TLC IEP Evaluation
Parent Infant Program
The Learning Center for the Deaf
848 Central Street, Framingham, MA 01701
888-703-2271 V 508-879-5126 (VP)
Date of report: 12/18/08
Child’s Age: 2.10
Li-Li is an adorable 2 year 11 month old little girl who presents with a bilateral, profound hearing loss. Li-Li was born in China and was raised by a foster family for one year until the H-Q family adopted her. She arrived in the United States with her mother on February 8, 2007. Her parents quickly suspected a hearing loss, which was confirmed through ABR testing at Children’s Hospital at age 14 months.
Li-Li received her first cochlear implant (on her right side) in Sept. 2007, with device activation the following month. Li-Li tolerated her first implant very well and quickly began to attend to sounds in her environment and imitate sounds/speech. Li-Li’s encouraging progress with her first implant, and her minimal benefit from a hearing aid trial, led to the decision to have her left side implanted. She underwent surgery for a left-side implant in Aug. 2008, with device activation the following month. She has used both processors throughout the day consistently ever since.
Li-Li has received early intervention services through Enable Early Intervention since her hearing loss was first diagnosed. Services have included weekly visits from a speech and language pathologist and referral to the Parent Infant Program at The Learning Center for the Deaf in April, 2007, where Li-Li participates in two playgroups weekly and receives thirty minutes of individual speech sessions with a speech/language pathologist. Li-Li’s parents have also taken advantage of a parent support group offered to families in this program.
Li-Li has attended the daycare center at The Learning Center for the Deaf since April, 2007. This setting has provided an opportunity for Li-Li to have daily exposure to American Sign Language.
Li-Li is a delightful child who enjoys participating in a variety of playgroup activities, including free play, story time, games, snack and art. She demonstrates good social skills and is comfortable with her peers and staff members. It is significant to note that Li-Li has made numerous gains in the last six months. Though her first language is ASL, and it remains the stronger of her two languages, she is quickly developing bi-lingual fluency as her spoken English skills emerge. For a child just turning three, she is quite sophisticated in her ability to code switch from ASL to spoken English depending on the language of her communication partner.
American Sign Language (ASL) is a language with its own pragmatics, syntax, and semantics. It is a rule-governed system as is any other language. All languages share some features with other communicative modalities but are also distinguished from other communicative systems by a number of features. ASL is a visual spatial language; therefore the eyes and hands as well as body language are involved while communicating. The conceptual information expressed in ASL is the same that is given in a spoken language but is expressed visually.
American Sign Language and English can be compared in some ways. The building block of spoken English is the phoneme. A parallel can be drawn between these speech sounds and the five parameters of ASL: handshape, location, palm orientation, movement and facial grammar.
Young children both deaf and hearing, aged 0-5, go through the same basic stages of language development that involves babbling, nonsense words and vocabulary related to their world. Deaf or hard of hearing children incorporate basic handshapes (8,A,C,O,S, 1, 5) into their communication in
the same way that hearing children would incorporate sounds such as “ba”, “da”, and “ma” on the way to developing meaningful words/concepts.
American Sign Language
Li-Li has responded to and is able to use appropriate visual cues. She responds to strategies (tapping on shoulder or table, waving in her visual field, flashing lights, etc) to get her attention and, in response, is able to direct her eye gaze toward her communication partner. Li-Li has, on occasion,
waved to obtain attention.
Through play and language interactions, Li-Li has been exposed to a variety of language structures in ASL. Li-Li is able to follow basic commands and requests such as “sit down”, “pick up”, “clean up”, and “give _ ” and responds through pointing, gesture, action, and sign. She can express herself through action, pointing, gestures, facial grammar, and sign, with communicative intent.
Li-Li is able to answer yes/no questions by nodding or shaking her head as well as by expressing the appropriate facial grammatical markers. An example would be, “Do you want more cookies?” Li-Li will respond by setting her eyebrows down and shaking her head and signing “NO, DON’T WANT”.
It is evident that Li-Li is able to incorporate visual information along with formal signs in this kind of question and answer session. She is able to respond to WH questions such as WHAT, WHO and WHERE.
Li-Li typically communicates using 2 sign utterances, though she has been noted to string up to 4 signs together.
