Top Ten Tips for Making a Classroom AccessibleDonna L. Sorkin, M.A., Vice President, Consumer Affairs, Cochlear Americasdsorkin@cochlear.com

Agenda1. Why does my child need FM?

2. What are the different types of FM ?

3. How can we optimize performance with a personal FM?

4. What suggestions can you make about troubleshooting?

5. What if my child attends private school or doesn't have an IEP? 6. Do we still need to pay attention to acoustics?7. What should we be looking for in terms of acoustical properties

of the classroom?

8. What tips should we give the mainstream classroom teacher about working with our child?

9. How can my child's classmates help?

10. What are some great resources for school personnel?

Why does my child need a FM System?

What is a FM System?

• Wireless amplification system that transmits speech signal from a microphone via FM radio signals to FM receiver

• Teacher/parent/speaker wears microphone

• Student wears FM receiver that connects with his/her sound processor or hearing aid

Factors that Limit the Child’s Listening & Perceptual Abilities

• Noise – Ambient noise levels interfere with access to the speaker’s voice

• Reverberation – classrooms have hard surfaces which can cause echo effect

• Distance – Sound loudness decreases with distance from the speaker

• Synergistic Interactions

• FM overcomes these barriers

Impact of Noise on Vowels versus Consonants

• Vowels: low frequency & louder

• Consonants: high frequency & softer

• Noise adversely affects intelligibility more on consonants than vowels

Effect of Age on Word Recognition with Distance and Noise

All children are at a disadvantage when listening to a distant speaker or in background noise

Hearing impaired children have an even greater disadvantage in these environments

FM overcomes the factors of background noise, reverberation and distance from sound source

Adapted from Johnson 1996

Age Group

Word recognition up-close in quiet

(1.8 m)

Word recognition with distance &noise

(7 m)

4 years5 years6 yearsAdult

88.3%94.3%98%

99.3% 97.0%

86.7%84%

67%

Normal hearing children and adults

Purpose of FM Fitting

• Ensure speaker’s voice is presented at a consistent dB level

• Overcome effect of background noise• Competing conversations• Distant speakers• Improve listening in rooms with poor

acoustics• Reduces listening effort and maximizes

learning

What are the different types of FM Systems?

Various Types of FM’s

Soundfield FM

Personal Soundfield FM

Personal FM

**Consider additional “Pass around” mic

Soundfield FM System

• Improves SNR* by producing a nearly uniform loudness level unaffected by the teacher’s position

• Less strain for teacher • Easy to monitor/troubleshoot• Benefits everyone in vicinity• Still need to address room acoustics• Child needs to sit near to speaker for full benefit

*SNR=Signal to noise ratio

Personal Soundfield System

• Provide 10-15 dB SNR advantage

• Good for very young children

• No modifications required to equipment

• Easy to troubleshoot

• Speaker placement is critical• On desk and must be at ear-level of student

for optimal effectiveness

Personal FM System

• Personal FM system - Receiver plugs directly into sound processor and/or hearing aids

• Provides 15 – 20 dB (the best) SNR advantage

• Travels with child wherever they go

• Small size

• Teacher/user training very important

What tips can you give me to achieve the best results when using a personal FM system with my child's cochlear implant and/or hearing aid?

Precursors to a child’s personal FM use with their CI

• Approximately 3 to 6 months of cochlear implant experience

• Adequate communicative skills (oral or sign) to provide feedback regarding what they hear

• Reliable responses to age-appropriate auditory tasks

For either CI or hearing aid user:• Someone trained to perform daily listening check and

troubleshoot the FM equipment• Partnership between teachers, educational audiologists,

and cochlear implant audiologists

Personal FM – Connection Options

• Connections vary depending on sound processor and FM system being used

• Can connect to a variety of FM manufacturers but proper connect is essential

• Consult with both hearing aid and/or implant manufacturer and FM manufacturer to ensure correct cabling

Performance Monitoring

• Audiologist, SLP, Teacher – (someone!) should perform a functional listening evaluation in the classroom, both with and without the FM system, to measure benefit

• Crucial for appropriate benefit

Microphones Options

• Boom – Worn on headband and provides the most consistent SNR advantage.

• Lapel – Clipped to clothing. Needs to be centered. Caution when clipped to loose clothing – position will shift.

• Collar – SNR can be diminished when speaker turns head.

Microphone Tips

• Position microphone 3-6 inches from mouth

• Avoid wearing jewelry that may rub/hit microphone and create unwanted sound

• Use the ON/OFF control so that student does not hear private conversations

What if my child’s school discourages us or even refuses to utilize FM? How should I deal with that attitude?

