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Who Pays For Audiograms Used In Schools?

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It recently came to my attention that several school districts require parents to obtain audiograms for their children, including the arrangement for, transportation to, and payment of same. In point of fact, this began as a cyber-discussion with some teachers of the deaf from Wisconsin, who insisted that in WI, it is the responsibility of the parents to provide the audiogram for the initial IEP. My protests to the contrary were to no avail. In fact, this cyber-discussion branched out and disclosed further information:

1) Teachers report that their school system does not have educational audiologists, therefore the parents must bear the responsibility for the audiograms.

2) Teachers report that although there is a program audiologist, there is no audiology suite, so parents must take their children to a clinic for accurate audiograms for the school to work from, and pay for it.

3) Parents report that the school nurse sent a note home that she had tested the child's hearing, and the child failed the hearing tests. The parent should therefore take the child for audiological and otological examinations. There was no offer of reimbursement.

4) Parents report that after moving, the new school district insisted that the parents obtain a current audiogram at their own expense, otherwise no educational services would be provided.

5) Parents report that they routinely receive notes from their children's HI programs advising them that it is time for the child to have a new audiogram, and that they should have it done, sometimes at their own expense, and send a copy to the school.

This is truly mind-boggling to me! I know from my own personal experience in this regard that parents not only do not have to pay for the audiological services that are related to school, but they do not have to transport, either. I have known parents who received notes telling them to take their child for an audiological, and they naively forfeited wages to take time off from work to do it, and paid for the audiogram themselves. I was one of them, years ago, before I learned better.

I am so upset that this continues to happen, and even when confronted, some school employees continue to insist that the parents must do this, that I will be pursuing this with the US Dept of Ed and their Office for Civil Rights. I am writing this, however, to hopefully dispel this myth, and to advise parents who have been victimized by this, that they have the right to file a complaint pursuant to IDEA, alleging a violation of FAPE, and also to seek reimbursement for their expenses.

For those who doubt this, I am providing a legal analysis. The implementing regulation to IDEA, prior to the 1997 amendments (but substantively unchanged by IDEA-97 states:

Assistance to States for Education of Children with Disabilities
34 C.F.R. Part 300
Subpart B -- State Plans and
Local Educational Agency Applications

Reg. Sec. 300.121 Right to a free appropriate public education. (a) Each State plan must include information that shows that the State has in effect a policy that ensures that all children with disabilities have the right to FAPE within the age ranges and timelines under Reg. Sec. 300.122.


Reg. Sec. 300.8 Free appropriate public education.

As used in this part, the term "free appropriate public education" means special education and related services that (a) Are provided at public expense, under public supervision and direction, and without charge;

Reg. Sec. 300.128 Identification, location, and evaluation of children with disabilities.
(a) General requirement. Each State plan must include in detail the policies and procedures that the State will undertake, or has undertaken, to ensure that
(1) All children with disabilities, regardless of the severity of their disability, and who are in need of special education and related services are identified, located, and evaluated;

(Authority: 20 U.S.C. 1412(2)(C))

Note 1: The State is responsible for ensuring that all children with disabilities are identified, located, and evaluated, including children in all public and private agencies and institutions in the State. Collection and use of data are subject to the confidentiality requirements of Regs. Secs. 300.560- 300.576.

Note 2: Under both Parts B and H of the Act, States are responsible for identifying, locating, and evaluating infants and toddlers from birth through 2 years of age who have disabilities or who are suspected of having disabilities. In States where the SEA and the State's lead agency for the Part H program are different and the Part H lead agency will be participating in the child find activities described in paragraph (a), the nature and extent of the Part H lead agency's participation must, under paragraph (b)(2), be included in the State plan. With the SEA's agreement, the Part H lead agency's participation may include the actual implementation of child find activities for infants and toddlers. The use of an interagency agreement or other mechanism for providing for the Part H lead agency's participation would not alter or diminish the responsibility of the SEA to ensure compliance with all child find requirements, including the requirement in paragraph (a)(1) that all children with disabilities who are in need of special education and related services are evaluated.


