Yes, Your Hearing Impaired Child Can Take Their FM Assistive System Home From School

The FM assistive listening system is one of the most powerful weapons in the arsenal against deafness, especially with children, which is why many experts as well as we at The Hearing Blog believe it should be used on every child in school. However — And sometimes intentionally for budgetary reasons — misinformation is being spread by the Special Education community as to whether these systems can be brought home, especially for toddlers. The definitive answer is if the FM system is needed for continued auditory therapy in the home as part of their IEP, then under Federal law the school must make it available. Period. This article will explain the child’s rights under the law, and the need.

The Law:
If in-home auditory, auditory-verbal or other therapy is prescribed, the school must by law allow the FM system to be brought home, as it is part of the child’s entitlement to Free and Appropriate Public Education (FAPE), as spelt out legislatively in the Individuals with Disabilities Education Act of 2004 (IDEA-2004 (PDF)), and codified in the Code of Federal Regulations (CFR) Title 34 § 300.105:

§ 300.105 Assistive technology.

(a) Each public agency must ensure that assistive technology devices or assistive technology services, or both, as those terms are defined in §§ 300.5 and 300.6, respectively, are made available to a child with a disability if required as a part of the child’s—
(1) Special education under § 300.36 [Ed.: Secondary school];
(2) Related services under § 300.34 [Ed.: Related Services; footnote 2]; or
(3) Supplementary aids and services under §§ 300.38 and 300.114(a)(2)(ii) [Ed.: Supplementary aids such as FM required for mainstream education in the Least Restrictive Environment (“LRE”), as opposed to segregating the students from the regular educational environment].
(b) On a case-by-case basis, the use of school-purchased assistive technology devices in a child’s home or in other settings is required if the child’s IEP Team determines that the child needs access to those devices in order to receive FAPE [Ed.: Free and Appropriate Public Education; emphasis added].

However, schools do indeed suffer losses from lost or damaged textbooks and school equipment, so they are understandably reluctant to sent equipment home if they are required to use it at school, as they could wind up in non-compliance if the FM equipment doesn’t come to school through no fault of their own. Note that although this applies to the transmitter, this will somewhat vary on the actual FM receivers used: If they are micro receivers attached to the hearing aids or CI’s, then this in not really an issue, as they can remain plugged in. Also, for toddlers not yet going to school, this does not apply as the FM system will be staying in the home.

The Need: Thomas Golden Asleep With His Monster Truck
We at The Hearing Blog have been banging the proverbial drum for some time now for hearing impaired people of all ages to use FM or remote mic assistive listening devices, to both improve speech perception and increase listening ease. Hearing loss is difficult on the sufferer because of the listening effort required: Think of listening to someone speak to you all day in a foreign language, which you have to expend cognitive effort to translate into English, causing “cognitive overload.” Parents of hearing impaired children see this every day how exhausting this is, as when they come home from school they have to take a nap, instead of going outside to play with their friends.

As we reported two years ago, individuals with hearing loss actually process sound differently in noisy environments, due to erosion of temporal resolution and processing in the presence of noise, demonstrating the need for the improved speech-to-noise level (S/N ratio) FM assistive systems provide. What’s more, even in relatively quiet settings, the reverberation time Tr (or T60) found in many rooms is often far in excess of the acceptable limit of 550 mSec.1 Basically, by using a wireless assistive listening system, the child will reap the low-hanging “listening ease” fruit that can be snatched just for the taking. To drive this point home, put your earbuds in and watch this independently produced demonstration, recorded in an actual Vermont classroom:

UPDATE: Our British friends at the National Deaf Children’s Society talk about tiredness in deaf children, and present strategies on combating this problem. Here is part of what they write:

You might have noticed that your deaf child gets more tired than hearing children. You’re not alone – fatigue is common in deaf children. Here we explain why this is and how you can help your child.

Most people have times when they find listening hard work, such as when concentrating on someone speaking softly, or when trying to make out a single voice in a noisy environment. Deaf children have to pay much more attention when listening than children with typical hearing levels. This means they use more of their cognitive resources in listening effort, and have less energy for other things.

Deaf children may be more tired at the end of a school day than their hearing siblings or friends. This fatigue may have a significant impact on their learning and development.

You might have noticed that your deaf child gets more tired than hearing children. You’re not alone – fatigue is common in deaf children. Here we explain why this is and how you can help your child.

Most people have times when they find listening hard work, such as when concentrating on someone speaking softly, or when trying to make out a single voice in a noisy environment. Deaf children have to pay much more attention when listening than children with typical hearing levels. This means they use more of their cognitive resources in listening effort, and have less energy for other things.

