Vol. 24, No. 2 Winter 2016 (2)

The Nevada Dual Sensory Impairment Project aims to enhance the educational services provided to children and youth, birth through 21 years who have dual sensory impairments, by providing technical assistance to families and involved agencies.

Stimulus Preference Assessments—successive choice

1-4

Resources in Nevada 5-6

Tips for Home and School : Constant Time Delay Prompting

7-8

Etiologies of Deafblindness: CMV 9

Conditions of the Eye & Ear: Tinnitus 10

Upcoming Conferences 11

Website in the Spotlight: tsbvi.edu 12

Inside this issue:

In the Summer 2014 newsletter, four types of stimulus preference assessments (SPA) were reviewed (1. paired stimulus, 2. multiple stimulus without replacement, 3. multiple stimulus, and 4. single stimulus engagement). Remember, a stimulus preference assessment is a procedure to identify stimuli (e.g., toys, activities) that may function as a reinforcer. In this newsletter, a preference assessment and special considerations for individuals with profound multiple disabilities (PMD) will be discussed. Individuals with PMD often have some, or all, of the following characteristics (Logan & Gast, 2001): physical, mental, health, sensory, and alertness impairments; medically fragile; dependent on caregivers for all aspects of daily living; little control over voluntary movement; movement

characterized by reflexive patterns; difficulty learning new skills; nonambulatory, etc.

To review: A stimulus preference

assessment is a term used to

describe several procedures to

identify stimuli (e.g., toys,

activities, edibles, etc.) that can,

potentially, function as reinforcers

(e.g., Daly III et al., 2009).

Identifying preferred stimuli can

help us to identify reinforcers.

Reinforcers are something (e.g.,

toy, activity, praise) that is

provided following a target

behavior that maintains or

increases the probability of the

target behavior occurring in the

future. ‘Target behavior’ is the

behavior that you are trying to

increase or maintain. Research has

demonstrated that learning occurs

faster when a preferred stimulus is

presented upon completion of a

target behavior (e.g., Carr,

Nicolson, Higbee, 2000).

Additionally, SPAs have been

used to identify a wide variety of

individual preferences: toys, food,

leisure items, activities, task

sequences, work preferences,

environmental preferences,

preferences for certain staff,

preferred sensory systems, etc.

For a child with PMD, it is

sometimes very difficult to

identify stimuli or “things” that

are reinforcing. Due to their

complex needs, specialized

assessment is needed. For

example, some children with

PMD may have a preferred

sensory system due to

impairments in certain systems.

That is, a child with PMD might

have vision and/or hearing

impairments that result in these

sensory systems being less

preferred or effective than other

systems. Taste and edibles may be

ineffective due to tube feedings or

harmful due to aspiration issues.

Olfactory or smell may be

ineffective due to tracheostomy.

Thus, preference assessments are

important for individuals with

PMD for several reasons (Logan

& Gast, 2001):

Nevada Dual Sensory Impairment Project

Page 1

Successive Choice Stimulus Preference Assessments

By Jill Grattan

Nevada Dual Sensory Impairment Project • Winter 2016 (2) Newsletter • Volume 24 Number 2 Page 2

MaryAnn Demchak, Ph.D. mad@unr.edu

Project Director

http://www.unr.edu/ndsip For past editions of our newsletter, visit our website.

Mailing Address: College of Education

Mail Stop 299 University of Nevada, Reno

Reno, NV 89557

(877)-621-5042 (Toll-Free in Nevada)

Fax: (775) 784-4384 (775) 784-6471 (In Reno/Sparks Area)

The University of Nevada, Reno is an Equal Opportunity/Affirmative Action employer and does not discriminate on the basis of race, color, religion, sex, age, creed, national origin, veteran status, physical or mental disability, and in accordance with University policy, sexual orientation, in any program or activity it operates. The University of Nevada employs only United States citizens and aliens lawfully authorized to work in the United States.

The contents of this newsletter were developed under a grant from the US Department of Edu-

cation, #H326T130011. However, these con-tents do not necessarily represent the policy of the US Department of Education, and you should not assume endorsement by the Federal Government.

Project Officer, Jo Ann McCann.

