Early Intervention Practice for Children Who are Deaf-Blind - Evidence Base Bibliography

by National Consortium on Deaf-Blindness on Aug 31, 2013
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This is a partial list of materials on this topic available from the NCDB Catalog Database. If you have additional questions, please contact us via email:

Updated 2/2015


The Carolina Record of Individual Behavior : Characteristics of Handicapped Infants and Children --Simeonsson, Rune J. Ph.D.; Huntington, Gail S.; Short, Rick J. M.Ed.; Ware, William B. Ph.D. TOPICS IN EARLY CHILDHOOD SPECIAL EDUCATION, vol. 2, #2, July 1982, pp. 43-55. (July 1982)  Validated the Carolina Record of Individual Behavior (CRIB) through correlative and factor analyses of data on 360 handicapped Ss (CAs 3–89 mo; developmental ages 1–60 mo). It is concluded that the CRIB holds promise as a tool for assessing the behavioral characteristics of young handicapped children.


Children with Sensory Impairments --Silberman, Rosanne K.; Bruce. Susan M.; Nelson, Catherine. Baltimore: Paul H. Brookes Publishing Co. Educating Children with Multiple Disabilities: A Collaborative Approach, F.P. Orelove,  D. Sobsey and R. K. Silberman. (2004) Chapter 10  provides content on definitions, prevalence, etiologies, and the impact of vision and hearing loss on development and learning. Unique characteristics of students with sensory impairments and multiple disabilities, along with specific adaptations, accommodations, and instructional strategies are provided. This book is a widely used textbook for undergraduate and graduate education in special education and related fields. It is also useful for practicing special and general educators.  It emphasizes research-based guidance. Publisher's web site:


Early Identification of Infants Who Are Deaf-Blind --Malloy, Peggy; Thomas, Kathleen Stremel; Schalock, Mark; Davies, Steven; Purvis, Barbara; Udell, Tom. National Consortium on Deaf-Blindness. (2009) This report summarizes the activities of NCDB's Early Identification Work Group, which was formed in July 2007. The initial goals of the group were to gather information about current needs related to early identification and intervention for infants and young children with deaf-blindness and to identify potential state and national entities interested in forming partnerships with NCDB on early childhood initiatives. Three primary activities were conducted to accomplish these goals: (1) a survey of state deaf-blind project directors, (2) focus group interviews with state deaf-blind project personnel in eight states, and (3) an extensive literature review. This report describes the findings of these activities, which led the work group to narrow its focus to efforts specifically designed to promote early identification and referral. Future directions for NCDB as it forms partnerships to develop and evaluate initiatives to improve early identification of children who are deaf-blind are outlined.

Available on the web: Publisher's web site:


Early Intervention for Children Who Are Deafblind --Murdoch, Heather. EDUCATIONAL AND CHILD PSYCHOLOGY, vol. 21, #2, pp. 67-79. (2004) Limited research has been undertaken regarding the benefits of early intervention for children with deaf-blindness.  Effective early intervention is needed, especially as the national introduction of newborn hearing screening will lower the average age at diagnosis.  The complexity of the disability means that many professionals are usually involved in delivering intervention, necessitating effective multidisciplinary coordination.  In this paper, the effects of deaf-blindness on development are summarized and the literature on early intervention for children with deaf-blindness is reviewed, together with an overview of findings from work with children with single sensory impairments and anecdotal evidence from programs in other countries (the author of this paper is in the UK) with well-developed services for children with deaf-blindness.  The review indicates that the provision of early intervention for children with deaf-blindness should be specialized, coordinated, and family-focused.  The requirements for children with other complex low-incidence disabilities are likely to be similar.  The author is at the School of Education, University of Birmingham.


Early Intervention for Infants with Deaf-Blindness --Martha G. Michael; Peter V. Paul. Exceptional Children, December/January 1991, pp. 200-210. (1991) The article argues that the establishment of appropriate early intervention programs entails methods that address the use of residual sight and hearing, as well as the development of other senses.  ERIC number EJ 421 430.


