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Section K: Extended Services

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Planning for Children with Special Health Care Needs It is predicted that most classroom teachers will meet a child with special health needs at least once in their careers. It is imperative that teachers possess at least some knowledge of that child’s health maintenance. Teachers should recognize too that children with special health needs are often on a roller coaster of changing needs that is unlike any other disability. Just as we must ensure a quality education for students with disabilities, we must also ensure that they receive quality medical services that enhance their school experience. Schools are encouraged to develop policies that protect the students and teachers.

When a child with a health impairment is in a school, two related documents are necessary. 1. A health services plan – a document that outlines the child’s specific needs, the

strategies needed to support the child, the responsibility of staff, and training and resources needed.

2. An emergency protocol – a document that contains the information on emergency practices and strategies developed by parents, school personnel, and medical personnel.

A team should be assembled to guide the planning for a student with complex health care needs in order to have:

§ Information on the condition or understanding the intervention procedures. § Planned strategies to support a child’s needs, note the responsibilities of staff, and

the training and resources needed. § A prepared environment. This could include special seating or accommodations

for medical equipment such as a ventilator. § Educated students and peers. Students should know what to expect. § A health services plan that outlines a child’s specific needs. For example, to

monitor the status of a diabetic child, the symptoms of insulin reaction, and the immediate remedies. Note the warning signs and symptoms of an asthma attack – the child may wheeze, show reactions where the tissue of the chest wall is sucked in as a child is wearing braces, teachers must be alert to circulations problems. Drug exposed children are often stressed and distressed; some of the most common stressors are transitions, classroom interruptions, and school disruptions such as field trips and fire drills.

§ An emergency protocol. This should include: o Parents or guardians: name, address, telephone numbers o Any other relevant parties: name, address, telephone numbers o School assistance: name, telephone numbers

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o Family physician: name, address, telephone numbers o Emergency contacts: name, address, telephone numbers o Local hospital: telephone numbers o Ambulance services: telephone numbers o Emergency practices based on the needs of a particular child, i.e., what to do in

an asthma attack or an epileptic seizure. § A medication log if necessary

For template examples of these forms see FNSEPH’s Section O.

Planning for Children Who Have Physical Disabilities To meet the programming needs of the at-‐risk students, the resource teacher will have to know what a speech language pathologist, an occupational therapist, a physiotherapist and a play therapist are able to do and how to access the different and various services.

The school-‐based occupational therapist is concerned with the student’s independent functioning and performance abilities in educational/life tasks. The occupational therapist evaluates the student’s functional performance level, and implements appropriate intervention strategies according to the student’s needs, in the following areas:

1. Occupational Performance:

§ Activities of daily living

§ School/homework activities

§ Pre-‐vocational skills

§ Play/leisure skills

2. Performance Components:

§ Neuromuscular development

§ Sensory-‐integrative development

§ Social/physiological development

§ Cognitive development

Common Occupational Therapy Interventions 1. Self-‐Care Activities:

§ Feeding, dressing, grooming, personal care

§ Instructions in compensatory methods, use of adapted equipment, energy conservation.

2. School/Home/Work Activities:

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§ May include environmental adaptations; instruction in adapted methods/equipment; energy conservation; home management skills.

3. Play/Leisure Skills:

§ Instruction in adapted methods/equipment

§ Instruction in appropriate activities

§ Facilitation of student’s participation in community programs

4. Pre-‐Vocational/Vocational Skills:

§ Improved endurance

§ Awareness and utilization of community resources

§ Environmental assessment/adaptations

5. Neuromuscular Development:

§ Activities for the development of gross and fine-‐motor coordination

§ Sensory stimulation

§ Instruction in the use of adapted equipment and proper handling and positioning techniques.

6. Sensory-‐Integrative Development:

§ Sensory facilitation/inhibition techniques for vestibular, tactile, visual, auditory, proprioceptive/kinesthetic, gustatory and olfactory stimulation.

7. Cognitive Development:

§ May include activities which assist the student in developing concentration/attention span, memory/recall and decision making/problem solving

Note: therapy interventions in the areas of social/psychological, cognitive development are supportive to academic or other appropriate programming to enhance the student’s performance skills.

Occupational Therapists in Private Practice The following is a list of occupational therapists who do private practice:

Block Building Therapies: P.O. Box 53060 RPO South, St. Vital Winnipeg, MB R2N 3X2 Phone: (204) 231-‐0785 Fax: (204) 231-‐4442 Email: [email protected]

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Website: www.blockbuilding.ca

Area Served: Province of Manitoba including satellite offices in Brandon and Dauphin.

Nature of Practice: Assessment, direct intervention and consultation for children and adults.

Services Provided: 1. Adults and Children – Specialization in discharge planning, environmental assessments, equipment prescriptions and cognitive assessment and treatment for clients with a brain injury, spinal cord injury or orthopedic injury. Also facilitating returns to school or work processes.

2. Children – Community-‐based occupational therapy services within the child’s functional environment (home, school, daycare). Services are directed toward increasing a child’s independence with activities of daily living which are affected by physical, cognitive or social difficulties. This includes but is not excluded to self-‐care (dressing, toileting), play (concepts, socialization) and work (reading, writing, cutting). Educational in-‐services can be provided to individuals or groups regarding various topics.

3. Adults – Completion of physical demands analysis, job side assessments and percentage of duties assessments for clients with soft tissue and/or back injury. Ergonomic assessments for the workplace and gradual return to work programs for the injured worker.

Ages Served: All ages.

Special Interests: 1. Adults and Children – Traumatic brain injuries, spiral cord injuries, orthopedic injuries.

2. Children – Attention deficit disorder, learning disorders, Autism Spectrum Disorder, neuromuscular disorders and developmental disorders.

3. Adults – Physical demands analysis, percentage of duties assessment, childcare assessments, return to work programs.

System of Referral: Self-‐referral, physician referral or referral directly from schools, family member or third party payer.

The Children’s Clubhouse—Developmental, Enrichment & Therapy Services Ltd. Karen Penner, OTM and Associates 2207 Henderson Hwy., Winnipeg, MB R2E 0B8 Phone: (204) 338-‐3572 Fax: (204) 339-‐8438

Nature of Practice: Comprehensive pediatric and adolescent services including assessment, consultation, counselling and advocacy. Individual and small group therapy, parent education, workshops and in-‐services, medical, legal and case management services provided in a unique, wheelchair accessible clinic in North East Winnipeg.

Services Provided: Neurodevelopmental, psychosocial, psycho-‐educational, and enrichment services are provided by a team of occupational therapists with specialties in child and adolescent mental health, neurodevelopmental assessment and therapy, sensory integration therapy, and psycho-‐educational approaches. We offer a variety of after-‐school Kids Clubs and Summer Day Camp programming and consult to agencies and schools, and provide professional or consumer workshops and in-‐services. Comprehensive

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neurodevelopmental assessments profile learning, attention, psychosocial and adaptive development and enable development of comprehensive home and school program plans.

Ages Served: 0-‐18 years plus care givers and agencies. Medical legal services for all ages.

Special Interests: Children with invisible disabilities including learning disabilities, attention deficit hyperactivity disorder, autism spectrum disorder, Asperger or Tourette syndrome, prenatal substance exposure, emotional dysregulation, stress/anxiety, depression and those requiring coaching in social skills, play or life skills, written output, or problem solving and organization.

System of Referral: Physician, psychologists, parents and professionals. Parents direct the services provided.

Choice Children’s Multi-‐Rehabilitation Services Leslie Assor, OTM 39 Stanford Bay Winnipeg, MB R3P 0T5 Phone: (204) 339-‐0138 Fax: (204) 632-‐6895

Area Served: Manitoba, primarily Winnipeg.

Nature of Practice: Direct service or consultation to families, children, caregivers and educators.

Services Provided: Assessment, direct intervention and consultation by one or more professionals, as needed. Services provided in the home, occupational therapy clinic or a community-‐based site, individually or in small groups. Workshops and in-‐services may be provided on a variety of topics. Services are directed toward maximizing children’s learning and development at home, school and other community settings. Comprehensive assessments provided. A variety of treatment modalities are used.

Ages Served: Birth to 18 years.

Special Interests: Neurodevelopmental dysfunction, attention deficits, brain injuries, autism/pervasive developmental disorder, sensory integration, deaf and hard of hearing, learning disabilities. Therapist is sensory integrative certified. Has working knowledge of American Sign Language.

System of Referral: Self-‐referral, families, physicians, professionals to call or make written referral.

Enabling Accessibility: Sole Proprietor Marnie Courage, OTM Phone: (204) 475-‐0433 Fax: (204) 475-‐4011 Email: accessibility @shaw.ca

Area Served: Winnipeg and surrounding area.

Nature of Practice: Assessment and consultation.

Services Provided: Comprehensive Accessibility Assessments – available for an individual’s home, vehicle,

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workplace or public facility. Each assessment is followed by a detailed report including photographs and descriptions of barriers to access as well as recommendations for environmental modification and function enhancing equipment. Price quotes on equipment like bath seats, lifts, ramps; overhead tracking, etc. are gathered and presented to the client. Computer Access and Ergonomic Analysis – On-‐site computer access assessments are provided in the home, workplace, or classroom to determine appropriate access methods for communication devices and computers. A report outlining recommendations for software and low or high tech enabling devices are provided. Functional Assessments – An evaluation of an individual’s current physical, cognitive and emotional status focusing in the areas of self-‐care, productivity and leisure. A detailed report includes the individual’s capabilities and barriers to function as well as recommendations for equipment and adaptive devices to improve function independence. Wheelchair and Seating Prescriptions – Comprehensive physical, cognitive and environmental assessments are conducted and help to determine the appropriate wheelchair and seating system for an individual. Manual and power mobility as well as commercial and custom seating products are explored. Recommendations are provided in a detailed report.