“To identify preferred stimuli that can be incorporated into activities” (that is, identification

of

stimuli that may motivate the child to participate in certain activities and produce higher levels of responding)

To identify preferred sensory systems “To capitalize on the individuals increased

responding to preferred and/or novel stimuli” It is difficult to determine preferred stimuli for

this population (e.g., due to lack of voluntary movement, individuals with PMD often have difficulty consistently indicating things they like or do not like)

Per multiple research studies, stimulus preference assessments are more effective in determining preferences than caregiver/family reports, teacher reports, and staff reports (e.g., nurse, early intervention team members).

To identify aversive stimuli (so they can be avoided). As part of the stimulus preference assessment, individuals may indicate things or sensory systems they do not like. For example, during the stimulus preference assessment, each time any light up toy is presented to an

individual, he/she cries. In the future, light up toys can be avoided for this particular individual.

Successive choice assessments may be the most

effective type of stimulus preference assessment for

individuals with profound multiple disabilities. To

conduct this assessment:

1. Gather stimuli (i.e., ‘things’) from a wide variety of categories (across sensory systems).

2. Approximately 5-8 objects from each sensory system are needed. The sensory systems are:

- Auditory – hearing (e.g., music) - Gustatory – taste (e.g., ice cream, apple juice) - Olfactory – smell (e.g., vanilla, spices) - Tactile – touch (e.g., vibrating objects,

brushing hair) - Vestibular – movement (e.g., swinging) - Visual – seeing (e.g., flashlight, mirror) - Multisensory – incorporating two or more of

the above (e.g., singing, tickling)

- NOTE: certain sensory systems may need to be avoided for medical reasons (e.g., gustatory if nothing can be placed in the individual’s mouth; certain types of visual stimuli if the individual has seizures).

3. Plan the time to complete the assessment; it typically takes 20-45 minutes per session.

- Modify the time if the individual appears fatigued or stops responding. That is, you can stop the assessment and start it again later.

- If necessary for an individual, take more than one period of time to complete an assessment session.

Jill Grattan, M.Ed. jillgrattan@gmail.com

Project Graduate Assistant

Nevada Dual Sensory Impairment Project • Winter 2016 (2) Newsletter • Volume 24, Number 2 Page 3

4. Responses to stimuli – clearly define each behavior for the individual participating in the assessment. The responses can include: approaching, avoiding, or not responding at all.

- Approaching – define the behavior the individual engages in when he/she wants to interact with something or someone. For example: smiling at, looking at, orientating toward, deep breathing, smacking lips, swallowing, laughing, reaching toward, etc.

- Avoiding – define the behavior the individual engages in when he/she does NOT want to interact with something or someone. For example: looking away, pushing away, closing eyes, fussing, whining, high pitched squeal, flapping hand, etc.

- Not Responding – no response at all (e.g., sleeping).

5.

Ensure the individual is positioned appropriately. That is, ensure the individual is well supported so he/she can interact and work, without having to focus on keeping him/herself stable and upright. If the individual is concentrating on being stable, he/she is less able to attend and indicate preferences.

6. Present one stimulus (object) to the individual for 15-30 seconds.

- For example, if the individual takes 15 seconds to respond to a stimulus, allow the individual 30 seconds to interact with the object.

- Make sure presentation and interaction times are consistent throughout the assessment.

7. After the individual is presented with the first object, wait 10-15 seconds before presenting the next object (remember that you will observe approaching, avoiding, or non responding).

8. Present each item once per session; conduct

multiple sessions.

9. Data collection – record all of the following:

- Whether the individual approached, avoided, or did not respond to each object presented.

- The length of time the individual interacted with each object.

- The specific response of the individual to each object (e.g., pushed away, closed eyes, smiled, looked at); use a timer.

10. Data interpretation – to determine the preferred sensory system and preferences (specifically, the items chosen 80% of presentations and above): separately, add up how many times each object was chosen and the number of times you presented each object. For example, if you presented a music toy 8 times, and the individual picked it 6 times (i.e., music toy was selected 6 out of 8 times) that is 75%).

Remember Present items in a random order (e.g., do NOT

present all tactile stimuli, then all visual, etc.); mix up the order of objects you present.

Present items in a different order during each session (e.g., do NOT always present warm washcloth first).

