““Thirty years ago this month, President Ronald Reagan issued a presidential proclamation designating the last week of June as “Helen Keller Deaf-Blind Awareness Week.” Every year since, the Helen Keller National Center for Deaf-Blind Youths & Adults (HKNC) commemorates the week with a national advocacy campaign in recognition of the achievements and capabilities of people who are deaf-blind.”
AHC – American Health Council
Orientation and Mobility
In addition, the child who is deaf-blind will need help learning to move about in the world. Without vision, or with reduced vision, he or she will not only have difficulty navigating, but may also lack the motivation to move outward in the first place. Helping a young child who is deaf-blind learn to move may begin with thoughtful attention to the physical space around him or her (crib or other space) so that whatever movements the child instinctively makes are rewarded with interesting stimulation that motivates further movement. Orientation and mobility specialists can help parents and teachers to construct safe and motivating spaces for the young child who is deaf-blind. In many instances children who are deaf-blind may also have additional physical and health problems that limit their ability to move about. Parents and teachers may need to include physical and occupational therapists, vision teachers, health professionals, and orientation and mobility specialists on the team to plan accessible and motivating spaces for these children. Older children or adults who have lost vision can also use help from trained specialists in order to achieve as much confidence and independence as possible in moving about in their world.
Education for a child or youth with deaf-blindness needs to be highly individualized; the limited channels available for learning necessitate organizing a program for each child that will address the child’s unique ways of learning and his or her own interests. Assessment is crucial at every step of the way. Sensory deficits can easily mislead even experienced educators into underestimating (or occasionally overestimating) intelligence and constructing inappropriate programs.
Helen Keller said, “Blindness separates a person from things, but deafness separates him from people.” This potential isolation is one important reason why it is necessary to engage the services of persons familiar with the combination of both blindness and deafness when planning an educational program for a child who is deaf-blind. Doing so will help a child or youth with these disabilities receive an education which maximizes her or his potential for learning and for meaningful contact with her or his environment. The earlier these services can be obtained, the better for the child.
When a person who is deaf-blind nears the end of his or her school-based education, transition and rehabilitation help will be required to assist in planning so that as an adult the individual can find suitable work and living situations. Because of the diversity of needs, such services for a person who is deaf-blind can rarely be provided by a single person or agency; careful and respectful teamwork is required among specialists and agencies concerned with such things as housing, vocational and rehabilitation needs, deafness, blindness, orientation and mobility, medical needs, and mental health.
The adult who is deaf-blind must be central to the transition planning. The individual’s own goals, directions, interests, and abilities must guide the planning at every step of the way. Skilled interpreters, family members and friends who know the person well can help the adult who is deaf-blind have the most important voice in planning his or her own future.
Inclusion in Family
Clearly, the challenges for parents, teachers and caregivers of children who are deaf-blind are many. Not least among them is the challenge of including the child in the flow of family and community life. Since such a child does not necessarily respond to care in the ways we might expect, parents will be particularly challenged in their efforts to include her or him. The mother or father of an infant who can see is usually rewarded with smiles and lively eye contact from the child. The parent of a child who is deaf-blind must look for more subtle rewards: small hand or body movements, for instance, may be the child’s way of expressing pleasure or connection. Parents may also need to change their perceptions regarding typical developmental milestones. They can learn, as many have, to rejoice as fully in the ability of their child who is deaf-blind to sign a new word, or to feed herself, or to return a greeting as they do over another child’s college scholarship or success in basketball or election to class office.
Parents, then, may need to shift expectations and perceptions in significant ways. They also need to do the natural grieving that accompanies the birth of a child who is disabled. Teachers and caregivers must also make these perceptual shifts. Parents’ groups and resources for teachers can provide much-needed support for those who live and work with children and adults who are deaf-blind. Such supports will help foster the mutually rewarding inclusion of children who are deaf-blind into their families and communities. (See section below for resources.)
Though deaf-blindness presents many unique challenges to both those who have visual and hearing impairments and to their caregivers and friends, these challenges are by no means insurmountable. Many persons who are deaf-blind have achieved a quality of life that is excellent. The persons who are deaf-blind who have high quality lives have several things in common.
