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Nevada Dual Sensory Impairment ProjectUniversity of Nevada, Reno
MaryAnn Demchak, Ph.D.Project Director
Deafblindness: An Introduction
Contact Information
MaryAnn Demchak
Nevada Dual Sensory Impairment Project/299
University of Nevada, Reno
Reno, NV 89557
Toll-free: 1-877-621-5042
Email: [email protected]
Website: http://www.unr.edu/educ/ndsip/
Purpose of this Presentation
Participants will understand:
• What deafblindness, or a dual sensory impairment, is
• The diverse nature of deafblindness
• Critical factors influencing the effects of deafblindness
• The challenges or impact of dual sensory impairments
What is Deafblindness?-- The Legal Definition
Deafblindness, or dual sensory impairment, refers to the concomitant hearing and visual impairments, the combination of which causes such severe communication and other developmental and education problems that the individual cannot be accommodated in programs solely for individuals who are deaf or blind (2004, IDEA)
The Diversity of “Deafblindness”
• Although “deafblind” implies a total absence of vision and hearing, this is not the case
• Most children who are deafblind have residual hearing and vision
• There is no single profile of a child who is deafblind
How Might Vision Be Impacted?
• Low vision (visual acuity of 20/70 to 20/200)
• Legally blind (visual acuity of 20/200 or less or field restriction of 20 degrees or less)
• Light perception only
• Totally blind
• Diagnosed progressive loss
• Cortical visual impairment
How Might Hearing Be Impacted?
• Mild loss (26-40 dB loss)
• Moderate (41-55 dB loss)
• Moderately severe (56-70 dB loss)
• Severe (71-90 dB loss)
• Profound (91+ dB loss)
• Diagnosed progressive loss
• Auditory neuropathy
Degree of Vision
Normal Vision
Low Vision(best corrected to 20/70)
Blind - legally,light perception, field loss, totally)
Progressive Loss
CVI
Degree of Hearing
Degree of Vision
Normal Hearing
Hard of Hearing
(mild-moderate)
Deaf(severe to profound)
Progres-sive Loss
Auditory Neuro-pathy
Normal Vision
Low Vision(best corrected to 20/70)
Blind - legally,light perception, field loss, totally)
Progressive Loss
CVI
Degree of Hearing
Degree of Vision
Normal Hearing
Hard of Hearing
(mild-moderate)
Deaf(severe to profound)
Progres-sive Loss
Auditory Neuro-pathy
Normal Vision
Normal for both
Low Vision(best corrected to 20/70)
Blind - legally,light perception, field loss, totally)
Progressive Loss
CVI
Degree of Hearing
Degree of Vision
Normal Hearing
Hard of Hearing
(mild-moderate)
Deaf(severe to profound)
Progres-sive Loss
Auditory Neuro-pathy
Normal Vision
Normal for both
Hearing impaired (HI)
Low Vision(best corrected to 20/70)
Blind - legally,light perception, field loss, totally)
Progressive Loss
CVI
Degree of Hearing
Degree of Vision
Normal Hearing
Hard of Hearing
(mild-moderate)
Deaf(severe to profound)
Progres-sive Loss
Auditory Neuro-pathy
Normal Vision
Normal for both
Hearing impaired (HI)
HI
Low Vision(best corrected to 20/70)
Blind - legally,light perception, field loss, totally)
Progressive Loss
CVI
Degree of Hearing
Degree of Vision
Normal Hearing
Hard of Hearing
(mild-moderate)
Deaf(severe to profound)
Progres-sive Loss
Auditory Neuro-pathy
Normal Vision
Normal for both
Hearing impaired (HI)
HI Depends on degree
Low Vision(best corrected to 20/70)
Blind - legally,light perception, field loss, totally)
Progressive Loss
CVI
Degree of Hearing
Degree of Vision
Normal Hearing
Hard of Hearing
(mild-moderate)
Deaf(severe to profound)
Progres-sive Loss
Auditory Neuro-pathy
Normal Vision
Normal for both
Hearing impaired (HI)
HI Depends on degree
HI
Low Vision(best corrected to 20/70)
Blind - legally,light perception, field loss, totally)
Progressive Loss
CVI
Degree of Hearing
Degree of Vision
Normal Hearing
Hard of Hearing
(mild-moderate)
Deaf(severe to profound)
Progres-sive Loss
Auditory Neuro-pathy
Normal Vision
Normal for both
Hearing impaired (HI)
HI Depends on degree
HI
Low Vision(best corrected to 20/70)
Visually impaired
(VI)
Blind - legally,light perception, field loss, totally)
Progressive Loss
CVI
Degree of Hearing
Degree of Vision
Normal Hearing
Hard of Hearing
(mild-moderate)
Deaf(severe to profound)
Progres-sive Loss
Auditory Neuro-pathy
Normal Vision
Normal for both
Hearing impaired (HI)
HI Depends on degree
