Monday, November 30

Holiday Gifts for the CI Child

As the Momma of a CI child, I am often asked about gift ideas for children with hearing loss. As we all know, much of our life with a CI child is spent playing games at home that also serve as the necessary therapy needed for communication. So, what are some of our most favorite gifts we have received for Drew that have also helped with therapy?
  1. 100 Hoops - Basketball Counting Game: Drew loves this game! It is perfect for a little boy, and allows for work on counting, and vocabulary like in, out, over, under, made it, missed it, dunk it, brick, etc. It counts in Spanish, two's, ten's, backward. This was Drew's favorite Christmas Gift of 2008, and nearly 365 days later, he plays with it daily.
  2. Giant Road Carpet and Melissa & Doug Wooden Vehicles & Traffic Signs: Drew loves to play with his transportation vehicles, and I love that he has no idea he is actually doing therapy! We work on things like, "Drew, you need to take the children to school! Which vehicle goes to school?" You can put up the stop signs and talk about stop vs. go. You can have the child make the vehicle go fast vs. slow. "Oh, Drew! The police car needs to go to the store - fast! Let's go!" So much fun...for everyone!
  3. Melissa & Doug Band in a Box: Perfect for these little CI kiddos! Work on the different sounds of musical instruments. You can work on making a beat. "Shake the maracas fast!"
  4. Plush "My Barnyard Friends Carrier" With Sound: When Drew was younger we loved this barnyard. They animals are soft and cuddly, and they each make noise! Plus the barn was nice because you could say, "Drew put the cow in the barn." This helped with working on in, out concepts. And, this plus barnyard works great for the small concept, you can get a larger animal sounds barn to talk about big vs. small, etc.
  5. Little People 'Busy Day Home": A perfect sized house to work on many daily activities! It can start of very basic. "Drew, Put Daddy in Bed." Then you can get really advanced, "Drew, Mommy is tired. Where should she go?" And then I would wait for Drew to find the Mommy and lay her in the bed. This shows that Drew understands what "tired" means and that he understands you need to go to sleep when you are tired and that you sleep in your bed. Really, really difficult concepts, yet somehow we all learn this stuff!
  6. Mr. Potato Head: Super fun to play with, reminding me of my childhood, yet excellent to help with learning body parts! At first, you can design Mr. Potato Head, and then ask your child, "Where is the nose?" Then you can have your child design Mr. Potato Head himself, talking about where each item goes. And, what we're doing now, you can play sabotage! One of my favorite things to do with Drew! I'll build Mr. Potato Head totally wrong...then Drew has to fix him. "No, Mommy, that isn't where the ear goes. The ear goes here! That's where the mouth goes!" Oh, how I love to play sabotage!
We actually have been given every toy I talked about above! And people say we have too many toys...ha! If you are reading this blog as a grandparent, aunt, uncle, friend...I can not tell you how much we appreciate these types of gifts. We work so hard with our kids daily on activities that seem so trivial, but in the grand scheme of things, these gifts help our children develop their listening, language and communication skills daily. The thoughtfulness of thinking about how a gift will help with the child's therapy is helpful beyond words.
So, what will Drew be getting for Christmas this year? We have so many of the "staples" when it comes to therapy, and in many ways, we are past the learning to listen phase of this journey. We're working on phonics, pre-reading, pre-math and fine motor skills. So, we've decided to get Drew a Leapster Learning Game System and Leapfrog Tag Reading System. He'll also be getting some of his favorite friends:

1) A Toy Story Talking Sheriff Woody
2) A Toy Story Talking Buzz Lightyear, and
3) ARex the Roaring Dinosaur from Toy Story!

He'll be so excited! Drew has worked so, so hard, so now we'll let him play.

What are some of your favorite therapy toys? Let's keep the list going!

These are some of Drew's favorites!

Saturday, November 28

Santa Claus is Coming to Town!

Now that I have kids, I just love the holidays! That's not to say that I didn't enjoy Christmas before having children, it's just that I enjoy it so much more now. Seeing the excitement in my children's eyes as we put ornaments on the Christmas tree or walk past Santa Claus in the mall is just wonderful! It makes me remember the magic that I felt during the holiday season, and reminds me to thank God for the precious gifts I have been given in my children.

Drew's Dad and I have done (what I think is) a wonderful job of meshing our two families' traditions together, while coming up with some new ones of our own. We want our children to enjoy many of the things that we did as children, and to learn to appreciate the value of family traditions.

