break or it can be formed in the form of a question, do you need to take a bathroom break? Tangible symbols, such as a sippy cup. If I hold a sippy cup up to a child, it is going to signify to that child do I need a drink? The child will responded back with a form of communication, to let you know that yes, they would

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like a drink. They may reach and grasp the cup. They may use sign language and say more or want, but yes, these are all excellent ways of communicating with the child.

Abstract symbols are also another. This is as a child really gets older, up to several years old and older than that. These are forms of communication that involve speech, manual sign language, Braille, print, just various amount of simple and complex modes of communication and you can develop things. I learned in one of my classes, several years ago I think, in one of my Masters classes, we had taken advanced assistive technology class and there were so many wonderful ideas and ways that we could develop that were inexpensive and they were not time-consuming, that you could use to communicate with a child who is deafblind. I want you to look on one side of the PowerPoint, it is braille the other side is a manual sign language. I want you folks to take a look at the little girl in the video, if we could start the video right, now she will show you various ways of communication.

[SITTEN] Angel? Are you getting audio?

[PEREZ]No I am not.

[SITTEN]Hold on one second we are trying to get the audio. Sorry, we tested right before we started but it is not playing now I am confirming the captioner is not getting audio either.

[PEREZ] I am happy to explain.

[SITTEN]Thank you, Teresa some people are reporting they do have audio.

[PEREZ] For others of you that may not be able to hear the audio, Lacy --

[SITTEN] I have audio.

[SITTEN] Wanted to start over it is only one minute long thanks everybody for letting us know. Go ahead and restart it is only one minute long I think it is worth listening to.

[VIDEO] Hi Lacy, can you say hi?

Hi.

Can you say I love you?

I love you.

I love you, momma?

I love you.

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Very good can you say mama? Dada? Grandma? Grandpa? Can you say aunt Chris? Can you say pig?

Pig.

Horse?

Horse.

You say sheep?

Sheep.

Can you say frog?

Frog.

Can you say fish?

Fish.

Can you say swing?

Swing.

Can you say slide?

Slide.

Can you say up? Down?

[PEREZ] Thank you for that beautiful audio and video. Lacy is a beautiful little girl with CHARGE syndrome this was her preferred modes of communication, what you were watching or seeing was a child who was not only voicing the request of her mother, but also signing those requests, a very remarkable job I might add. Elements of a good conversation. You want to make sure that there is mutual respect given both ways from the two communicators. Emotional and physical comfort is extremely important if the child is emotionally or physically threatened or feels emotionally and physically threatened in any way, they are going to completely shut down the line of communication. Conversing in motion, means kind of what I am doing now with all the hand gestures and things, that is communication in motion. Topics of interest to a child. You want to try to raise interest by talking about things they like and this will open up lines of communication and make them feel more comfortable and free to communicate with you. And of course good, mutual respect -- respectful touch.

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Now we will talk about teaching effective communication. A child, you want to make sure that a child is facing you when you are ready to communicate with them. They need to be looking at you. You need to teach them there are proper ways of communicating, ways you can do that without being pushy or aggressive. There is good ways, good, positive ways to show communication for your wants and needs instead of using negative connotations. You want to teach a child to be sensitive to messages communicated in a proper tone of voice and body language. And I am sure that we are all aware of improper tones and voices and body languages, things that were inappropriate and can be very disturbing to everybody around them, other people around them, very inappropriate, very disturbing to other children around them.

We want to teach them that we have positive ways of asking for our wants and needs. We went to provide them with opportunities, opportunities to communicate with different people in different environments. What I’m meaning is you want to be able to get this child out into the community, teach them and give them those opportunities to communicate with people from various areas. For instance, I will give you an example. If you have a child who is in a school environment where they have a greenhouse, they can go and learn to communicate and learn by growing, how to communicate with the person who is growing fruits and vegetables in the greenhouse. They may learn how to communicate with the grocery clerk, how to communicate with people in authority like a principle, various, different types of people they would encounter in their environment. How to communicate, give them the opportunity to communicate, asking, allowing them to ask questions and explore the different people and the different environments. And you want to help the child expand the functions of communication. And by that I mean you don't want to just pick and choose one mode of communication and that is it, you want to open up and give them opportunities to explore ways of communication that is going to be comfortable for them. If I give a child a picture system and that is the only mode of communication I offered them, that may not be the best fit for that child, especially if they still have residual vision and hearing, that may not be the best mode of communication.

