Top Ten Tips for Making a Classroom Accessible Donna L. Sorkin, M.A., Vice President, Consumer Affairs, Cochlear America

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

2. Agenda • 1. Why does my child need FM? • 2. What are the different types of FM ? • How can we optimize performance with a personal FM? • What suggestions can you make about troubleshooting? • What if my child attends private school or doesn't have an IEP? • 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?

3. Why does my child need a FM System?

4. 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

5. 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

6. Impact of Noise on Vowels versus Consonants • Vowels: low frequency & louder • Consonants: high frequency & softer • Noise adversely affects intelligibility more on consonants than vowels

7. 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 Normal hearing children and adults Word recognition up-close in quiet (1.8 m) Age Group Word recognition with distance &noise (7 m) 67% 4 years 88.3% 5 years 94.3% 84% 6 years 98% 86.7% Adult 99.3% 97.0% Adapted from Johnson 1996

8. 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

9. What are the different types of FM Systems?

10. Various Types of FM’s Personal Soundfield FM Soundfield FM **Consider additional “Pass around” mic Personal FM

11. SoundfieldFM 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

12. 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

13. 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

14. 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?

15. 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

16. 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

17. 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

18. 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.

19. 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

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

21. 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

22. 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

23. 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

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

25. 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

26. 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

27. 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”

28. 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

29. Signal to Noise Ratio Needs • Normal Hearing Children > Adults • Adult Listeners with Hearing Loss: 10 to 15 dB • Children with Hearing Loss  15 dB

30. 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

31. 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

32. 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

33. 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 rooms Room design  address shape, design Any space  install acoustical panels

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

35. ANSI S12 Standard Specifics

36. 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

37. 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?

38. 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

39. 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

40. 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

41. 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)

42. 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!

43. 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

44. 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

45. 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

46. These strategies help every child perform better

47. 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

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

49. 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!”)

50. 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)