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Figure 1.

Flow diagram illustrating each of the stages in the data review
Flow diagram illustrating each of the stages in the data review

Characteristics of Included Studies

Article/Content (Author/s, Year, Title) Participants Setting/Location Methods/Quality Results/Outcomes
Bruce, S., Farrell, K. & Luckner, J. L. (2018). Assessment of students with sensory disabilities: Evidence-based practices. Assessment for Effective Intervention, 43, 79-89 N/A N/A A systematic review

(1) There is a need for trained personnel in DeafBlindness to teach communication and to implement child-guided and systematic approaches with students who are congenially DeafBlind.

(2) The educational team of a student who is DeafBlind should include a member who is knowledgeable about the impact of DeafBlindness, the specialized communication methods, the instructional approaches to assist with assessment, instructional planning, and program implementation.

Hartmann, E. (2012). A scale to measure teachers' self-efficacy in deaf-blindness education. Journal of Visual Impairment & Blindness, 106, 728-738. 87 in-service teachers comprising of: teachers of students with visual impairments, teachers of students who are deaf/hard-of-hearing, and teachers of students with moderate to severe disabilities. N/A Surveys and interviews Teachers have limited training in the education of children who are DeafBlind and faced many challenges.
Hersh, M. A. (2014). Improving deafblind travelers’ experiences: An international survey. Journal of Travel Research, 55, 1-15. Twenty-seven individuals who are DeafBlind, a woman with DeafBlind ness and autism, and a mother of a woman with DeafBlind ness and autism. Six different countries in Europe A qualitative approach

(1) There are main differences between countries pertaining to the availability of audio output for pedestrian crossing.

(2) Participants have various abilities with regards to perception of space and formation of mental maps.

(3) Measures are necessary for people who are DeafBlind to travel safely every day, for tourism, as well as for business (e.g., access to information, crossing indicators, street furniture, O&M training, public transport, and international standards).

(4) All transport and other workers dealing closely with the public need disability equality training, cartography courses, and training to provide services for people with DeafBlindness and other disabilities.

(5) A need exists for an international standard in accessible crossing points.

(6) Individuals with visual impairment and O&M instructors need training to use tactile maps and cartography equipment.

(7) Public transport is vital for individuals who are DeafBlind, so there should be an increased availability/frequency of buses, trams, and local trains with extended hours, including the availability of vocal announcement, and tactile information for names of bus stops.

Howley, C, Howley, A., & Teifer, D. (2017). National provisions for certification and professional preparation in low-incidence sensory disabilities: A 50-state study. American Annals of the Deaf, 163, 277-294. 50 U.S. states' preparation and licensure practices regarding students with: hearing impairment (HI), visual impairment (VI), and DeafBlindness (DB). State education agencies for document reviews and interviews Multimetho d study

(1) Many states were unable to provide trained professionals to serve students with low-incidence sensory disabilities (USD).

(2) Preparation programs for teaching students with LISD were rare and difficult to maintain because these programs targeted a "low-incidence" population that prepared very few teachers.

Jackson, L, Corea, S., Luckner, J., Muir, S. & Ferrell, K. (2005). Perceived needs of students with low incidence disabilities in rural areas. Rural Special Education Quarterly, 24, 3-14. Educators, service providers, administrators, and parents who are linked to the provision of special education and related services to students with low-incidence disabilities The United States of America (U.S.A.) Survey

(1) There is a need for qualified teachers to provide appropriate educational experiences to students with low-incidence disabilities.

(2) Around 65% of the participants thought that services to students with low-incidence disabilities were not adequate.

(3) Information on best educational practices for students with low-incidence disabilities was not easily found, posing significant challenge to teacher preparation programs.

(4) The best educational practices including positive behavior interventions, the use of assistive technology, and using technology for learning in the home were not being provided to learners with low-incidence disabilities.

(5) There is a need to develop competencies among teachers and service providers who serve students with low-incidence disabilities, especially in the areas of knowledge, skills for behavioral challenges and technological support for learning.

Jackson, R.L., Ammerman, S.B., & Trautwein, B.A. (2015). Deafness and diversity: Early intervention. American Annals of the Deaf, 160, 356-367. N/A N/A N/A

(1) Deaf educator teacher preparation programs need to provide more information to deaf educators and early interventionists about children who are deaf with a disability, including DeafBlindness.

(2) A need exists for early hearing detection and intervention programs.

(3) Deaf mentors can be on early intervention teams.

(4) Educators need to use transdisciplinary teaming and teach this skill to students in university training programs.

(5) The use of telepractice is recommended wherein early intervention professionals do not see the child in person but evaluate a child remotely - more buy-in is required for telepractice from parents.

(6) More training on evidence-based practices is needed.