If they have ability to speak that may not be always the best mode of communication, so you want to open that up to them. A lot of times in doing that, you want to do different types of assessments that will help you understand a proper mode of communication and even assistive technology that that child might need. How many of you are familiar with communication modes? What type of communication those are you exactly familiar with? Let's take a poll and see.

[SITTEN] I think everybody has responded.

[PEREZ] This is fantastic. This is a variety of modes of communication and it looks like most of you know most of these modes of communication or you are pretty familiar anyway. So let's look at some of these modes of communication. Before we go into that there are some things toward the end I want to address in behaviors and working with IEP teams, but for now we will give modes of communication. Oral, we all know speech

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and hearing. Sign language, American Sign Language, English sign language, and I am wondering how many of you may have experience with tactile sign?

One of the best experiences I ever encountered was early in my career I was able to communicate with a woman that works for the Alabama Industries for the blind and she was profoundly deaf and profoundly blind and we carried on about a 10 minute conversation using tactile sign, and this lady did sew production for the military for the industries for the blind. It is quite incredible to see some of these people in that environment and how proud they are and their abilities to do things I can't even do, which is sew production. She was such a wonderful person and that was such a great experience to have early on in my career. Finger spelling is great. Teaching finger spelling to get over one word, needs and wants. If a child isn’t familiar with the sign for water yet, or if you want to teach them water and how to spell water, that is fine. However, you don't want to spend all of your time communicating through finger spelling. It is going to become very exhausting and taxing on your wrist. Symbols and picture symbols for communications - you can use a communication notebook, symbols, pictures, those are the same as the picture exchange system I was showing you earlier.

There’s a company that puts out probably the majority of that type of stuff, Mayor Johnson, those are readily available usually through big catalog type books and DVD/CD type thing. Communication notebooks are a good way to communicate with a student.

Another thing I wanted to tell you about that I saw. I paid a visit to Perkins, actually I did an internship there several years back, and one of the most wonderful modes of communication that I saw when I was there to observe was of a student who typed out what her communication desires and needs were. She had this makeshift keyboard but it was a paper keyboard that had been laminated and she pointed out the keys and spells out what she needed. You would watch what she was doing she had a yes and no key, that was amazing to watch her communicate with her teacher using such a simple object that was homemade, that worked so perfectly for her and her teacher.

And then there is cued speech. Not sure everybody is familiar with cued speech, but cued speech is different words and syllables and they’re formed most of the time really near the face. So then you have other modes of communication, total communication - that is if I am signing like this and voicing at the same time. Braille - braille is a wonderful form of communication. Gestures - if the person isn't familiar or has not been taught sign language, they may gesture and grunt, that is what they want. Or, they may leave you by the arm and lead you somewhere maybe they need to go to the kitchen and have a drink but that is gestures and we need to be mindful sometimes of those gestures, especially of a child is pulling on your arm, wanting to show you something or needing something.

Facial expressions like the little boy in the picture earlier. Tadoma is a form of communication that is rarely used anymore. It was the mode of communication that Amy Sullivan taught Helen Keller and it is where the person puts their fingers, the blind

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person puts their fingers on the lips and on the throat. That mode of communication is not used that often anymore. Object communication, like the tactile symbols I was telling you about earlier with the roll of toilet paper or the sippy cup. Calendars - calendars are very important. Visual communications, we were discussing this earlier, visual communications almost similar to using picture communications with facial expressions to express what you are needing or wanting or desiring. A lot of times this is something used with children who are nonverbal they can use their eyes and pictures to express what they are trying to convey.