HI
Low Vision(best corrected to 20/70)
Visually impaired
(VI)
Blind - legally,light perception, field loss, totally)
VI
Progressive Loss
CVI
Degree of Hearing
Degree of Vision
Normal Hearing
Hard of Hearing
(mild-moderate)
Deaf(severe to profound)
Progres-sive Loss
Auditory Neuro-pathy
Normal Vision
Normal for both
Hearing impaired
Hearing impaired
Depends on degree
Hearing impaired
Low Vision(best corrected to 20/70)
Visually impaired
(VI)
Blind - legally,light perception, field loss, totally)
VI
Progressive Loss
Depends on degree
CVI
Degree of Hearing
Degree of Vision
Normal Hearing
Hard of Hearing
(mild-moderate)
Deaf(severe to profound)
Progres-sive Loss
Auditory Neuro-pathy
Normal Vision
Normal for both
Hearing impaired
Hearing impaired
Depends on degree
Hearing impaired
Low Vision(best corrected to 20/70)
Visually impaired
(VI)
Blind - legally,light perception, field loss, totally)
VI
Progressive Loss
Depends on degree
CVI VI
Degree of Hearing
Degree of Vision
Normal Hearing
Hard of Hearing
(mild-moderate)
Deaf(severe to profound)
Progres-sive Loss
Auditory Neuro-pathy
Normal Vision
Normal for both
Hearing impaired
Hearing impaired
Depends on degree
Hearing impaired
Low Vision(best corrected to 20/70)
Visually impaired
(VI)Identified as
DB
Blind - legally,light perception, field loss, totally)
VI
Progressive Loss
Depends on degree
CVI VI
Degree of Hearing
Degree of Vision
Normal Hearing
Hard of Hearing
(mild-moderate)
Deaf(severe to profound)
Progres-sive Loss
Auditory Neuro-pathy
Normal Vision
Normal for both
Hearing impaired
Hearing impaired
Depends on degree
Hearing impaired
Low Vision(best corrected to 20/70)
Visually impaired
(VI)Identified as
DB DB
Blind - legally,light perception, field loss, totally)
VI
Progressive Loss
Depends on degree
CVI VI
Degree of Hearing
Degree of Vision
Normal Hearing
Hard of Hearing
(mild-moderate)
Deaf(severe to profound)
Progres-sive Loss
Auditory Neuro-pathy
Normal Vision
Normal for both
Hearing impaired
Hearing impaired
Depends on degree
Hearing impaired
Low Vision(best corrected to 20/70)
Visually impaired
(VI)Identified as
DB DB DB
Blind - legally,light perception, field loss, totally)
VI
Progressive Loss
Depends on degree
CVI VI
Degree of Hearing
Degree of Vision
Normal Hearing
Hard of Hearing
(mild-moderate)
Deaf(severe to profound)
Progres-sive Loss
Auditory Neuro-pathy
Normal Vision
Normal for both
Hearing impaired
Hearing impaired
Depends on degree
Hearing impaired
Low Vision(best corrected to 20/70)
Visually impaired
(VI)Identified as
DB DB DB DB
Blind - legally,light perception, field loss, totally)
VI
Progressive Loss
Depends on degree
CVI VI
Degree of Hearing
Degree of Vision
Normal Hearing
Hard of Hearing
(mild-moderate)
Deaf(severe to profound)
Progres-sive Loss
Auditory Neuro-pathy
Normal Vision
Normal for both
Hearing impaired
Hearing impaired
Depends on degree
Hearing impaired
Low Vision(best corrected to 20/70)
Visually impaired
(VI)Identified as
DB DB DB DB
Blind - legally,light perception, field loss, totally)
VI
DB
Progressive Loss
Depends on degree
CVI VI
Degree of Hearing
Degree of Vision
Normal Hearing
Hard of Hearing
(mild-moderate)
Deaf(severe to profound)
Progres-sive Loss
Auditory Neuro-pathy
Normal Vision
Normal for both
Hearing impaired
Hearing impaired
Depends on degree
Hearing impaired
Low Vision(best corrected to 20/70)
Visually impaired
(VI)Identified as
DB DB DB DB
Blind - legally,light perception, field loss, totally)
VI
DB DB
Progressive Loss
Depends on degree
CVI VI
Degree of Hearing
Degree of Vision
Normal Hearing
Hard of Hearing
(mild-moderate)
Deaf(severe to profound)
Progres-sive Loss
Auditory Neuro-pathy
Normal Vision
Normal for both
Hearing impaired
Hearing impaired
Depends on degree
Hearing impaired
Low Vision(best corrected to 20/70)
Visually impaired
(VI)Identified as
DB DB DB DB
Blind - legally,light perception, field loss, totally)
VI
DB DB DB
Progressive Loss
Depends on degree
CVI VI
Degree of Hearing
Degree of Vision
Normal Hearing
Hard of Hearing
(mild-moderate)
Deaf(severe to profound)
Progres-sive Loss
Auditory Neuro-pathy
Normal Vision
Normal for both
Hearing impaired
Hearing impaired
Depends on degree
Hearing impaired
Low Vision(best corrected to 20/70)
Visually impaired
(VI)Identified as
DB DB DB DB
Blind - legally,light perception, field loss, totally)