Reg. Sec. 300.303 Proper functioning of hearing aids.

Each public agency shall ensure that the hearing aids worn by children with hearing impairments including deafness in school are functioning properly.

(Authority: 20 U.S.C. 1412(2)(B))

Note: The report of the House of Representatives on the 1978 appropriation bill includes the following statement regarding hearing aids:
"In its report on the 1976 appropriation bill the Committee expressed concern about the condition of hearing aids worn by children in public schools. A study done at the Committee's direction by the Bureau of Education for the Handicapped reveals that up to one-third of the hearing aids are malfunctioning. Obviously, the Committee expects the Office of Education will ensure that hearing impaired school children are receiving adequate professional assessment, follow-up and services."
(Authority: H. R. Rep. No. 95-381, p. 67 (1977))

Reg. Sec. 300.308 Assistive technology. Each public agency shall ensure that assistive technology devices or assistive technology services, or both, as those terms are defined in Regs. Secs. 300.5-300.6, are made available to a child with a disability if required as a part of the child's
(a) Special education under Reg. Sec. 300.17;
(b) Related services under Reg. Sec. 300.16; or
(c) Supplementary aids and services under Reg. Sec. 300.550(b)(2).

(Authority: 20 U.S. 1412(2) (5)(B))

Reg. Sec. 300.5 Assistive technology device.

As used in this part, "assistive technology device" means any item, piece of equipment, or product system, whether acquired commercially off the shelf, modified, or customized, that is used to increase, maintain, or improve the functional capabilities of children with disabilities.

Authority: 20 U.S.C. 1401(a)(25))

Reg. Sec. 300.6 Assistive technology service.

As used in this part, "assistive technology service" means any service that directly assists a child with a disability in the selection, acquisition, or use of an assistive technology device. The term includes
(a) The evaluation of the needs of a child with a disability, including a functional evaluation of the child in the child's customary environment;
(b) Purchasing, leasing, or otherwise providing for the acquisition of assistive technology devices by children with disabilities;
(c) Selecting, designing, fitting, customizing, adapting, applying, retaining, repairing, or replacing assistive technology devices;
(d) Coordinating and using other therapies, interventions, or services with assistive technology devices, such as those associated with existing education and rehabilitation plans and programs;
(e) Training or technical assistance for a child with a disability or, if appropriate, that child's family; and
(f) Training or technical assistance for professionals (including individuals providing education or rehabilitation services), employers, or other individuals who provide services to, employ, or are otherwise substantially involved in the major life functions of children with disabilities.

Authority: 20 U.S.C. 1401(a)(26))

Note: The definitions of "assistive technology device" and "assistive technology service" used in this part are taken directly from section 602(a)(25)-(26) of the Act, but in accordance with Part B, the statutory reference to "individual with a disability" has been replaced with "child with a disability." The Act's definitions of "assistive technology device" and "assistive technology service" incorporate verbatim the definitions of these terms used in the Technology-Related Assistance for Individuals with Disabilities Act of 1988.

(Emphasis added.)

Reg. Sec. 300.16 Related services.

(a) As used in this part, the term "related services" means transportation and such developmental, corrective, and other supportive services as are required to assist a child with a disability to benefit from special education, and includes speech pathology and audiology, psychological services, physical and occupational therapy, recreation, including therapeutic recreation, early identification and assessment of disabilities in children, counseling services, including rehabilitation counseling, and medical services for diagnostic or evaluation purposes. The term also includes school health services, social work services in schools, and parent counseling and training.
(b) The terms used in this definition are defined as follows:
(1) "Audiology" includes
(i) Identification of children with hearing loss;
(ii) Determination of the range, nature, and degree of hearing loss, including referral for medical or other professional attention for the habilitation of hearing;
(iii) Provision of habilitative activities, such as language habilitation, auditory training, speech reading (lip-reading), hearing evaluation, and speech conservation;
(iv) Creation and administration of programs for prevention of hearing loss;
(v) Counseling and guidance of pupils, parents, and teachers regarding hearing loss; and
(vi) Determination of the child's need for group and individual amplification, selecting and fitting an appropriate aid, and evaluating the effectiveness of amplification.

