iT h i s b o o k b e l o n g s t o 

If lost please call 


DO 


What Is 

RIGHT 


NOT 


What Is 

EASY 


CONTENTS 


MEDICAL 

P17 Initial Hearing Flow Chart 
P18 Tips for DAE 
P20 Type of Hearing Loss 
P21 Communication Approaches 
P23 Audiogram 

CHILD DEVELOPMENT 

P27 Milestones Checklist 
P47 Shared Plan of Care 


FAMILY SUPPORT 

P81 GPPT 
P82 HunterSpeaks 
P83 ACT 
P84 DSAG 
P85 GSAT 

P86 Early Intervention 

CHILD ADVOCACY 

P93 504, IDEA, ADA 

P94 504, IDEA, ADA Comparison 
Chart 

P98 Caleb’s Story 

P100 Parent Reflections 

P108 Tasha Cruz 

04

P110 IFSP 
P112 IEP 
P113 IFSP/IEP Comparison Chart 

05
05
EDUCATION 

P116 Academia 
P117 GDOE Directory 

CALENDAR 

P119 Calendar with Notes 

06 



EMERGENCY 


NUMBERS 


FOR EMERGENCIES 


CALL 911 
TEXT 322 


911 is capable of 
answering a TTY/ 
TDD 

For Persons who 
are Deaf/Hearing 
Impaired: 
(671) 475-9080 

Telephone Relay 
Service: 
711 

MY EMERGENCY CONTACTS 

Name 

Mobile Phone 

Work Phone 

Relationship 

Name 

Mobile Phone 

Work Phone 

Relationship 

Name 

Mobile Phone 

Work Phone 

Relationship 



POLICE 


MY EMERGENCY CONTACTS 

Police Precincts 

Main Office ...................................................................................(671) 472-8911 
Dededo (Northern)............................................................... (671) 632-9808/11 
Hagåtña (Central) ....................................................................... (671) 475-8541 
Tamuning (Central) ....................................................................(671) 649-6330 
Agat (Southern)...........................................................................(671) 475-8642 
Text for Speech/ Impaired ............................................................................. 322 
Crime Stoppers Hotline................................................ (671) 472-HELP (4357) 

Fire Dispatch 

FIRE 

Main Office .............................................................................. (671) 475-9082/3 
Agat ............................................................................................... (671) 565-2700 
Astumbo ....................................................................................... (671) 633-6626 
Barrigada...................................................................................... (671) 734-2264 
Dededo ..........................................................................................(671) 632-5197 
Inarajan..........................................................................................(671) 828-8177 
Piti...................................................................................................(671) 472-8139 
Sinajaña ........................................................................................ (671) 472-6342 
Talofofo ........................................................................................ (671) 789-3473 
Tamuning ................................................................................. (671) 646-8801/2 
Umatac/Merizo ........................................................................... (671) 828-8572 
Yigo ............................................................................................... (671) 653-3473 
Yoña................................................................................................(671) 789-2231 
Rescue Base 2 (Agat Marina)......................................................(671) 565-4118 

Guam Memorial Hospital Authority 


Hospital ........................................................................................ (671) 647-2555 
Ambulance............................................................................... (671) 475-9082/3

HOSPITAL 

Emergency Room...................................................................(671) 648-7908/9 
Poison Control Telephone Advice.........................................1-800-222-1222 


JCIH Joint 
Committee 
on Infant 
Hearing 

1-3-6 Plan 


screening of all infants born on 
Guam by 1 month 

complete a Diagnostic 
Audiological Evaluation (DAE) 
for infants who refer at followup 
screening by 3 months 


enrollment in early intervention 
services for infants with a 
hearing loss by 6 months 
Purpose 

The purpose of this Early Hearing Detection 
and Intervention (EHDI) Shared Plan of Care 
(SPoC) Journal is to help families navigate 
through the hearing screening process 
with ease, to assist parent(s)/caregiver(s) 
track and monitor their child’s growth and 
development, to provide families with the 
tools to become advocates for their child, 
and to easily find the appropriate services 
for the child identified with a hearing loss. 
The EHDI Journal provides families with 
contact information of agencies, service 
providers, nonprofit family support groups, 
and activities to encourage language and 
speech development. 

