DEAFBLINDNESS

Vision & hearing

• We learn about the world mostly through our sense of vision and hearing.
• Main sensory avenues for accessing information, interacting with our surroundings and perceiving events.
• Impairment, even on a mild level, can affect ability to communicate, interact, develop personal relationships, and acquire concepts.

DEAFBLINDNESS

• "Concomitant (occuring at the same time) hearing and visual impairments, the combination of which causes such severe communication and other developmental and educational needs that they cannot be accommodated in special education programs solely for children with deafness or children with blindness." (Individuals with Disabilities Education Improvement Act of 2004)

UNIQUE population

• Highly diverse group of individuals with complex needs
• Rarely totally deaf or totally blind. Often have usable hearing & vision.
• 90% have additional disabilities (motor, health related, behavioral, and/or developmental)
• May be congenital or acquired
• Degree of hearing and/or vision loss may vary greatly and can change over time.

CHallenges

• Lack of complete visual and auditory information results in varying degrees of isolation and disconnection from the world.
• Greatly impacts learning and communication.
• Difficulty interacting & bonding with others.
• Inwardly focused
• Behavioral difficulties
• Perception of the world can be fragmented and disorganized.

VISion Loss

• 17% totally blind or light perception only
• 24% legally blind
• 21% low vision
• 17% cortical visual impairment
• 21% other
• (National Consortium on Deaf-Blindness)

Hearing loss

• 39% severe to profound hearing loss
• 13% moderate hearing loss
• 14% mild hearing loss
• 6% central auditory processing disorder
• 28% other
• (National Consortium on Deaf-Blindness)

Additional disabilities

• 66% cognitive disability
• 57% physical disability
• 38% complex health care needs
• 9% behavior challenges
• 30% other
• (National Consortium on Deaf-Blindness)

Causes

• Complications of prematurity
• Heredity (chromosomal syndromes)
• Pre or post-natal complications
• CHARGE Syndrome
• Microcephaly
• Hydrocephaly
• Meningitis
• Usher Syndrome

AUDitory System

• Outer Ear - Externals parts of the ear
• Middle Ear - Eardrum, Ossicles
• Inner Ear - Cochlea, Auditory Nerve, Vestibular System

hearing Loss

• Conductive Hearing Loss
• Sensorineural Hearing Loss
• Mixed Hearing Loss
• Neural Hearing Loss
• Central Auditory Processing Disorder (CAPD)
• Loss: Mild, Moderate, Severe & Profound

VISION SYSTEM

• The Eyes - Collect & focuses light on retina
• The Optic Nerve - Transmits/carries image from retina to brain
• The Brain - Interprets visual input, allowing us to see =>Visual Processing

Vision Loss

• Acuity Loss
• Field Loss
• Loss of Contrast Sensitivity
• Colorblindness
• Oculomotor Problems
• Visual Processing Disorder- Cortical Visual Impairment

Visual Impairment

• Moderate - 20/70 acuity with best correction
• Severe - 20/200 to 20/400
• Profound - 20/500 to 20/1000
• "Legally Blind" - 20/100 to 20/200
• Total Blindness - Complete lack of light perception and form perception

Simulation

intervention

• Build TRUST!
• Establish a Communication System
• Address Sensory Needs
• Active engagement through Direct Learning
• Create opportunities for expectation & choice within predictable routines
• Treatment plan should reflect child's unique and complex needs
• Ongoing collaboration with providers & family

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Damian

• Medical History: Born 39 weeks gestation, Hypoxia at birth, Intraventricular Hemorrhage (Grade IV), Respiratory distress & Seizures
• Diagnosis: Cerebral Palsy, Deafblindness, Cortical Visual Impairment (CVI)
• Mode of Communication: Tactile Signing, Communication Device & Eye Gaze
• Hearing Aids, FM System
• Mobility: Wheelchair, Gait Trainer

Treatment Strategies

• OT services provided via "push-in" model to support educational goals
• Direct Learning Approach
• Communication Device Access
• Self-Feeding Skills
• Visual Motor Skills
• Fine Motor Coordination Skills

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ADAIR

• Medical History: Born full-term, PE tubes placed multiple times, Dysphagia
• Diagnosis: Agenesis of Corpus Callosum, Cerebral Palsy, Cortical Visual Impairment, Conductive and Sensorineural Hearing Loss.
• Communication Modes: Communication Device, Tactile signing, Calendar System
• Wears Bone Conductor
• Mobility: Posterior Gait Trainer

TReatment strategies

• OT services provided via "push-in" model to support educational goals
• Direct Learning Approach
• Pre-Vocational Skills
• Dressing Skills
• Fine Motor Coordination Skills

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