Understand the laws in your country

•In the U.S., children who have “educationally significant” disabilities have the right to a free and appropriate public education•Federal regulations in U.S. mention assistive technology as a service that children may require and which must be provided•Understand laws in your own country and use them maximally to make your case•Even in the U.S. (where FM must be provided if needed), some schools will decline to provide

Some comments we have heard…

•Your child’s hearing loss is too severe to benefit from a FM system

•Your child’s hearing loss isn’t severe enough to benefit from a FM system

•We have this FM system left from another child

•We improved the acoustics in the room so she won’t need a FM system

•Her speech is perfect, she hears everything and she’s on grade level—she doesn’t need it

Laws Don’t Ensure Access

•Having laws that support children doesn’t mean that the services will automatically be provided•Many families still experience difficulty•Reference need for the child to have access and the impact that technology has on child’s ability to fully participate at school•Demonstrate impact (i.e, give them a spelling test in noise or use tapes that demonstrate impact of hearing loss)•Know that you are right

If we’re using FM, do we still need to pay attention to acoustics?

YES! Acoustics are Still Important

• Simply increasing volume isn’t enough• HA’s/CI’s still need larger SNR*• All children have immature listening

systems• Poor acoustics exacerbate word

comprehension • Children don’t necessarily note they’re

having a problem *Signal to Noise Ratio

Acoustics and FM are not either/or

• Poor acoustics can overwhelm FM

• If reverberation, amplified sound (soundfield) will bounce around

• Children communicate in small groups or informally when FM is not in use

• Informal interactions are an important element of the school/educational experience

Where should acoustics be considered?

• Classrooms and Core learning spaces

• Auditorium, cafeteria, gym, music rooms, offices

• Day care centers and preschools• Site away from sources of noise• Throughout design, construction,

renovation• Acoustics as part of design, not as

an “add-on”

Key Factors in Classroom Listening

• Ambient Noise Levels (Given in dB)• Sound Pressure Level of Speech Signal

(i.e., speaker) (dB) – Decreases with distance from speaker

• Signal/Noise Ratio (SNR) Difference between Speech Signal (speaker) and Background Noise

• Reverberation Echo from hard surfaces (time in seconds required for sound to decay 60 dB)

• Combined effect of noise and reverberation is greater than each alone

Signal to Noise Ratio Needs

• Normal Hearing Children > Adults

• Adult Listeners with Hearing Loss: 10 to 15 dB

• Children with Hearing Loss 15 dB

Ambient Noise: Heating/Ventilation Systems

• Common problem in classrooms

• Ensure working properly• Avoid room air conditioners• Purchase quiet equipment• Design for low noise output• Last resort: turn it off during

instructional periods

Ambient Noise: Other Common Problems and What to Do

•Open Space Classrooms confined spaces•Street Noise in City Locations Close windows & install double pane glass•Classrooms adjacent to noisy activities choose classroom locations for quiet•Self Noise from children No real solution, carpeting muffles sounds from chairs and feet

Reverberation: Likely to be a problem if:

• Tile floors (no carpeting)• No acoustical tile in the ceiling• High ceilings > 10 feet• Ceiling tiles have been painted• More than 10% of ceiling occupied

by lighting fixtures, HVAC grilles, other non-absorptive surfaces

• Classroom is a trailer

Reverberant Surfaces and What to Do

Tile floors carpeting, tennis balls on chair legs

Temporary Classrooms (trailers) move to regular classroom

Less than best ceiling option install highest rating acoustical tile

Large rooms small roomsRoom design address shape, designAny space install acoustical panels

What should we be looking for in terms of the acoustical environment?

ANSI S12 Standard Specifics

Background Noise

Max Reverberation

Classrooms and COR Learning Spaces of 10K CuFt

35 dB 0.6 sec

Classrooms and COR Learning Spaces of 20K CuFt

35 dB 0.7 sec

Ancillary Spaces 40 dB

Acoustics at School

• Appropriate as part of the child’s programs and services related his/her hearing loss

• May not be able to attain ANSI standard as retrofit but any room can be improved

• Get involved in renovation/construction projects to help kids in the future

• Std is available Online (free!)

http://asastore.aip.org

What tips should we give the mainstream classroom teacher about working with our child? We don’t want to overwhelm her but can you identify some items for her/him that will really make a difference for our child?

Tips for Mainstream Teacher

•May not have had a child with hearing loss

•Likely is afraid (s)he is not prepared

•Communicate early/often

•May feel entire burden will fall on him/her

•Provide training

Facilitate/Encourage Team Approach

• Ensure discussions between people/ organizations• Regular team meetings• Teacher/Parents/Child part of the team

• Highlight role of everyone—it’s not just the classroom teachers

• Train others in contact with the child

Possible Team Members for a Child with Hearing Loss

• Classroom Teacher/Special Teacher

• Auditory/Speech Therapist(s)

• Educational Audiologist

• Someone from the CI or HA center/clinic

• School Principal/Administrator

• Tutor, aid, school nurse, others

• Parents + Child + Classmates

• Interpreter, notetaker

• See HOPE Online seminar on topic

Share Hearing Loss Basics

•Show them child’s audiogram and explain it•Help them understand the benefits and limitations of personal hearing technology•Show them the child’s technology and let them handle it•Explain why the FM is important•Determine who is charge of troubleshooting and develop a plan for how that will work (more on that later)

Ensure Proper Classroom Seating

• Close to front but visually accessible to entire room

• Seat away from noise generators (HVAC fans, hall doors)

• If unilateral CI (or unilateral hearing loss), seat so CI ear (or better ear) is opposite noise sources (i.e, HVAC fans, projectors) and towards center of room

• No aquariums!