Repeat SPAs frequently to determine if preferences have changed – preferences change across weeks, days, or within a session.

Frequently test if a preferred stimulus functions as a reinforcer.

Always allow the individual time to interact with stimuli (‘things’) that are unknown or unfamiliar (i.e., novel) before presenting them in the preference assessment. If you do not allow the individual to become familiar with novel stimuli, he/she may avoid or select the item because it is new.

How to Use the Information (Logan & Gast, 2001)

Always pair the delivery of a tangible object with vocal reinforcement (i.e., praise).

Embed preferred stimuli into “ongoing, functional, instructional activities” to produce higher levels of responding (i.e., to help build motivation to respond). For example, to motivate an individual to use a switch, only give a little of the reinforcer (a highly preferred toy identified through a SPA) each time she/he activates the switch. That is, prompt her/him to touch the switch, allow the switch to

Nevada Dual Sensory Impairment Project • Winter 2016 (2)Newsletter • Volume 24, Number 2 Page 4

activate a preferred toy for a brief period of time (e.g., 10-30 seconds), then prompt her/him to touch the switch again to activate the toy. The individual will be much more motivated to activate the switch if the toy attached to it is highly preferred.

Systematically teach choice-making through the use of preferred stimuli.

Find stimuli to use in teaching (e.g., stimuli to motivate the individual). For example, if you find, through the preference assessment, that the individual really likes tactile objects (things you can touch and feel), you could make sure art projects contain a tactile component (e.g., add sand to finger paint, put different textures under the art paper).

“Identify voluntary affective and motor behaviors that can be increased or maintained” (e.g., used for communication). For example, the individual moves her right hand when presented with visual toys, but not when presented with any other kind of toy, and interacts with visual toys for longer periods of time. You could then start to teach the individual that when she moves her right hand, she is given the object presented to her (i.e., a request for the object).

Identify preferred sensory systems. For example, if during the SPA, you find the individual consistently chooses auditory stimuli, you might want to incorporate auditory stimuli into classroom routines and activities.

Identify non-preferred systems and/or stimuli (‘things’) to be avoided.

Stimulus preference assessments are more effective in determining which stimuli may function as a reinforcer than reports from people who interact with the individual frequently. Reinforcers may

effectively help to motivate an individual to participate in a variety of activities (e.g., work, self-care) and can be used to increase communication

(e.g., requesting). Research shows that for individuals with PMD, non-preferred stimuli do not function as reinforcers. Preferred stimuli are more likely to function as reinforcers (i.e., things chosen on 80% or more). Preference assessments can be a powerful tool to identify stimuli that may help to engage the individual.

References

Carr, J. E., Nicolson, A. C., & Higbee, T. S. (2000). Evaluation of a brief multiple-stimulus preference assessment in a naturalistic context. Journal of Applied

Behavior Analysis, 33, 353-357. Daly III, E. J., Wells, J. N., Swanger-Gagne, M. S.,

Carr, J. E., Kunz, G. M., & Taylor, A. M. (2009). Evaluation of the multiple-stimulus without replacement preference method using activities as stimuli. Journal of Applied Behavior Analysis, 42, 563-574.

Logan, K. R., & Gast, D. L. (2001). Conducting

preference assessments and reinforcer testing for individuals with profound multiple disabilities: Issues and Procedures. Exceptionality, 9, 123-134.

Logan, K. R., Jacobs, H. A., Gast, D. L., Smith, P.

D., Daniel, J., & Rawls, J. (2001). Preferences and reinforcers for students with profound multiple disabilities: Can we identify them? Journal of Developmental and Physical Disabilities, 13, 97-122.