Early Intervention Model for Infants Who Are Deaf-Blind --Chen, D.; Haney, M. JOURNAL OF VISUAL IMPAIRMENT AND BLINDNESS, vol. 89, #3, May-June 1995, pp. 213-221. (1995) Few techniques have been developed specifically for deaf-blind infants, but this article is based on one technique, the transactional model, which views developmental outcome as a consequence of the reciprocal interactions between an infant and his or her caregiving environment, and proposes a model of early intervention that focuses on developing and supporting the relationship between infants who are deaf-blind and their caregivers.  Following a review of the literature on caregiver-infant interaction related to dual sensory impairment, the authors propose interventions strategies to (1) develop contingent responsiveness in caregivers, (2) promote active learning in infants, (3) support mutually satisfying exchanges, and (4) address the exceptional learning needs of these infants.


Effectiveness of an Intervener Model of Services for Young Deaf-Blind Children --Watkins, Susan; Clark, Thomas; Strong, Carol; Barringer, Donald. AMERICAN ANNALS OF THE DEAF, vol. 139, no. 4, 1994, pp. 404-409. (1994) Project Validation of the Intervener Program (VIP) studied and documented the effectiveness of the Intervener Service Model which provides the services of a paraprofessional (intervener) to families of young children who are deaf-blind.  The intervener provides auditory, visual, and tactile stimulation for the child and helps the child develop interactive behaviors instead of isolated, defensive, or self-stimulatory behaviors.  The intervener also enables the parents to obtain much needed respite.  Project VIP obtained abundant quantitative and qualitative data on the effectiveness of the Intervener Service Model.  The data strongly support the need for Intervener Services for young children who are deaf-blind and their families.


Effects of Motionese on Infant and Toddlers Visual Attention and Behavioral Responsiveness --Dunst, Carl J.; Gorman, Ellen; Hamby, Deborah W. CELL REVIEWS, vol. 5, #9, 2012. (2012) Findings from eight studies (12 samples) of infants and toddlers (N = 261) investigating the effects of adults use of motionese (modifying and simplifying gestures, actions, or signs when interacting with infants and toddlers) on child outcomes are reported. Results showed that child positive affect, visual attention, and behavior engagement were enhanced when the children experienced gestures and signing that included simplifications, exaggerations, repetitions, and was slower paced. Implications for practice are described. Available on the web: Publisher's web site:


Instructional Strategies in Early Intervention Programs for Children with Deaf-Blindness --Schwartz, Ilene S.; McBride, Bonnie. Baltimore: Paul H. Brookes Publishing Co. Welcoming Students Who Are Deaf-Blind into Typical Classrooms: Facilitating School Participation, Learning, and Friendships. Norris G. Haring and Lyle T. Romer. (Eds.). (1995) Chapter 15 outlines nine recommended practices for early intervention programs and discusses how these practices can be implemented in inclusive settings serving young children with deaf-blindness and multiple disabilities.  The nine practices are (1) inclusive and community based, (2) comprehensive and adaptable, (3) multidomain assessments, (4) individualized programming, (5) normalized instructional methodologies, (6) high levels of active engagement, (7) transition planning for future placements, (8) family-focused intervention, and (9) outcome-based programming.  The information in this chapter is intended to be used by practitioners in program development and by families in evaluating prospective programs. Includes information about classroom ecology and using assessments for programming.


Interaction Between Mothers and Their Visually Impaired Infants: An Intersubjective Developmental Perpsective --Loots, Gerrit; Devise, Isabel; Sermijn, Jasmina. JOURNAL OF VISUAL IMPAIRMENT AND BLINDNESS, July 2003, pp. 403-417. (2003) In this article, an intersubjective developmental theory that focuses primarily on the development of the interworld between the caregiver and the infant is used to integrate and interpret the seemingly incoherent and contradictory research findings on the interactions between mothers and their infants with visual impairments.  The implications for further research and early intervention practices are presented.