Speak so (s)he can understand you

• Always face forward when talking• Stay within the child’s vision• Closer is better• Don’t “bounce” around • Speak clearly, naturally and directly to the child• Make sure she’s looking at you when you begin

speaking• Ensure volume is appropriate• Speak just a little slower—too slow is not natural and will

make understanding harder• View HOPE Online on Clear Speech

What if (s)he doesn’t understand?

• Don’t ask her directly “Did you understand that?”

• Learn to recognize “the look” that means he didn’t get it

• Repeat once, then paraphrase

• Explain things a different way

• Encourage him to ask

• Use a signal or “secret sign” so she can tell you she missed something

• Write difficult (key) word(s) on the blackboard

Other Communication Strategies

• Provide key new words/concepts to parents or team members in advance

• Use concrete materials or natural gestures to illustrate points

• Write assignments and directions on the board

• Point to the speaker

• Repeat classmates’ questions thru the FM

• If you think she might have missed a comment, rephrase or restate what another child has contributed

These strategies help every child perform better

Set the Child up for Success

• Pre-teach—share lesson plans—before the child encounters a new segment in class

• Provide key new words/concepts to parents or team members in advance

• Send words to new songs home in advance so parents can help the child learn words and melody

• Build her confidence by asking questions you think she can answer and then work up to more difficult challenges

• Help him shine in areas where he has competency

What about my child’s classmates? How can they help?

Involve Classmates

• Believe that having a child with different needs is beneficial for all children

• Let them see the technology and learn about it• Talk about differences/special needs• Ask professional in deafness to visit• Have a “cool” adult with hearing loss visit• Help the child know how to talk about his/her

technology (e.g., “these are my super computers” or “I’m the bionic boy!”)

Assign a hearing buddy

• Help the child keep on task and show him where the class is, if needed

• Make it a privilege to be the hearing buddy

• Share notes (if old enough)

What about teasing?

• Your child may get teased about his technology

• Listen and put yourself in her shoes

• Help him deal with it—“I can handle this”

• Use humor, deflect it, ignore it

• Agree with it and put the teaser off balance

• Know that most kids—with or without hearing loss—experience teasing at some point

• Encourage him to ask for help when teasing becomes harassment or bullying

What suggestions can you make about troubleshooting the cochlear implant processor to minimize downtime?

General Troubleshooting Concepts for ANY Sound Processor

• Check for visible breakage or loose connections

• Check processor is ON and set on appropriate user settings

• Change batteries• Check microphone• Check transmission (coil)

Preventative Maintenance

• Use dry aid kit daily

• Establish a schedule for changing batteries

• Keep batteries at school

• Consider Nucleus Troubleshooting Kit for school

Troubleshooting Resources

Troubleshooting Guide for sound processors• www.cochlearamericas.com/Support/845.asp• Can copy entire guide or directions for a specific

processor

Resources for Educational Professionals

HOPE: Habilitation Outreach to Professionals in Education

• Program to improve educator knowledge about the needs of children with hearing loss

• Some programs also appropriate for parents• Online training 2x month• Over 60 archived (recorded) courses• Regional (one-day) Rehab Workshops around

the country—ongoing• Sign up for e-news• www.cochlear.com/HOPE

HOPE Notes

HOPE Notes

• 18 topics we often get inquiries about

• Crystallizes key issues and highlights questions to ask (no “right” answer), issues to think about

• Provides understanding on topic without being definitive

• Suggests additional resources • Available on the web: www.cochlear.com/HOPE

Educator Guide

• MUST HAVE!

• Comprehensive review of key topics• Introduction to CI’s• Getting Started• What Children with a CI Need at School• Preparing the Classroom • Troubleshooting• Accessories and Assistive Listening Devices• Resources

www.cochlearamericas.com/support/2156.asp

Cochlear Implant Resource Guide

Cochlear Implant Resource Guide:Meeting Children’s Needs at School

• Designed for professionals who regularly work with CI children and want to selectively share materials with others

• Loose leaf notebook organized by topic (i.e, evaluation, considerations at school, guidance for children whose primary language is sign)

• Incorporates both existing and new materials• All authors gave permission to copy their

materials • $50 from Cochlear Customer Service

(800.523.5798)

Some Favorite Books for Teachers

• A Child With a Hearing Loss in Your Classroom? Don’t Panic!! (A Mangiardi)

• Questions Teachers Ask (JW Otto, V Kozak)

• Tips for Friends (K Stein, C Gustus)—from Moog Center for Deaf Education, St. Louis

Web Resources on Classroom Acoustics

• http://www.quietclassrooms.org/ada/ada.htm

• www.access-board.gov/acoustic/index.htm

• www.classroomacoustics.com

• www.hearingloss.org/html/nixonmj02.htm

• http://asa.aip.org/classroom/booklet.html

• www.cochlearamericas.com/PDFs/FAQAcoustic.pdf

• ASHA and AG Bell monographs

• Acoustics in Educational Settings: Technical Report, ASHA, 2005.

Questions?