Файл: Учебник по английскому языку.doc

How can we help prevent the abuse of children with physical or health impairments? How can we help support their families?

Is inclusion appropriate for children with physical and health impairments?

What can teachers do to make inclusion of physically impaired children a more pleasant, nonthreatening experi­ence?

CHILDREN WITH HEARING IMPAIRMENTS

Deaf children are disabled to the extent that they cannot hear speech through the ear, even with some form of amplification. They are dependent on vision for language and communication. Hard-of-hearing children can hear speech through the ear, but they need some form of amplification to make it more understandable. Hard-of-hearing children far outnumber deaf children. Most of them can be enrolled in inclusive education programs, with some modifications to the classroom and to their ears. While 8 to 10 percent of school children have some loss of hearing, only about 1 percent qualify for special educational services for their hearing impairments.

The assessment of hearing impairments is usually ac­complished by identifying and measuring the decibel levels (loudness) of sounds, which the child can hear. These units can be generated on an audiometer. The child holds up a finger and points to the ear in which he or she hears a sound. An audiogram shows the results of an audiometric test. Children should be able to discern the pitch of sounds from 500 to 2,000 hertz, the range for spoken language. They normally can hear between 0-25 decibels (dB). A hearing loss from 26-40 dB is slight, loss from 41-55 dB is mild, loss from 56-70 dB is moderate, loss from 71-90 dB is severe, and a loss of more than 90 dB is deaf in each ear.

If an infant is born with a hearing impairment, he or she has a congenital hearing impairment. If the hearing loss is acquired later in life, it is an adventitious hearing impair­ment. If a hearing loss is present in both ears, it is bilateral. If it is present in only one ear, it is unilateral. If the loss of hearing occurs before a child learns language, it is prelinguistic. If it occurs after a child learns language it is postlinguistic. In terms of special adaptations required in education programs, the child with the former of each of these terms (congenital, bilateral, prelinguistic) usually needs more help. These forms of losses can occur in many combinations.

Two additional terms are very important in the assess­ment of hearing impairments: sensorineural hearing loss and conductive hearing loss. A sensorineural loss is usually more serious and requires more education adap­tations than a conductive loss. Sensorineural hearing impairments involve defects or disorders of the auditory nerve or portions of the inner ear. They are difficult or impossible (depending on the prpblem) to correct with surgery, medicine, or sound amplification. Conductive hearing impairments involve defects or disorders of the outer or middle ear. Depending on the problem, they are often correctable with surgery, medicine, or sound ampli­fication.

The causes of hearing impairments are not always easy to determine. In about 1/3 of all cases, the cause is unknown. Congenital losses may be inherited or caused by something during the mother's pregnancy and delivery, such as viral infections, drugs, prematurity, or low birth weight. Adventitious hearing losses may be due to injuries or diseases such as encephalitis, meningitis, or otitis media.

It is very important to assess hearing in infancy. PL 99-457 mandates comprehensive multidisciplinary ser­vices for infants and toddlers and their families. Once a hearing impairment is assessed, services should begin immediately. If the loss is conductive, the infant or toddler should be fitted with a sound amplification device (hearing aid). If the loss is sensorineural, the infant or toddler and the parents should begin learning sign language. Special educational services should also begin. Both receptive language (understanding what is said) and expressive language (speaking) are fostered with the earliest possi­ble intervention. Cognitive processes and socialization processes are also dependent on early comprehension of some form of language.

Children who are deaf or hearing impaired are fre­quently enrolled in regular education classes for elemen­tary, middle, and/or high school. Decisions about where to place them depend on many factors: age of onset of hearing loss, degree of hearing loss, language ability, cognitive factors, social factors, parental factors, and presence or absence of other educational disabilities. Individualized education programs must be annually up­dated. Sometimes the best environment (least restrictive) for a hearing impaired child is regular class for a portion of time and special class for another length of time. The nature of the child's problem determines the long- and short-term goals and the criteria for gauging the effective­ness of each special educational modification.