First, they have each, in their own way, come to accept themselves as individuals who have unique experiences of the world, and valuable gifts to share. This fundamental acceptance of self can occur regardless of the severity of the particular sensory losses or other challenges that a person has. Second, they have had educational experiences which have helped them maximize their abilities to communicate and to function productively. Finally, these happy, involved persons who are deaf-blind live in families, communities, or social groups that have an attitude of welcoming acceptance. They have friends, relatives, and co-workers who value their presence as individuals with significant contributions to make to the world around them. For these persons with limited sight and hearing, and for those near them, deaf-blindness fosters opportunities for learning and mutual enrichment.
“If a child is born totally blind, how will that limitation affect her connection with those around her? The literature estimates that 75%of most people’s learning comes through vision (Smith & Cote, 1982). A deaf infant with normal vision will not have the same trouble developing early bonds with his caregivers as an infant who is blind because, as we have seen,the eyes are a main avenue for these early bonds.”
National Center on Deaf and Blindness (nationaldb.org)
Today, many children who are born deaf or blind have access to amazing support to help them navigate the world. Similarly, those who suffer loss of hearing or sight later in life have numerous resources to help them overcome communication barriers introduced by their new reality. It’s unlikely that those in this situation would be cut off completely from communicating with others. In the 1880s, Helen Keller wasn’t so fortunate. Despite all of the barriers that she faced because of her deafness, her blindness and her gender, she was able to do impressive work with Anne Sullivan to move care of the deaf-blind population forward
Those unfortunately born with no sight and hearing face many challenges.
It may seem that deaf-blindness refers to a total inability to see or hear. However, in reality deaf-blindness is a condition in which the combination of hearing and visual losses in children cause “such severe communication and other developmental and educational needs that they cannot be accommodated in special education programs solely for children with deafness or children with blindness” ( 34 CFR 300.8 ( c ) ( 2 ), 2006) or multiple disabilities. Children who are called deaf-blind are singled out educationally because impairments of sight and hearing require thoughtful and unique educational approaches in order to ensure that children with this disability have the opportunity to reach their full potential.
A person who is deaf-blind has a unique experience of the world. For people who can see and hear, the world extends outward as far as his or her eyes and ears can reach. For the young child who is deaf-blind, the world is initially much narrower. If the child is profoundly deaf and totally blind, his or her experience of the world extends only as far as the fingertips can reach. Such children are effectively alone if no one is touching them. Their concepts of the world depend upon what or whom they have had the opportunity to physically contact.
If a child who is deaf-blind has some usable vision and/or hearing, as many do, her or his world will be enlarged. Many children called deaf-blind have enough vision to be able to move about in their environments, recognize familiar people, see sign language at close distances, and perhaps read large print. Others have sufficient hearing to recognize familiar sounds, understand some speech, or develop speech themselves. The range of sensory impairments included in the term “deaf-blindness” is great.
As far as it has been possible to count them, there are over 10,000 children (ages birth to 22 years) in the United States who have been classified as deaf-blind (NCDB, 2008). It has been estimated that the adult deaf-blind population numbers 35-40,000 (Watson, 1993). The causes of deaf-blindness are many. Below is a list of many of the possible etiologies of deaf-blindness.
Major Causes of Deaf-Blindness
Syndromes-Like Down Syndrome, Trisomy13 Syndrome & Usher
Multiple Congenital Anomalies- Like CHARGE Association, Fetal alcohol syndrome, Hydrocephaly, Maternal drug abuse and Microcephaly.
Prematurity=Congenital Prenatal Dysfunction. Like AIDS, Herpes, Rubella, Syphilis and Toxoplasmosis.
Post-natal Causes- Like Asphyxia, Encephalitis, Head injury/trauma, Meningitis and Stroke.