These are a few tips to help guide you 
through the process when your child is 
identified with a hearing loss: 

• 
Get fitted with hearing aids, 
• 
Get connected with 
family support services for 
families with Deaf or Hard 
of Hearing (DHH) children 
by connecting to Guam’s 
Positive Parents Together 
(GPPT) 
• 
Get connected with DHH 
Adults who serve as role 
models and provide insight 
to Deaf Culture. 

CONTACT 

Guam CEDDERS 
Address: University of Guam 
CEDDERS 
Office of Graduate Studies, 
Sponsored Programs, & Research 
303 University Drive 
UOG Station 
Mangilao, Guam 96913 

Phone: (671) 735-2481 
TTY: (671) 734-6531 
Fax: (671) 734-5709 
Email: cedders.online@gmail.com 

Guam EHDI 
Address: 303 University Drive 
House 22/23 Dean Circle 
Mangilao, GU 96913 

Phone: (671) 735-2466/2418 
TTY: (671) 734-6531 
Fax: (671) 735-2436 
Email: nenihearing@guamcedders.org 

NOTES 

GUAM 
CEDDERS 

ABOUT 

The University of Guam Center for Excellence in 
Developmental Disabilities Education, Research, 
and Service (Guam CEDDERS) serves as a training 
and technical assistance provider in the Pacific 
Basin region. It is the largest training, service, and 
technical assistance center at the University. 
From its inception in 1993, Guam CEDDERS has 
evolved into a dynamic organization that aims 
to build bridges with partners to create stronger 
linkages, programs, services, and supports to 
positively impact the quality of life of individuals 
with developmental disabilities and their families. 

CORE FUNCTIONS 

As mandated by the Developmental Disabilities 
Assistance and Bill of Rights Act of 2000, Guam 
CEDDERS is committed to its core functions that 
include interdisciplinary training, services and 
supports, and research and dissemination activities 
that reflect cultural relevance and sensitivity. 

MISSION STATEMENT 

Guam CEDDERS creates partnerships and 
pathways to increase the quality of life of 
individuals with developmental disabilities and 
their families. 


Guam EHDI Program Phone: (671) 735-2466 
Address: 303 University Drive House TTY: (671) 734-6531 
22/23 Dean Circle Mangilao, GU Fax: (671) 735-2436 
96913 Email: nenihearing@guamcedders.org 

GUAM 
EHDI 

The Guam Early Hearing Detection and Intervention Project (Guam 
EHDI) is 100% federally funded and was established in 2002 through 
a federal grant awarded to the University of Guam Center for 
Excellence in Developmental Disabilities Education, Research, & 
Service (Guam CEDDERS) by the U.S. Department of Health & Human 
Services (HHS), Health Resources and Services Administration (HRSA) 
to establish Guam’s Newborn Hearing Screening and Intervention 
Program. 

In 2002, Guam CEDDERS also applied for and received funding 
through a Cooperative Agreement with the U.S. HHS, Centers for 
Disease Control and Prevention (CDC) to establish an integrated 
data tracking and surveillance system to support the Guam EHDI 
Project. Guam received training and technical assistance from the 
University of Maine to develop the data system, known as Guam 
ChildLink – EHDI. 

Over the course of the Project’s 18 years of operation, Guam EHDI 
has conducted newborn hearing screening for over 50,800 babies 
born, referred 599 babies for early intervention services, and 
identified 139 babies with a hearing loss. Currently, approximately 
99% of Guam’s newborns are screened at the Guam Memorial 
Hospital Authority and the Sagua Mañågu Birthing Center. 


If I, deaf, blind, find life rich and 
interesting, how much more can you 
gain by the use of your five senses! 