Let's talk about service providers. Someone asked earlier in this webinar about how to get service providers and IEP team members on the same page. Because of what you want to do with that is that you are you have to form an open line of communication, here we go with communication. You have to form an open line of communication with your team members. You need to involve all the team members necessary to meet the needs of the child and I have a list here of some of those service providers on that list. You are going to want to sit down and have some regular face-to-face meetings. If you have these service providers and IEP team members that can come together and sit down at a conference table for 10 minutes a week,that is keeping the lines of communication open. You want to do observations yourself, encourage observations with the other team members and intervention. You want to sit down with them and plan interventions that are best used for the child who is deafblind. And you want to try to come up with creative ways to express the impact of that sensory loss to the other team members. You and I may be very familiar with deafblindness. We may be familiar with their needs, whether it be communication needs, sensory, integration needs, whatever that might be. We may be familiar with it but you will have IEP team members who are not quite as familiar, very well-meaning people but they aren't as familiar and sometimes we have to sit down and explain the impact maybe do a little educating to help them understand how desperate and dire the needs are for this child, whatever they may be. And some keys to effective team membership is that you need the team should share the same values, goals, team member should be committed and accountable, and you want to give each team member the respect they deserve for the knowledge and skills that they have acquired.

And, you want it again hold regular face-to-face meetings, have discussions, resolve your conflicts, those types of things, some things that are very important to forming an effective IEP team. And one of the things I wanted to talk to you about too, in communication you are going to experience children who have behavior issues and maybe they are not really issues, maybe you don't quite understand them, some of the ways that you want to address that would be to look for patterns. Maybe get a chart and chart their behavior and the patterns and their routine throughout the day and look back in about two weeks and say this child this is what we are doing during the day when this child’s behavior changes and becomes may be unruly. When you are doing things with that deaf blind child, you want to let them experience their environment to the fullest and you have to help them do that. If you are going on a trip, you need to devise ways of explaining that to them I had of time to keep down anxiety and frustration.

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Things like, maybe if you're going to the grocery store. Let's say you will take little Susie to the grocery store to teach her how to buy a few items for herself or teach her about what is available in a grocery store, maybe you want to integrate her into the sensory aspect of smelling and feeling fruit even. What you want to do is maybe you want to find a story about grocery shopping and read that ahead of time, or just explain to them this is what we are going to do and this is what is going to happen. Sounds can be very startling to children who have residual hearing. You want to label those sounds. Oh that’s Aunt Patty, she’s just emptying the garbage can, or don't worry about you hear a sound in the hall, it is just a group of students going to the restroom. You want to label them; announce any changes that child is going to encounter in their environment. Children with deaf blindness like a routine.

When there are changes in the environment, those that can spark some behavior problems or issues for you, so you want to announce ahead of time any changes. And desensitize some things, for instance, you take little Johnny to the doctor. We want to explain where we are going, what we are doing and why we are doing this and what the doctor there may do so that he doesn't become alarmed, excited or frustrated when the doctor approaches, and as the doctor is doing certain things, you want to let him know this is what the doctor is going to do. Feel your tummy or something like that because children with deafblindness are very sensitive and can be very sensitive to strange touch and things like that. So you want to desensitize the issues.

And to reduce problem behaviors, you want to include strategies for teaching more appropriate skills. You want to avoid situations that might lead to problem behaviors that comes in with charting and trying to analyze and figure what is going on with the child. Be sure the communication efforts of the students are understandable not just to yourself but everyone else in their environment as well and another strategy you can use for that is you can use a functional behavior assessment, so you can understand why the child is having these behaviors and you can devise an intervention plan with your IEP team.

So here are some resources, wonderful resources for those of you who are interested in learning more about deafblindness. You will see these on the slides. Last but not least, it is my all-time hero, Helen Keller, who said, “Once I knew only darkness and stillness, by life was without past or future. But a little word from the fingers of another fell into my hands that clutched at emptiness and my heart leapt to the rapture of living.” Thank you for being here with me for allowing me to present this webinar to you. If you have any questions, please, please ask, I will be glad to answer them as best I can.