Some of our favorite traditions are hiding the pickle in the Christmas tree, and the first child to find the pickle receives a special gift. We enjoy baking a birthday cake on Christmas Eve as a family to celebrate Jesus's birthday. We enjoy having a Christmas "sing-a-long" on Christmas Eve with the whole family! When I was a child, my sister and I used to perform for all of the grandparents. I can't wait until Drew and his sister put on a little Christmas Eve show for us! We enjoy driving around our area looking at all of the holiday lights, and we enjoy a trip to the Zoo each year for the Wildlights.

There are just so many little things to look forward to at this time of year, where we celebrate our saviours birth! What are your favorite holiday traditions?

Thursday, November 26


Happy Thanksgiving! Drew and his family hope you are having a wonderful day, surrounded by friends and family, reflecting on all you have to be thankful for. Throughout the month, many of my Facebook friends have been sharing daily things they are thankful for. Some of the things I am thankful for:

Sunshine ~ God's Love ~ Slobbery Kisses ~ "Backburgers" ~ Fall Leaves ~ Dancing ~ "I feel better!" ~ Family Movie Night ~ Our Home ~ Unconditional Love ~ Drew's School ~ "Oh, oh oh oh oooo" ~ Family Walks ~ Freedom ~ Our Dog and the kids' love for our dog ~ Mommy Mornings ~ My Mom & Dad ~ Our Health ~ Drew's Words ~ Donut Mornings ~ Music ~ An Afternoon at the Park ~ Technology ~ My Job ~ College Football ~ "Open, Shut Them" ~ Cooking with My Little Helpers ~ Friends ~ My Daughter's Love for Ballet ~ "Mom, I wanna tell you something...Good night!" ~ Carmen Ohio ~ An Evening at the Park ~ Shoes ~ Singing ~ Cochlear Implants

There is nothing I am more thankful for than these two:

Thank you, God, for giving them to me.

Tuesday, November 24


Drew and his sister are pictured with Drew's Cochlear Implant Surgeon, Dr. Richard Kang, in the latest edition "Spotlight". The article is highlighting the work being done by the Hearing Team Parent Advisory Board, of which I am a member.

Our cochlear implant program has been experiencing some growing pains, which our family has personally encountered, and as a result forced us to make some difficult decisions. While we have certainly had our frustrations, we are very happy that Dr. Kang, and his staff, recognize the need for continuous improvement, and that they have reached out to parents to understand our needs. I am hopeful that this group will be able to make some significant changes to better the program, not only for my son, but for the community at large.

Monday, November 23

Having Trouble Keeping CI's on Your Little Girl?

When Drew was first diagnosed with hearing loss, I spent all of my time researching cochlear implants, talking to professionals, at doctors appointments, with one goal in mind: getting Drew implanted at as early of an age as I could. What I didn't think about was the post-activation time. Sure, I knew he would need multiple mappings, and that the implants would be slowly activated to the hearing we have established for him today and that we would spend a lot of time in therapy. But I didn't consider how difficult just keeping his cochlear implants on his head would be!

To celebrate Drew's activation, we had lunch with family at Champp's. By the end of the lunch, I was so frustrated with keeping the coils and processors on Drew's ears. It was so challenging with a little baby that was constantly wiggling and moving around. I would get one ear back on, just to have Drew move and knock the other ear off. I left that lunch feeling so defeated! I had worked so hard to get Drew implanted so early, but it wasn't going to work if I couldn't keep the implants on his head!

So, as I drove home that day, feeling so sad and defeated, with Drew safely sitting in his car seat without any hearing, I remembered reading about how other family's on CI Circle had successfully used Hanna Andersson pilot caps to keep the equipment on their child's head. Problem solved! We used those caps for about a year, until Drew was fully walking and had much more control of his head, causing the implants to be knocked off less often.

I'm always interested in how other families keep the equipment on their child's ears, as it truly is a huge struggle. Lily's Mom showed how Lily is wearing her CI's these days. Check out these headbands! They are so cute, and so effective at keeping CI's on little ears. For anyone with a little girl, I think this would be great!

Saturday, November 21

Blog Friends

I'm thankful that November has brought so many of our Internet friends to our hometown!

Drew and Lily got to meet up a week ago, their first reunion since attending the Moog Summer Workshop together. They both have grown so much in 3 1/2 short months, both in size, but most recognizably in language! Lily is a talking machine!

And, Drew got to meet Aiden for the very first time! Aiden was so cute, as he kept pointing to Drew's ears. He was so excited that Drew has ears just like him. I think they are friends for life!

