Rare Disorders  
Linda Blevins, Division Director
The MAGIC Touch • Summer 1998
Vol. 9, Issue 2, pp. 28-30
  Reprinted with the permission of The MAGIC Foundation
1327 N. Harlem Avenue, Oak Park, IL 60302-1376
1 (800) 3 MAGIC 3
(708) 383-0808 Fax: (708) 383-0899
E-Mail: mary@magicfoundation.org

From Your Division Director
In the spring issue of the newsletter I looked at different aspects revolving around hearing. Presented were the guidelines from the National Institutes of Health to evaluate hearing loss in infants and children. Information and sources for sound fields and Personal Amplification (FM trainers) devices were covered. In this Quarters newsletter, I continue to look more in depth at studies on hearing impairment. Children with disabilities have a higher rate of hearing impairment as compared to normal children. Further, articles on the "acoustical environment" and its impact on hearing will be placed on file at MAGIC for you review.

One of our MAGIC parents participated in the process to obtain sound field systems for their first grade classes. I encourage everyone to read this powerful and well-informed letter on the positive educational impact the children and teachers experienced form utilizing sound-field technology.

Hearing loss, hearing impairment, and fluid in the ears is such a "silent" disorder. In a quiet room at home, our children may hear adequately. Put that same child in a noisy, active classroom surrounded by loud heating and cooling systems, humming overhead lights, squirming children (and the list goes on), the sound to noise ratio becomes such that even the "normal" hearing child is documented to have difficulty deciphering intelligible speech and instructions. Audible is when the child hears sound, but intelligible is when the child can hear and interpret spoken language. The problems become even more magnified when one considers health issues such as colds, ear infections, allergies, sinus infections and every flu, viral and bacterial situation children have challenging their health, which in turn affects their learning abilities. Since the mid 1970's, medical studies cite an alarming increase of ear infections by 224%.

For my son Jordan, his audiological testing was always normal. Testing always occurred in a perfectly acoustical environment with head phones to direct the signal directly into his ears. This hardly represents "real" acoustical situations in classrooms. Despite "normal" hearing tests, Jordan has a pattern of speech delay and articulation problems that defy quantifying. A very big thank you to Widget Rodgers, a sales representative, for loaning a personal FM system for Jordan to use. When Jordan wears the Personal FM system, his speech production and articulation improve. Jordan's teachers at his Montessori school report that Jordan's attentiveness and classroom involvement dramatically increase while he is wearing the system. The speech therapist thinks Jordan has difficulty "listening: for intelligible speech in noisy situations. The FM device focuses the teachers voice directly into Jordan's ears and allows him to hear. I am currently involved in a battle with the school system to install a sound field in his regular education classroom for next year.

I can not urge you enough to look at this material closely and evaluate its relevance to your child's learning situation. Many supporting literature and abstracts have been placed on file at MAGIC. As always, consult with you local professionals.

Benefits of Sound-Field Classroom Amplification
Recent studies have verified that hundreds of thousands of children are academically (7 million) at risk due to a high incidence of poor classroom acoustics, high ambient noise levels in the classrooms, and mild hearing loss among preadolescents (K-6) due to common ear infections. These studies show conclusively that conditions in the majority of current kindergarten through 6th grade classrooms make it difficult for a significant portion of student to hear adequately. These same studies show that many of these children become academically deficient in at least one subject by the 6th grade. The results from three of the largest studies, die MARRS Project (1979-1993), have been validated by the U.S. Department of Education.

All of the recent studies validate sound-field classroom application as a proven tool that can overcome adverse classroom conditions, providing student with enhanced speech recognition and therefore, much improved opportunity to learn. Sound-field amplification is now recognized as one of the most powerful and cost effective tools for student listening enhancement.

Young children spend 45-60% of their school day involved in listening activities. Their primary channel for learning is hearing. The better children can hear, the more they can learn. For maximal learning to occur the teacher's voice must be highly intelligible to every child. Younger children's lack of experience and knowledge with speech and language makes them very dependent on the soft, subtle consonant sounds that make up the key element of word recognition. The goal of sound-field amplification is to enable every child in a classroom to hear clearly all the speech components of the teacher's voice no matter where a child is seated relative to the teacher's position in the room.