Special Interests: Traumatic brain injuries, spinal cord injuries, orthopedic injuries, neuromuscular disorders and developmental disabilities.

System of Referral: Phone, fax, email.

Emotions Therapy for Kids & Teens Rosanne Brezden Papadopoulos, OTM 304-‐1 Wesley Avenue Winnipeg, MB R3C 4C6 Phone: (204) 254-‐3146 Fax: (204) 253-‐6105 Email: [email protected]

Area Served: No particular geographic district.

Nature of Practice: Direct or small group of children, adolescents and parents; Consultation to parents or professionals; Workshops or professional development opportunities; experiential classroom presentations.

Services Provided: Interventions include a child-‐centred approach that includes cognitive behavioural strategies, sensory processing, therapeutic listening strategies, and social interventions. Certification in Relationship Development Intervention (RDI) is currently being pursued. Therapy includes the following goals and services: • Relationship development, e.g., friendships • Increasing emotional self-‐awareness • Improving self-‐management skills, e.g., anger • Relaxation strategies • Using the environment to support the child’s needs

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• Understanding child’s sensory system and using it to assist their learning • Video-‐feedback to teach and modify behaviours, i.e., role playing • “Therapy goal book” to improve transfer of skills between home and therapy • Sexuality and disability awareness, teaching and strategies for home and school Facilitating understanding of the child with parents, caregivers or teachers and within the child’s community

Ages Served: Primarily 4-‐18, parents and teachers; Special needs adults also considered

Special Interests: • Sexuality and developmental disabilities • Social relationships • Female bullying and teasing • Autistic spectrum disorders (Asperger’s syndrome), non-‐verbal learning disabilities,

Tourette syndrome, attention deficit disorder • Using small group intervention in community or school

System of Referral: Self, physician, parent, etc.

Key Steps Rehabilitation and Consulting Services: Sole Proprietor Stephanie Jordan, OTM Box 21005, 3360 Victoria Avenue Brandon, MB R7B 2L0 Phone: (204) 573-‐6262 Fax: (204) 867-‐2391 Email: [email protected] Website: www.keysteps.ca

Area Served: Province of Manitoba

Nature of Practice: Key Steps is a privately owned rehabilitation company that provides consultation and disability management services to a variety of organizations and individuals. The main goals of the occupational therapy services provided are: safe return to work, increased work productivity, safe discharge from hospital, increased independence and/or safety within the home, and increased mobility.

Services Provided: Functional home assessments, wheelchair assessments, power mobility assessments, hospital discharge coordination, worksite/ergonomic assessments, job demands analysis, return to work programs, permanent impairment assessments (e.g., scarring, range of motion), cognitive screening, educational workshop.


System of Referral: Direct or third part referrals accepted via fax, phone, email, or mail. Referral form available upon request or can be downloaded from website.

Learninglinks Therapy: Vionna Hladky, OTM 791 Foxgrove Avenue Winnipeg, MB R2E 0A8

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Phone: (204) 661-‐0921 Fax: (204) 661-‐0762 Email: learning-‐[email protected]

Area Served: Winnipeg and surrounding area.

Nature of Practice: Direct service and consultation.

Services Provided: • Developmental assessment: sensory/motor skills, functional daily living and learning skills.

• Treatment planning, direct intervention, consultation to enable the child to overcome barriers to learning.

• Clinic or community-‐based service oriented to the priorities of the family. • Support to caregivers in caring/planning for their child. • Sensory Integration and Praxis Tests (certified). • Interactive Metromom® therapy (certified). This program offers a means to improve

attention, motor planning and sequencing, which, in turn, positively impacts many cognitive, behavioural and physical functions.

Ages Served: Birth to 15 years.

Special Interests: Sensory processing and sensory defensiveness hand skills development (printing, writing) motor control/coordination, motor planning skills focus and attention, organizational skills.

System of Referral: Self, parent, professional referral by phone or in writing (email, fax, mail).

Planning for Children with Speech and Communication Disabilities The speech language pathologist provides diagnostic evaluations and recommendations for students with communication disorders in order to enhance, compensate, and extend their communication skills. The speech language pathologist also helps students with special communication needs to use maximum communication as possible.

In the identification, evaluation and assessment categories, the following services are provided:

§ Screen and assess students who have been referred in order to determine whether or not a communication disorder is present and if so, its type and severity.

§ Interpret reports and share recommendations and clinical impression to parents and/or to school personnel.

In the management, treatment and follow-‐up areas, the following services are provided: § Plan intervention objectives and strategies for students who possess

communication disorders specific to the student’s needs. § Aid in the development of Individual Education Plans.

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§ Train and supervise paraprofessionals via in-‐services, lectures, distribution of information.

§ Monitor the progress of students who are receiving speech and language services. § Initiate referrals to other professionals when appropriate. § Provide written reports to appropriate personnel in a reasonable length of time

and in accordance with established rules, regulations, and ethical standards. § Make informed decisions regarding the discontinuation of services to students.

In the education and prevention areas, the following services are provided: § Provide information to school personnel regarding the characteristics of students

who may have a communication disorder in the areas of articulation, language, fluency or voice, so that they can assist in the early identification

§ Counselling on aspects of communication and therapy § Client/family/communication partners, education and support § Advocacy on behalf of families, clients and support services § Supervision and training of paraprofessionals that are involved in the intervention

programming § Be involved in activities that will inform others about communication disorders

research § Promote professional development through attendance at continuing education

programs

Speech-‐Language Referral Procedure

If you suspect students with communications concerns: 1. Contact your resource teacher about a possible referral for speech-‐language

Assessment.

2. The following steps are taken if a referral is recommended:

a) Classroom teacher should complete the pre-‐referral screening checklist for speech-‐language therapy form (See Pre-‐referral Form for Speech-‐Language Therapy in Section O and The “Sequence” of English Speech Sound Development chart which follows).

b) Classroom teacher should advise the resource staff that he/she would like to make a speech-‐language referral. Explain his/her concerns.

c) Resource teacher should complete the speech-‐language referral form. d) A Consent form must be signed by a parent/guardian before any student can

be removed from their classroom for formal testing. The resource teacher will fill out the consent form and contact the parents for their signature. This

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consent form is a combination of consent to assess, consent to receive services, and consent to share pertinent information with other professionals if speech language pathologist feels it is necessary.

3. A speech-‐language assessment report will be completed, and one copy of the report will be sent to the school to be reviewed by the principal, classroom teacher, and resource teacher who will then file the report in the resource office. At the same time, a letter will be sent home informing the parent that a speech-‐language assessment report has been completed and they are instructed to call the resource staff to set up a meeting with the speech language pathologist to review the report. The parent/guardian will be given a copy of the report after it has been discussed at the meeting with speech language pathologist.

§ Recommendations in report may include:

a) Direct/Group b) Suggestions for classroom teacher c) Home program d) Monitor

Or a combination of several suggestions

On the following page is a developmental chart indicating the customary age a child produces the different consonant sounds.

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Speech and Language Services Providers Due to the large caseloads MFNERC’s speech language pathologists carry, some schools will have to seek alternative sources of clinical services for their students. Below is an alternative list of contacts for speech and language services for First Nations’ Schools:

NB: At the time of FNSEPH update, MSHA’s website (www.msha.ca) was under construction and the following information could not be revised. Therefore, it is highly recommended that MSHA’s website be checked to verify the following information before contacting the service providers.

ABC All About Children Profession: SLP Work Hours: Full Time Address: 87 Brittany Drive, Winnipeg, MB R3R 3H1 Phone: 204.896.3964 Email: [email protected]

Concentration Areas: Articulation/phonology, cochlear implants, early intervention, education services, language learning disorders, motor speech disorders, stuttering, autism and related disorders.

Locations: Northern Manitoba, Winnipeg and surrounding area.

Age Groups: 0 -‐ 3, Preschool, School Age.

Buchel Speech and Language Group Profession: SLP Work Hours: Full Time Address: 178 Niagara Street, Winnipeg, MB R3N 0V2 Phone: 204-‐791-‐3352 Email: [email protected] Website: www.buchelgroup.ca

Concentration Areas: Accent reduction, acquired brain injury, augmentative and alternative communication, aphasia, dementia, dysphagia (swallowing disorders), geriatrics/gerontology, interdisciplinary rehab, motor speech disorders, stuttering, voice/resonance disorders.

Locations: Brandon, Dauphin, Gimli, Morden, northern Manitoba, Portage la Prairie, Selkirk, Steinbach, Winnipeg and surrounding area, other rural.

Age Groups: School Age, Adults, Geriatric.