Teachers who have children who are hard of hearing in their classrooms should learn to read their audiograms, help them benefit from any residual hearing, and learn to use any kind of amplification system provided. These may include FM auditory training devices, microphones, or hearing aids. If a deaf child is enrolled in a regular education classroom, the teacher should make provisions for an interpreter, a notetaker, and/or captioned films and videos. If the child reads lips, the teacher must keep mouth movements visible. Speech reading (also called lipreading) is difficult for the child. The teacher should remember that the average speechreader only grasps about 5 percent of what is being said. If a computer is provided for the hearing impaired student, the teacher should be aware of software needs and appropriateness. Many deaf students are taught oral speech. It may be difficult to understand. A regular education teacher should work to comprehend it as much as possible. Since speech is important to the integration of deaf individuals to a hearing society, they are discouraged from using ges­tures, pointing, or written messages instead of speech.

Each child with a hearing loss should be motivated to do all he or she is capable of doing in both the educational and in the social activities of the school. The teacher has a major responsibility to help the nonhearing impaired peers understand the special needs of the child with a hearing loss. Teachers, peers, and all ancillary school personnel should encourage the child to participate to the fullest extent possible. The hearing impairment should not be allowed to become an excuse for nonparticipation. Children with hearing losses should be reinforced for their efforts but not praised for inaction. Understimulation and/ or pity are detrimental both to educational progress and to socialization and self-esteem.

The first article selected for this unit provides informa­tion about the uses of the frequency modulation (FM) auditory training device in a regular class. FM devices are increasingly being used by children with hearing losses in inclusive education classes. The second article provides information about the presence of an educational inter­preter in a regular classroom to assist children who are deaf. The interpreter may translate spoken language into sign language or may silently mouth the message in an oral form that is easier to speechread. The third selection addresses the controversy of providing special services to deaf and hard-of-hearing children who choose a private school over a public school education. The final article selected for this unit emphasizes the nonacademic les­sons that deaf and hard-of-hearing students need to learn: independence and responsible transitional behaviors for success in life.

Looking Ahead: Challenge Questions

What is a FM (frequency modulation) auditory training device? What must a classroom teacher know about wearing a microphone and checking the receiver worn by the student?

When an interpreter accompanies a deaf child to class, what should a teacher do? What role, if any, will the interpreter have with other students, other school person­nel, or parents?

Should tax dollars pay for an interpreter for a deaf student who attends a private school? Why, or why not?

What skills should be taught to adolescents with hear­ing impairments to help them make a successful transi­tion to adulthood?

CHILDREN WITH MENTAL RETARDATION

Mental retardation (MR) diagnosis has changed dramati­cally in recent years. Most notably, the IQ test score necessary for the diagnosis has dropped from one stan­dard deviation below the mean (85) to two standard deviations below the mean (70). The business of IQ testing has become controversial. Early in their history, IQ tests were considered a large step forward in diagnostic procedure. In recent years many persons involved with the assessment of mental retardation have labeled IQ tests a step backward in diagnosis.

The current definition of mental retardation has three criteria: IQ test score of 70 or below; deficits in personal-social adaptive behaviors, and a manifestation during the developmental period (birth to age 18). Only the last criterion is clear-cut. If an individual sustains brain dam­age that leaves him or her developmentally disabled in adulthood, we do not apply the label mental retardation. The second criterion, deficits in personal-social adaptive behaviors, has gained in importance in assessment pro­cedures since IQ tests have been deemed invalid and unreliable by some professionals. However, adaptive scales measure independence and social behaviors with a simple yes or no (present or absent) rating. The person completing the scale can be biased to report more or less success in personal-social adaptation. The definition of adaptive behavior is unclear. Adaptive scales may also be invalid and unreliable. What, then, is used to determine mental retardation?

A 1979 court case in California concluded that IQ tests were racially and culturally biased because disproportio­nate numbers of culturally diverse children had been mislabeled as mentally retarded and placed in segregated special classes in violation of PL 94-142. The judge ruled that California children must be assessed for intelligence without the use of existing IQ tests, and any future IQ tests must be approved by the courts before use. While most states still use IQ tests, mental retardation today is usually determined only after multiple assessments of adaptive behavior, cognitive processes, problem-solving strategies, observations of real-life behaviors, and histories of prena­tal, neonatal, and early childhood health and develop­ment.