Helen Keller 


NOTES 


MAYORAL CONTACT 

Agaña Heights 

Tel: (671) 472-6393/8285/8286 
Fax: (671) 472-6124 

Agat 

Tel: (671) 565-2524/4335/2531 
Fax: (671) 565-4826 

Asan-Maina 

Tel: (671) 472-6581,479-2726 
Fax: (671) 472-6446 

Barrigada 

Tel: (671) 734-3737/3859 
Fax: (671) 734-1988 

Chalan Pago - Ordot 

Tel: (671) 472-8302/8303/7173 
Fax: (671) 477-7131 

Dededo 

Tel: (671) 632-5203/5019, 637-9014 
Fax: (671) 632-1129 

Hagåtña 

Tel: (671) 477-8045/472-6379 
Fax: (671) 477-6686 

Inarajan 

Tel: (671) 475-2509/2510/2511 
Fax: (671) 828-2543 

Mangilao 

Tel: (671) 734-2163/5731 
Fax: (671) 734-4130 

Merizo 

Tel: (671) 828-8312/2941 
Fax: (671) 828-2429 

Mongmong-Toto-Maite 

Tel: (671) 477-6758/9090, 479-6800/6801 
Fax: (671) 472-6494 

Piti 

Tel: (671) 472-1232/1233 
Fax: (671) 477-2674 

Santa Rita 

Tel: (671) 565-4337/4302/4304/2514 
Fax: (671) 565-3222 

Sinajaña 

Tel: (671) 472-6707, 477-3323/9229 
Fax: (671) 472-5084 

VILLAGE MAP 

GUAM MEMORIAL HOSPITAL 

850 Gov Carlos G Camacho Rd, 
Tamuning, 96913, Guam 
Tel: (671) 647-2555 
Fax: (671) 649-5508 
Email: administration@gmha.org 
Website: www.gmha.org 

215A Chalan Santo PapaSuites 110F & 111F Commercial CenterHagatna, Guam 96932Tel: (671) 472-6940/477-8461Fax: (671) 477-8777Email: mcogadmin@teleguam.netWebsite: www.mcog.guam.govMAYORS' COUNCIL OF GUAM

VILLAGE MAP 


GUAM REGIONAL MEDICAL 
CITY 

133 Route 3, Dededo Guam 96929 
Tel: (671) 645-5580 
Fax: (671) 969-4879 
Email: customer.service@grmc.gu 
Website: https://www.grmc.gu/ 

CONTACTS 

Talofofo 

Tel: (671) 789-1421/3262/2010 
Fax: (671) 789-5251 

Tamuning-Tumon-Harmon 

Tel: (671) 646-5211/8646, (671) 6479816/
1920 
Fax: (671) 646-5210 

Umatac 

Tel: (671) 828-8252/8258/2940/8251 
Fax: (671) 828-2676 

Yigo 

Tel: (671) 653-5248/9446/9119 
Fax: (671) 653-3434 

Yoña 

Tel: (671) 789-4798/1525/1526/0012 
Fax: (671) 789-1821 

NOTES 

Guam Regional Transit Authority 

GRTA OFFICE HOURS INQUIRE PARATRANSIT 

• 
Monday-Friday ELIGIBILITY 
(671)475-4686/4616 
• 
8:00AM to 5:00PM 

STREET ADDRESS 

• 
Closed: Weekends 
542 N. Marine Corps 
and Holidays 

Drive Tamuning, 
Guam 96913

DISPATCH /SCHEDULER 

(671) 647-7433/34/35 

WEBSITE 

www.grta.guam.gov 

COMPLAINTS, TRANSIT 
ISSUES 

MAILING ADDRESS 

(671) 475-4686/4616 

P.O. Box 2896 Hagatna, 
Guam 96932
FAX NUMBER 

(671) 475-4600 


EMERGENCY PREPARATION 

PREPARE BASIC SUPPLIES 

In the event of an emergency, you should be prepared to be self-sufficient for up to 7 days. 
Preparing and maintaining an emergency supply of essential items can help you ensure that you 
have adequate supplies to meet you and your family’s needs until help arrives. 

Basic emergency supplies include: 

• 
One week supply of canned and dried food 
items 
• 
Drinking water – at least one gallon per 
person per day 
• 
Flashlights and extra batteries 
• 
Battery operated radio 
• 
First Aid kit 
• 
Whistle 
MAKE A PLAN 

• 
10 - 30 day supply of medications 
• 
Toilet tissue and personal hygiene supplies 
• 
Water for flushing toilet in the event water 
is shut off 
• 
Trash bags, gloves, duct tape or masking 
tape, and plastic containers for storing items 
• 
Chlorine bleach for sanitizing 
• 
Propane stove and extra propane gas 
Emergency preparedness also means making a plan. 

