DOCUMENT RESUME ED 328 005 EC 2?3 217 AUTHOR Cress, Cynthia J.; And Others TITLE Augmentative Comm%nication for Children with Deaf-Blindness: Guidelines for Decision-Making. INSTITUTION Oregon State System of Higher Education, Monmouth. Teaching Research Div. SPONS AGENCY Office of Special Education and Rehabilitative Services (ED), Washington, DC. REPORT NO 300-83-0237 PUB DATE 89 NOTE 63p. PUB TYPE Guides - Non-Classroom Use (055) -- Tests/Evaluation Instruments (160) EDRS PRICE MF01/PC03 Plus Postage. DESCRIPTORS Assistive Devices (for Disabled); *Communication Aids (for Disabled); *Deaf Blind; *Decision Making; Hearing Aids; *Needs Assessment; Nonverbal Communication; *Sensory Aids IDENTIFIERS *Augmentative Communication Systems ABSTRACT This manual is intended to assist in developing augmentative communication systems for deaf-blind children. After a brief introduction, section II provides an overview o.6: general augmentative communication systems and theory. Section III presents a general decision-making process for developing and selecting augmentative communication systems for nonspeaking individuals. Techniques for assessing needs, the current communication system, and potential changes in the communication system are discussed. Nineteen systems of nonverbal communication are described, as are 10 communication aids, and contact information for companies producing and distributing the aids is provided. A form for relevant motor assessment is also presented. (94 references) (PB) Reproductions supplied by EDRS are the best that can be made from the o,.iginal document. U.S. DEPARTMENT OF EDUCATION Office ol Educational Reseerch and Improvenvve EDUCATIONAL RESOURCES INFORMATIO CENTER (ERIC) e This document has peen reproduced ari received from the arson or organizahot ongmating it 0 Minor changes have bean made to 'preys reoroduchon duality Forms ol vow or oprmons stated in the doeu ment do not necessarily represent Oboe OE Jar positron or pokey AUGMENTATIVE COMMUNICATION FOR CHILDREN WITH DEAF-BUNDNESS: GUIDELINES FOR DECISION-MAKING 2 _ AUGMENTATIVE COMMUNICATION FOR CHILDREN WITH DEAF-BLINDNESS: GUIDELINES FOR DECISION-MAKING Cynthia J. Cress Trace Research and Development Center Pamela Mathy-Laikko Meyer Children's Rehabilitation Institute Jennifer Angelo University of Buffalo Project Director: Michael Bullis Communication Skills Center Oregon State System of Higher Education Teaching Research Division 345 North Monmouth Avenue Monmouth, OR97361 This project was funded in part by contract 1300-83-0237 from the Office of Special Education and Rehabilitative Services, U.S. Department of Education. The information presented herein does not necessarily reflect the policy of the Office of Special Education and Rehabilitative Services, and nu official endorsement shoun be inferred. PREFACE Perhaps no handicapping condition is as debilitating as the dual sensory impairment of deaf-bli 'clness.All too often, young children with this type of condition have difficulty developing even rudimentary communication skills.Tins situation is further exacerbated by a relative absence of systematic research, assessment tools, and curricula expressly designed for personswith deaf- blindness. Fortunately, in recent years, the professional communfty has directed more attention to this population, and various researchendeavors have been initiated to develop appropriate and useful materials. One such effort is the Communication Skills Center for Young Ctildren with Deaf-Blindness (CSC).This project was funded through a 5-year contract that was awarded in 1983 to the Teaching Research Divisionof the Oregon State System of Higher Education by the United States Office of Special Education and Rehabilitation.The overall goals of CSC were to develop, implement, evaluate, and disseminate communication interventions to increase the early communication and language competencies of young children (0 to 5 years) with deaf-blindness. Toward this end amultisite, consortium model was adopted. The CSC was administered through the Teaching Research Division and included as members the Portland, Oregon, Public Schoolr;; Universityof Wisconsin-Madison, Weisman Center; St. Luke's Hospital, New York; and Utah State University, Exceptional Child Center. At each of these sites specific topics related to communication development in children with deaf-blindness were investigated. This manuscript is only one of the products generated from the project. Itis our hope that the document will be both interesting and helpful to the reader; and that, in some way, it will aid children with deaf-blindness. Michael Bull's, Ph.D. Project Director Communication Skills Center for Young Childrep with Deaf-Blindness This product was developed under contract #300-83-0237, Office of Special Education and Rehabilitative Services, U.S. Department ol Education. The statements and materials contained herein do not necessarily reflect the position or policy of that office. SECTION I INTRODUCTION 4. Overview and Purpose of Manual This manual is intended to bc a tool for rehabilitation personnel, teachers, therapists, caretakers, and clients to assist in developing augmentative communication systcms. Persons with deaf-blindness have difficulty using standard verbal communication techniques because of limited access to visual and auditory channels of information transmission. Children with impaired vision and speech arc at ri',k for developing v.:rbal communication skills as well as language and interaction skills, beca ise of limited experience with language reception, expression, and application in functional settings. Nearly all persons with deaf-blindness need some form of assistive communication for managing communicative interactions. As used by this manual, augmentative or assistive communication has a very broad definition: any behaviors, activities, materials, or techniques that help a person convey and receive mcssages, in addition to verbal language. Nondisabled persons routinely usc natural nonverbal behaviors such as facial expressions and gestures to augment verbal communication, although their verbal message is generally adequate without this information. Persons who have more difficulty with producingor understanding verbal language may use a combination of nonverbal behaviors, gesture systems and signs, actions, vocalizations, symbols, communication boards, and electronic devices to send and receive information. A person's augmentative system, then, :s their particular combination of these Lommunication techniques used across diffeient settings, persons, and purposes. An auonentative systcm is not a single decision madc once in a person's lifetime, butan ongoing, constantly changing process of determining what is the most effectivemeans to communicate in a given situation. The manual is structured according to basic decisions about augmentative communication applications, because similar things must be decided for all individuals. The focus isto discuss issues that arc liable to occur in developing a system to meeta person's communicative needs, and to cover as complete as possible a range of concerns. Specific imi lementationsor modification, of general techniques for deaf-blind individualsarc covered with each step in thc decision process. Equipment and resources specific to deaf-blindarc covered in sertion IV and the appendices. 1 ar 11,WELIAlhat:Blindmit Deaf-blindness is a double disability, which includes the functional problems of both hearing and sight loss, as well as unique problems associated with the combined disability. To be labelled deaf-blind, a person must be either a) legally blind or legally deaf, with enough associated vision or hearing impairment to significan:ly affect functional use, or b) severely hearing and vision impaired, with only residual sight and/or hearing. Thus, a person need not be totally deaf (unable to hear and understand speech, even with amplification) and blind (201200 or 201250 vision with maximum correction, and/or tunnel vision of 20 degrees or less) to be labelled deaf-blind (Gallaudet, 1980). In some cases, the term "blinu-dear is used if a peron's first or primary disability is blindness. An estimated 20-30,000 persons in the United States are considered deaf-blind (Zuckerman, 1983). C. Causes of Dfalf-Ilindness One of the most common causes of deaf-blindness is maternal rubella, dating particularly from the rubella epidemic of the 1960's. Another common cause is Usher's Syndrome, which combines early deafness with progressive blindness from retinitis pigmentosa. Other common causes of blindness (such as cataracts, glaucoma, or accidents) or deafness (such as otosclerosis, nigh fevers, or tumors) may affect someone who is already deaf or blind, and result in functional deaf-blindness. The cause and time of onset of sight and hearing loss have a great influence on the communicative and behavioral implications of deaf-blindness. Sometimes deaf-blind children also have other health problems such as motor impairments and mental retardation associated with the primary etiology. Typically, deaf-blind infants behave differently from other infants in three ways: 1) they remain passive and unresponsive to apparent stimuli; 2) they react vigorously, protectively and with hypersensitivity to most all handling attempts; and 3) they cry whether being handled or left alone (Mouchka, 1971). Because these children are more often passive than other children, the job of the caretaker and therapist is to bring the world to the child at