Clear Speech -‐ Speech Language Pathology Services Profession: SLP Work Hours: Full Time

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Address: 92 Innsbruck Way, Winnipeg, MB R2P 1L8 Phone: 204.619.1653 Email: [email protected]

Concentration Areas: ccent reduction, acquired brain injury, augmentative and alternative communication, aphasia, articulation/phonology, central auditory processing disorders, cognitive impairments (developmental), dysphagia (swallowing disorders), language learning disorders, motor speech disorders, stuttering, voice/resonance disorders, phonological awareness.

Locations: Brandon, Selkirk, Winnipeg and surrounding Area, Interlake Region, southern Manitoba.

Age Groups: Preschool, School Age, Adults, Geriatric.

Lakeview Speech Therapy -‐ Kara Plamondon Profession: SLP Work Hours: Part Time Address: 117 Manitoba Ave, Flin Flon, MB R8A 0N4 Phone: 204.687.8521 Email: [email protected]

Concentration Areas: Not Specified (All).

Locations: Northern Manitoba, Flin Flon.

Age Groups: School Age, Adults, Geriatric.

Luella Jonk Consulting Profession: SLP Work Hours: Full Time Address: 305 Kingston Crescent, Winnipeg, MB R2M 0T5 Phone: 204.771.7650 Email: [email protected] Website: http://www.speakreadspell.com

Concentration Areas: Accent Reduction, Acquired Brain Injury, Articulation/Phonology, Counselling, Interdisciplinary Rehab, Motor Speech Disorders, Multicultural/Multilingual Issues, Stuttering, Tinnitus, Voice/Resonance Disorders.

Locations: Winnipeg and Surrounding Area, Other Rural.

Age Groups: School Age, Adults.

Milestones Therapy—Danna Kaplan Profession: SLP Work Hours: Part Time Address: 3 -‐ 1250 Waverley Street, Winnipeg, MB R3T 6C6 Phone: 204.291.8173 Email: [email protected]

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Concentration Areas: Acquired Brain Injury, Aphasia, Articulation/Phonology, Cleft Lip/Palate, Cognitive Impairments (Developmental), Dementia, Dysphagia (Swallowing Disorders), Early Intervention, Geriatrics/Gerontology, Language Learning Disorders, Motor Speech Disorders, Parent/Caregiver Training, Stuttering, Autism and Related Disorders .

Locations: Winnipeg and Surrounding Area.

Age Groups: 0 -‐ 3, Preschool, School Age, Adults, Geriatric.

Speech Works Inc. Profession: SLP Work Hours: Full Time Address: B1 -‐ 101, 11 Evergreen Place, Winnipeg, MB Phone: 204.231.2165 Email: [email protected] Website: www.speechworks.ca

Concentration Areas: Acquired Brain Injury, Augmentative and Alternative Communication, Aphasia, Articulation/Phonology, Cognitive Impairments (Developmental), Computer Applications, Counselling, Dementia, Dysphagia (Swallowing Disorders), Geriatrics/Gerontology, Interdisciplinary Rehab, Motor Speech Disorders, Multicultural/Multilingual Issues, Parent/Caregiver Training, Stuttering, Autism and Related Disorders .

Locations: Gimli, Northern Manitoba, Selkirk, Steinbach, Swan River, Thompson, Winnipeg and Surrounding Area, Any location via a TeleHealth site.

Age Groups: 0 -‐ 3, Preschool, School Age, Adults, Geriatric.

The Brandon Speech & Language Clinic Profession: SLP Work Hours: Full Time Address: Unit 2-‐217 10th Street Brandon MB R7A 4E9 Phone: 204.720.7570 Email: [email protected]

Concentration Areas: Acquired Brain Injury, Augmentative and Alternative Communication, Articulation/Phonology, Central Auditory Processing Disorders, Cleft Lip/Palate, Cognitive Impairments (Developmental), Computer Applications, Counselling, Early Intervention, Education Services, Language Learning Disorders, Laryngectomy, Motor Speech Disorders, Multicultural/Multilingual Issues, Parent/Caregiver Training, Stuttering, Autism and Related Disorders.

Locations: Brandon, Portage la Prairie, Other Rural, Westman Region.

Age Groups: 0 -‐ 3, Preschool, School Age, Adults.

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Rehabilitation Centre for Children – School Therapy Services – Winnipeg (for children who require communication devices) 633 Wellington Crescent, Winnipeg, MB R3M 0A8 Phone: 452-‐4311

Child Guidance Clinic of Winnipeg (for children attending a school within Winnipeg School Division #1) 700 Elgin Avenue, Winnipeg, MB R3E 1B2 Phone: 786-‐7841

The following is a list of Speech Language Pathologists who are in private practices:

Ames-‐Smith, Lynda 204-‐918-‐0165

Anderson, Shanon 204-‐255-‐7254

Baird, Allison 204-‐231-‐2165

Bamburak, Megan 204-‐250-‐4373

Bergen, Alyssa 204-‐770-‐2702

Buchel, Caitlin 204-‐791-‐3352

Bywater, Susan 204-‐999-‐5484

Cameron, Angela 204-‐729-‐8589

Cameron-‐Schoenhofer, Deborah 204-‐889-‐0503

Crawford, Erin 204-‐253-‐8003

Davis, Carla 204-‐475-‐5514

DeWarle, Partick 204-‐788-‐5791

Eudoxie, Lauren 204-‐213-‐1112

Fehr, Lisa 204-‐878-‐9184

Gustafson, Monica 204-‐896-‐3964

Hargraves, Lisa 204-‐801-‐9132

Harvey, Stephanie 204-‐231-‐2165

Highmoor, Lisa 204-‐467-‐5815

Howden, Alana 204-‐832-‐8315

Johannson, Tammy 204-‐720-‐7570

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Jonannson, Kim 204-‐415-‐9279

Jonk, Luella 204-‐771-‐7650

Kaplan, Danna 204-‐291-‐8173

Kernaghan, Karen 204-‐952-‐0614

Krawczyk, Sherise 204-‐470-‐6769

Lorteau, Lindsey 204-‐471-‐8963

Mikita, Jennifer 204-‐333-‐9274

Mittemayr, Vicky 204-‐668-‐1132

Moore, Jill 204-‐414-‐2533

Myers, Candace 204-‐233-‐5036

Newsham, S. 204-‐298-‐9266

Nowell, Glen 204-‐872-‐1954

Okrainec, Alexa 204-‐338-‐9724

Plamondon, Kara 204-‐687-‐8521

Ring-‐Whiklo. Kelly 204-‐470-‐5059

Saifer, Shawn 204-‐489-‐4864

Shpak, Heather 204-‐416-‐2057

Smith, Aileen 204-‐269-‐5295

Tonque Twisters Inc. 204-‐298-‐9266

Tugby, Ken 204-‐942-‐3712

Tye-‐Vallis, Kelly 204-‐256-‐5774

Willborn, Marlaine 204-‐478-‐4448

Planning for Children Who Are Deaf / Hard of Hearing Hearing loss has been organized traditionally into seven categories which consider the range of sound used in speech:

1. Normal hearing—students can detect all speech sounds even at a soft conversation level (-‐10 to +15 decibel range)

2. Minimal loss—students may have difficulty hearing faint or distant speech. Peer conversation and teacher instructions presented too rapidly, particularly in noisy

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classrooms, are likely to result in missed information (loss is between 16 to 25 decibels).

3. Mild—students may miss up to 50% of class discussion especially if voices are soft or the environment is noisy. Students will require the use of a hearing aid or personal FM system (loss between 26 to 40 decibels).

4. Moderate—classroom conversation from 3 to 5 feet away can be understood if the structure and vocabulary is controlled. Hearing aids and/or personal FM systems are essential. Specific attention will need to be directed to language development, reading and written language (loss is between 41 to 55 decibels).

5. Moderate to severe—without amplification students with this degree of loss can miss up to 100% of speech information. Full-‐time use of amplification is essential. The students will probably require additional help in all language based academic subjects (loss is between 56 to 70 decibels)

6. Severe—students can only hear loud noises at close distances. They require individual hearing aids, intensive auditory training and specialized instructional techniques in reading, language, and speech development (loss is between 71 to 90 decibels).

7. Profound—for all practical purposes these students rely on vision rather than hearing for processing information. If you have student in this category, he/she is usually a candidate for signing systems and specialized instructional techniques in reading, speech, and language development (loss of 91 decibels or more). It should be remembered that sometimes loss of hearing can be only at high or low frequencies. This can interfere with the ability to hear specific speech sounds. Hearing can also fluctuate depending on the student’s state of health or upon differences in the environment. FM Systems (Frequency Modulated Radio Transmission) FM systems are assistive listening devices designed to enhance the signal to noise ratio (relationship between speech and background noise) by improving the audibility and intelligibility of the speaker’s voice.

They help to solve the problems of background noise, distance from the speaker and room reverberation (echo). There are two types:

§ Personal—units are available with multiple options for internal and external settings. The unit may be fitted instead of a hearing aid or coupled with the student’s personal hearing aid.

§ Sound-‐field (classroom)—aid children with mild, fluctuating (primarily caused by ear infections or ear wax) hearing impairments or unilateral (hearing impairment in one ear) hearing impairments. This type of system benefits the entire classroom since all the students will hear the amplified sound. It is most effective for group

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instruction. The “needy” listener of the sound-‐field system is not obvious and does not stand out in the classroom.

It needs to be remembered that hearing aids alone will not substitute for an FM unit in a classroom where the speaker cannot be consistently close to the listener.