Issues in the Evaluation of Infants and Young Children Who Are Suspected of or Who Are Deaf-Blind --Holte, Lenore; Prickett, Jeanne Glidden; Van Dyke, Don C.; Olson, Richard J.; Lubrica, Pena; Knutson, Claudia L.; Knutson, John F.; Brennan, Susan. INFANTS AND YOUNG CHILDREN, vol. 19, #3, pp. 213-227. (2006) This article provides an overview of the following topics: the effects of deaf-blindness on development, causes of deaf-blindness, and early screening and assessment strategies.  It addresses hearing and vision evaluation, developmental and cognitive assessment, educational and communication assessment, and genetic evaluation.


Issues in the Management of Infants and Young Children Who Are Deaf-Blind --Holte, Lenore; Prickett, Jeanne Glidden; Van Dyke, Don C.; Olson, Richard J.; Lubrica, Pena; Knutson, Claudia L.; Knutson, John F.; Brennan, Susan; Berg, Wendy. INFANTS AND YOUNG CHILDREN, vol. 19, #4, pp. 323-337. (2006) Young children with major auditory and visual impairments are identified as "deaf-blind." They have unique communication, developmental, emotional, and educational needs that require special knowledge, expertise, technology, and assistance. Having a child with this dual sensory impairment can create emotional and financial stress on a family. Programs that provide consultative training and technical assistance for families, education, and service providers are key in meeting the needs of such children and their families. Behavior concerns, circadian rhythm disturbances, amplification, and special education needs all require expert and prompt attention. New research is adding to our knowledge of cochlear implants, cortical stimulators, and augmentative communication, which have the potential to improve the quality of life for the child who is deaf-blind. This article is intended to introduce professionals from a variety of disciplines to current practices and important considerations in intervention with infants and young children who are deaf-blind. It also includes discussion of the crucial role of family support in optimizing outcomes for these children. A companion article on evaluation of infants and young children who are suspected of or who are determined to be deaf-blind previously appeared in Infants & Young Children, vol. 19, #3. (Author Abstract)


Lessons from Project PLAI in California and Utah : Implications for Early Intervention Services to Infants Who Are Deaf-Blind and Their Families --Chen, Deborah, Ph.D.; Alsop, Linda, M.Ed.; Minor, Lavada, M.A. Monmouth, OR: DEAF-BLIND PERSPECTIVES, vol. 7, #3, Spring 2000, pp. 1-5. (2000) This article reviews Project PLAI (promoting learning through active interaction) which developed an early communication curriculum and accompanying videotape for pre-school children who are deafblind.  The curriculum consists of five modules with strategies for recognizing communication behaviors, responding to them, and supporting the development of communication.  The article reviews the study, its participants, training, and challenges presented in the early intervention process. Available on the web:


Online Professional Development for Early Interventionists : Learning a Systematic Approach to Promote Caregiver Interactions With Infants Who Have Multiple Disabilities --Chen, Deborah; Klein, Diane; Minor, Lavada. INFANTS AND YOUNG CHILDREN, vol. 21, #2, pp. 120-133. (2008) This article describes the development, implementation, and evaluation of an online course designed to train early interventionists to implement strategies with caregivers (parents) that promote interactions with infants who have multiple disabilities. The focus was on supporting caregivers to observe and understand their infants' states and cues, and to develop responsive interaction strategies that encourage their infants' development of intentional communicative behavior. Because infants with multiple disabilities represent a low-incidence and challenging population, there is a significant need for efficient inservice methods, such as online instruction. A total of 86 early interventionists in California completed the online course successfully and used the strategies effectively with caregivers and their infants. An overview of the course content, structure, assignments, and online instruction is provided. A discussion of outcomes includes feedback from students on (a) their perception of changes in their own professional competencies based on pre- and posttest data, (b) their satisfaction with the overall course design, (c) challenges and benefits of online instruction, and (d) the impact of what they learned on their professional practice. Course effectiveness was also measured through informal analyses of online discussions, course assignments, and instructor reflections. Implications for future professional development efforts are identified.