VI
DB DB DB DB
Progressive Loss
Depends on degree
CVI VI
Degree of Hearing
Degree of Vision
Normal Hearing
Hard of Hearing
(mild-moderate)
Deaf(severe to profound)
Progres-sive Loss
Auditory Neuro-pathy
Normal Vision
Normal for both
Hearing impaired
Hearing impaired
Depends on degree
Hearing impaired
Low Vision(best corrected to 20/70)
Visually impaired
(VI)Identified as
DB DB DB DB
Blind - legally,light perception, field loss, totally)
VI
DB DB DB DB
Progressive Loss
Depends on degree DB
CVI VI
Degree of Hearing
Degree of Vision
Normal Hearing
Hard of Hearing
(mild-moderate)
Deaf(severe to profound)
Progres-sive Loss
Auditory Neuro-pathy
Normal Vision
Normal for both
Hearing impaired
Hearing impaired
Depends on degree
Hearing impaired
Low Vision(best corrected to 20/70)
Visually impaired
(VI)Identified as
DB DB DB DB
Blind - legally,light perception, field loss, totally)
VI
DB DB DB DB
Progressive Loss
Depends on degree DB DB
CVI VI
Degree of Hearing
Degree of Vision
Normal Hearing
Hard of Hearing
(mild-moderate)
Deaf(severe to profound)
Progres-sive Loss
Auditory Neuro-pathy
Normal Vision
Normal for both
Hearing impaired
Hearing impaired
Depends on degree
Hearing impaired
Low Vision(best corrected to 20/70)
Visually impaired
(VI)Identified as
DB DB DB DB
Blind - legally,light perception, field loss, totally)
VI
DB DB DB DB
Progressive Loss
Depends on degree DB DB DB
CVI VI
Degree of Hearing
Degree of Vision
Normal Hearing
Hard of Hearing
(mild-moderate)
Deaf(severe to profound)
Progres-sive Loss
Auditory Neuro-pathy
Normal Vision
Normal for both
Hearing impaired
Hearing impaired
Depends on degree
Hearing impaired
Low Vision(best corrected to 20/70)
Visually impaired
(VI)Identified as
DB DB DB DB
Blind - legally,light perception, field loss, totally)
VI
DB DB DB DB
Progressive Loss
Depends on degree DB DB DB DB
CVI VI
Degree of Hearing
Degree of Vision
Normal Hearing
Hard of Hearing
(mild-moderate)
Deaf(severe to profound)
Progres-sive Loss
Auditory Neuro-pathy
Normal Vision
Normal for both
Hearing impaired
Hearing impaired
Depends on degree
Hearing impaired
Low Vision(best corrected to 20/70)
Visually impaired
(VI)Identified as
DB DB DB DB
Blind - legally,light perception, field loss, totally)
VI
DB DB DB DB
Progressive Loss
Depends on degree DB DB DB DB
CVI VI DB
Degree of Hearing
Degree of Vision
Normal Hearing
Hard of Hearing
(mild-moderate)
Deaf(severe to profound)
Progres-sive Loss
Auditory Neuro-pathy
Normal Vision
Normal for both
Hearing impaired
Hearing impaired
Depends on degree
Hearing impaired
Low Vision(best corrected to 20/70)
Visually impaired
(VI)Identified as
DB DB DB DB
Blind - legally,light perception, field loss, totally)
VI
DB DB DB DB
Progressive Loss
Depends on degree DB DB DB DB
CVI VI DB DB
Degree of Hearing
Degree of Vision
Normal Hearing
Hard of Hearing
(mild-moderate)
Deaf(severe to profound)
Progres-sive Loss
Auditory Neuro-pathy
Normal Vision
Normal for both
Hearing impaired
Hearing impaired
Depends on degree
Hearing impaired
Low Vision(best corrected to 20/70)
Visually impaired
(VI)Identified as
DB DB DB DB
Blind - legally,light perception, field loss, totally)
VI
DB DB DB DB
Progressive Loss
Depends on degree DB DB DB DB
CVI VI DB DB DB
Degree of Hearing
Degree of Vision
Normal Hearing
Hard of Hearing
(mild-moderate)
Deaf(severe to profound)
Progres-sive Loss
Auditory Neuro-pathy
Normal Vision
Normal for both
Hearing impaired
Hearing impaired
Depends on degree
Hearing impaired
Low Vision(best corrected to 20/70)
Visually impaired
(VI)Identified as
DB DB DB DB
Blind - legally,light perception, field loss, totally)
VI
DB DB DB DB
Progressive Loss
Depends on degree DB DB DB DB
CVI VI DB DB DB DB
Degree of Hearing
Degree of Vision
Normal Hearing
Hard of Hearing
(mild-moderate)
Deaf(severe to profound)
Progres-sive Loss
Auditory Neuro-pathy
Normal Vision
Normal for both
Hearing impaired
Hearing impaired
Depends on degree
Hearing impaired
Low Vision(best corrected to 20/70)
Visually impaired
(VI)Identified as
DB DB DB DB
Blind - legally,light perception, field loss, totally)
VI
DB DB DB DB
Progressive Loss
Depends on degree DB DB DB DB
CVI VI DB DB DB DB
What Might You See & Hear
Simulations
DVD: Sensory Perspectives
(from SKI-HI)
Critical Factors that Influence the Impact of Deafblindness
• Age at onset of loss