References Flexor, Carol 1999. Facilitating Hearing and Listening in Young Children. San Diego:

Singular Publishing Group.

One FM system is the REDCAT or REDMIKE. Each one delivers clear audio, excellent sound distribution and high speech intelligibility. It allows schools to eliminate installation costs.

For further information, contact:

John Hiebert email: [email protected] phone: 204.786.6169

Communication Tip Sheet One to One:

§ Get the student’s attention with a soft touch or visual sign and keep eye contact. § Speak naturally without overemphasizing. Short sentences are best. § Keep mouth visible, i.e., don’t turn away, cover your mouth, etc. § Use gestures, body language, and facial expressions to support communication. § Facilitate speech reading by not standing in front of windows or other light

sources. § Use the words “I” and “you” and keep direct eye contact, even when using an

interpreter. Remember you are communicating directly with the student. § Use open-‐ended questions that invite interaction and wait. This prevents the

student from nodding without really comprehending. § Check comprehension of instructions or content of lessons, i.e., “tell me what you

need to do.” § Repeat, and then rephrase if you have problems being understood. Use pencil and

paper if necessary since some combinations of consonants and vowels are difficult to speech read.

In Groups: § Identify the speaker. § Identify the topic, repeat questions asked, and summarize whenever possible. § Insist on one speaker at a time and reduced general noise. § Provide new vocabulary ahead of time or write on board or on chart paper.

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§ Make sure the student who is hard of hearing or deaf gets all the vital information. You may need to repeat answers given by students seated behind the student with a hearing loss.

§ Seat the student where he/she can see the speaker and classmates, and receive the clearest possible audio signal (round table or semi-‐circle arrangements are best).

§ Remain in one position as much as possible when speaking. Walking up and down in front of the class makes speech reading difficult.

§ Invite full participation from the student who is hard of hearing or deaf and ensure that turn-‐taking occurs.

§ Interpreters (oral and signing) can assist in group situations and will need a bit more time to finish transferring the speaker’s message.

§ Use a note taker where possible to record information. This allows the student to fully attend to the conversation. It is impossible to speech read and take notes at the same time.

Through an Interpreter: § Speak directly to the student who is hard of hearing or deaf, not the interpreter.

The interpreter is not part of the conversation and relays everything you say. § Allow some extra time for the interpreter to transfer your complete message and

for the student to form thoughtful questions and responses. § Speak clearly in normal tones at a well-‐paced rate and volume. § Provide good lighting for the student and interpreter, especially during slides,

films, videos. An outline of main points ahead of time is helpful. § In classes, outlines of the materials to be studied, new vocabulary, and lots of

visual aids assist the student and the interpreter. § During a normal class day, the interpreter will need regular breaks. The student

needs breaks as well, because reading sign is an intensive kind of work. § If is helpful to spend a few minutes ahead of class with the interpreter to briefly

review the topics, agenda, and information.

Hints for Note Takers: § Arriving a few minutes early to talk with the teacher really helps. § Leaving wide margins makes it easy for later notes and questions. § Each page should be dated and numbered. § Highlighting the main points helps organize the notes and emphasize topics. § Ask the speaker to check your notes for accuracy at the end of class.

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References Badger, Signe 2006. Resource Material for Classroom Teachers & Resource Staff with

Deaf/hard of hearing students. Manitoba Education, Citizenship and Youth. Winnipeg, Manitoba

Manitoba Education provides support to provincial schools with students who are Deaf/Hard of Hearing through consulting services from trained teachers with specialization in the area of deaf/hard of hearing.

Deaf/hard of hearing educational consultant services include working in collaboration with the school team to:

§ Develop specialized educational programs § Model appropriate teaching techniques § Provide suggestions regarding communication facilitation § Support teachers and parents regarding deaf/hard of hearing issues and liaise

between the home, community and organizations, i.e., Manitoba School for the Deaf, The Society for Manitobans with Disabilities, etc.

Because of jurisdictional issues, First Nations schools cannot access all these services but Manitoba Education will make one consultative visit per First Nation if requested. First Nations schools can also access resources, e.g., Braille books, audio books, etc. from Manitoba Education’s extensive library through MFNERC once the appropriate forms have been submitted.

These forms are listed at the end of this section and also in Section O.

Hearing Screening Survey: General Information Purpose

The purpose of the hearing screening survey will be to identify those children who may have educational difficulties due to impaired hearing. Early identification will ensure that such children will receive appropriate habilitative, educational and/or medical follow-‐up.

Identification Audiometry

Identification audiometry in school age population is best described in two stages. The first has traditionally been called “screening audiometry.” It involves testing, in an abbreviated way, of large numbers of children resulting in the ready identification of those who have no hearing problems and the tentative identification of those who may have hearing problems. The second stage involves more detailed testing by an audiologist using more elaborate equipment. Its purpose is to lead to the cause and degree of the hearing problem so that remediation can be implemented. Thus, the program may be broken down into the following stages:

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1. screening

2. audiological assessment

Screening Test

An individual manually administered pure-‐tone air conduction screening procedure will be utilized. This entails the presentation of two pre-‐specified frequencies (pitches) at specific intensity (loudness) levels to each ear. The hearing screening procedure should take approximately two minutes per child.

Population § Children in kindergarten and Grade 1 § Children with known hearing impairments § Children referred because of parental or teacher § Suspicions of hearing impairment § Children who are new to the school division

Environment

A quiet environment is necessary to prevent failures due to excessive noise levels. The testing room should be located as far away as possible from internal (heating systems and mechanical equipment) and external (student traffic in hallways, music room, school shop, typing room) noise sources.

Screening Progression 1. Initial Screening of all the children in the population to be tested.

2. Rescreening of those children who did not pass the initial screening according to the pass/fail criteria established. During the initial screening, many will have misunderstood the instructions, others will be poor responders, or afraid of the testing situation, etc. This second screening should take place within one week of the initial test.

Pure-‐Tone Screening Procedures

A. Pre-‐Test Considerations: 1. The appropriate forms (Individual Hearing Screening Record and the Master

Rearing Screening Record) should be distributed and filled in prior to the screen by school personnel.

2. An aide should be assigned to assist the hearing screener gather children from the classroom and escort them on their return. The aide may be a student from a higher grade level.

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3. The school should be surveyed and a relatively quiet room selected for the screen. If possible, student “traffic” should be re-‐routed away front the test area to insure that noise conditions do not distract and invalidate test proceedings. If more than one audiometer is to be used per room, be sure to use a large room and attempt to isolate each test area.

B. General Test Considerations 1. Before testing the children, each class should be instructed as a whole in the

classroom. The children should be told that they are going to play a “listening game” or have a “listening check.” Avoid using the word “test” to prevent unnecessary anxiety about the proceedings. Instruct the children that when they hear a sound they are to raise their hand and when the sound goes away they are to put their hand down. You may wish to rehearse this procedure in the classroom.

2. Approximately 6 to 10 children should be taken to the test room for the screen. Two children should enter the test room, one to be tested and one to observe, and the rest should remain in the hail. When one child has been tested, the second child should move to the “test” chair and the first should leave the room. Another child should enter to observe the proceedings. The aide should insure a constant flow of children to the screener to expedite the testing.

3. The test room should contain a table for each audiometer and at least three chairs. The “test” chair should be situated so that the child is not able to see the screener’s hands manipulate the controls on the audiometer, but yet it should be at such an angle so that the screener can observe the child’s face.

4. Eyeglasses, earrings, etc. should be removed prior to placing the earphones on the child’s ears.

C. Specific Test Procedures 1. The audiometer should be plugged in and allowed to warm up for at least 2 to 3

minutes. The screener should screen his/her own hearing before testing any children to insure that the audiometer is functioning properly.

2. Remind the child that he is to raise his hand when he hears the sound and to lower it when the sound goes away.

3. Place the earphones over the child’s ears, red on right and blue on left. Be sure the “phones are centred properly” over the ears before beginning the test. The cord(s) should be at the child’s back so as not to interfere with the raising of his hand.

4. The dials of the audiometer should be set as follows to begin the test:

§ Frequency: 2000 Hz

§ Intensity (Attenuator): 45 dB

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§ Output Control: Right

5. Present a 2000 Hz tone of approximately one second in duration to the right ear at 45 dB. This is a practice tone only and NOT part of the test. The child should raise his hand.

§ With the FREQUENCY dial still at 2000 Hz change the INTENSITY dial to 20 dB and present a tone.

§ Change the FREQUENCY dial to 4000 Hz and present a tone of 20 dB.

§ Change the OUTPUT CONTROL to “Left” and present a tone of 4000 Hz and 20 dB.

§ Change the FREQUENCY dial to 2000 Hz and present a tone of 20 dB.

6. If the child missed one tone at any frequency in either ear, that child should be tested later that same day or within one week. If the child still misses one tone at any frequency in either ear on the rescreen, he/she should be referred to the regional audiologist for further testing. The coordinator should be given the Individual Hearing Screening forms of the children who failed, along with the completed Master Screening Record so that these may be passed along to the audiologist for further follow-‐up. Only those children that fail the second screen should have an Individual Hearing Screen Record filled out.

Common Errors Committed in Screening Audiometry

The following is a checklist of pitfalls to be avoided in performing screening audiometry: 1. Failing to check the operational status of the audiometer before initiating the day’s

testing is a serious oversight. The testers should administer a rapid sweep-‐check on themselves, in order to ascertain the correct operation of the audiometer. This also allows the tester to determine subjectively whether the ambient noise level is sufficiently reduced to permit satisfactory screening.