Mental retardation diagnosis has also been changed by reducing the use of arbitrary labels such as mild, moder­ate, severe, and profound based on IQ test scores. There are vast differences between children with mental retarda­tion even if they score exactly the same on an IQ test. For example, one student with an IQ of 50 (formerly consid­ered moderately retarded or "trainable'Vnot "educable") may learn to read, write, and find a skilled vocational job

Another student with an IQ of 50 may have difficulty completing even unskilled tasks and may drop out of school at age 16 with functional illiteracy. Mildly retarded individuals can usually profit from academic training and can learn to live alone or semi-independently. Severely retarded individuals can usually profit from training in self-help and communication, but they will probably need custodial care for life.

What causes mental retardation? For the majority of persons with MR, the exact cause(s) cannot be deter­mined. Over one-half of all cases of mental retardation are suspected to be due to some biological factor(s) causing brain damage. Nearly 300 factors have been identified as risks that singly, or in combination, can alter brain func­tioning or destroy neurons. Prenatally, some risks include drugs, viruses, radiation, chromosomal defects, defective genes, maternal gestational disorders, and inadequate nutrition of mother. Neonatally, some risks include pre­maturity, low birth weight, trauma, infection, anoxia, meta­bolic and nutritional factors, and tumors. Early childhood risks include tumors, malnutrition, exposure to drugs or poisons, brain infections, head injuries, physical abuse, and psychiatric disorders. In addition to biological risk factors, some environmental conditions put infants and children at greater risk of developing mental retardation. It is usually impossible to pinpoint exactly what factor(s), singly or in combination, cause each child's unique type and degree of MR.

The Individuals with Disabilities Education Act, PL 94-142, and its amendments, require nondiscriminatory evaluations, zero reject, parental participation, individu­alized education programs, due process, least restrictive education, and transitional services for persons with men­tal retardation. As much as possible, everyone involved with the education of MR students should strive to estab­lish the most normal life for them and teach them coping and adapting skills that are culturally appropriate. The earlier that MR infants and preschoolers can be identified and the earlier that they can be brought into special educational services, the easier it is to achieve a measure of "normalization" in their lives.

Early identification and treatment of mental retardation in infants and toddlers (age 0-5) is now mandated by PL 99-457. States are given incentives to establish not only preschool programs for MR children, but also to try to prevent MR through prenatal care, genetic counseling, and improved family planning. Preschool programs for MR children develop Individualized Family Service Plans (IFSPs) and provide parental education as well as early childhood remediation. Diet management, safety, education, socialization skills, and communication are included in preschool special services. Social services are pro­vided long term for the MR child and his or her family.

Public schools develop Individualized Education Pro­grams (lEPs) for every child with MR and update them annually. In addition to academic skills, the curriculum for MR students usually includes socialization and adaptive behaviors and prevocational and vocational skills. By high school the lEPs for students with MR usually include competitive employment training and community living skills (e.g., travel, personal maintenance, leisure, home-making).

Transitional services for MR students are now manda­ted by PL 101-476. Public schools must provide assis­tance for MR individuals as they move from school to employment and independent living until they reach age 21.

The first article in this unit discusses prevention of, and intervention for, MR caused by drug exposure. Selection two provides strategies for integrating MR students into regular education classes, and it presents both chal­lenges and solutions.

The next article discusses training peer tutors to both help teach transitional skills to MR students in high school and to teach social interaction skills.

Looking Ahead: Challenge Questions

How can poor outcomes such as MR after prenatal drug exposure be avoided? How can the MR caused by drug exposure be ameliorated by intervention?

What solutions have been successfully pursued to meet the challenges of integrating MR students into supported regular classes?

Can social interaction training help peer tutors teach social as well as academic and job-related skills to stu­dents with MR?

ENABLING THE LEARNING DISABLED

Sally Smith

Sally Smith is the founder and director of The Lab School in Washington, D.C. She is also professor and head of the American University's masters degree program in special education: learning disabilities, and is the author of six books.