The one major CHALLENGE these patients face:
The disability of deaf-blindness presents unique challenges to families, teachers, and caregivers, who must make sure that the person who is deaf-blind has access to the world beyond the limited reach of his or her eyes, ears, and fingertips. The people in the environment of children or adults who are deaf-blind must seek to include them—moment-by-moment—in the flow of life and in the physical environments that surround them. If they do not, the child will be isolated and will not have the opportunity to grow and to learn. If they do, the child will be afforded the opportunity to develop to his or her fullest potential.
The most important challenge for parents, caregivers, and teachers is to communicate meaningfully with the child who is deaf-blind. Continual good communication will help foster his or her healthy development. Communication involves much more than mere language. Good communication can best be thought of as conversation. Conversations employ body language and gestures, as well as both signed and spoken words. A conversation with a child who is deaf-blind can begin with a partner who simply notices what the child is paying attention to at the moment and finds a way to let the child know that his or her interest is shared.
This shared interest, once established, can become a topic around which a conversation can be built. Mutual conversational topics are typically established between a parent and a sighted or hearing child by making eye contact and by gestures such as pointing or nodding, or by exchanges of sounds and facial expressions. Lacking significant amounts of sight and hearing, children who are deaf-blind will often need touch in order for them to be sure that their partner shares their focus of attention. The parent or teacher may, for example, touch an interesting object along with the child in a nondirective way. Or, the mother may imitate a child’s movements, allowing the child tactual access to that imitation, if necessary. (This is the tactual equivalent of the actions of a mother who instinctively imitates her child’s babbling sounds.) Establishing a mutual interest like this will open up the possibility for conversational interaction.
Teachers, parents, siblings, and peers can continue conversations with children who are deaf-blind by learning to pause after each turn in the interaction to allow time for response. These children frequently have very slow response times. Respecting the child’s own timing is crucial to establishing successful interactions. Pausing long enough to allow the child to take another turn in the interaction, then responding to that turn, pausing again, and so on—this back-and-forth exchange becomes a conversation. Such conversations, repeated consistently, build relationships and become the eventual basis for language learning.
As the child who is deaf-blind becomes comfortable interacting nonverbally with others, she or he becomes ready to receive some form of symbolic communication as part of those interactions. Often it is helpful to accompany the introduction of words (spoken or signed) with the use of simple gestures and/or objects which serve as symbols or representations for activities. Doing so may help a child develop the understanding that one thing can stand for another, and will also enable him or her to anticipate events.
Think of the many thousands of words and sentences that most children hear before they speak their own first words. A child who is deaf-blind needs comparable language stimulation, adjusted to his or her ability to receive and make sense of it. Parents, caregivers, and teachers face the challenge of providing an environment rich in language that is meaningful and accessible to the child who is deaf-blind. Only with such a rich language environment will the child have the opportunity to acquire language herself or himself. Those around the child can create a rich language environment by continually commenting on the child’s own experience using sign language, speech, or whatever symbol system is accessible to the child. These comments are best made during conversational interactions. A teacher or a parent may, for example, use gesture or sign language to name the object that he or she and the child are both touching, or name the movement that they share. This naming of objects and actions, done many, many times, may begin to give the child who is deaf-blind a similar opportunity afforded to the hearing child—that of making meaningful connections between words and the things for which they stand.
Principal communication systems for persons who are deaf-blind are these:
- touch cues
- object symbols
- picture symbols
- sign language
- Signed English
- Pidgin Signed English
- braille writing and reading
- Tadoma method of speech reading
- American Sign Language
- large print writing and reading
- lip-reading speech
Along with nonverbal and verbal conversations, a child who is deaf-blind needs a reliable routine of meaningful activities, and some way or ways that this routine can be communicated to her or him. Touch cues, gestures, and use of object symbols are some typical ways in which to let a child who is deaf-blind know what is about to happen to her or him. Each time before the child is picked up, for example, the caregiver may gently lift his or her arms a bit, and then pause, giving the child time to ready herself or himself for being handled. Such consistency will help the child to feel secure and to begin to make the world predictable, thus allowing the child to develop expectations. Children and adults who are deaf-blind and are able to use symbolic communication may also be more reliant on predictable routine than people who are sighted and hearing. Predictable routine may help to ease the anxiety which is often caused by the lack of sensory information.
