DOCUMENT RESUME ED 406 795 EC 305 497 AUTHOR Chen, Deborah; And Others TITLE Effective Practices in Early Intervention: Infants Whose Multiple Disabilities Include Both Vision & Hearing Loss. INSTITUTION California State Univ., Northridge. SPONS AGENCY Office of Special Education and Rehabilitative Services (ED), Washington, DC. PUB DATE 97 NOTE 336p. CONTRACT H025D30002 PUB TYPE Reports Descriptive (141) EDRS PRICE MFO1 /PC14 Plus Postage. DESCRIPTORS Communication Skills; *Deaf Blind; *Disability Identification; Drug Therapy; Early Childhood Education; *Early Intervention; *Evaluation Methods; Infants; *Interdisciplinary Approach; Motor Development; Preschool Education; Program Development; Self Evaluation (Groups); Skill Development; Teamwork; Toddlers ABSTRACT This manual documents key program development strategies and inservice training topics provided by the Model Demonstration Early Intervention Network Project. This project focused on building the capacity of early intervention programs to serve infants who are deaf-blind and their families. The first section covers program development and includes information on "program self reviews," mentorship and collegial support in early intervention teams, and the art of collaboration. The identification of infants who are deaf-blind is addressed in the second section along with strategies for gathering information. The third section includes information on functional vision assessment and interventions, tests used to diagnose visual impairments in infants, and clinical vision assessment for infants with severe and multiple disabilities. Section 4 describes hearing loss, assessments, and interventions and audiological tests for infants with multiple disabilities. Gross motor development in infants with multiple disabilities and medications and medical interventions are reviewed in section 5. The sixth section provides strategies for beginning communication, vignettes describing four infants who are deaf-blind, and the rationale for an integrated therapy model. Transition to preschool is highlighted in the last section. Blank forms are attached for self reviews and disability identification. (Each section includes references.) (CR) ******************************************************************************** Reproductions supplied by EDRS are the best that can be made from the original document. ******************************************************************************** U.S. DEPARTMENT OF EDUCATION Office ducational Research and Improvement EDU TIONAL RESOURCES INFORMATION CENTER (ERIC) This document has been reproduced as received from the person or organization originating it. Minor changes have been made to improve reproduction quality. Points of view or opinions stated in this document do not necessarily represent official OERI position or policy. .11111b. Infants whose multiple disabilities include both vision & hearing loss Deborah Chen, Ph.D. Project Director California State University, Northridge i BEST COPY AVAILABLE Effective Practices In Early Intervention Infants whose multiple disabilities include both vision & hearing loss ©1997 California State University, Northridge 3 Effective Practices In Early Intervention Infants whose multiple disabilities include both vision & hearing loss Introduction Introduction to the Project iii Acknowledgements vi About the authors vii Program Development Program Self Review: 3 A Program Development Process Mentorship & Collegial Support: 13. Enhancing the Early Intervention Team The Art of Collaboration 23 Identification Identifying Infants who are Deaf-Blind 33 Strategies for Gathering Information 51 Vision Functional Vision Assessment & Interventions 67 An Easy Guide to Tests Used to Diagnose Visual 79 Impairments in Infants Clinical Vision Assessments for Infants with Severe 83 & Multiple Disabilities Hearing Hearing Loss, Assessments, & Interventions for Infants 119 with Multiple Disabilities Audiological Tests for Infants with Multiple Disabilities 137 Motor & Health Gross Motor Development in Infants with 167 Multiple Disabilities Understanding Medications & Medical Interventions 177 Strategies Beginning Communication 195 Infant Vignettes 213 From Interdisciplinary to Transdisciplinary Interventions 229 Transition Off to Preschool! A Parent's Perspective 249 Planning Transitions to Preschool 253 Educating Young Children with Severe & Multiple 263 Disabilities in Typical Preschool Settings Blank Forms 4 al MO an AM ins ea eft ail ali* M. Ilit mil AO mil Introduction to the Project The Model Demonstration Early Intervention Network serving Infants who are Deaf-Blind and their Families was a three year project of California State University Northridge funded by the U.S. Department of Education from October 1, 