Teaching Strategies and Content Modifications for the Child with Deaf-Blindness.

by Kate Moss

TSBVI Deaf-Blind Outreach Family Training Specialist and LindaHagood, TSBVI Deaf-Blind Outreach Education Specialist

from January 1995 edition of P. S. NEWS!!!

Children with deaf-blindness have unique educational needs. Althoughthey are deaf the adaptations needed for their learning style will differfrom the child who only has deafness. Although they are blind the adaptationsneeded for their learning style will differ from the child who only hasblindness.

In order to understand what this means we can examine a variety of issuesthat might be addressed for three different children with disabilitiesin a regular preschool class: one born with a severe hearing loss, oneborn with visual impairment resulting in acuities of 20/600, and one bornwith a combined severe hearing loss and visual impairment resulting inacuities of 20/600.

It is important to note these are not actual children and that instructionfor any child with a disability must accommodate his/her individual needs.Our intent is to demonstrate some of the basic differences in educationalapproaches to address each of these disabilities. It is also importantto note that the additional disabilities experienced by the majority ofchildren with deaf-blindness further complicates program development.

Imagine each child is in a preschool classroom structured around playcenters such as the House Center, Art Center, Block Center, Library Center,and Science Center. There is a morning welcome, a story time, and filmswhich occur in a large group. Small group activities are conducted arounda theme or unit such as Families, Animals, etc. The play centers have materialswhich require some explanation or direction from an adult. For example,the teacher must demonstrate or have examples to help the children makeanimal puppets from socks. Recess occurs in a large group and the childmay choose an area of recreational activity, i.e., swings, slide, tricycles,wagons, or the sandbox. All the children eat together in the cafeteria.Using the example of a unit on farm animals, we can look at the differencein teaching strategies and content modifications that might be made foreach of these three children.

Teaching Strategies and Content Modifications
The Child with Hearing Impairment
Most of the same teaching strategies used to instruct children whodo not have a disability would be appropriate for the child with a hearingimpairment. This child will learn from what he sees and what he does (action).He learns a great deal incidentally by watching others. Instruction ina large group can be very beneficial for this child because he can preparefor his response while waiting for his turn.

Adaptations for teaching communication and auditory training goals includesmall group or individual instruction. Real experiences should be the basisof units that are taught, however this child would probably be able torelate story books, role play, and discussion to the real experience. Theteacher may also rely on print, pictures, gestures, and movements to supportor give instruction.

Issues for the child with hearing impairment include difficulty withEnglish language structure which can effect the development of readingand critical thinking skills. Special attention should be given to teachingsuch structures as "why", past tense verbs, complex sentences, etc. Hemay also need additional practice in using language to explain and makepredictions such as, "Why didn't the brick house fall down?" or "What willhappen if you don't take a nap?"

The child with hearing impairment would probably have an experientialbase about animals before he began to study the unit on farm animals. Hemight have a pet at home, has probably seen birds and squirrels in hisyard, or has watched animal stories on television. He will understand storiesabout farm animals if it is signed and he can see the pictures. He mightplay with plastic farm animals and farm figures in the sandbox. He mightcolor pictures of farm animals in the Art Center and sort zoo and farmanimal figures in the Science Center. At recess he could pretend to bea horse that pulls a wagon outside. During auditory training he might tryto discriminate between the sound a pig and a cow makes or point to theappropriate picture of each animal in the Old MacDonald song. Speech orspeechreading might focus around the names of farm animals. At the endof the week his class may visit a working farm which would build on hisweek-long study of farm animals.

The Child with Visual Impairment
Some of the same instruction strategies could be used with the childwho has a visual impairment. However, his learning will take place primarilythrough his own actions/experiences and information he receives auditorily.He can learn many things through group instruction with minimal support.Unlike the child with hearing impairment, this child will need more instructionthat occurs through real experience. Imaginary play may be difficult forhim, reducing the effectiveness of role play as an instructional tool.Language instruction for this child should be paired with ongoing activities.The use of pictures and print would be of limited value.

Using the example of a unit on farm animals, the child with visual impairmentswould likely have less knowledge of animals to begin with than the childwho is deaf. He would not have seen the television programs or watchedanimals playing in his yard. He might have a pet and perhaps has some knowledgeabout caring for an animal. This unit may be most meaningful for him ifthe visit to the farm was scheduled before beginning classroom instruction.

Although he might be able to sort the animals in the Science Centerusing visual cues of color and shape, he may or may not relate them tothe real animals. A more appropriate activity might be telling a classmateor teacher whether the animal lives in the zoo or on the farm after theyname the animal or make the animal sound. Then he could put the animalin the proper area. Instead of coloring animal pictures he might use modelingclay to make an animal figure or scraps of fur to make tactile pictures.He could interact with other children in the wagon while working on theconcepts of "left", "right", "fast", "slow", "stop" and "go" pretendingto drive the horse. These concepts might be taught and practiced individuallywithin orientation and mobility training. New textures can be introducedat the sandtable. Working on listening skills during story time may alsobe somewhat effective, especially after the child visited the farm. Hecould be encouraged to explore his environment to search out the soundof a mooing cow.

The Child with Deaf-Blindness
The child with deaf-blindness requires considerable modifications toteaching content and different teaching strategies. He cannot learn fromwhat he sees like the deaf child does. He can not learn from listeninglike the blind child does. He learns only by what he does. This means thatno learning is taking place for him while waiting for others to take theirturn. For this reason small group or individual instruction becomes morecritical. Large group instruction is only valuable if he can be consistentlyactive (e.g. playground activities).