Deaf children may be more tired at the end of a school day than their hearing siblings or friends. This fatigue may have a significant impact on their learning and development.

“My 15-year-old daughter takes herself off to bed exhausted by 7.30-8pm on a school night.”
~Parent

>Footnotes & References:

  1. ANSI/ASA S12.60-2010 Standards on Classroom Acoustics Parts 1 & 2, available for free download at the Acoustical Society of America website store, courtesy of Armstrong;
  2. Johnson, Cheryl DeConde (March 2015). 20Q: Understanding and supporting reluctant users of remote microphone technology.  AudiologyOnline, Article 13554.
  3. DOJ/OSEP. (November 12, 2014). Frequently asked questions on effective communication for students with hearing, vision, or speech disabilities in public elementary and secondary schools (PDF file);
  4. Johnson, Cheryl DeConde (2014). Important ADA Policy Guidance on Effective Communication. Educational Audiology Review (PDF file);
  5. 34 CFR § 300.34 deals with Related Services [Note: Items not related to hearing & speech omitted]:

(a) General. Related services means transportation and such developmental, corrective, and other supportive services as are required to assist a child with a disability to benefit from special education, and includes speech-language pathology and audiology services, interpreting services, psychological services, physical and occupational therapy, recreation, including therapeutic recreation, early identification and assessment of disabilities in children, counseling services, including rehabilitation counseling, orientation and mobility services, and medical services for diagnostic or evaluation purposes. Related services also include school health services and school nurse services, social work services in schools, and parent counseling and training.

(b) Exception; services that apply to children with surgically implanted devices, including cochlear implants.
(1) Related services do not include a medical device that is surgically implanted, the optimization of that device’s functioning (e.g., mapping), maintenance of that device, or the replacement of that device.
(2) Nothing in paragraph (b)(1) of this section—
(i) Limits the right of a child with a surgically implanted device (e.g., cochlear implant) to receive related services (as listed in paragraph (a) of this section) that are determined by the IEP Team to be necessary for the child to receive FAPE.
(ii) Limits the responsibility of a public agency to appropriately monitor and maintain medical devices that are needed to maintain the health and safety of the child, including breathing, nutrition, or operation of other bodily functions, while the child is transported to and from school or is at school; or
(iii) Prevents the routine checking of an external component of a surgically implanted device to make sure it is functioning properly, as required in § 300.113(b).
(c) Individual related services terms defined. The terms used in this definition are defined as follows:
(1) Audiology includes—
(i) Identification of children with hearing loss;
(ii) Determination of the range, nature, and degree of hearing loss, including referral for medical or other professional attention for the habilitation of hearing;
(iii) Provision of habilitative activities, such as language habilitation, auditory training, speech reading (lip-reading), hearing evaluation, and speech conservation;
(iv) Creation and administration of programs for prevention of hearing loss;
(v) Counseling and guidance of children, parents, and teachers regarding hearing loss; and
(vi) Determination of children’s needs for group and individual amplification, selecting and fitting an appropriate aid, and evaluating the effectiveness of amplification.
(3) Early identification and assessment of disabilities in children means the implementation of a formal plan for identifying a disability as early as possible in a child’s life.
(4) Interpreting services includes—
(i) The following, when used with respect to children who are deaf or hard of hearing: Oral transliteration services, cued language transliteration services, sign language transliteration and interpreting services, and transcription services, such as communication access real-time translation (CART), C-Print, and TypeWell; and
(ii) Special interpreting services for children who are deaf-blind.
(8) [Counseling]
(i) Parent counseling and training means assisting parents in understanding the special needs of their child;
(ii) Providing parents with information about child development; and
(iii) Helping parents to acquire the necessary skills that will allow them to support the implementation of their child’s IEP or IFSP.
(12) Rehabilitation counseling services means services provided by qualified personnel in individual or group sessions that focus specifically on career development, employment preparation, achieving independence, and integration in the workplace and community of a student with a disability. The term also includes vocational rehabilitation services provided to a student with a disability by vocational rehabilitation programs funded under the Rehabilitation Act of 1973, as amended, 29 U.S.C. 701
et seq.