2. Rushing through the screening so rapidly those accurate responses may not be obtained. The tester should understand that some subjects take longer than others to respond. Sufficient time (within reason) must be given to each child to respond to the stimulus. Faster and more definitive responses can be obtained if the directions are concise and explicit prior to testing.

3. Allowing the subjects to sit so that they can watch the control panel of the audiometer or the motions of the operator may result in inaccurate responses.

4. Placing the wrong receiver on the ear and recording the results for the wrong ear is another common error that should be avoided. Repeated checks should be made .to see that the earphones are placed correctly, and that they correspond with the switch on the control panel.

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5. Presenting the signal and then looking up at the subjects as if to ask if they have heard the tone should be avoided. This is poor audiometric technique and. the subject (particularly children) may respond even though the tone was not heard.

6. Presenting the sound signal for a long period of time. The tone should be presented for approximately one second.

7. Avoid rhythmic presentation of the stimulus tones.

8. If, during the screening of many subjects, a significant number of subjects appear to fail consecutively because of similar patterns of loss, i.e., they all fail at the same frequency or frequencies in the same ear, it is wise for the testers to recheck the earphones on themselves to ascertain, whether anything has gone wrong during the testing procedures.

9. If an uncooperative or difficult child is encountered during the screening, it is wiser to recall the child at a time when he can receive more individual attention, rather than delay the entire testing procedure.

10. When the tester is depressing the interrupter switch, he/she must be careful not to press down on this switch too hard, or let it spring back so quickly that it makes a clicking sound, which may result in a subject’s responding to the click rather than to the pure tone presented.

11. Neither the examiner nor the subject should do any unnecessary talking during the test procedure, as this may disturb the subject’s concentration. If instructions are given properly, before the test, only rarely should a discussion be necessary during the test procedure.

See Section O for a copy of the hearing screening record sheet.

Information for Ordering Hearing Screening Equipment 1. Welch Allyn AudioScope 3 Screening Audiometer/Otoscope $850.00

Product # 92680 Complete Set Includes: § AudioScope 3

§ Set of Audio Specs

§ Charging transformer

§ Charging stand

§ Transformer

OR

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2. AM232 Manual Audiometer $1305.00

Product #23200 § Instrument with headphones

Both Avail @ Northland Healthcare Products Ltd. 865 Bradford St. Winnipeg, MB Phone: 1-‐204-‐786-‐3345 (Tracey) Fax: 1-‐204-‐783-‐7496 www.nhcp.com

To order: Phone and they will order it in because they don’t carry any stock (takes about two weeks).

Planning for Children with Visual Impairment / Blindness Visually impaired students are now included in community schools and it is important to understand the role of vision in the learning process. About 80% of information we receive is received through visual channels. For those students who cannot see we must be prepared to present information and experiences in other formats or in supported activities in the classroom.

If a child comes to the classroom with a diagnosis of visual impairment, other techniques can be employed to provide information and experiences. It will be necessary to provide information through other sensory inputs such as large print or Braille, and/or auditory inputs. Tactile opportunities will help the child learn experientially. Special seating and lighting may be advantageous for children with low vision. Depending on the degree of visual loss the student may require mobility and orientation (M and O) training. Ideally this skill will be directed by an “M” and “O” trainer or in some other situation an occupational therapist will provide the training program, but the day-‐to-‐day program may be carried out by classroom staff. The place of technology for children with visual impairments cannot be underestimated. The era of talking computers and voice activate equipment can greatly enhance the potential of the child.

If a child has other disabilities as well as vision loss, other professionals such an occupational therapist, speech and language pathologist, and or a behaviour specialist may become involved. The composition of the team will depend on the specific impairments of the child.

The child you think may have a visual problem There are many reasons why children are having difficulty in a classroom. Visual impairment especially an undiagnosed impairment is the one which may be demonstrated by many symptoms or behaviours including but not limited to:

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§ Tendency to rub eyes § Squinting, linking, twitching of eyes § Extreme sensitivity to light § Unusual eye movements § Tendency to close one eye when looking at materials § Complaint of pain or discomfort in eyes § Poor eye-‐hand coordination

Consideration when planning for children with visual deficit—the IEP § Visual loss is more than the ability to see. It is related to all areas of function § Visual skill training must cross all subject and activity boundaries § Social skill development must be an integral part of all activities § Goals must translate to all life situations § Independence or the highest possible level of independence must be an ultimate

goal of all programs § Environmental accommodation must be made for students § Evaluation may be accomplished using alternative formats.

Visual Difficulties that are not considered visual impairments § Those children with visual processing difficulties may require additional

assistance from other professionals to program for these needs. § Children with visual perception, spatial relations, visual motor and/or visual

memory difficulties should be referred to other professionals for assessment and program development.

Vision Screening in Manitoba Schools Directions for Kindergarten, Grades 1, 3, 5, 7, 9, 11 Manitoba Education Student Services Branch Room 204 1181 Portage Avenue Winnipeg, Manitoba R3G OT3 Phone: 204-‐945-‐7916 Fax: 204-‐948-‐3229 Refurbishing, Forms & Parts Phone: 204-‐945-‐7835 Toll free: 1-‐800-‐282-‐8069 ext. 7835 Revised 2013

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Important to Read and Follow these Suggestions: § Parents should be notified in advance that the screening is scheduled. Vision

Screening is not compulsory for any student. § This is a vision screening not an eye test or vision test. It is designed to assist in

the detection of possible unidentified vision difficulties. Eye tests are only done by optometrists or ophthalmologists. Because it is a screening only, it is designed not to miss any students therefore you can expect a 15%–20% rate of over-‐referral.

§ Note: There is no cost for children under 19 years for an eye examination by an optometrist in Manitoba.

§ This is not a pass/fail situation as in other types of tests. Students are given positive feedback for cooperation and are not informed as to whether they have been “passed” or “referred.”

§ Screening is not designed for students who wear glasses. If, however, a decision is made to test such a student, the test should be done with the student wearing his/her glasses.

§ In addition to testing the grades outlined in the directions many schools also screen students who are new to the school and also students whose parents or teacher request it.

§ Vision is not static and can change quite dramatically without the individual necessarily being aware of it. Older students can be particularly at risk because of hormonal changes and “growth spurts”; therefore, it is important that older students receive regular eye examinations.

§ All equipment (particularly lenses) should be cleaned immaculately and constantly. Equipment should be thoroughly tested and assembled before student screening commences.

§ Testing environment should be free of glare from windows, overhead lights, and shiny reflective surfaces.

§ Testing environment should be quiet and free from distractions. The equipment should be set up so that children waiting their turn cannot observe the tests and memorize the charts.

§ Assess the suitability of the screening environment by sitting and viewing the test items at precisely the same distance and viewing height as outlined in this guide.

§ Always confirm that the student you are screening is the same student that you have listed on the sheet!

§ If your team is new to vision screening: o Practice the tests on each other—it is important to personally experience what

you will be asking the student to do.

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o Practice with a group of students and screen them (e.g., Grade 2). There is no need to record their results but it will help the screeners to remedy any short comings in their techniques and procedures.

§ Begin your testing with the older grades if possible. The younger students are the most challenging to work with.

§ A student that cannot readily demonstrate mastery of the teaching component level should not proceed to be tested (Testing Component) in that particular item. He/she should be referred for a second screening. If that is unsuccessful the student is neither recorded as a pass nor a refer. Suggest a call to parents to explain the situation.

§ In preparation for the tests, K and 1 students should be pre-‐taught in their classroom to o Point their arms the same way as the “E” points o Say “hit” when a large pointer held parallel to an arrow drawn on the

blackboard touches or crosses it. Students should be taught to say “hit” precisely when the pointer is over the arrow.

Note: This pre-‐teaching is worthwhile for the younger children to understand the screening procedure and expectations.

§ Do your best to ensure that students take their time and really take a look. Some feel it must be done quickly.

§ All students in the designated grades receive the first screening. Only those students who cannot meet the test criteria from the first screening are referred for the second screening. Then they are only rescreened on the particular test that they “failed” the first time. They do not redo all the tests a second time.

§ Other items to have readily at hand, in addition to the screening equipment, include:

masking tape measure 3-‐prong extension cords

sturdy tape lens cleaners marking pens.

Viewing distances are always measured from the student’s eye ball to the surface of the object being viewed (e.g., Eye chart or Random Dot E Cards.)

The Random Dot E Test—for Kindergarten and Grade 1 Only § Not used for any other grades § Tests for depth perception § Testing distance is 50 cm. (20 inches) for the teaching component and one metre

(39 inches) for the testing component

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Teaching Component 1. Have the student put on the M A G I C G L A S S E S (small black plastic glasses

with 30 lenses).

2. Show the student the “Model E” Card at very close visual range and have the student trace the “E” with his/her finger.

3. At 50 centimetres (20 inches) distance from the student’s eyes, present together several times the “Model E” Card along with the “Stereo Blank” Card. It is important to hold both cards in exactly the same manner and at the student’s eye level, approximately 10 -‐ 15 cm. (4"–6") apart—no further. The student: “Show me which card has the E.” (Student points to the “Model E” Card). Student must be able to demonstrate that they can correctly choose the “E” card consistently over several attempts.