Remember In the Summer 2014 newsletter, you can review four types of stimulus preference assessments: 1. Paired stimulus, 2. Multiple stimulus without replacement, 3. Multiple stimulus, and 4. Single stimulus engagement

You can access our past newsletters at http://www.unr.edu/ndsip/secpagesEnglish/newsletters.html

Nevada Dual Sensory Impairment Project • Winter 2016 (2)Newsletter • Volume 24, Number 2 Page 5

Resources in Nevada Vegas PBS Described and Captioned Media Center

The Vegas PBS Described and Captioned Media Center is a grand funded free-loan li-brary available to all Nevada residents. We offer a specialized collection of educational media to meet the needs of deaf, hard of hearing, blind, and visually impaired persons, their parents, and educators. Order items on line or by calling our office for assistance. Your order will be mailed direct to you free-of-charge (includes return shipping). The ac-count is free. Create your account: Online: http://VegasPBS.org/DCMC/Media Phone: 702 - 799 -1010 x5419 TTY: 702 - 799 - 1050 Email: SAbston@VegasPBS.org Our collection includes: American Sign Language Instructional vid-

eos and books Books, educational games, puzzles, and

videos addressing a wide variety of disabil-ities

Braille books, and much more!

El centro de medios de comunicación descritos y con subtítulos de Vegas PBS es una biblioteca de pré-stamo disponible a todos los residents de Nevada. Ofrecemos una colección especializada de medios educativos para satisfacer las necesidades de las personas sordas, con problemas de audición, ciegos y personas con discapacidad visual, a sus padres y educadores. Ordene por internet or llamando a nues-tra oficina para asistencia por teléfono. Su orden será enviada directamente a usted sin cargos de envio e incluiremos al giro postal de regreso. La inscripción es gratuita! Obtenga su número cuenta hoy: Online: http://VegasPBS.org/DCMC/Media Phone: 702 - 799 -1010 x5419 TTY: 702 - 799 - 1050 Email: SAbston@VegasPBS.org Nuestra colección incluye: Libros de Audio Libros sobre el tema de la ceguera y la discapaci-

dad visual Libros in Braille DVD y VHS títulos con descripciones and mas

State of Nevada, Department of Health and Human Services

Aging and Disability Services Division (ADSD)

The state of Nevada Aging and Disability Services Division would like to introduce you to

a new resource for seniors, people with disabilities, caregivers, and service providers. It is called Ne-vada’s Care Connection: Aging and Disability Resource Centers (ADRC). This program has seven (7) physical sites were consumers and caregivers can access comprehensive information and assistance in Options Counseling and long term services and supports access. One valuable component of this program is an online web portal that provides information and access to resources 24 hours a day/7 days a week. This web portal contains many components to help consumers’ find programs and ser-vices to meet their long term care needs.

www.NevadaADRC.com

Aging and Disability Services Division: adsdhelpdesk@adsd.nv.gov (775) 687- 4210

Nevada Dual Sensory Impairment Project • Winter 2016 (2) Newsletter • Volume 24 Number 2 Page 6

Visit the NDSIP website to review ALL of our Tips for Home & School as well as past newsletters

www.unr.edu/ndsip All tip sheets newsletters are available in English & Spanish

NVPep.org

“Nevada PEP is a nonprofit organization that provides a variety of services to families of children with disabilities in Nevada. Nevada PEP can help with educating parents, advocacy, and providing training on a variety of topics. Nevada PEP offers free workshops (e.g., IEP clinics are offered each month) and webinars on a variety of topics (e.g., skills for effective parent advocacy webinar, introduction to IEP workshop webinars). The schedule of webinars and workshop trainings are located on the home page. Upcoming trainings include: skills for effective parent advocacy, workshops on literacy, and evaluation and response to intervention. Check out the website for more upcoming events!

Offers a variety of services: Workshops Webinars Advocacy Skill building Statewide family network Resources

iCanConnect The National Deaf-Blind Equipment Distribution Program

“The goal of the National Deaf-Blind Equipment Distribution Program (NDBEDP) is to ensure that every person with combined hearing and vision loss has access to modern telecommunication tools and the training necessary to use them, granting every individual the opportunity to interact with the world as an involved, contributing member of society. The program — promoted by iCanConnect — provides out-reach, assessments, telecommunications technology and training free of charge to those who meet fed-eral eligibility guidelines.”

Website: http://www.icanconnect.org/

Phone: 800-825-4595 TTY: 880-320-2656

Resources in Nevada

A variety of upcoming webinars and workshops are offered, a sample is listed below—check the calendar on the webpage.

March 2—IEP clinic, Reno

March 4—webinar on bullying

March 5—IEP clinic, Las Vegas

March 10—webinar on the IEP, Spanish

March 16—webinar on reading

March 29—webinar on getting a job

Tips for Home or School Constant Time Delay Prompting

Nevada Dual Sensory Impairment Project • Winter 2016 (2)Newsletter • Volume 24, Number 1 Page 7

By: Jill Grattan & MaryAnn Demchak

What is a prompt?