Stay tune for Part II tomorrow on other challenges.
Hot weather has its hazards, from rip tides to shark scares to sunburn and close encounters with poisonous plants. Simply step outside on a hot summer evening and you’re bound to become instant mosquito bait.
There are less well-known summer health hazards you should keep in mind. Hazards that affect your body from within. Here are some summer health ailments that get worse as the temperatures rise.
1. Kidney Stones
Climate change is affecting not only our planet, it’s taking a toll on our health. Case in point: A University of Texas study has found that the incidence of kidney stones will increase in step with rising record temperatures. Researchers predict a huge increase in kidney stones by 2050. To help prevent kidney stones, which are made up of mineral and acid salts, the Mayo Clinic advises staying well-hydrated (which also will help protect you from heat stroke) when the weather’s sultry. It’s important to keep levels of protein, sugar and sodium (especially) in your diet low. Note that if you live in a warm part of the country or tend to sweat a lot, you may be at higher risk of kidney stones.
2. Migraine headaches
As the temperature rises, so does the risk of migraine for someone who’s prone to them. A study of more than 7,000 emergency room patients who came in for migraine symptoms during a seven-and-a-half-year period revealed that for every 9 degree F bump in temperature, migraine cases increased. To head off migraines in summer, the Cleveland Clinic advises staying hydrated (rely on water and other non-caffeinated beverages) with eating regular meals no matter how busy you are (your bike partner can wait) and steering clear of common migraine triggers if they affect you. Some you’re likely to encounter in summer are like hot dogs, pickles, beer and certain cheeses.
Sun exposure, elevated temperatures and wind — hallmarks of summer weather — can bring rosacea flare-ups. If you have rosacea, a skin condition that causes redness, bumps, eye irritation and thickening of skin around the face and other parts of the body, fend off flare-ups!
Tips from the National Rosacea Society:
- Apply sunscreen at least 30 minutes before heading out and reapply every couple of hours.
- If you can, stay out of the sun when it’s at its strongest (between 10 a.m. – 4 p.m.)Head outside early in the morning or late in the afternoon to stay cool and avoid the heat that may trigger a flare-up
- Add a wide-brimmed hat and a good pair of shades protect your face and eyes from UV rays.
4. Heart attack
Winter may be peak season for heart attacks, but summer heat also can take a toll on people with cardiovascular disease or who are at risk for it, according to the American Association of Heart Failure Nurses (AAHFN). That’s because high temperatures increase heart rate and lower blood pressure. Folks with weak hearts may not be able to pump enough blood to cool their bodies and can quickly become overheated. If you have heart problems, the AAHFN recommends you stay inside on blistering days, make sure you drink enough fluids (and back off of caffeine and alcohol) to keep you hydrated and have someone on speed dial who can get to you quickly if you need help.
Summer whims can spell trouble for people with asthma. When air temperatures change suddenly — as when the thermometer plummets just before a thunderstorm — it can bring on asthma symptoms, according to the American Lung Association. Asthma sufferers also may have trouble breathing in outdoor air pollution as well as when ozone levels are high, which occurs more often in the summer. If you have asthma, your best protection is prevention: Keep a check on daily air quality and, if you live in a city, heed the smog warnings that often occur on steamy days. If the weather outside seems frightful, stay indoors as much as possible.
6. Summer Ozone Dangers
As the weather heats up during the summer months, ground-level ozone pollution increases as pollutants react to heat and sunlight. So if going on vacation from non ozone levels to danger ozone areas be careful. Ozone levels often increase with summer wildfires, further worsening the air quality and ozone-related breathing issues. Areas consider high in danger ozone areas are Bishop, CA, Great Basin Air District, CA, Bishop Paiute Tribe, CA, Southern Ute Indian Reservation, CO, Tallahassee, FL
|Great Basin Air District, CA||
|Bishop Paiute Tribe, CA||
|Southern Ute Indian Reservation, CO||
Go to www.airnow.gov
Exposure to ground-level ozone can exacerbate chronic respiratory symptoms, reduce lung capacity and be a trigger for asthma attacks. Other conditions affected by high ozone levels in the summertime include COPD, heart disease and diabetes.