4. Put the “Model E” Card away. Present the “Raised E” Card at very close visual range. When the student finds it (sometimes it seems to be “hiding”) have the student trace the “Raised E” with his/her finger. (Remember to use the card with the words “Raised E” printed at the top of the card on the reverse side. The words “Recessed E” should be at the bottom of the card and appear upside down).

Testing Component 1. Move the cards (“Stereo Blank” and “Raised E”) further away from the student’s

eyes to a distance of one metre (39"). Present the “Raised E” Card and the “Stereo Blank” Card simultaneously using exactly the same method as in the teaching component above. Ask the student to: “Show me which card has the E.” (Student points to the “Raised E” Card for a correct response).

2. Present the cards a total of four times in succession and in random order.

Pass or Refer Criteria Pass -‐identifies the “Raised E” Card four out of four times (no errors) Refer -‐unable to identify the “Raised E” Card four out of four times (one or more errors is a “refer”)

The Insta-‐Line Tests Note: As of January 2013 there are three generations of the insta-‐line. All are current, but there are differences in the control/remote and the electronics.

The first generation—the tester suppresses switches on the control panel. If using the newer remote versions, buttons are activated. The third generation of insta-‐line requires charging for 24 hours or overnight. There is still the option to plug in if needed. The first

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generation (brown veneer box) must be plugged in. The second generation (beige metal container) must be plugged in but not the remote.

§ Use only the “E” chart, not the alphabet letters for these grades § Two different tests are done with this instrument § Distance from chart to eye = 10 feet (3 metres) § The “Vision ON” switch at the top of the control-‐panel box must be activated

before any of the other buttons will work (old insta-‐line units)

1. Kindergarten and Grade 1 Teaching Component—covers both tests #1 and #2 that follow

1. Tester to sit facing the student, not the eye chart. (The control panel/remote is “in synch” with the eye chart). The student faces the eye chart.

2. Determine correctness of student responses according to the buttons depressed on the control panel/remotex. (Avoid reading the E chart to determine whether the student is correct as this technique will cause errors.)

3. Introduce the student to the chart by using the top row of marked buttons on the control-‐panel box (highlighting the largest letters on the eye chart) and direct the student to: “Show me which way the E points.”

4. This several times, with the “E” facing different directions, until you are satisfied the student clearly can demonstrate their ability to point his/her arms in the exact same direction that you called for on the control panel/remote.

2. TEST #1 MYOPIA § -‐A test to check the ability to see at a distance § -‐Sometimes referred to as “short sighted” § -‐Only one eye at a time is permitted to view the chart

Testing Component 1. Have the student cover one eye with an occluder (eye patch) and highlight the four

different positions of the letter “E” bottom set of marked buttons. At each different position the student should be asked to point in the same direction as the “E” points.

2. After a brief rest period to allow the covered eye to clear itself, cover the other eye with an occluder and present the four positions of the letter “E” in a different sequence, using again the bottom set of marked buttons. Ask the student in each case to show you which way the “E” is pointing.

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3. PASS OR REFER CRITERIA Pass -‐ can identify three out of four positions with one eye

(note: both eyes must be screened).

Refer -‐ 2 or more errors in one eye TEST #2 HYPEROPIA

A test to check the ability to focus both eyes together at near distance

+2.25 lenses (the children’s glasses)

Testing Component 1. Have the student put on the +2.25 lenses (glasses).

2. Highlight the testing line (bottom marked buttons). Ask the student to show you which way the “E” points in each of the four different positions.

3. If the student has been unable to see with the glasses on have the student remove the glasses; then quickly show them the largest “E’s” on the eye chart several times (top marked buttons of the control panel/remote) to reduce student anxiety. Provide reassurance to the student that he/she has done a great job. Never explain to the student that “he/she was not supposed to be able to see with these thick glasses on.”

PASS OR REFER CRITERIA

Note: In this test the student is referred if they are able to see with the special glasses on. This is a reversal of the way in which the results are interpreted for all of the other tests.

Pass: cannot identify three out of four positions of the “E” with the +2.25 glasses on

Refer: can identify at least two out of four positions of the “E” with the +2.25 glasses on

THE INSTA-‐LINE TESTS—Grade 3 and Up § Use the alphabet chart for most students. The “E” chart should only be used with

students who are EAL or developmentally delayed § Two different tests are done with this instrument § Testing distance from eye to chart = 10 feet (3 metres) § No teaching component necessary for most students § The “vision on” switch at the top of the control panel/remote must be activated

before any of the switches will work (old insta-‐line only).

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Test #1 Hyperopia § Test to check the ability to focus both eyes together at near distance +2.25 lenses

(hand-‐held glasses) § Conducted before the myopia test to reduce the opportunities for the student to

memorize the chart

Testing Component 1. Tester to sit facing the student not the eye chart. Have the student hold the +2.25

hand-‐held glasses to his/her eyes and face the eye chart.

2. Highlight the testing line (the bottom marked buttons of the older lnsta-‐lines) using four different positions using random order selection. Ask the student to read the letters at each highlighted position. Identifying any of the letters is considered a mistake.

3. Have the student remove the hand-‐held glasses. Ask the student to read the top row of letters (highlighted) on the chart (top marked buttons/on the control panel/remote). This technique reduces anxiety for students who have been unable to read the letters with the glasses on. They should never be told that “they were not supposed to be able to see with those glasses on.”


Note: In this test the student is referred if they are able to see with the special glasses on. This is a reversal of the way in which the results are interpreted for the other test.

Pass -‐ Cannot identify 3 out of 4trials with +2.25 glasses on

Refer -‐ Can identify at least two out of four trials with +2.25 glasses on

Myopia § A test to check the ability to see at a distance § Sometimes referred to as “short sighted” § Only one eye at a time is permitted to view the chart

Testing Component

Have the student cover one eye with the occluder (eye patch). Highlight the testing lines. The bottom marked buttons on the panel/remote using four different positions. After a brief rest period to allow the covered eye to clear itself, cover the other eye. Repeat the process.


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Pass -‐ can identify 3 out of 4trials with one eye (note: both eyes must be screened) (a total of one error per eye is permitted).

Refer -‐ more than one error per eye.

THE BIOPTER TESTS—Using the 3 Circle Target Cards § All grades § Tests the ability of the two eyes together to focus simultaneously § Three different tests are done with this instrument

Note: There are three generations of the biopter. All are still current. § The first generation is metal with a black screw-‐in handle for adjustment. There is

no longer a need to plug in the unit. § The second generation is plastic and uses a spring clip. § The third generation is also plastic but has a screw to adjust height.

Preparation There is no longer any requirement to turn on the biopter lights. In fact, they can cause dangerous over-‐heating of the metal shields. The new models of the biopter do not come equipped with lights. A good, glare free source of regular lighting is sufficient.

The black plastic card holder is placed on the shaft by squeezing together the spring clip (or by using the screw to adjust the card holder). The card holder will be moved to near and far marked positions as indicated by the test.

The Circle Target Card Booklet is then inserted into the slot on the card holder (or between the ridges on the newer models). It is very important that every page in the booklet—including the one that is currently being viewed—is inserted into the slot on the card holder each time a page is turned. This will prevent the page, being viewed, from protruding forward and thus not be straight or at a precise distance from the student’s eyes.

Have the student stabilize his/her position at the biopter by placing both hands over the base of the instrument with the forearms and elbows on the table. Many testers choose to secure the biopter base to the table with masking tape.

Have the student lean forward and look through the biopter lenses without pressing his/her eyes against the lens piece or without being too far back.

The forehead should contact the “rest” comfortably.

It is the responsibility of the tester to raise or lower the angle (height) of the metal biopter (to suit the student and to ensure that the student’s eyes are at a correct distance from the

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lens at all times. The plastic biopter can be adjusted by pulling (stretching apart). The metal biopter uses the black handle and screw to adjust.

Student should be instructed to focus on the arrow on the card and not attempt to visually follow the moving pointer stick.

Should the masking tape/plastic tabs at either end of the shaft become damaged or inadvertently removed it must be replaced in precisely the following manner:

§ At the bottom end of the shaft place a Yi inch section of masking tape wound around the shaft several times, between the letter “B” and the letter “C.” For the correct position the card itself will then rest on the card holder exactly on the “O” mark.

§ At the top end of the shaft place a Yi inch section of masking tape, wound around the shaft several times, centred over the number 12. For the correct position the card itself will then rest on the card holder exactly on the “1O” mark.

Vertical Phoria at Far (Card #3 -‐ is displayed on the cardholder)

Teaching Component (Work on the left arrow side of the card) 1. The card holder is DOWN the shaft as far as possible to the marked position (the

card itself will then be at the zero mark on the shaft). This means that the card is at a maximum distance away (at far) from the viewing lens.

2. Introduce the pointer and ask the child to:

“Say ‘hit’ when the pointer touches or crosses the arrow.” It is important to keep the pointer parallel to the arrow.

3. With your pointer in a horizontal position parallel to the arrow, move the pointer slowly and smoothly down the card past the arrow without stopping on it. Repeat, moving the pointer up and down the card until the student consistently says ‘hit’ when the pointer touches or crosses the arrow. It is a good idea to suggest that the student concentrate on looking at the arrow instead of trying to visually follow the moving pointer stick.