In general, a prompt is assistance provided to a learner by another person (e.g., parent, teacher, paraprofessional) to in-crease the probability of correct responding to a ‘stimulus’ (e.g., vocal instruction, task materials). Prompting a child to re-spond correctly helps the child to learn faster by reducing the number of errors (or mistakes) the child may make.

What is a controlling prompt?

A controlling prompt is a prompt that increases the probability the learner will produce the correct response (i.e., almost always ensures the child will make the correct response). For example, for a child that consistently responds to a gesture prompt (e.g., the teacher points at the correct response), the controlling prompt may be a gesture. For a child who does not respond to gesture prompts, the controlling prompt may be gentle physical guidance from the teacher. The controlling prompt will be different depending on the activity and the learner. What is important to remember is that the controlling prompt is the prompt that basically guarantees child success without providing any more assistance than necessary.

What is Constant Time Delay prompting? Constant time delay (CTD) is one type of prompting strategy that can be used to effectively teach a variety of skills or tasks. CTD prompts have two levels: a) the 0-second delay and, b) the set or constant delay trials. With CTD prompting, one prompt is used (it does not change); rather, the time (or delay) when a prompt is delivered changes.

How to use What to decide in advance (prior to a teaching session):

1. The number of teaching trials with a 0-second delay; 2. The set or constant delay interval (e.g., 3 seconds, 5 seconds, 7 sec-

onds), which is the interval used for all subsequent teaching trials until the learner masters the task;

3. The type of controlling prompt; 4. The criteria to move from 0-second delay to the set or constant delay interval; 5. The criteria to move back if the child makes multiple errors at the set or constant delay interval

Initially, the discriminative stimulus (e.g., instruction) is presented at the same time as the controlling prompt; this is re-

ferred to as the 0-second delay. After a set number of trials with a 0-second delay, the delay between the instruction and

the prompt is increased (i.e., set at a specific time). For example, when teaching a child to touch a photo of a dog and the

controlling prompt is a gesture prompt: the teacher would say “Touch dog” while simultaneously pointing at the photo of a

dog. The number of trials at a 0-second delay will vary based on the student. Consider moving to the set delay trials when

the child responds correctly to the prompt at a 0-second delay across several days.

After a set number of trials with a 0-second delay, the delay between the instruction and the prompt is in-

creased (i.e., set at a specific time). Continuing with the above example, for a 5-second delay: the instruc-

tion is presented, “Touch dog,” the teacher silently counts ‘one one-thousand, two one-thousand, three

one-thousand, four one-thousand, five,’ when the teacher reaches 5, he/she presents the prompt (e.g.,

gesture prompt). This delay between the instruction and the prompt, allows the child an opportunity to re-

spond independently. However, if he or she does not respond, the prompt will still be provided. The length

of the increase between the instruction and the prompt, is dependent on the child and the task; it is generally set between

4-5 seconds. If your child requires longer processing times, the delay may be increased. The key is to have the delay be-

tween the instruction and the prompt remain constant.

Differentially reinforce prompted and independent responses – that is, provide more or bigger reinforcement for inde-pendent responses (i.e., when the child beats the prompt) and smaller or lesser quality reinforcement for prompted re-sponses (i.e., when the child responds correctly to the prompt provided).

Types of responses:

Correct responses before the prompt (i.e., child ‘beats’ the prompt) – provide more or bigger reinforcement

Correct responses after a prompt was provided – provide lesser or smaller amounts of the reinforcer

If the child responds incorrectly before the prompt – provide error correction (e.g., informational “No”) and move to the next trial.

If the child does not respond or responds incorrectly after the prompt - provide error correction (e.g., informational “No”) and move to the next trial.

Nevada Dual Sensory Impairment Project • Winter 2016 (2) Newsletter • Volume 24, Number 2 Page 8

If the child makes several consecutive errors, consider changing the set delay time. For ex-ample, if the child correctly responds to prompts at the 0-second delay, however, consistent-ly responds incorrectly at the 5-second delay – consider changing the set delay to 2-seconds and increasing the time between the instruction and the prompt when the child is successful. Example 1 of using CTD to teach a child to identify a dog in response to the instruc-tion, “Touch dog.”