Friday, November 20

Preparing for the IEP Meeting: Booklet

As your IEP meeting approaches, you may want to create a booklet that highlights your child, and provides the IEP team with important documents that help the team decide on appropriate educational services.

Table of Contents:

1. Evaluation Team Report: Part B
  • This document will be provided at the Eligibility Meeting that establishes the child has educational need and an IEP must therefore be developed.
2. Future Planning Statement

3. Did You Know?

4. Deaf Students Education Services: Policy Guidance

5. Essential Issues and Aspects of the IEP

6. IEP Checklist

7. Preschool Observations

  • I wrote a summary for all area preschool options, including main-stream, cross-categorical and hearing impaired programs. Information included basic program offering (days, times, etc.), age span of children, number of peer language models, communication modes, personnel (teachers of the deaf, special education, general education, etc.), general observations (including lighting, treatment to reduce noise, spill over noise), on-site services (including speech, OT, PT, etc.), auditory training curriculum used and a summary (including daily schedule, snack time interaction, general learning environment, peer interaction, etc.)

Sample of the page dividers we used. We made them

in our school colors, just to show our school pride!

Wednesday, November 18

Preparing for the IEP Meeting: Future Planning Statement

As your IEP meeting approaches, you will want to prepare a "Future Planning Statement". This part of the IEP is for parents to express their goals, wants, needs and aspirations for their child. It can be very simple, with short-term goals. Or, it can be very detailed, with long-term, complex goals. Below is our "Future Planning Statement" from Drew's IEP:

We see the first five years of Drew’s life as a critical window where he needs intensive intervention to establish his communication and listening skills that he will need in all future educational and life experiences.

In the short term, we see Drew attending the [School for the Deaf and Hard of Hearing] in Columbus, Ohio. The program will offer Drew extensive, structured and specialized educational curriculums specifically designed for the hearing impaired child. The goal for these preschool years is to establish an appropriate foundation of communication, language, listening and literacy that will hopefully allow him to integrate into a mainstream Kindergarten class in [our school district] with minimal or no services and accommodations.

If Drew receives this appropriate education, we see Drew graduating from High School and attending college or post-secondary education, should he choose to do so. We see Drew as a positive, contributing member of society, who is able to support himself and his family both financially and emotionally, without letting his deafness define him.

Yeah, that about sums it up.

Tuesday, November 17

Drew Update

So, what has Drew been up to these days?

Drew loves playing outside! He has had so much fun helping rake leaves, playing in the leaves and mowing the lawn?!

He mowed for quite some time, making sure to stop and say "Hi!" and "Bye!" to Daddy each and every time. I just love the quality of his voice. And I just love how truly sweet this little boy is!

And here is video of the dinner ritual with Drew. I was truly spoiled by my first born, who will eat just about anything. She will try just about anything! But not my little Drew! He usually starts saying "I don't want that!" before dinner even hits the table. It's just lovely.

It certainly is annoying, but I love the fact that he is able to tell me with his own, whiny words that he "doesn't want to eat that food!" It's just tuna noodle casserole. Who wouldn't want to eat it?

Monday, November 16

Determining Eligiblity: Relevant Medical Information

During the evaluation process, your school district should ask you for a statement of "Relevant Medical Information". This is to help your district understand your child's clinical diagnosis, and to assist in understanding educational implications. I would recommend that you are as specific and detailed as possible.

Below is the information we provided to our district.

Andrew was born with profound hearing loss in both ears. The cause of the hearing loss is genetic defect in the Connexin 26 gene, which disrupts potassium flow in the inner ear that prevents the hair cells’ stimulation of the auditory nerve. The hearing loss was diagnosed at birth, and was later found to be at least 90 decibels in each ear.

Drew obtained bilateral hearing aids in December 2006 at 8 weeks old. With the amplification, audiological testing showed that Drew was only able to hear at 70 dbs for the lower frequencies. This level of hearing would include an airplane overhead, but no speech sounds or other typical environmental sounds, such as a doorbell, or dog barking. Parents never saw any reaction to sounds when Drew was using his hearing aids.

Drew’s parents were aggressive in their quest for Drew to hear. After traveling to St. Louis , Cincinnati , and Cleveland to consult with experts in the field of newborn hearing loss, cochlear implants, and oral-deaf education, they decided to pursue simultaneous bilateral cochlear implants, which were almost unheard of at that time. Not only was it rare for persons to have two cochlear implants, but it was even more rare for a child to receive two during the same surgery.