Li-Li currently receives speech-language/aural rehabilitation services through Early Intervention (2 hours a week) and TLC’s PIP program (30 minutes aweek). Li-Li can complete a Ling 6 sound check using listening alone (without speechreading cues) using both of her processors simultaneously.
She currently completes the Ling check using toys to represent the Ling sounds (she will point to the toy that corresponds to the sound she
hears). Using listening alone (such as during Bingo games), Li-Li is able to identify environmental/animal sounds such as a cat’s meow, a dog’s bark, and a cow’s moo.
Li-Li’s mom reports that, at home, she can follow many familiar one-step directions without sign support. She readily combines 2-3 spoken words spontaneously, such as (during dollhouse play) “baby beh (=bed),” “two baby (=babies),” and “mama, dada, eat.” She enjoys imitating animal sounds (e.g., “ee-oww! Wuh wuh! Moo!”) and saying letter and number names (e.g., “wuh, two, tee, pour, pie” = “1, 2, 3, 4, 5”).
Li-Li is now very interesting in attempting to imitate new words, revealing a growing range of speech sounds that she can produce in at least one position in words (or in isolation).
Overall, Li-Li is making steady progress in the areas of listening and speech using her bilateral cochlear implants. She is regularly followed by staff at the Deaf/Hard of Hearing Program at Children’s Hospital in Waltham for mapping updates and follow-up language evaluations. Staff at Children’s and this clinician are encouraged by Li-Li’s progress to date and expect that she will continue to make significant gains in her spoken English skills by being involved in a preschool program with Deaf Educators and other deaf
children with cochlear implants.
Li-Li is interested in various activities, especially hands on activities, which can include puzzles, blocks, dollhouse, kitchen play, etc. During play interactions, she can follow directions such as: turn the lights off (to indicate it’s time to clean up). Li-Li is able to participate in literacy related activities.
She is able to look at books by herself and turn the pages appropriately with reminders. Li-Li always enjoy attending to a story in sign in a one to one or in a group situation. Sometimes she takes the book from the storyteller to repeat the story. Li-Li can identify all colors. Li-Li can recognize her name on
Social Emotional Skills
Li-Li is a very friendly and sweet little girl who never complains. She likes to interact with people that she feels comfortable or familiar with. She responds to or greets others by smiling, laughing or waving along with the sign “hello”. Li-Li shows compassion for other children by offering them special toys. She is able to play cooperatively and has been noted to sign to her peers “WANT
Fine/Gross Motor/Self Help Skills
Li-Li’s fine motor skills seem to be age appropriate. She is able to use crayons, paintbrushes, eating utensils and can drink from a sippy cup. She plays age appropriately with manipulative items such as building blocks and doll house dolls and furniture. Li-Li is able to push, roll and throw balls. Li-Li is very interested in art related activities, and shows a high level of concentration, fine motor and visual perceptual skills for these activities.
Li-Li’s gross motor skills appear to be age appropriate. She is able to move around easily in her environment. She is able to walk up and down the stairs with a hand on the rail. Li-Li is able to kick a large ball.
Li-Li is able to take care of herself during daily routines. She is able to take off her shoes and can put them on with support. She also is able to put on her coat with support. She is able to put away her possessions with reminders. She is able to wipe her hands before eating and art activities.
- Li-Li needs full visual access to language through ASL.
- Li-Li needs a program that will also encourage the development of basic auditory/oral skills.
- Li-Li needs a developmentally appropriate preschool environment that will allow her to make progress in all areas -language, cognition, gross and fine motor, social-emotional.
- Li-Li needs certified teachers of the Deaf, as well as support staff, who are fluent in ASL.
- Li-Li needs a peer group of similar age and with similar language abilities.
- Li-Li needs specialized instruction in ASL and Deaf Studies.
This summary report just gives a snapshot of what skills Li-Li has incorporated through a variety of interactions in her environment. It was a pleasure to work with Li-Li and her family in facilitating all areas of Li-Li’s development as well as to provide them information related to deafness. Please do not hesitate to contact us with any questions that you may have regarding this report at __, or via email.
Parent Infant Coordinator
Claire Miller, M.S., CCC-SLP