This child also may have problems experiencing new things. Encounteringthe world without benefit of vision and hearing requires a great deal oftrust. Bonding with the child is critical for the instructor, thereforeit is important to evaluate the child's response to an individual whendetermining who will be the primary provider of instruction. He may bewithdrawn or passive, content to stay in one place and let the world cometo him. Remember for him he will learn only through doing.

Things often magically appear and disappear before him. Cause and effectare elusive. People do things to him but not necessarily with him. Thereis little explanation of events before they occur. For this reason it isimportant to make interactions balanced (my turn, your turn) to encouragehim to be responsive. Instruction that is always directive requires noresponse from him.

Safety is also of critical importance to this child. Not only must theenvironment be made safe for him, but he must feel safe in order to movearound on his own. If he does not, he is likely to stay glued to one spotresisting interaction with his environment and the people in it. Instructionand support from an orientation and mobility specialist is very important.She may need to help staff evaluate the environment for hazards and developtravel routes for the child to use. She may work directly with him to orienthim to that environment, and provide training on travel techniques andtravel equipment.

The curriculum focus for the child with deaf-blindness will differ fromthat of the child with only a single sensory impairment. The deaf educationfocus may be primarily on using language to code existing concepts. Thecurriculum focus for a child with visual impairment may be more orientedtoward building concepts and experiences which can provide a firm cognitivefoundation for language. The curriculum focus for a child with deaf-blindnessshould be on bonding and developing interactions and routines for expandingthe frequency and functions of communication. This child will not learnabout objects or actions incidentally. He cannot tie together the fragmentedinput he receives without interpretation and instruction from others. Hemust be taught to use and accept this instruction.

Developing a communication foundation for learning is a priority. Typicallycommunication is tactile in nature using signals, objects, gestures andlater on sign language or tactile symbols or some combination of forms.Language is developed through the use of routines, calendar systems, discussionboxes, etc. Because of the degree of vision impairment and his inexperiencewith real events in the world, the use of print, pictures, and demonstrationwill be of little or no value to this child. He may not understand pretendor role-play as an event that relates to some real experience. The childwith deaf-blindness may first need to be moved co-actively through an activityto know what is expected of him. After he understands what is expected,this support would be faded to avoid building prompt dependence.

Because concepts develop so slowly for this child, there should be afocus on making learning functional. Great care needs to be given to developingclear goals and objectives for this child. Typically these objectives needto be limited in number since this child will need many opportunities topractice skills before he is able to generalize the concept to other situations.

This child would have a very limited knowledge of animals because hecan not observe them or hear them. He has not seen television shows aboutanimals. He may have a pet at home, but might only encounter it if thepet is placed in his lap or brought to him. His experience with that animalwould be primarily tactile. He may not be able to distinguish his long-haircat from his long-hair dog if he only pets the animal. Or he may experiencethe animal as a thing that licks or smells a certain way.

For this reason vocabulary (concepts) which are taught should be morebroad in nature. Careful consideration should be given to concepts whichcan be applied to other units throughout the year and across a varietyof settings. For example, the farm animal unit might focus on action conceptssuch as feed, pat, rub, pull, walk, open, close, pour. These same conceptsshould be applied to other units or in different environments. For example,"pull the leaf", "pull the wagon", "pull the drawer", "pull off the lid"and so forth. This child may have a "pull" unit throughout the year thatis embedded in the various units the other students will study. If thischild has a pet at home, another approach to instruction could focus onthings this child can learn to do with his pet. For example, he might learnto feed his pet, walk it, pet it, brush it, etc. Units could be developedaround things that can be fed, walked, brushed, etc.

The child with deaf-blindness could meaningfully participate in theplay centers but his goals would be different from the other children.For example, while the other children pretend to be animals, the childcould "rub" or "pat" them as if he was the farmer they come to for attention.In the Art Center he could "pat" and "pull" modeling clay to help a classmateform an animal shape. At recess he could direct the other children to "pull"him in the wagon or practice pulling them with help from a classmate. Theteacher for the hearing impaired or other staff could help him to learnto vocalize to get the other children's attention before he signs "stop"or "go". In the Science Center he could use his vision to find objectsin the sandbox. Then he could "open" and "close" the door to the toy barn,"pour" sand on the toy animals, "pull" the shovel out of the sand, etc.

When he visits the farm with the other children he would experiencethe differing size, textures and smells of the animals, but his goal mightbe to use his cane or sighted-guide technique in unfamiliar environments.If field trips are regular events, he might also learn a field trip routine.Unless he actually lives on a farm, learning about the animals and whatthey do will be of little value to him even though it may be a very pleasurableevent.

Obviously this child will require a great deal of individual support.Initially this may need to be provided by the teaching staff. However,if good interaction and communication skills are modeled for the otherstudents and an effort is made to draw them into successful play situationstogether, they may be able to provide instructional support for some activities.

The educational needs of a child with deaf-blindness are unique. Teacherswithout specific training in the area of deaf-blindness may be unable toappropriately program to meet these needs without specialized trainingand support. Few school districts have even one teacher with this kindof specialized knowledge. In addressing the child's education from birth- 21 a large number of teachers and support staff as well as communitymembers and human service staff must work with the child. However, if hisunique learning style is not addressed, the child with deaf-blindness isat risk for being excluded from the classroom, the family and the community.

This article originally appeared in the January 1995 edition of P. S.NEWS!!! published by the Texas School for the Blind Visually ImpairedDeaf-Blind Project.

This document is from the Outreach Servicesfrom Texas School for the Blind and Visually Impaired.

A-Z to Deafblindness http://www.deafblind.com