Chances are you'll have at least one learning disabled (LD) student in your classroom this year. And if you teach in a district that's already moved toward inclusion (see sidebar "Inclu­sion"), that number could be higher. Teaching children with learning disabilities brings with it special joys, and special challenges. To help you manage, instructor went to Sally Smith, founder and director of the Lab School in Washington, D.C., and professor and head of special educa­tion at the American University— and asked her to address some of your biggest concerns. Her advice follows.

What does the term learning dis­abled really mean?

Learning disabilities encompass a broad range of neurological prob­lems that are quite distinct from either retardation or emotional dis­turbances. The LD child is likely to have difficulty with reading, writ­ing, spelling, and math. More subtle - and harder to pinpoint—are dif­ficulties the child will have in attend­ing; concentrating; remembering; organizing; sequencing; coordinat­ing; and distinguishing right from left, letters, and numbers. The ability to make these distinctions is essen­tial in learning the rudiments of reading, writing, and mathematics. If not addressed, a child's academic, emotional, and social development is adversely affected.

What instructional strategies work best with LD students?

LD students need opportunities to apply what they're learning. Ask them to reenact events, draw pic­tures, collect magazine photos to il­lustrate topics, construct models, and so on. Follow up with discus­sions that encourage students to ver­balize what they've learned.

Also, whenever possible, show photos that will help students com­prehend a topic. All children will enjoy the pictures, but for the LD child—who tends to have disabilities with language and tends to learn visually—pictures can mean the dif­ference between not understanding and understanding a subject.

My LD students have trouble grasp­ing abstract concepts. What can I do?

Turn an abstract idea into something concrete by having kids illustrate the concept using their bodies, objects, and pictures. For example, to intro­duce the concept of our govern­ment's balance of power, you might begin with balancing exercises—have students use weights to even out a pair of scales. Then you could divide students into threes—to represent the judicial, executive, and legisla­tive branches—and have them clasp hands and gently tug on one an­other's arms to illustrate the system's give-and-take. Afterward, kids could draw a triangular chart to show the balance of power and discuss a cur­rent example of the balance in action.

Especially during the early part of the year, when I'm trying to get to know all the students in my class, I sometimes have trouble remember­ing each of my LD students' main problem areas. What do you suggest?

Create a handy profilе for each stu­dent. On separate index cards list each child's strengths, weaknesses, and interests, as well as the class­room-management methods that he or she responds to and the tech­niques that don't work. Add other information you've discovered about the student, and you'll have a quick reference tool at your fingertips.

How can I help the LD student feel successful?

Break down tasks into as many steps as necessary to ensure that the stu­dent can complete each step suc­cessfully. By starting with what a youngster can do and then building from there, you'll give the child a boost of confidence. (Hint: Be sure the student understands each step thoroughly before moving on to the next.)

When a student feels overwhelmed or depressed, how can I help?

I give the student tangible proof of his or her progress and commit to working together on trouble spots. On a sheet of paper folded down the middle, I make a column on the left-hand side called "Your Strengths" and write down such observations as: You work hard, you are a good artist, and so on. I read the list aloud to the child. Then I make a column on the right-hand side called "Needs Work" and write down skills the student needs to work on, such as spelling, subtraction, and reading. I read the list aloud. Next I tear the sheet down the middle, hand the list of strengths to the student, and say something like, "You keep the list of your strengths. I'll keep the list of what you need to work on because it's my job to take care of those things for a while until you can be­come responsible for them."

Following my oral instructions is difficult for the LD students in my class. What can I do?

First, to reinforce sound, make sure the children are looking at you when you're giving instructions. It helps to stand near them, too. Be sure you speak slowly and loudly enough to be heard and keep your directions clear, precise, and succinct. Also, break down your instructions into simple steps, give only one or two at a time, and ask students to repeat each one aloud. Consider pairing an LD child with a considerate class­mate who can check whether the student understands the instructions and can help explain them when he or she doesn't.

Because concrete reinforcement works well for the LD child, consider giving students gold stars or stickers when they follow instructions properly.

How can I approach the student who is afraid to admit he or she doesn't know something or is afraid to make mistakes?

When you don't know the answer to something yourself, set an example by saying, "I don't know, but we can find out together."

Send the signal to all students that it's okay to make mistakes and that everyone—even teachers—makes them. When kids do something wrong, tell them about mistakes you've made and talk about how you learned from them.