The 1997 Amendments, commonly referred to as IDEA-97, do not substantively change the obligation of the public agency to IDENTIFY AND EVALUATE, AT NO COST TO THE PARENTS, children with or suspected of having disabilities. The 1997 statute states:

20 U.S.C. Sec. 1414 - Evaluations, Eligibility, IEPs, & Placement

(a) Evaluations and Reevaluations.--
(1) Initial evaluations.--
(A) In general.--A State educational agency, other State agency, or local educational agency shall conduct a full and individual initial evaluation, in accordance with this paragraph and subsection (b), before the initial provision of special education and related services to a child with a disability under this part.
(B) Procedures.--Such initial evaluation shall consist of procedures--
(i) to determine whether a child is a child with a disability (as defined in section 602(3)); and
(ii) to determine the educational needs of such child.
(C) Parental consent.--
(i) In general.--The agency proposing to conduct an initial evaluation to determine if the child qualifies as a child with a disability as defined in section 602(3)(A) or 602(3)(B) shall obtain an informed consent from the parent of such child before the evaluation is conducted. Parental consent for evaluation shall not be construed as consent for placement for receipt of special education and related services.
(ii) Refusal.--If the parents of such child refuse consent for the evaluation, the agency may continue to pursue an evaluation by utilizing the mediation and due process procedures under section 615, except to the extent inconsistent with State law relating to parental consent.
(2) Reevaluations.--A local educational agency shall ensure that a reevaluation of each child with a disability is conducted--
(A) if conditions warrant a reevaluation or if the child's parent or teacher requests a reevaluation, but at least once every 3 years; and
(B) in accordance with subsections (b) and (c).
(b) Evaluation Procedures.--
(1) Notice.--The local educational agency shall provide notice to the parents of a child with a disability, in accordance with subsections (b)(3), (b)(4), and (c) of section 615, that describes any evaluation procedures such agency proposes to conduct.
(2) Conduct of evaluation.--In conducting the evaluation, the local educational agency shall-
(A) use a variety of assessment tools and strategies to gather relevant functional and developmental information, including information provided by the parent, that may assist in determining whether the child is a child with a disability and the content of the child's individualized education program, including information related to enabling the child to be involved in and progress in the general curriculum or, for preschool children, to participate in appropriate activities;
(B) not use any single procedure as the sole criterion for determining whether a child is a child with a disability or determining an appropriate educational program for the child; and
(C) use technically sound instruments that may assess the relative contribution of cognitive and behavioral factors, in addition to physical or developmental factors.

(3) Additional requirements.--Each local educational agency shall ensure that-
(A) tests and other evaluation materials used to assess a child under this section--
(i) are selected and administered so as not to be discriminatory on a racial or cultural basis; and
(ii) are provided and administered in the child's native language or other mode of communication, unless it is clearly not feasible to do so; and
(B) any standardized tests that are given to the child--
(i) have been validated for the specific purpose for which they are used;
(ii) are administered by trained and knowledgeable personnel; and
(iii) are administered in accordance with any instructions provided by the producer of such tests;

(C) the child is assessed in all areas of suspected disability; and
(D) assessment tools and strategies that provide relevant information that directly assists persons in determining the educational needs of the child are provided.

Please don't let anyone bamboozle you into paying for things our tax money is to pay for. There are procedures for filing complaints if your rights have been violated. If you have paid for audiograms used by the school, you should at least request reimbursement. If reimbursement is denied, you have the right to file a complaint alleging a violation of IDEA and also to pursue reimbursement. You can obtain information and assistance about the complaint process from the office of special education of your State Department of Education.


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