After interviewing and comparing three surgeons for this new and relatively untested surgical procedure, they finally found a surgeon in Columbus who would implant Drew simultaneously at a young age. They then fought the FDA guideline which suggested children be at least 12 months old before receiving a cochlear implant, arguing that implanting him at 8 months of age would give him a better chance at having normal speech.

Andrew continued wearing his hearing aids until he received simultaneous cochlear implants, which were first activated at age 9 months. These implants were activated fully by age one. Activation involves slowly turning the implants on so that he gradually became accustomed to hearing. The cochlear implant is an array of 22 electrodes inserted in the cochlea of each ear, with an accompanying magnetic receiver which is implanted in his skull. Andrew wears external processors on each ear, which are programmed by a skilled pediatric audiologist. The external pieces consist of microphones which pick up sound, the processor which “codes” the sound, a magnetic receiver (referred to as a coil) which transmits the electronic stimulus to the internal parts. His mother described his hearing as “electronic” and not natural, often referred to as acoustic. Drew will never hear as well as a hearing person does, and he will never hear more than a slice of the frequencies others do. Fortunately, his implants are programmed to pick up most of the speech frequencies.

Immediately following activation, Andrew began aggressive auditory training with professionals specifically trained in teaching deaf children how to listen and speak. Drew has attended therapy a minimum of two hours a week in a formal, clinical setting. These therapists have been instrumental in ensuring the processors are mapped appropriately, that Drew is meeting listening and language milestones and for his overall language and communication progress. This therapy has been essential in the development of spoken language for Drew.

Potential Problems
1) Equipment Maintenance

His mother noted that equipment issues are very common and impact Andrew’s ability to hear properly. Faulty baby worn wires, coils, dirty microphone covers, loose batteries and cracked controllers can cause the speech processor to turn off. Dirty microphone covers can muffle the sound being coded by the speech processor. Some potential areas that could affect microphone clarity include dirt, sand and moisture. Also, if anything is placed over Drew’s ears, such as a hat or hood, ability to hear is compromised.

2) Internal Failure

An additional area of concern is breakage of the internal parts. A fall or bump at the “right” spot on the head can cause the magnetic receiver or electrode array to break. This would require surgery, and the process of reprogramming (referred to as mapping) would be extensive.

3) Static Electricity

Static also presents a problem. A static charge can trigger the processor to turn off, or in the case of a strong static charge, can erase the map on the processor, which would require an appointment with the audiologist. Areas to avoid include plastic play equipment and fleece clothing.

4) Ear Infections

Ear infections can cause the equipment to work inefficiently, and have the potential to cause an infection around the implant which could require its removal. Fortunately, he has had very few ear infections, and all ear infections are treated aggressively by Drew’s ENT/Surgeon.

5) Moisture

The speech processors (“ears”, as they are referred to by Andrew and his family) are not allowed to get wet, so he can not wear them when swimming or bathing. Andrew is now able to take his “ears” off by himself. He is also now able to sometimes let his parents know when they are not working.

6) Hearing In Noise and Sound Localization

Lastly, noisy situations, including classrooms, restaurants and the outdoors, can be difficult for Andrew, as sound localization and quality is affected.

Educational Implications

His parents judge Andrew in need of continued auditory training/listening therapy, in order to develop his communication skills and ultimately literacy skills. They would like a preschool teacher, specifically one for the deaf, who would reinforce what he learns in an auditory training program, which will fine tune his ability to listen within his environment and will benefit him significantly when he moves to the mainstream.

As cochlear implant maps change over time, his parents daily check his hearing using the ling six sounds. Drew’s teacher will also be expected to review Drew’s ling sounds each morning as he arrives at school. Lings are six sounds (/oo/, /e/, /m/, /sh/, /ah/, and /s/) that predict well his ability to hear all other English phonemes. This check needs to be conducted in a variety of conditions, such as with noise, at a distance of 6, 9 or 12 feet and when the speaker is using a listening hoop. An equipment check is required at the beginning of each day to make sure the processors are on and working.

Another concern is literacy. Knowing that adult deaf people have an average reading level of fourth grade, the parents are concerned about Drew’s ability to learn to read. While speech alone is a huge concern, reading and greater literacy is a task that will be learned over many years. Drew’s Mom reports having struggled with literacy and knows how frustrating those struggles will be.

Drew needs to have an intensive literacy program, with teachers that are trained in teaching the deaf to read to provide a foundation that can be built upon during the school age years. Without this foundation, the parents are very concerned that Drew will fall behind and require significant intervention throughout his entire school career. With appropriate preschool education, they are hopeful that his needs will be minimal once he is of school age. The primary goal is literacy, with speech being only one part of being literate in society at large.