[SITTEN] Thank you so much, Angel, this is Robin, I want to remind people that Q&A box you can see on the screen, feel free to write in there. Marcela comments, if I have a student who already formulated certain signs, to communicate by sign is it recommended, determined by the teacher or should I respect what he already has? A good question about how you determine what signs a student is responding to. When do you try to introduce or expand on their sign vocabulary?

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[PEREZ] That is really an excellent question. One question I would have for you, is how old is the child? The other question I have for you is, are you referring to home signs?

[SITTEN] Let's try again it came out as a number. Are these signs of the student is using at home, in home now coming to school and using family signs? I would also ask if anyone else has suggestions or ideas about the topic we would love to hear from you too I know there is a lot of experience in the room right now.

[PEREZ] If you are going to use a formal sign language, what you want to do is try to use various ways of introducing those formal science to the child, for instance, if the child uses a strange home find any figure out what they are trying to say, you might want to use a tactile communication mode or concept, as well as if they have residual hearing, maybe some voice and pictures showing what the actual sign is. Integrate them into this slowly so you don't frustrate them because some of the children, this is a very difficult thing for them, and they are having to start all over again, I feel like if you are going to do that you need to integrate that. And Susan has got, I am thinking she is making a good point here, she says that respect the child's signs that they have because that is respecting their communication. I agree. However, we do want to integrate them eventually into the formal way of signing and my reason for saying that again do it slowly because we don't want to frustrate and upset the child or show disrespect the child or family but by expanding that sign language and other modes of communication, to that child, it will help them communicate throughout their life. If we allow them to continue on with that basic home sign, when they move up in grade or transition to other aspects of their lives, other people will be unable to understand and the frustration is really going to grow when no one seems to understand what little Susie wants.

[SITTEN] Thank you. Angel I want to represent a couple of points Katie has also mentioned. She is the parent of a child with deaf blindness, also an intervener and she mentions that she has encountered this issue of home signs, formal signs and had requested the school not change the signs because it has taken so much work, as you say, to get him to the signs he could use and it was becoming confusing for him to make changes or use different signs for words he already understood. In a previous webinar, we had talked about that. Natalie De Wit presented how to help that vocabulary grow so if a child knows the word for shoe or sign for shoe or can recognize a symbol for shoe at what point do you start to expand that there are sneakers and flip lots and sandals and help them grow their vocabulary of words. An interesting point.

Jane mentions Linda Burkart has suggestions for transitioning from conventional to unconventional and Colby recommends in addition to resources mentioned, utilizing the skills of a vision rehab therapist or an OT who has training in low vision and blindness. Nice feedback.

[PEREZ] Very incredible suggestions. I do agree with these ladies, you want to respect that and you don't want to frustrate the child, with a whole new way of forming signs, but

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I guess my point would be the same as yours, we have to keep the expansion of communication open. We've got to let them expand vocabulary as much as possible.

[SITTEN] Yes, the teachers here presented last month from the deafblind program here at Perkins were talking about adaptations and I know we come back to this often about finding those age-appropriate activities and examples and supports as much as cognitive so you don't want everything to always be about toys or dolls as a child is a growing, to help them find things they are interested in and respond to.

Angel, I really appreciate it you described some fairly low tech kinds of approaches. A laminated spelling board or just tangible symbols. Things that there is so much technology available often sometimes we forget something like a picture board or peg system and I wonder if other people have suggestions but they would -- they have used as well that are low-tech and while people are entering those, I want to catch up on new comments coming in Georgia - a parent of a blind child says I have achieved getting professional training in my son's IEP as is mandatory for all professionals on his team. You’re also asking will this presentation be available later online. Yes this is being recorded right now and tomorrow, those of you who have registered will get a follow-up e-mail, that will have a link to the recording of the webinar as well as a download of the presentation Angel has shared with us both in the PowerPoint format and also in a braille ready format if that is better for some of you.

Teresa has a comment - I presume the student is able to comprehend the language I am communicating. This is a really interesting topic using the method used by him however I think it is important we continue to model language and concepts throughout a child's day giving him many opportunities to experience the concept via hands on, active learning again and again.