1993 to February 28, 1997. The project focused on building the capacity of early interven- tion programs to serve infants who are deaf-blind and their families. To this end, project goals involved identifying and developing effec- tive early intervention practices with infants whose multiple disabili- ties include both vision and hearing loss and their families. Project goals were accomplished through a series of activities: family/profes- sional focus group meetings, program self reviews, program develop- ment plans, interdisciplinary focus group meetings, a supervisory focus group meeting, workshops, follow up consultation, and the de- velopment of videos and this manual. Over 16 early intervention pro- grams participated in at least one component of the project. The fol- lowing programs were involved in major components in all three years of the project: Off to a Good Start Program, Blind Babies Foundation, San Francisco Preschool Program, Blind Children's Learning Center, Santa Ana Infant-Family Program, Foundation for the Junior Blind, Los Angeles Infant Deaf and Hard of Hearing Program, Los Angeles County Office of Education Deaf and Hard of Hearing Infant Program, Los Angeles Unified School District PIVIT (Parents and Infants with Visual Impairment Together), Los Angeles Unified School District Early Start Program, Marin County Office of Education, San Rafael Infant Program, West End Selpa Early Start, San Bernardino County Office of Education, Ontario Deaf Special Needs Program, San Diego Unified School District The project conducted program self reviews and family/professional focus group meetings to identify primary program needs and to re- veal effective practices. The program self reviews involved commit- tees of administrators, direct service personnel, and families. These reviews were facilitated and recorded by the project through a fami- ly/professional team of consultants or staff of California Deaf-Blind Services. The family/professional focus group meetings were com- posed of teams of direct service providers and parents of children INTRODUCTION who are deaf-blind. A total of 15 family representatives and 15 profes- sionals participated in these meetings plus three educational special- ist/family specialist teams from California Deaf-Blind Services who as- sisted project staff in facilitating and recording group input. Program self reviews and focus group meetings revealed a primary need for inservice training and materials on beginning communica- tion strategies, audiological assessment and interventions, and vision tests and interventions for infants. In general, family members wanted materials that could help staff work with their infants more effective- ly. Both professionals and family members requested strategies for beginning communication particularly with infants who have signifi- cant motor and cognitive delays in addition to vision and hearing loss. Early intervention personnel requested information not only for beginning professionals, but also for those with significant training and experience in vision impairment or hearing loss, particularly on recent developments in audiological and vision tests for infants. For this reason, the manual provides chapters on clinical assessments to assist early interventionists in understanding audiological and vision tests and reports, as well as chapters on functional vision and hearing screenings and interventions. The project addressed identified train- ing needs through a series of workshops, onsite consultation, and the development of videos. This manual documents the training topics, effective practices, and key strategies developed and identified by the project process. Videotapes developed by the project What can baby hear? Auditory Tests and Interventions for Infants with Multiple Disabilities (27 minutes). Paul H. Brookes Publishing, PO. Box 10624, Baltimore, MD 21285. Identifies the impor- tance of early identification of hearing loss particularly in infants with severe and multiple disabilities. A pediatric audiologist demon- strates selected audiological tests (Behavioral Observation Audiometry Visual Reinforcement Audiometry Auditory Brainstem Response, Otoacoustic Emissions) for infants (under 24 months). Shows an early interventionist obtaining functional hearing informa- tion with an infant who has both vision and hearing loss through structured observation in the home and parent interview.The moth- ers and early interventionists of three other infants with different types of hearing loss discuss their infants' listening and communica- tion skills. Shows selected strategies in a total communication early intervention program and emphasizes the consistent use of hearing aids. Includes a booklet. Making the Most of Early Communication