Testing Component (Work on right /circle side of the card) 1. In the same manner as used in the teaching component move the pointer slowly

and smoothly from above the circle to below the circle and back again, asking the student to say ‘hit’ when the pointer touches or crosses the arrow. Always keep your pointer parallel to the arrow.

2. Repeat from below the circle and again from the top of the circle several times.


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Pass -‐ Student says ‘hit’ either on the circumference or anywhere inside the circle in a consistent manner. (May make the occasional incorrect response but in most cases is correct.)

Refer -‐ Student says ‘hit’ outside the circumference of the circle and is incorrect in his/her responses most of the time.

Lateral Phoria at Far (Card #4 is displayed on the card holder) Teaching Component (Work on the left/arrow side of the card)

1. The card holder is DOWN the shaft as far as possible to the marked position.

2. With your pointer in a vertical position parallel to the arrow, move the pointer slowly and smoothly across the card past the arrow without stopping on it. Repeat, moving the pointer from side to side across the card until the student consistently says ‘hit’ when the pointer touches or crosses the arrow. It is a good idea to suggest that the student concentrate on looking at the arrow instead of trying to visually follow the moving pointer stick.

Testing Component (Work on the right/circle side of the card) 1. Move the pointer slowly from the left side of the circle to beyond the right side of

the circle and back again. Ask the student to say ‘hit’ when the pointer touches or crosses the arrow. Always keep your pointer parallel to the arrow.

2. Repeat several times.

PASS OR REFER

Pass Student says “hit” either on the circumference or anywhere inside the circle in a consistent manner. (May make the occasional incorrect response but in most cases is correct.)

Refer Student says “hit” outside the circumference of the circle and is incorrect in his/her responses most of the time.

Lateral Phoria at Near (Card #5)

Teaching (Work on the left/arrow side of the card) 1. Move the card holder into the NEAR position (the card is at the ten mark on the

shaft or as high as it can go to the upper marked position). It is crucial that the card be moved up the shaft from its previous “far” position at the bottom of the shaft.

2. With your pointer in a vertical position parallel to the arrow, move the pointer slowly and smoothly across the card past the arrow without stopping on it. Repeat, moving the pointer from side to side across the card until the student consistently says ‘hit’ when the pointer touches or crosses the arrow. It is a good

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idea to suggest that the student concentrate on looking at the arrow instead of trying to visually follow the moving pointer stick.

Testing Component (Work on right/circle side of the card) 1. Move the pointer slowly from before the left side to beyond the right side of the

circle and back again. Ask the student to say “hit” when the pointer touches or crosses the arrow. Always keep your pointer parallel to the arrow.

2. Repeat several times.

3. Return the card holder at this time to the “down” or “at Far” position to ensure that it will be in the proper position for the next student.

PASS OR REFER

Pass Student says ‘hit’ either on the circumference of anywhere inside the circle in a consistent manner. (May make the occasional incorrect response but in most cases is correct).

Refer

Student says ‘hit’ outside the circumference of the circle and is incorrect in his/her responses most of the time.

PROCEDURES FOR SECOND SCREENING—ALL GRADES 1. Second screening should definitely not be done the same day. Try to conduct the

second screening after an interval of two or three days.

2. Conduct the second screening for only those students who had referrals (failures) on the first screening.

3. Conduct a second screening on only the particular test (s) in which the student was referred.

4. Repeat the same test as you did for the first screening. Use the same pass/refer criteria.

5. A special exception is made for the Hyperopia (+2.25 lenses) -‐ lnsta-‐line test if both the first and the second screenings are “referrals.” In the event of such an occurrence you should add the following steps:

§ With the student still wearing the +2.25 lenses hold the white (5"x5") cardboard with the black “E” in the centre, directly in front of the lnsta-‐line Screen. This will ensure that the students eyes are at an exact distance of 10 feet (3 metres) from the card.

§ Show the “E” on this card in four different positions and ask the student to: “Show me which way the E points.” (Do not allow the student to observe how you change the positions of the E-‐card).

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§ PASS/REFER criteria is the same as it was for the first screening.

PACKING EQUIPMENT

When repacking equipment please follow the directions below. This will ensure the equipment can be used efficiently at future vision screenings. Newer versions of the Biopter are called “Bernell-‐o-‐scopes.”

1. Repack equipment in the container appropriate to the test, e.g., Biopter cards etc. in the biopter bag and the occluder (patch) etc., in the lnstal-‐line Box.

2. The Random Dot E Cards and the Magic Glasses should be placed in a Ziploc Bag and packed in the biopter case.

3. The lens mount on the metal biopter need not (should not) be undone for packing -‐ simply unscrew the black handle on the underside of the biopter track and remove the cards and card holder from the top side of the track. The unit will then fit in the biopter bag with no difficulty. Plastic biopters adjust/fold down easily to fit the bag.

4. Spare bulbs are supplied for emergency use. Discard any defective bulbs.

Note: With the third generation lnsta-‐line no bulbs are used.

Insta-‐line box Includes Biopter (Bernell-‐O-‐Scope) Case Includes 1 2 eye charts (one “E” and one with Alphabet

letters). 1 1 Random Dot E kit (RDE cards and magic

glasses) in a Ziploc bag. (Random Dot E Cards -‐ to include: 1 Stereo Blank, 1 Model E and 1 Raised E.)

2 Control-‐panel box and cords attached. 2 Several wooden pointer sticks.

3 Hand-‐held glasses (+2.25 lenses). 3 Biopter viewing lenses still mounted on the biopter shaft.

4 Children’s glasses (+2.25 lenses). 4 Black plastic cardholder.

5 Occluder (eye patch). 5 Black handle (older unit).

6 Bulb changer with spare bulbs (discard defective bulbs).

6

7 Small white card (approx. 5” x 5”) with one black “E” in the centre.

7

8 Large handmade cardboard, construction paper or wooden “E’s” may sometimes be included and are used in Grades K and 1 for the pre-‐teaching.

8

Information for Ordering Vision Screening Equipment 1. Biopter/Bernell-‐O-‐Scope Bernell Variable Prismatic Trainer $200.00 + taxes + shipping

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Item # BC-‐200 Avail @ Topcon Canada Inc. Unit 111, 5621-‐11th St. NE Calgary, AB, T2E 6Z7 Phone: 1-‐800-‐661-‐8349 Fax: 1-‐800-‐882-‐9597 www.topcon.com Phone and they will order it in. It takes approximately two weeks. 2. Complete LED Insta-‐Line Quantum $1,425.00 Catalogue # 915000 3. Random Dot E Stereoacuity Test $140.00 Catalogue # 1015VAC Both Avail @ Good-‐Lite Company 1155 Jansen Farm Dr. Elgin, Ill 60123 Phone: 1-‐800-‐362-‐3860 Fax: 1-‐888-‐362-‐2576 www.good-‐lite.com

Planning for Children Who Have Scotopic Sensitivity

Irlen Syndrome / Scotopic Sensitivity Syndrome is a perceptual disorder which is neurologically based. Irlen Syndrome prevents an estimated 10-‐12% of the population from being able to learn, read, or study efficiently. Irlen Syndrome has a genetic component and affects both males and females equally.

Scotopic Sensitivity Syndrome was first identified by Educational Psychologist Helen Irlen while she was working as Director of the Adult Learning Disability Program as CSULB in the early 1980s. She developed a patented treatment method for Irlen Syndrome, which uses coloured filters either worn as glasses or plastic sheets to reduce or eliminate the perceptual difficulties affecting reading.

Individuals who have Irlen Syndrome often experience distortions when viewing black print on white paper. There are a variety of distortions. Not everyone experiences the same or all of the distortions.

The first step in determining if a student has Irlen Syndrome is to complete the self screen. Then, based on those results, a specially trained Irlen Syndrome screener will conduct a formal screening and assess the need for further referral to a certified Irlen Syndrome diagnostician.

MFNERC’s Special Education Program has three trained Irlen Syndrome screeners who can be contacted for assistance.

For further information on Irlen Syndrome see Section R. For the Self-‐Test for Irlen Syndrome see Section O.

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Planning for Children with Social and Emotional Needs To meet the needs of students who are at risk socially and/or emotionally, resource teachers will initiate referrals for the services of a psychologist. These referrals are based on concerns and collected information from various sources, i.e., classroom teacher, parent(s). Some of the concerns may include:

§ Learning Difficulty § Developmental Problems § Attention Deficits § Depression § Suicide Risk § Stress and Anxiety § Interpersonal Difficulty § Violence and Aggression § Low Self-‐Esteem § Substance Abuse § Trauma § Effects of Abuse

Services of a Psychologist

Psychologists provide a comprehensive range of services to schools including assessment, diagnosis, intervention, consultation and prevention. Psychologists have strong clinical skills and a broad knowledge base in child and adolescent development, cognitive processes, psychopathology, school and community systems, learning, and behaviour disorders.