• Accompanying disabilities
• Degree, type, and stability of vision and hearing loss
Critical Factors that Influence the Impact of Deafblindness
• Age at onset of loss
– Congenitally deafblind
– Adventitiously deafblind
– One sense congenitally impaired; other loss acquired
• Accompanying disabilities
• Degree, type, and stability of vision and hearing loss
Critical Factors that Influence the Impact of Deafblindness
• Age at onset of loss
• Accompanying disabilities
– Cognitive impairments
– Physical impairments
– Complex health care issues
Critical Factors that Influence the Impact of Deafblindness
• Age at onset of loss
• Accompanying disabilities
• Degree, type, and stability of vision and hearing loss
– Progressive losses
Impact of Deafblindness on Development
• Limited access to information
• Movement
• Learning
• Emotional development
• Communication
– Receptive
– Expressive
Accessing Information
• Vision and hearing are our distance senses
• Even a mild loss can have a serious effect
• Hearing is our only sense that can “bend around corners”
• Vision takes in more information all at once than any other sense
• Fragmented or distorted information often acquired with a dual sensory loss
Movement
• Seeing objects and hearing sounds influences motivation to interact with the environment
• When vision and hearing impaired, motivation is diminished
Learning
• Incidental learningMore likely to require formal instruction on
“topics” others acquire incidentally
• Concept developmentAbstract concepts more difficult to learn
• Mental imageryChallenging to construct mental images of
simple objects
Emotional Development
• Bonding and attachment behaviors
• Sense of self and body image
• Motivation
• Perception of safety
• Isolation
Communication
• Early communication involves movement
• Infants gain experiences in using their actions to influence people and objects in their environments, form of early communication
• They may not understand their actions influenced those around them or caused something to happen
Communication
• They do not have the same opportunity to acquire symbols to represent their communication
• They do not have repetitive, meaningful exposure to incidental use of objects, pictures, sign language, speech
• May have difficulty finding communication partners
• May have difficulty finding common topic
Communication & “Problem” Behaviors
• “Problem” behaviors serve a purpose for the child
• All behavior can be communicative• Behavior does not have to be intentional to
be communicative• Behavior is influenced by events in the
setting• Understanding the message behind
“problem” behaviors can be difficult
It Is Important to Remember:
• Children who are deafblind--
Require thoughtful and unique educational approaches
Can participate in almost any activity
Communicate in a variety of ways
What if you are working with a child who is deafblind and would like assistance?
Contact the Nevada Dual Sensory Impairment Project
Information about the project
• How do you refer a child?
• What happens after a child is referred?
• What assistance can be provided?
• How does a family or service provider get assistance?
• Where is assistance provided?
• Is there a cost?
• What are the benefits?
Remember Who is Eligible for the Project
• Vision and hearing impairments• Can also have other disabilities:
–Cognitive impairments–Physical impairments–Complex health care needs–Speech / language / communication delays–Behavior disorders
• Most of the time do have other disabilities in addition to impairments in both vision and hearing
How to refer to the project?
• Complete a referral packet and fax or mail to MaryAnn
• Call MaryAnn and discuss referral over phone or request packet
• 1-877-621-5042
Why refer to the project?
• Project newsletter & other TA documents (e.g., Tip sheets)
• Print or video resources
• Parent-to-parent network
• Family-to-family network and listserv (western states)
• Project sponsored trainings
• Help in finding resources
• Home and/or school visits
• Annual parent conference
What happens after referral?
• Referral packet reviewed• Potential phone calls for clarification on some
questions• Intro binders mailed to parent and service
provider:– TA request forms, all tip sheets, newsletter & more
• Introductory phone call and/ or visit
Questions