Proven benefits of sound-field classroom amplification are:

  1. High ambient noise levels are easily overcome.
  2. 30% of K-6 children will hear their teacher significantly better.
  3. Attention and on task time improve.
  4. Class interaction and participation increases.
  5. Classroom stress is lowered and fewer behavior problems arise.
  6. Teacher absenteeism due to voice and throat illness is almost eliminated.
  7. Academic test scores improve.
  8. Children with other learning disorders can benefit.
  9. Teachers survey shows sound-fields more useful than A/V equipment.
I would like to thank LightSPEED Technologies for supplying this information.

Sound-Field in Michigan, Parent Feedback
Recently my regular education first grader had the opportunity to experience a classroom amplification system on a trial base. Nearing the end of the loan time our PTA met in the classroom to experience the system, talk with the teacher and hear a presentation by a member of our intermediate school district office. Every member of the PTA in attendance of this meeting was so impressed that we began to look at how to purchase at least one system for the first grade. We have since purchased two and are looking at ways to purchase a third. At this time nearly every school in our county has at least one of these systems.

A sound system consists of a wireless microphone for the teacher, optional hand-held microphone for children, receiver and amplifier and loudspeakers). The brand we purchase is the Sound-filed System from LightSPEED Technologies (800-732-8999). The Sound-field System uses FM radio waves ensuring that each classroom has it's own wavelength and will not pick up CB or ham radio channels. The system installed costs $1,000.00 per classroom.

Comments by teachers who have utilized this technology cite the same benefits, especially in the lower elementary classrooms. Imagine the benefits a special education student could reap. Students can hear the teacher in every part of the classroom. Students are more focused and engaged in lessons and classroom behavior improves. The sound system helps teachers get the edge over internal and external classroom noise, reverberation, speaker-listener distance and poor classroom acoustics that steal student attention. Shy children are more likely to read aloud using a microphone. Teachers report that they repeat directions less frequently and hold the students attention for longer periods of time. Two of our first grade teachers elected to receive the sound system over a computer because the sound system benefits every student in the classroom.

When considering a sound system for the classroom be aware of the following:

The Genesee Intermediate School district is responsible for pulling together the numbers and studies that our PTA relied on while making decisions.

Not only is this a valuable tool for teachers but the students cite benefits from having the system in their classroom. My daughters first grade class voted 28 to I in favor for keeping the system because they can hear better. I'm pleased to have had ? part in the acquisition of this piece of technology. Michelle Waite

Growth Hormone and Mosaic 14
Dear Linda,
Marcus came back with deficient levels of both clonidine and arginine. His arginine level was 2.3 and his clonidine was 7.7. This time his IGF-I was 36 at age 5 and his thyroid tests were normal. He will start on .55mg daily or 0.3 mg/kg per week.

Dear JW.
That is terrific that Marcus is starting on GHU! Your persistence has been rewarded. Keep us posted on your results.

In Memory
Recently, a very dear friend of mine lost her baby. Little Claire had a genetic disorder. Her mother shared this poem with us. I would like our MAGIC family to remember Claire. Our hearts and prayers go out to this family.

A Time to Decide, A Time to Heal
Please don't tell me, you can have another, I wanted her.
Please don't say the next one will be normal, she was normal, her disease was abnormal.
Please don't tell me everything will be all right, its not all right, she's not here.
Please hug me when the tears come, with out any questions why I am crying.
Please talk about her with me when I bring her name up.
Please don't feel awkward when I show you her pictures and the baby things I saved.
Please don't tell me that time heals, it can never heal this wound.
Please treat her as our daughter, we may have had her for only a few months but she is still our daughter.

Please don't every forget Claire Elise.