The roles and services of psychologists in school communities have expanded over the last half-‐century to include:

§ Direct and indirect student-‐focused interventions § School-‐wide interventions § Division/system interventions

Psychologists provide services that promote the development of a positive school environment that benefits all students by:

§ Developing and implementing prevention and early intervention programs such as crisis response and violence prevention

§ Collaborating with administrators and teachers to support the inclusion of students with special needs

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§ Developing and implementing parenting programs § Consultation and in-‐servicing with teachers concerning child and adolescent

development, behaviour management, and learning styles

Psychologists can assess: § Development § Intellectual Functioning § Learning Style § Emotional Functioning § Neuropsychological Functioning § Behaviour § Personality § Social Functioning

Psychologists can develop and implement programs for: § Suicide Prevention § Bullying § Crisis Response § Risk and § Threat Assessment

Psychologists can conduct treatment consultation and training for: § Anger Management § Behaviour Management § Cognitive Therapy § Conflict Management § Individual, Family and Group Therapy § Psychotherapy § Stress Management

Reference Manitoba Association of School Psychologists (MASP), 162-‐2025 Corydon Avenue, Suite 562, Winnipeg, Manitoba Phone: 1 -‐ 204 -‐ 488-‐4563 Fax: 1 -‐ 204 -‐ 488-‐0132 Website: www.masp.mb.ca May 2007

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Psychologists Available for contract work These professionals have submitted their names as they are willing and available to do contract for schools.

Name Phone Number Email Address Areas Available Marilyn Barr (204) 664-‐5365

(204) 739 8330 [email protected] Winnipeg, Rural, Northern

Carla Betker (204) 284-‐9761 [email protected] Winnipeg, Rural and Northern

April Buchanan, Ph.D., C. Psych.

(204) 452-‐ 4053 [email protected] Winnipeg Rural

Colleen Doerksen (204) 822-‐1945 [email protected] Rural Areas (South Central)

Carol Gieni, B.A., M.Ed (204) 296-‐9102 [email protected] 100 km radius around Winnipeg

Dr. Marlene Krenn, Ph.D. (204) 269-‐6359 [email protected] Rural and Northern

Dr. John McCaig, Ph.D. (204) 334-‐5813 [email protected] Winnipeg, Rural, Northern

Dr. Robert Paulet (204) 771-‐6388 (204) 855-‐2661

[email protected] Winnipeg and Rural

Sirppa Sterling (807) 276-‐7256 [email protected] Rural, Northern

Dr. Graham Watson (204) 291-‐7600 [email protected] Winnipeg, North of Winnipeg, willing to consider further travel

Planning for Children with Reading Difficulties To meet the needs of students who are still having difficulties with reading after various programs and strategies have not been successful, resource teachers will initiate referrals for the services of a reading clinician. These referrals are based on concerns and collected information from various sources including observations, informal and formal assessments collected over time.

Indirect Service

1. Consultation Support Services Before a student is referred for a formal assessment, a school team can request for consultation from the reading clinician. School teams collect information and ask the clinician to consult with them regarding individual students. The reading clinician helps the school in determining if sufficient assessment information has been collected. The following are potential outcomes of the consultation:

§ The reading clinician helps school teams sort out what data they have and what data they need. With sufficient data, the team can plan for the student without completing a formal referral to the reading clinician. The reading clinician’s role

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remains as consultative and no direct services are accessed by the reading clinician.

§ The team requires the indirect support from the reading clinician for the classroom and/or resource teacher (i.e., modelling a reading strategy, support to set up an intervention program, peer coaching). The reading clinician’s role remains as consultative and no direct services are accessed by the reading clinician.

§ The classroom teacher and/or resource teacher collects more assessment data (i.e., observations, reading inventory), while the reading clinician remains consultative.

2. Reading Programs The reading clinician can assist schools in setting up school-‐wide reading programs, programs for small groups of students, or programs for individual students.

3. Early Intervention Programs The reading clinician can help schools develop and implement early intervention programs for reading.

4. Professional Development The reading clinician can conduct workshops for entire schools or groups of participants on various topics pertaining to reading.

Direct Service

1. Student Assessments The reading clinician can conduct assessments which the classroom and resource teacher cannot obtain. A formal referral to the reading clinician needs to be completed, with parental consent obtained. The formal referral form states exactly what assessment(s) the reading clinician will complete, then the reading clinician conducts the assessments outlined on the referral form. Afterward, the reading clinician meets with the school team and parent(s) to discuss the interpretations and recommendations. The reading clinician completes a formal assessment report for the school team.

A list of certified Reading Clinicians in Manitoba who do private practice are on the following pages. This list is accurate for the 2012-‐13 school year. For further information or an updated list, please phone the Manitoba Council of Reading Clinicians at (204) 488-‐4634.

Last Name First Name City, Province

Ph: Home Work (Ext) Email

Adamson Pat Winnipeg, 204-‐261-‐7795 204-‐477-‐2400 [email protected]

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MB (442)

Barnabe Susan Winnipeg, MB

[email protected]

Bjornson Valdine Grand Pointe, MB

204-‐222-‐6950 204-‐885-‐1334 [email protected]

Buettner Ed Winnipeg, MB

204-‐275-‐5028 [email protected]

Carson Louise Winnipeg, MB

204-‐269-‐4553 204-‐475-‐2199 [email protected]

Cassidy Fay Gimli, MB 204-‐642-‐4186 204-‐642-‐6279 [email protected]

Caszic-‐Halem Desa Winnipeg, MB


Christianson Anne Winnipeg, MB

204-‐888-‐4086 204-‐786-‐7841(506)

[email protected]

Coleman Janet East St. Paul, MB

204-‐654-‐9714 204-‐669-‐5643 [email protected]

Decon Shelagh Anola, MB 204-‐755-‐2726 204-‐669-‐4482 [email protected]

Faber Regina Winnipeg, MB

204-‐663-‐4918 204-‐786-‐7841 (477)

[email protected]

Fischer Allison Winnipeg, MB

204-‐488-‐1395 204-‐786-‐7841 (443)

[email protected]

French Susan Winnipeg, MB

204-‐294-‐0244 204-‐895-‐7221 (4031)

[email protected]

Froehlich Eileen Winnipeg, MB

204-‐254-‐2554 204-‐786-‐7841 (415)

[email protected]

Holder Junette Winnipeg, MB

204-‐287-‐2362 204-‐394-‐2429 [email protected]

Gender Monique Winnipeg, MB

204-‐944-‐9571 204-‐7867841 (470)

[email protected]

Hryniuk-‐Adamov

Carol Winnipeg, MB

204-‐889-‐3500 204-‐786-‐7841 (451)

[email protected]

Jacson-‐Davis Khalie Winnipeg, MB


Johnston-‐Remple

Kim Winnipeg, MB

204-‐284-‐5240 204-‐663-‐9630 [email protected]

Jones Norma Winnipeg, MB

204-‐487-‐3177 204-‐786-‐7841 (490)

[email protected]

Joyce Janet Winnipeg, MB

204-‐774-‐2641 204-‐786-‐7841 (434)

[email protected]

Khan Heather Winnipeg, MB

204-‐783-‐9910 204-‐885-‐1334 (2257)

[email protected]

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Koloski Susan Winnipeg, MB

204-‐661-‐2000 204-‐453-‐5740 [email protected]

Kowall Jessica Winnipeg, MB

204-‐488-‐9102 204-‐786-‐7841 (473)

[email protected]

Krestanowich Jennifer Winnipeg, MB


Larson Esther Winnipeg, MB

204-‐488-‐84123


Lovegrove Richelle Erickson, MB


McDonald Tracie Winnipeg, MB

204-‐795-‐8428 204-‐785-‐8224 (334)

[email protected]

Montebruno Rosana Winnipeg, MB

204-‐261-‐3501 204-‐885-‐1334 (2262)

[email protected]

Nikkel Susan Winnipeg, MB


Norris Vikie Winnipeg, MB


Oberholtzer Lorna Winnipeg, MB

204-‐897-‐1263 204-‐786-‐7841 (487)

[email protected]

Palson Inga Arborg, MB 204-‐378-‐5583 [email protected]

Paterson Jodianna Winnipeg, MB

204-‐996-‐1851 204-‐786-‐7841 (498)

[email protected]

Peever Wendy Winnipeg, MB

204-‐895-‐7340 204-‐786-‐7841 (520)

[email protected]

Rossnagel Noreen Winnipeg, MB

204-‐254-‐1555 204-‐770-‐5555 [email protected]

Routledge Susan Winnipeg, MB

204-‐269-‐5793 204-‐786-‐7841 (432)

[email protected]

Semchyshyn Lori Winnipeg, MB


Sigurdson Craig Winnipeg, MB

204-‐334-‐9836 204-‐668-‐9442 [email protected]

Stebbins Dixie Winnipeg, MB

204-‐222-‐1823 204-‐222-‐9577 (2224)

[email protected]

Stevenson Joan Winnipeg, MB


Subtelny Carrie Winnipeg, MB

204-‐231-‐9381 204-‐788-‐0203 [email protected]

Thiessen Cindy Winnipeg, MB

204-‐475-‐4113 204-‐786-‐7841 (505)

[email protected]

Unrau Andrea Winnipeg, 204-‐995-‐8758 204-‐958-‐6840 [email protected]

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MB (2822)

Van De Vijsel Christine Winnipeg, MB


Waschuk Anne Winnipeg, MB


Wiebe Monica Winnipeg, MB

204-‐452-‐3834 204-‐786-‐7841 (489)

[email protected]

Winchell Joy Winnipeg, MB


Zakaluk Beverley Winnipeg, MB


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Section L: Extended Programs

section k: extended services - mfnerc.org · service or consultation to families, children,...

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