Other concerns include, but are not limited to, articulation, consonant deletion, consonant production through listening only (using a listening hoop where the speakers mouth is concealed) and grammar. Drew has also developed an issue with speech production, where he will “stutter” as he searches for the word(s) he needs to answer a question or to convey his need(s).

Sunday, November 15

Eligibility for Special Education - School Age

After the initial transition meeting, a multi-factored evaluation must be completed by and at the expense of the school district of residence if there is a suspected disability (as determined at the 120 Transition Meeting). For our deaf or hard of hearing children, currently enrolled in birth to three years of age services, this transition through the evaluation and writing of the Individual Education Plan should be seamless. Our case, as you know, was everything but seamless.

The evaluation process is supposed to be very detailed, with testing of the child in a variety of settings completing a variety of tasks. The testing performed on Drew was completed in one setting, an isolated, small, quite therapy room. In addition, only one test was administered. The PLS-4 was completed in this setting, and Drew's IEP team, including myself and Drew's Dad, his EI therapist, a parent advocate, and then representatives from the school district, attempted to determine educational needs off of this one test.

Here's the problem: The PLS-4 sucks. It's basically like a vocabulary test, which when administered to a deaf child with any almost-normal language makes them look like an absolute genius. It's completed in a quite - seriously quite - environment, and allows for rephrasing and gestures. Seriously. If the speech therapist didn't think Drew understood her the first time, she would rephrase her question and allow him additional time to answer. What a joke! Will he get that extra time in a noisy classroom? Will the teacher even know he struggled to understand the context of the sentence? Will the teacher constantly repharse her directions until Drew understands? Heck no!

I seriously sat in my chair as the test was administered knowing there would be an issue if the district was only going to base my son's needs off of this test. To give an example, in the expressive category of the test, the school therapist could not find a threshold level of language for Drew. She stopped the test at 60 months (or five years of age). He never got more than two answers in a row incorrect. I mean, it was really quite disgusting. Of course, I know the amount of work, therapy, language that went in to that score, but I knew the school district would take that test as basis for denying my son services. (And I was right...)

Here's the thing about the whole evaluation process: No one, no one, understands hearing loss! At our MFE Meeting, where eligibility for an IEP is determined, Drew's Dad and I spent forty-five minutes explaining Drew's aided and unaided audiogram, cochlear implants and their educational impact and the effects of hearing loss on children in a classroom setting. The school district representative didn't even know what the threshold for normal hearing children is, nor did she understand that even with his cochlear implants, Drew's hearing is not restored to normal levels. Her comment when we explained cochlear implants? "That's fascinating!" Oh, it is just disgusting.

After a three-and-a-half hour meeting trying to establish Drew eligible for services, the meeting ended with the Special Education Agency representative storming out of our meeting. It was eventually decided, over the course of a week, that additional testing needed to be administered in order to determine Drew's educational needs. (Of course we knew this going in to the original testing, as it is supposed to be a multi-factored evaluation, and I can hardly see how an evaluation takes in multiple factors when only one test is administered, but I am just the Mom.)

Below is the evaluation that was conducted that resulted in eligibility. I would strongly encourage parents to make sure that the TACL-3, Goldman-Fristoe Test of Articulation and SPICE are administered, as they are excellent at identifying the speech sounds that our children can not hear, and omit in their speech. This is the summary:
Drew was seen on August 27, 2009, to further assess his auditory and articulation skills. He was accompanied by his mother. This assessment session lasted for approximately 90 minutes and Drew again exhibited an attention span and ability to focus on structured activities that appears more mature than his age. Testing was administered in a relatively quiet room with Drew sitting on his own in a chair, approximately 6 feet from a low volume air conditioning unit. Testing was alternated between listening and speaking tasks, in order to help Drew maintain his attention. He needed to return to some tests to complete sections.