Promoting Interactions With Infants Who Have Complex Multiple Disabilities : Development and Field-Testing of the PLAI Curriculum --Chen, Deborah, PhD; Klein, Diane M., CCC-SLP, PhD; Haney, Michele, PhD. INFANTS AND YOUNG CHILDREN, vol. 20, #2, April-June 2007, pp149-162. (2007) This article describes primary outcomes of the development and field-testing of the curriculum "Promoting Learning Through Active Interaction" with 27 infants and their caregivers and early interventionists in 2 different states. The curriculum was designed to provide a systematic approach to supporting interactions with infants who have sensory impairments and complex multiple disabilities and who are at the preintentional level of communication. Participating infants had both a visual impairment and hearing loss and additional disabilities. Their families represented diverse socioeconomic, educational, and cultural backgrounds, and participating early interventionists varied widely in their qualifications. Results indicate that a diverse group of families used the strategies successfully and found them to be helpful in supporting their children's interactions and communication development. The article outlines key components of the curriculum and discusses evaluation data on the basis of caregiver feedback on use of strategies and analysis of videotaped observations on the caregivers' use of sensory cues with their infants.


Usher Syndrome : Characteristics and Outcomes of Pediatric Cochlear Implant Recipients --Jatana, Kris R.; Thomas, Denise; Weber, Lisa; Mets, Marilyn B.; Silverman, Josh B.; Young, Nancy M. OTOLOGY & NEUROTOLOGY, vol. 34, #3, April 2013, pp. 484-489. (April 2013) OBJECTIVE: To evaluate the characteristics and outcomes of pediatric cochlear implant recipients diagnosed with Usher syndrome (US). STUDY DESIGN: Retrospective study of consecutive pediatric cochlear implant recipients (1991-2010). SETTING: Tertiary care children's hospital. PATIENTS:Children who received a cochlear implant who were diagnosed with US either before or after implantation. MAIN OUTCOME MEASURES: Electroretinography and ophthalmologic findings, cochlear anatomy based on preoperative imaging, age of independent ambulation, age at implantation, speech perception level, and communication method. RESULTS: Approximately 26 (3.7%) of 712 cochlear implant recipients were diagnosed with US based on the results of electroretinography and/or genetic testing. Preoperative imaging revealed no evidence of cochlear malformations. Average age of independent ambulation was 21.9 months (range, 12-30). Average age at implantation was 3.3 years (range, 6 mo to 11.6 yr). Mean follow-up after implantation was 7.8 years (range, 10 mo to 15.6 yr). Open-set speech perception was present in 92% of children, with use of a primarily oral communication mode in 69.2%. CONCLUSION: In this large series of patients with the diagnosis of US who have undergone cochlear implantation, CT and MRI imaging were normal. Significant delay in independent ambulation was present in this population secondary to abnormal vestibular function associated with US Type I. A majority of children developed significant open-set speech perception and oral communication skills. Implantation of US children provides them with the opportunity to develop useful hearing and oral communication.


Young Children Who are Deaf-Blind : Implications for Professionals in Deaf and Hard of Hearing Services --Chen, Deborah. VOLTA REVIEW, vol. 104, #4, Winter 2004, pp. 273-284. (2004) Most professionals (e.g., teachers, speech and language therapists, audiologists) providing deaf and hard of hearing services may not be experienced in working with a child who has a visual impairment in addition to a hearing loss. However, these professionals play a critical role in facilitating early identification and providing early intervention services to infants and pre-schoolers who are deaf-blind. This article identifies high risk factors associated with deaf-blindness. It provides relevant definitions, basic information on types of visual impairment, ways to enhance a child's use of vision and touch, and considerations in working with a young child who is deaf-blind.

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