For this example, the constant prompt delay is set at 3-seconds (remember, the maxi-mum delay can vary based on learner needs and the task)

The controlling prompt is a gesture (point) prompt.

The criteria to move to the next delay level is: responds correctly to prompt 100% of opportunities across two days

Example 2 of using CTD to teach a child to read the sight word ‘stop’

For this example, the constant prompt delay is set at 5-seconds (remember, the maximum delay can vary based on learner needs and the task)

The controlling prompt is a vocal prompt.

The criteria to move to the next delay level is: responds correctly to prompt 100% of opportunities across two days

What can CTD be used to teach? Research indicates CTD can be successfully used to teach a wide variety of skills (this list is not comprehensive) from self-help skills, to functional life-skills (e.g., shopping), to social skills, to academic skills (e.g., number recognition), etc.

References Walker, G. (2008). Constant and progressive time delay procedures for teaching children with autism: A literature review. Journal of Autism and Developmental Disorders, 38, 261-275.

Wolery, M., Holcombe, A., Cybriwsky, C., Doyle, P. M., Schuster, J. W., Ault, M. J., & Gast,

D. L. (1992). Constant time delay with discrete responses: A review of effectiveness and

demographic, procedural, and methodological parameters. Research in Developmental Dis-

abilities,13, 239-266.

Delay level What the teacher does Child response Criteria to move to next level

0-second delay

Instruction and prompt are presented at the same time (say: “Touch dog” pointing at the photo of the dog).

Child points to the photo of the dog

Responds correctly to prompt 100% of opportuni-ties across two days, move to next prompt level

3-second delay

Instruction presented “Touch dog” then teacher silently counts (“One one-thousand, two one-thousand, three”). When teacher says “3,” the teacher points to the photo of the dog.

Child points to the photo of the dog Initially, child points to photo after the prompt; eventually, she points to the photo before the prompt.

Delay level What the teacher does Child response Criteria to move to next level

0-second de-lay

Instruction and prompt are presented at the same time – the teacher holds up the written word ‘stop,’ and immediately reads, “Stop.”

Child reads, “Stop” Responds correctly to prompt 100% of opportuni-ties across two days, move to next prompt level

5-second de-lay

The written word ‘stop’ is held up then teacher silently counts (“One one-thousand, two one-thousand, three one-thousand, four one-thousand, five”). When teacher counts ‘5,’ the teacher reads the word, “Stop.”

Child reads, “Stop” Initially, reads the word after the prompt; eventual-ly, she reads the word be-fore the prompt

Nevada Dual Sensory Impairment Project • Winter 2016 (2)Newsletter • Volume 24, Number 2 Page 9

By: C. J. Fields

Nevada Dual Sensory Impairment Project

College of Education / MS299

University of Nevada, Reno

Reno, NV 89557

The contents of this brief were developed under a grant from the US

Department of Education, #H326C080050. However, these contents do not necessarily represent the policy of the US Department of Education, and you should not assume endorsement by the Federal Government.

Project Officer, Jo Ann McCann.

Page 1 of 1

What is cytomegalovirus?

Cytomegalovirus (CMV) is one of a group viruses which includes the herpes simplex viruses, varicella-zoster virus (chickenpox and shingles causing virus), and Epstein-Barr virus (which causes mono). These viruses are referred to col-lectively as the herpesviruses. CMV is usually harmless, and once initial infection occurs the virus can remain dormant in the infected person’s body for life. Somewhere between 50-80 adults out of every 100 in the United States are infected with CMV by the time they turn 40. Most infected adults do not become symptomatic, and most will go their entire lives never knowing that they have the CMV infection.

Transmission

CMV is often transmitted from infected people to non-infected people through di-rect contact with body fluids, such as urine, saliva, breast milk, or through reproductive secretions. CMV may also be spread through transplanted organs and blood transfusions.