(13) School health services and school nurse services means health services that are designed to enable a child with a disability to receive FAPE as described in the child’s IEP. School nurse services are services provided by a qualified school nurse. School health services are services that may be provided by either a qualified school nurse or other qualified person.
(15) Speech-language pathology services includes—
(i) Identification of children with speech or language impairments;
(ii) Diagnosis and appraisal of specific speech or language impairments;
(iii) Referral for medical or other professional attention necessary for the habilitation of speech or language impairments;
(iv) Provision of speech and language services for the habilitation or prevention of communicative impairments; and
(v) Counseling and guidance of parents, children, and teachers regarding speech and language impairments.
(Authority: 20 U.S.C. 1401(26))

~

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About the author

Dan Schwartz

Electrical Engineer, via Georgia Tech

2 Comments

  1. Cory Schaeffer
    February 19, 2015 at 6:59 pm

    Dan,
    With the recent changes (March 15, 2012) the ADA requires assistive listening to be in any room with amplified sound. It defines in the code assembly areas and first on the list is “Classrooms”. How do we get people to request assistive listening for their children in school? Many schools invest in systems, yet they say that “no one ever uses it or asks for them…”

      Assembly Areas

    Under the ADA an assembly area is defined as a building or facility, or a portion thereof that is used for the purpose of entertainment, education, civic gatherings, or similar purposes. Specific assembly areas that require assistive listening systems include, but are not limited to: classrooms, public meeting rooms, legislative chambers, motion picture houses, auditoriums, theaters, playhouses, dinner theaters, concert halls, centers for the performing arts, amphitheaters, arenas, stadiums, grandstands, or convention centers.


    • Dan Schwartz
      February 23, 2015 at 12:20 am

      Cory, you bring up an excellent point, but we believe the problem for schoolkids is in enforcing recalcitrant administrators & teachers to actually use the technology… And this varies widely from district-to-district in each state as well as state-to-state. Our Good Friend Jane Madell PhD writes about the need to have virtually all hearing impaired children in an Individualized Education Plan (IEP):

      Does a Child Have to Fail to Get an IEP?

      School districts are less and less willing these days to put children on IEPs (individualized education programs), preferring to keep them on 504 plans. On the surface, it may seem like this is okay – but is it?

      What’s the difference between an IEP and a 504 plan?
      An IEP sets out specific services a child will receive and specific goals and objectives that the school district is expected to accomplish. The 504 plan (which refers to Section 504 of the Rehabilitation Act) is designed for children who need less assistance. The kids on 504 plans may need only to have an FM provided, and they may have a teacher of the deaf and/or speech-language pathologist check on their progress periodically. Kids on 504 plans are not usually getting direct services. Kids on IEPs get evaluated regularily ( though not often enough), while but kids on 504 plans are not evaluated regularily.

      What’s the problem?
      Kids who are on 504 plans do not have goals and objectives that the school district is being required to provide. In districts where I have been asked to consult (by parents who feel they need assistance) the district says that the child does not need to be on an IEP if the child is academically at grade level. On the surface that seems reasonable. So here are my concerns. Many kids with hearing loss enter school in kindergarten at grade level but develop difficulties in second or third grade as the work becomes more difficult and the teacher starts to repeat less. “I’m going to say this once, so you had better listen carefully.” For a child with hearing loss, once may not be enough. As class discussion becomes an important part of learning, a child with hearing loss may miss out on a lot. Kids do not fail all of a sudden. Things start to slip but not all at once. It can take a year or sometimes more to realize that the child is not working at grade level.

      How good is “good enough”?
      Depending on the particular school district there are different standards for what is good or excellent. It is one thing to compare your kids to those across the nation, and another to compare them to the kids in their class. A child in a high performing school district will have significant problems if they are performing at the 50 percentile level when compared to children nationwide. The kids in their district are performing at a much higher level and those with hearing loss need to be able to compete. In my view, kids deserve to be the best they can be. And if that means the school district has to provide a little more, then it just does.

      How can we get kids on an IEP?
      In my opinion, almost all kids with hearing loss should be on an IEP. It just makes it easier to get them services when needed. Some kids will need very little, others will need much more. How do we know what services a child needs? By evaluating their performance. When I am trying to determine what services a child needs I ask for three evaluations. I want to see: (1) an audiological evaluation with extensive speech perception testing in quiet and noise with technology, (2) a speech-language-listening evaluation by a clinician experienced in working with children with hearing loss who are using audition to learn, and(3) a recent psychoeducational evaluation.

      With the audiological evaluation, I want to compare what the child can hear with technology to what their peers hear. Normal hearing in quiet and in noise is 90%-100%. Is the child hearing at that level? If not, how will that affect learning in school? When reviewing the other evaluations I am not interested in the total score (which is what many school districts use to determine if services are needed). I am interested in looking at subtests and seeing areas of weakness. Many children have significant areas of strength that bring their total score into the normal range, yet they also still have significant areas of weakness. If those areas are not addressed, they can have significant negative consequences for learning.

      By demonstrating what the child can and cannot hear, and areas of weakness, it is easy to make a case for what services a child needs and to make an argument for who needs to provide the services. We do not always succeed but we have the data to make the case.


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