Landa-Vialard, O., Ely, M.S., & Lartz, M.N. (2018). Early learning visual impairment services training and advancement (EL VISTA) project: Leading the way for a new profession within a profession. Journal of Visual Impairment & Blindness, 112, 103-112. 30 certified teachers of visually impaired students and O&M specialists. Illinois State University Case study

(1) The curriculum developed in the EL VISTA project recommended practices and personnel preparation standards for early intervention and visual impairment professionals.

(2) The practices presented in the national special education organizations should become the basis for the development of graduate courses.

(3) Personnel preparation programs need to incorporate curricula (assessment, intervention, professional collaboration, multiple disabilities) on DeafBlindness.

Nelson, C, & Bruce, S. M. (2016). Critical issues in the lives of children and youth who are deafblind. American Annals of the Deaf, 767,406-411. N/A N/A Literature review

(1) There is a need for intensive intervention in communication for individuals who are DeafBlind to become active members of society.

(2) Evidence-based strategies to help individuals who are deafblind is necessary to moderate stress, self-regulate and develop social relationships and friendships.

Nelson, C, Hyte, H.A., & Greenfield, R. (2016). Increasing self-regulation and classroom participation of a child who is deafblind. American Annals of the Deaf, 160, 496-509. A five-year-old child who was blind, had severe hearing loss, developmental disabilities, sensory integrative disorder, and echolalic speech. A self-contained classroom for children with visual impairmen ts and multiple disabilities. Single-case multiple baseline study

(1) Interventions employed by a child's intervener for decreasing challenging behaviors were successful in reducing dysregulated behaviors, and was also successful in increasing the participation of the child in school activities.

(2) The significance of meaningful activities, calming strategies, and anticipatory strategies in the development of self-regulation for a child who has several disabilities.

Parker, A. T., & Nelson, C. (2016). Toward a comprehensive system of personnel development in deafblind education. American Annals of the Deaf, 161, 486-501. Western Oregon University, Monmouth and University of Utah, Salt Lake Literature review

(1) Parents and family members are strong allies in advocating for the engagement and development of partnerships with professionals, administrators, and policymakers.

(2) University teacher preparation programs have attempted to meet the needs of teachers for preservice training with specialized knowledge in DeafBlind education through several different models including the incorporation of DeafBlind competencies into existing coursework in visual impairments, hearing loss, and/or severe disabilities, as well as the addition of specific course work in DeafBlindness.

Parker, AT. (2009). Orientation and mobility with persons who are deaf-blind: An initial examination of single-subject design research. Journal of Visual Impairment & Blindness, 103, 372-377. Twenty participants with DeafBlindness and cognitive abilities, ranging in age from 8 to 36 years (with an average age of 23 years) were included in the 13 studies. Studies were conducted in an institutiona I matrix within a closed setting. Single-Subject Design

(1) It was important to develop orientation and mobility skills for persons who are DeafBlind.

(2) Persons who are DeafBlind and have additional disabilities have experienced increased emotional and physical health due to the development of strategies for improved independence in travel as well as purpose in movement.

(3) Assistive technology (e.g., mobility tools) is important for individuals with DeafBlindness and cognitive disabilities to assist them with their orientation and mobility skills.

Sauerburger, D., Siffermann, E., & Rosen, S. (2008). Principles for providing orientation and mobility to people with vision impairment and multiple disabilities. International Journal of Orientation and Mobility, 1, 52-56 N/A N/A Best practice approach

(1) Most certified O&M specialists were not familiar with techniques for other disabilities (e.g., deaf and hard of hearing).

(2) The impact of vision impairment and multiple disabilities on people's options and abilities to function were not added together but multiplied.

(3) There was a need to be functional in the areas of assessment and instruction.

(4) Orientation and mobility specialists require orientation and mobility techniques for students who are DeafBlind.

(5) Support personnel services are needed to encourage people who are deafblind to actively participate in society.

Sample of general themes with corresponding text evidences

Recommended practices and competencies for professionals in DeafBlindness [A-15] Practices should be based on the practices presented in the national special education organizations and should include: assessment, intervention, professional collaboration, multiple disabilities/DeafBlindness, early intervention and visual impairment [25]Should be based on recommendations for quality personnel development for leading national organization in early childhood special education impairment of DeafBlindness. [A-49] There is need to develop competencies among teachers and service providers who serve students with low incidence disabilities in the areas of knowledge and skills for behavioral changes as well as technological support for learning [A-57] Orientation and mobility specialists need to provide assessment and instructional services using functional activities and environments.
Need for resources/services for students with low incidence disabilities [A-49] The best educational practices (e.g., positive behavior interventions, the use of assistive technology, and using technology for learning in the home were not being provided to learners with low incidence disabilities. [A-57] Skilled personnel need to advocate for support personnel services to enable individual in the society. [A-54] The DeafBlind population has grown over the years but their needs of access to teachers and interveners with specific knowledge and training in DeafBlindness has remained unchanged overtime [A-5] There is need for individuals with DeafBlindness to receive training in O&M skills such as communication and access to information, crossing indicators and street furniture, public transport and international standards.
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