Congenital CMV

Prenatal exposure to CMV can result in significant consequences for the infected child (referred to as congenital CMV infec-tion). Congenital cytomegalovirus refers to transmission of CMV from an infected pregnant mother to the fetus, through the placenta. Because CMV can be dormant in a human carrier, the mother may not know she has the infection. Current statistics indicate that 1 in every 150 children are born with congenital CMV infection; howev-er only about 1 of every 5 children born with congenital CMV infection will develop permanent issues related to the infection (such as hearing loss or developmental disabilities) due to the infection.

Newborn children with CMV may not immediately appear to have symptoms, but this does not indicate that they never will.

Signs of CMV that may be present at birth:

premature birth

liver problems

lung problems

spleen problems

small size at birth

small head size

seizures

inflammation of the retina

jaundice

mineral deposits in the brain

rash (petechiae)

Taken from http://www.cdc.gov/cmv/index.html

Permanent health problems/disabilities associated with congen-ital CMV infection:

hearing loss

vision loss

intellectual disability

small head size

lack of coordination

seizures

death (in rare cases only)

Taken from http://www.cdc.gov/cmv/index.html

Children born with CMV can develop hear-ing and vision problems over time and should therefore be screened regularly. While children born with CMV infection can develop health problems and disa-bling conditions up to two years after birth, it is more common for the CMV infection to remain dormant. Currently 80% of chil-dren with congenital CMV never develop symptoms.

Preventing Congenital CMV

Here are a few simple steps that pregnant women can take to avoid expo-sure to saliva and urine that might con-tain CMV:

Wash your hands often with soap and water for 15-20 seconds, espe-cially after:

changing diapers

feeding a young child

wiping a young child’s nose or drool

handling children’s toys

Do not share food, drinks, or eating utensils used by young children

Do not put a child’s pacifier in your mouth

Do not share a toothbrush with a young child

Avoid contact with saliva when kiss-ing a child

Clean toys, countertops, and other surfaces that come into contact with children’s urine or saliva Taken from http://www.cdc.gov/cmv/index.html

References: Centers for Disease Control and Prevention (2010). Cytomegalovirus (CMV) and congenital CMV infec-tion. Retrieved on July 25, 2013 from, http://www.cdc.gov/cmv/index.html

MedlinePlus (2013). Congenital cytomegalovirus. Retrieved on July 25, 2013 from, http://www.nlm.nih.gov/medlineplus/ency/article/001343.htm

Pregnancy image retrieved on July 25, 2013 from, http://www.nlm.nih.gov/medlineplus/ency/imagepages/17144.htm

Nevada Dual Sensory Impairment Project • Winter 2016 (2) Newsletter • Volume 24, Number 2 Page 10

What is Tinnitus? And what are the symptoms?

Tinnitus is noise (e.g., ringing, roaring, buzzing, clicking, hissing) heard, in one or both ears, when no external noise is present. The noise may be high pitched or low pitched; it may be soft or loud.

What Causes Tinnitus?

Approximately 1 in 5 people are affected by tinnitus (Mayo Clinic, 2013). Tinnitus is a symptom of an underlying condition; it is not a condition itself. Tinnitus can be caused by (Mayo Clinic, 2012; MedlinePlus, 2013):

An age-related hearing loss, an ear injury, inner ear cell damage, ear bone damage (otosclerosis), earwax blockage, exposure to loud noise, acoustic neuroma (a noncancerous [benign] tumor), other ear problems

Ear infections and/or sinus infections TMJ disorders (problems with the temporomandib-

ular joint, the joint on each side of your head in front of your ears)

Injuries or conditions that affect the nerves in your ear or the hearing center in your brain (e.g., head or neck injuries)

A circulatory system disorder (heart or blood ves-sel problems), high blood pressure, turbulent blood flow (e.g., narrowing or kinking in a neck artery), atherosclerosis

Chronic health conditions Meniere's disease (inner ear disor-

der) Brain tumors Hormonal changes in women Thyroid problems Certain medicines (e.g., certain an-