7. Eczema Flare Ups
Yes those of us suffering from eczema understand very well that winter months can be the toughest time of year – dry air, cold temperature, low humidity making skin susceptible to eczema breakouts and flares. Remember that also here’s a plenty of sunshine, high humidity and warm temperature. All weather conditions that is ideal for eczema.
Hot weather makes everyone sweat more. Sweating is our natural defense mechanism to control the body’s temperature. Sweat consists of mostly water. As water evaporates from the skin surface, it provides a natural cooling sensation and also lowers the body temperature. In addition to water, there are trace amounts of sodium, potassium, calcium, magnesium, lactic acid, urea, copper, zinc, nickel, iron, chromium and lead in the sweat. Many of these chemicals, if presented at a high enough concentration, may be irritating to the skin.
Hot weather worsens the itch, blockage of sweat glands, and other bad summer exposures are chlorine it can wreak havoc on your skin and hair. For one thing, chlorinated water can definitely dry out your skin. Also, to prevent skin cancer, premature aging, and sunburn, it is a good idea to use sunscreens.
“Sinusitis usually occurs after a viral upper respiratory infection or cold and includes thick, discolored nasal mucus, decreased sense of smell, and pain in one cheek or upper teeth. Headaches due to sinus disease often last days or longer and migraine headaches most commonly last hours to a day or two. Headaches due to sinus disease often last days or longer and migraine headaches most commonly last hours to a day or two.”
During summer and on those very hot days it is marvellous to go to the beach, relax at the pool side, have a barbeque or even picnic out with friends and family but then you may notice that your nose starts to run, you suddenly develop a headache or you feel stuffy.
Sinuses, which are paired air spaces connected to your nose, is lined with very delicate skin called the mucus membrane. The mucus membrane may then become inflamed by many things like bacteria, colds and flu’s, allergies or even a fungus invasion. We start to feel all those dreadful symptoms when these sinus spaces are blocked, causing mucus build up and pressure.
The most common culprit of summer sinus problems is allergies and hay fever. We don’t hear enough about how pet hair, pollen, dander, dust and dust mites and even milk or how certain food allergies cause sinus problems. But what else about those hot days cause our sinuses to go ballistic?
One often hears about sudden extreme temperature changes causing increased sinus pain and a stuffy or runny nose, but how?
There are millions of tiny hair like structures called cilia that make up the mucus membrane, which lines your nose and sinuses. These cilia work together as a broom, helping to get rid of stagnant mucus that may block the sinuses. Your mucus membranes prefer a moist warm environment as opposed to it being very cold or very hot.
On hot summer days the air is very dry causing the mucus in your nose to become thick and sticky. This makes it difficult for the cilia to move or “sweep” the excess mucus out. This thick mucus then blocks the sinuses. When mucus flow is interrupted or blocked, it often becomes hard in nature and causes pressure and congestion. The pressure and the congestion then cause you to experience pain, stuffiness and headaches.
Know the difference:
Viral sinus infections are the most common type of sinusitis. Viruses that cause the common cold are usually the reason for the sinus infection. The symptoms of a viral sinus infection typically last up to seven to ten days. The first few days your symptoms will worsen and after about the fifth day you may start to see improvement. These types of sinus infections generally go away on their own with rest and vitamin C. The symptoms you may experience while having a viral sinus infection are headaches, congestion, low fever, nasal discharge, and trouble sleeping. If your cold is lingering around and does not runs its course naturally you may actually have a bacterial sinus infection. Learn the signs that indicate your cold may be a bacterial sinus infection. Viral sinus infections do not require antibiotics. When you experience any type of sinus infection it will more than likely be a viral sinus infection.
Bacterial sinus infections are less common than viral sinus infections. It may be difficult to tell the difference between bacterial and viral sinus infections because they share common symptoms.