[PEREZ]Absolutely I agree with that and you need to do it in as many ways as possible, offer as many ways as possible to give that child that opportunity to expand on their language, vocabulary and knowledge of their surroundings. The more you can integrate into that child's life and opportunities you can give them to communicate, the better off you are going to be, the less frustrating it’s going to be for the child and for you.

[SITTEN] I want to direct a number of you, particularly parents, any of you new to this topic to some videos being shared on our Paths to Literacy website we share with the Texas school, it is pathstoliteracy.org. One of our contributing parents posted videos of showing tactile sign with her son. Katie is mentioning she guides her son's hands to make correct signs and over time, while he is manipulating her hands to sign and eventually he begins signing on his own without modeling her hands. There are nice videos about how to use tactile sign when working particularly with a small child that just happens to be this family’s experience but obviously as the boy grows he will be getting older. Katie mentions she's noticed that any signs requiring both hands he is not yet able to do on his own and some of that is again maybe his developmental level.

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[PEREZ] You're right, it’s most likely the development level and it can take a little longer, patience is a virtue, a key for us. They are not going to make changes overnight so hang in there and he will adapt to handed sign. One of the things I am wanting to say about assistive technology also, addressing what Robin had said about the low-tech. If you get an opportunity to have a webinar or some type of training in low tech, I suggest there is some great, great ideas out there just so simple to make, so easy for you to do and if you are in a school system as professionals, money is always an issue going out and getting your system to spend large amounts of money for high-tech devices when sometimes a low-tech product will solve your problem.

There is so many wonderful ideas. A school in Mobile, Alabama, the school for the blind, they have walls of just communication they call them their communication boards and have tactile, tangible be the things up everywhere the child can communicate by using that and they use the calendar, this is what you are doing now. Perkins use calendars every day in the classroom and the way they develop theirs was they took black felt, put over a simple cardboard, laminated their picture system and the child can go in and this is what we are doing now, doing next in this keeps them a routine going and helps them be able to enjoy their day without a lot of frustration or without a lot of changes or miscommunication.

[SITTEN] Thank you, Angel and thank you, Krista, for this reminder, I think it is important to note that if you are choosing tactile symbols that the symbols chosen have to be meaningful to the child. Not just what I was talking before about age appropriateness or something that they respond to, she has a practical example if the child is using a diaper, the diaper is a better symbol for a bathroom then say toilet paper. If they are more independent toilet paper is great but symbols needs to be, Krista writes, with the child actually encounters and may change over time.

[PEREZ] I agree they need to be meaningful so you really have to expand your creativity because there is several things you can use to convey one message. You have to get out your creative juices and get them flowing so you can use various things that are very meaningful to the child because if it is not meaningful it won't work.

[SITTEN] We are running out of time we have a couple more questions. Angel I wonder if it is all right if we take those questions to you off-line and post the answers to them after words afterwards on the webinar page?

[PEREZ] Sounds great.

[SITTEN] One of them has to do with you mentioned the calendar box whether, calendar systems should have a lid or not and another question very interested in hearing from others about abstract concepts as opposed to nouns, object symbols would have to do with things that are a little bit more less tangible but question is much longer but Teresa I will pass the question along to Angel, both yours and Katie's that came in at the end and anything that comes in in the next couple of minutes. We will respond to those to the website. I want to thank everybody for participating, it was

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exciting to have the dialogue back and forth in the chat box I know that can fill a little constricting but it was nice to see that very few of you felt constricted by that so thank you and thank you, Angel Perez, really great topic.

Again, I will refer everyone back to our website for previous webinars specific to deaf blindness, this is a topic of interest to you, you will find many other things about communication there. I want to quickly plug next month's webinar, on dual media, specifically braille, print or braille audio and print and audio, using dual media in literacy. That, I am afraid, is out of time. I am Robin Sitten, on behalf my partners Phuong Nguyen and Dr. Mary Zatta, everyone a Perkins e-learning and professional development, thank you so much, waving goodbye from Angel, and leave these questions up and we will contact these later. Thanks very much.