Medicaid Waiver For Children With Disabilities
Medicaid eligibility option (formerly known as the Katie Beckett Waiver) was added to federal Medicaid law through the enactment of Section 134 of the Tax Equity and Fiscal Responsibility ACT (TEFRA) of 1982. It is often referred to as the Deeming Waiver or the TEFRA 134 Option. In simplest terms, this provision permits a state to extend Medicaid eligibility to otherwise ineligible children with severe disabilities who live with their families but would qualify for the Medicaid program if institutionalized. The option enables such children to receive Medicaid services while keeping the family intact. If a child has insurance from the families private health insurance plan, that plan is expected to be used first to cover needed health care services before Medicaid will compensate for care.

The following states have incorporated the TEFRA 134 option into their Medicaid programs: Alaska, Arkansas, Delaware, Georgia, Idaho, Louisiana, Massachusetts, Michigan, Minnesota, New Hampshire, South Carolina, Vermont, West Virginia, Wisconsin, Florida.

The other route available to states to secure Medicaid eligibility is via the home and community-based waiver program (HCB). Most states that operate HCB waiver programs provide for making children eligible for these programs on much the same basis as provided by the TEFRA 134. The HCB waiver is different from TEFRA 134 in two areas: a) waiver programs operate under caps on the number of participants; and b) states may offer services that are not reimbursable under Medicaid. To discover the full extent of HCB you must check with your individual state.

Any family has the right to apply for TEFRA (Deeming Waiver) and have an eligibility determination made. The family may appeal a negative decision, at no cost to the family. The requirements:

  1. The child must be under the age of 18 and be found to be disable by the State Medical Review Team (SMRT).
  2. The child must need a certain level of home health care if they are to stay at home.
The level would compare to the level of care provided in a hospital, nursing home or intermediate care facility for persons with mental retardation. (Basically, this form would say it is most cost effective for the state to give the child Medicaid and keep the child at home with the family versus the cost of institutionalizing the child.)

This information on the Deeming Waiver was supplied from the Down Syndrome News, Vol 19, No 2 and a copy will be on file at MAGIC.

Articles on File At MAGIC

  1. The Benefits of Sound-Field Amplification.
  2. Improving Classroom Acoustics, Enhancing Listening and Learning Environments with FM Sound-field Classroom Amplification, IDEA, Part B Special Project.
  3. The Use of Sound Field Amplification of the Teacher's Voice in the Regular Education Classroom, found Field FM Amplification: Crandell, Smaldino, Flexer.
  4. Benefits of Sound-field Amplification Systems in the Regular and Special Education Classroom, A report by Genesee Intermediate School District: Blanck.
  5. Two newspaper articles on Sound-Fields in the Classroom by the Tri-County Times, Fenton, MI.
  6. Statement from Mrs. Powell's First grade class, Fenton MI.
  7. Group Amplification in Schools for the Hearing Impaired: Bess, Sinclair, Riggs.
  8. The Effects of Classroom Acoustics on Children with Normal Hearing: Implication for Intervention Strategies: Crandel.
  9. Effect of FM Auditory Trainers on Attending Behaviors of Learning Disabled Children, Blake, Field, Foster, Platt, Wertz.
  10. The Changing Sound of Education.
  11. Quiet Please, The Link Between Architectural Acoustics and Hearing Accessibility: Nixon, IFHOHJ, Jor 3. Acoustics in Educational Settings, Subcommittee on
  12. Acoustics in Education, Settings of the Bioacoustics Standards and Noise Standard Committee, American Speech Language Hearing Association.
  13. Architectural Acoustics and the ADA: Nixon.
  14. Shhh: Noise Affects Learning, Health: Hendrick, Health Watch.
  15. Sound Field FM Systems: Question Most Often Asked About Classroom Amplification: Flexer, Heresay Vol II, Num 2.
  16. Classroom Amplification Demonstration Lab, Lewis, The Fourth International Symposium on Childhood Deafness.
  17. Consideration of Determination for FM or Sound-field Benefits, 4 check list and evaluations.
Convention Time!!
The 4th Annual Convention of MAGIC will take place July 23-26. Programs have been mailed to all. If you did not receive your program, please contact MAGIC.
Hope to see many of you there!
 
  Revised: February 21, 1999.