In some cases a viral sinus infection can develop into a bacterial sinus infections. This occurs when bacteria multiplies in fluid-filled sinus pockets. Bacterial sinus infections may also resolve on their own but may require antibiotics to fight off the bacteria. Signs that your viral sinus infection has increased to a bacterial sinus infection are a noticeable increase in the severity of symptoms or failure to get better after seven to ten days. Some common symptoms of bacterial sinusitis are worsening congestion, more severe facial pain, and thickening or increase of nasal discharge. Bacterial sinus infections can also return shortly after your symptoms have healed, making you think, why do I keep getting sinus infections? If your nasal discharge or mucus is thick, dark, and/or greenish-yellowish, you may have converted to a bacterial sinus infection. Evaluation by your doctor can determine whether or not you have a bacterial or viral sinus infection. If your symptoms show no sign of improvement after ten days it is safe to say you have developed a bacterial sinus infection.
Summer Sinus Health Tips
- Try to Avoid Pollen: Pollen levels are usually highest in the morning so try and stay indoors. Use a HEPA filter, reduce carpeting, and try and vacuum the interior of your home often. Keep your windows closed during especially bad sinus days.
- Make sure you always have a Saline Nasal Spray: One of the most helpful precautions to ward off colds are to keep your nasal passages moist.
- Consider Nasal Irrigation: Cleaning out the nasal passages helps remove bacteria, pollutants and other irritants that can lead to sinus pain and infection. The simplest way is to lean over a sink and use a neti pot to run warm saline into and out of your nasal cavity. You can also use a squeeze bottle which is specifically designed to irrigate the nasal passages.
- Avoid nasal irritants: The membranes that line the nostrils and sinuses are very sensitive and can be damaged from an array of irritants. Two common irritants are tobacco smoke and chlorine. Additional items to avoid are exhaust, mold, and smoke of any kind.
- Be prepared when flying: The dry air and poor interior conditions in an airplane cabin are a perfect area for germs and bacteria to collect. Drinking lots of water and sporadically spraying inside your nose with a saline solution can help fight against these conditions.
“Nasal sinus disease, or sinusitis, affects approximately 33 million people and accounts for more than $5.8 billion in healthcare costs annually, according to a release from Monell. Most of the time, the condition is caused by infection or allergy, which, in turn, causes sinus tissues to swell.”
• The maxillary sinuses (the largest), in the cheekbones.
• The frontal sinuses, in the low-center of the forehead.
• The ethmoid sinuses, between the eyes, at the nasal bridge.
• The sphenoid sinuses, in bones behind the nasal cavity.
The sinuses are lined with soft, pink tissue called mucosa. Normally, the sinuses are empty except for a thin layer of mucus.
The inside of the nose has ridges called turbinates. Normally these structures help humidify and filter air. The nose is divided in the center by a thin wall, called the septum. Most of the sinuses drain into the nose through a small channel or drainage pathway called the middle meatus.
The purpose of the sinuses is unclear. One theory is that sinuses help humidify the air we breathe in; another is that they enhance our voices.
There are millions of bacteria in our noses, and most of the time, they’re harmless. Even when a few creep into the sinuses, they don’t cause trouble, as long as they keep draining into the nose along with mucus. But if sinus drainage is blocked, glands in the sinuses continue to produce mucus, and the resulting pool of backed-up mucus provides what Dr. Metson calls “the perfect culture medium.” The bacteria grow out of control, causing infection, and the immune system kicks off an inflammatory response. The result: swelling, which causes headache and facial pain; mucus buildup, which produces congestion; and an influx of white blood cells to fight the bacteria, which thickens the mucus and may tint it yellow or green. Other symptoms include loss of smell or taste, cough, bad breath, fever, toothache, and fullness in the ears.Sinus blockage can have a variety of environmental, anatomical, and genetic causes, but the main culprit is swelling of the nasal passages produced by the common cold or allergies. More serious sinusitis can result from structural problems, such as a deviated septum (a crook in the partition that separates the right from left nasal cavities) or nasal polyps (small, grapelike growths in the lining of the sinus cavity).