Conditions of the &

References and Pictures retrieved from: Mayo Clinic (February 5, 2013). Tinnitus. Retrieved April, 21, 2014, from, http://www.mayoclinic.org/diseases-conditions/tinnitus/basics/definition/con-20021487 MedlinePlus (March 21, 2013). Tinnitus. Retrieved April, 21, 2014, from, http://www.nlm.nih.gov/medlineplus/tinnitus.html National Institute on Deafness and Other Communication Disorders (NIDCD) (February 2014). Tinnitus. Retrieved April, 21, 2014, from, http://www.nidcd.nih.gov/health/hearing/Pages/tinnitus.aspx Ear image retrieved on April 21, 2014 from, https://www.google.com/search site=imghp&tbm=isch&source=hp&biw=1440&bih=796&q=tinnitus&oq=tinnit&gs_l=img.1.0.0l10.1995.8902.0.12659.14.12.2.0.0.0.194.1340.4j8.12.0.ehm_loc%2Chmss2%3Dfalse%2Chmnts 3D50000...0...1.1.41.img..1.13.1146.88C5vgtlE2k#imgdii=_

tidepressents, certain antibiotics)

Is hearing affected by Tinnitus?

Some cases of tinnitus are so severe that is be-comes difficult to concentrate, hear, and/or sleep. Tinnitus may interfere with the ability to hear actu-al noise.

How is Tinnitus treated?

If you have tinnitus, see your doctor. Commonly, the doctor will examine your head and neck, including asking you to move in certain ways (e.g., clench your jaw, move your arms). You may receive imag-ing tests (CT, MRI) and/or re-ceive an audiological exam. Make sure to describe the sounds you hear; this may help in diagnosis. If you receive a diagnosis of an underlying heath condition, the underlying cause of the tinnitus will be treated. This may or may not alleviate the tinni-tus. Sometimes the doctor may not be able to find a cause for tinnitus. Treatment of tinnitus depends on the cause. Treatments that may be effective include hearing aids, tinnitus retraining, acoustic neural stimula-tion, sound-masking devices (similar to hearing aids, these devices produce a white noise), white

noise machine, medicines, and ways to learn how to cope with the noise.

Tinnitus

By: Jill Grattan

I enjoy your newsletter, and I know someone who would benefit from receiving future issues. I have entered the address below.

I’ve moved! Please send future issues of your newsletter to my new address below.

E-mail required; newsletter disseminated electronically.

Name: E-mail: Address: City: State: Zip:

Return to: MaryAnn Demchak College of Education / MS 299 University of Nevada, Reno Reno, NV 89557 FAX 775-784-6298

Nevada Dual Sensory Impairment Project • Winter 2016 (2) Newsletter • Volume 24, Number 2 Page 11

2016 Mega Conference

The 2016 Mega Conference, Ready, Set, Succeed! Building Foundations for Workforce Readiness and Success, will offer quality professional development on how to provide effective instruction using inno-vative practices in the classroom and school setting. Additional keynote presentations and breakout sessions will be offered that focus on Digital Support for Learning, Gap Reduction in Special Populations, Effective Early Literacy & Reading Practices, School Climate and Culture, Setting the Stage for Post-Secondary Readiness & Success, and Differentiated & Brain Research Based Instruction. Presenters will include educators from across the state and the nation, including the renowned International Center for Leadership in Education (ICLE).

Where: Harvey’s Hotel & Casino Lake Tahoe, at Stateline

When: April 8 – 10, 2016

Website: Click on this hyperlink 2016 Mega Conference or type in this URL: http://tinyurl.com/

zp3orkw

2016 NevAEYC Conference

Theme: Leadership from Within

Where: Atlantis Casino resort Spa in Reno, Nevada

When: May 19-21, 2016

Website: http://nevaeyc.org/events/state-conference/

University of Nevada, Reno Nevada Dual Sensory Impairment Project College of Education Mail Stop 299 Reno, Nevada 89557

Texas School for the Blind and Visually Impaired

This website contains lots of information related to deaf, blind, and deaf-blindness. Some information is Texas specific; however, it has great resources for general information as well. The site has a wonderful distance learning sec-tion filled with videos on a wide variety of topics (e.g., instructional strategies, information on transition, assistive technology). Numerous publications, re-

sources, evaluations (e.g., deafblind assessments), curriculum strategies, and information on a wide variety of conditions (e.g., cortical vision impairment) are

listed on the website too.

Nevada Dual Sensory Impairment Project • Winter 2016 (2) Newsletter • Volume 24, Number 2 Page 12

Website

Www.tsbvi.edu