Drew was administered the Test for Auditory Comprehension of Language, Third edition (TACL-3). Norms for 3-0 year olds were used to derive his scores. Drew obtained a TACL-3 quotient of 102 (mean=100, s.d.=10), which is within the average range. He obtained the following sub test standard scores (mean=10, s.d.=2): I. Vocabulary=8, II. Grammatical Morphemes=11, III Elaborated Phrases and sentences=12. Drew’s sub test scores were all within the average range. During this assessment, Drew demonstrated difficulty identifying both simple and elaborated sentences, characterized by lengthy pausing, repeating sentences quietly a few times and looking to the examiner for clarification, and reviewing picture choices. Lengthier pauses of up to 20 seconds were noted on 4 out of 17 sentences during the Grammatical Morphemes sub test and 5 out of 15 sentences during the Elaborated Phrases and Sentences sub test. Single repetitions of TACL-3 sentences are allowable following pauses of more than 10 seconds for children younger than 5-0. Drew required at least one repetition and extra time before responding to almost half of all sentences presented. Sometimes he required 2 and 3 repetitions of sentences, including simple structures such as “The cat is in the box.”, “The boys ran.”, and “She jumped rope.”

Sections of the Speech Perception Instructional Curriculum and Evaluation (SPICE) were attempted, in order to screen selected auditory skills. During more casual conversations on familiar topics, Drew was observed to respond more readily than he did during structured sentence comprehension tasks. He demonstrated an ability to delay and correctly repeat back modeled sentences following demonstrations with toys during play. He did continue to require extra processing time, repetitions, rephrasings and exaggerated key words intermittently, in order to respond in conversations. Drew responded to most simple questions and some more complex questions accurately. He was able to comment back with related statements readily, when presented with statements that he understood. When Drew did not understand a question or statement, he often did not respond and/ or would smile and look to the examiner for more information. Due to Drew’s level of fatigue, he was unable to respond to tasks, requiring him to identify among SPICE word sets of up to 4 choices or maintain his attention for a large enough sample of oral directions with one to two key words varied.

Drew was administered Simple Consonant Steps 1 and 2 sections of the Phonetic Level Speech Evaluation and items 1 through 26 of the Goldman Fristoe Test of Articulation 2. These tests were used to obtain information on Drew’s ability to auditorally discriminate and produce sounds when imitating syllables and words. Results of the Phonetic Level Speech Evaluation indicate that Drew can consistently imitate single syllables with initial position /b,p,w,f,m,n,y/ sounds, using only audition. Drew was inconsistent in imitating single syllables with initial position /v/ and /h/ using only audition. He was able to improve or repair both /v/ and /h/, through speech reading and tactile cues. Drew was unable to imitate syllables with voiced or voiceless /th/, final position /p,t,d/ and initial position /sh,s,z,l,/ using only audition. It should be noted that Drew produces most of these consonant sounds (except /th/), that he could not imitate in syllables correctly, when producing familiar words in connected speech samples. Specific substitution errors noted when Drew imitated syllables during this test were: vowel for /h/, /d/ for /t/, /s/ for /z/, /n/ for /y/, voiced /th/ for /z/, /l/ for voiced /th/, /p/ for /t/, and /b/ for /v/. Drew also demonstrated the following substitutions when imitating or identifying words during administration of the Goldman-Fristoe and TACL-3, that are related to difficulty with auditory discrimination of consonant sounds: /h/ for /k/, /t/ for final position /p/, and /t/ for final position /k/. These sounds were also noted as correctly produced in familiar words produced by Drew, during connected speech samples. Consistent substitution errors with voiced and voiceless /th/, /l/ (vocalized and glided), /r,er/ (glided and vocalized) were again noted in connected speech samples and when imitating words included in the Goldman Fristoe Test of Articulation 2. These later types of errors are common in children Drew’s age with normal hearing, although he may have difficulty discriminating them. Because Drew was unable to complete the Goldman-Fristoe Test of Articulation 2, he did not obtain a standard score for this test. Remaining words included consonant clusters. Drew has shown emerging skills with /s/ and /z/ clusters and inability to produce /l/ and /r/ clusters in connected speech samples.

After the completion of a more multi-factored evaluation, Drew was found to be a student of educational need under the category of Hearing Impaired - Deafness (who would have thunk?). Below is Drew's Educational Need Statement:

Drew has difficulty identifying/comprehending both simple and elaborated sentences. Drew needs direct instruction to: improve and practice his comprehension skills, to maintain development of his auditory memory skills, which will help reduce processing time, and he needs to acquire and maintain these skills at a pace typical of his age group. Drew needs to apply these skills to verbally indicate his need for clarification when he doesn't understand.

Drew needs direct instruction on phonetic listening skills in order to better produce and discriminate among phonemes, especially for those sounds he doesn't hear well, in order to improve overall auditory skills. Further development of phonetic skills will improve his understanding and use of word endings and sentence endings.

Drew needs to maintain expressive and receptive vocabulary at a level typical for his age group. To do so, he will require direct instruction, which will include ample practice along with repetition and review.