Meet Sarah: Why are we concerned about this student?

Sarah is 18 years old and attends a school for students with disabilities. Despite an extensive medical history, she is in good health. Various psychological assessments over time place her in the borderline or mildly deficient range of performance ability. She has a moderate-to-severe bilateral sensor neural hearing loss that was diagnosed at age four for which she wears hearing aids. Her local education agency provides a personal FM system for use during the school day. The purpose of the FM system is to augment her hearing aids by bringing the speaker’s voice into the foreground.

Sarah is an excellent speech reader and also uses sign language. Her speech and language expression is usually intelligible. She reads at a mid-third-grade level. Weekly, Sarah receives one hour of audiology services , one hour of speech/language therapy services and consultative OT and PT services. Sarah is known throughout her school for her outgoing personality and cooperative attitude. However, her teachers are concerned because she often misunderstands or does not comprehend spoken information, does not indicate when she does not understand, and forgets to bring or use her personal FM system.

How can we support this student to achieve her goal(s)?

Despite the fact that an appropriate tool is in place, Sarah is not benefitting from its use. Strategies used during the preceding year, such as frequent verbal or gestured reminders from teachers to bring the FM system to class or to hand the microphone to the main speaker, were unsuccessful. So the staff reviewed the challenges and generated a specific list of strategies to address them.

Challenge 1:

Although Sarah is supposed to be responsible for handing her personal FM system to her teachers, she often forgets to bring it to class and she neglects to give it to them.

Solutions:

Staff expects Sarah to take responsibility for her FM system.

She must:

  • Carry it with her at all times.
  • Hand it to the lead teacher/staff person for each activity in school or to her job coach/supervisor at her job site when needed.
  • Help staff position it appropriately.
  • If needed, tell staff the system is not working.

When Sarah does not meet expectations, staff does not give direct verbal cues. Instead the teacher waits for her to realize what she needs to do. If that strategy is unsuccessful, the teacher gives an indirect cue (e.g., “Is everyone ready to begin?”).

Challenge 2:

Teachers’ use of the FM system is inconsistent or incorrect. Teachers forget that Sarah is supposed to give them the microphone and/or the teachers use or position the microphone incorrectly.

image of the fm system

Solutions:

The audiologist will plan and implement an in-service for key staff (head teacher, job coach, speech therapist) to teach proper operation and troubleshooting of the FM system. Trained staff can then model how to properly use the device for other staff members.

Sarah and the audiologist will work together to successfully operate her personal FM system so that Sarah can then instruct staff, job coaches, and job supervisors in its proper use.

The audiologist will provide staff with updates on new skills Sarah is learning.

Challenge 3:

When Sarah looks at printed materials during class, she often misses key discussions, especially if they include multiple speakers and require her to turn her body to see speakers.

Solutions:

Teachers will rearrange desks in a long C-shape for large group activities. This not only helps Sarah to see the teacher without having to turn, but also helps the teacher discern if students are listening to discussions. In this arrangement, Sarah can see the teacher and hand the microphone to other speakers during discussions. She can also follow the teacher’s gaze and body orientation to signal the person speaking.

Sarah, the audiologist, and the speech therapist will work on verbal scripts for Sarah to use when she does not understand (e.g., “Please use my microphone.”, “I didn’t understand.”, “Please say it again.”, “I didn’t understand.”, “I need to see your face.”, “I didn’t understand.”, “Please say it slowly.”).

Staff will expect Sarah to use rehearsed scripts with both teachers and peers to seek explanations, ask for clarification, or request repetition.