Your plan should: 

• 
Designate a place to meet if you and your 
family are separated from each other. 
• 
Pick a primary and alternate contact number 
for you and your family to call if you are 
separated from each other. 
• 
Establish a buddy system with other family 
members, friends, neighbors, or co-workers, 
and develop a plan on how you can help 
each other. 
• 
Share your plan and your emergency contact 
list with members in your buddy system. 
• 
Make a plan on how to secure your house in 
case you are not home or you are otherwise 
unable to secure your home. 
• 
Identify another place to go to in case you 
need to evacuate. 
• 
Establish your primary and alternate 
evacuation routes. 
• 
If you use mobility aids, plan on how to take 
them with you and how to store extra aids at 
your alternate shelter, if possible. 

EMERGENCY PREPARATION 

PREPARE A GO-KIT (DISASTER SUPPLY KIT) 
You should prepare a bag with your most essential items which you can grab if an emergency 
situation occurs, and you need to evacuate right away. Be sure the bag is not too heavy for you 
or someone to carry. 

Your emergency go-kit should include: 

• 
List of contact numbers 
• 
Dried foods and bottled water 
• 
Flashlight and extra batteries 
• 
Whistle 
• 
Small portable radio and extra batteries 
• 
Basic toiletries and sanitary items 
• 
Medications 
• 
Important documents, including medical 
information 
• 
Place your bag near an entry or exit way so 
it can easily be carried out. 
• 
Put reminder notices in your calendar or 
appointment book to check and replace 
items in your bag at least every 6 months. 
• 
Let people in your buddy system know 
where your GO-KIT is located. 
COMMUNICATING WITH INDIVIDUALS WHO ARE DEAF/HARD OF HEARING 
IN EMERGENCY SITUATIONS 

• 
Ask deaf individual preferred mode of communication. 
• 
Book appropriate service provider to match communication mode (e.g. sign language 
interpreter or CART). 
• 
Talk directly to the deaf individual. 
• 
Make sure you have deaf individual’s full attention before talking. 
• 
Maintain eye contact while communicating. 
• 
Separate talk from doing. Example, show paperwork to patient before asking questions. 
• 
Speak at a normal volume. Shouting can make communication more difficult. 
• 
Make sure the room is well lit so that the deaf individual can see your face clearly. 
• 
Offer quiet room or area to minimize impact of background noise. 
• 
Use written notes or diagrams to assist. 
• 
Use gestures and facial expressions. 
• 
Keep checking to make sure there are no misunderstandings. 

THINGS MAY COME TO 

THOSE WHO WAIT, BUT 
ONLY THE THINGS LEFT BY 
THOSE WHO HUSTLE. 

ABRAHAM LINCOLN 

14 

01 



The Medical section 
provides an overview of 
Guam EHDI’s hearing 
screening process and 
communication choices. 

MEDICAL 

01 



16 
SHARED PL AN OF CARE 
Guam Department of Education, Division of Special Education, Guam 
Early Intervention System (GDOE-GEIS) 
Address: 501 Mariner Avenue, Barrigada, Guam 96913 
Phone: (671) 300-5776/ 5816 
GUAM EHDI PARTNERS 
Guam Memorial Hospital Authority (GMHA) 
Address: 850 Governor Carlos Camacho Road, Tamuning, Guam 96913 
Phone: (671) 647-2330/2552 
Fax: (671) 649-5508 
Guam’s Positive Parents Together, Inc. (GPPT) 
Phone: (671) 777-7991 
Guam Hearing Doctors (GHD) 
Address: 341 S. Marine Corps Dr., Tamuning, GU 96913 
Phone: (671) 989-8378 
Sagua Mañagu Birthing Center 
Address: PeMar Place, 472 Chalan San Antonio, Tamuning, Guam 96913 
Phone: (671) 647-1417 
Department of Public Health and Social Services (DPHSS) 
Address: Northern Region Community Health Center 
520 Santa Monica Avenue, Dededo, Guam 96929 
Phone: (671) 635-4410 
TTY: (671) 734-6531 
Fax: (671) 635-4413 
Address 2: Southern Region Community Health Center 
162 Apman Drive, Inarajan, Guam 96917 
Phone: (671) 828-7516-18/ 7604/ 7501/ 7605 
Fax: (671) 828-7533 / 7504

PASS 
PASS WITHRISK FACTORS 
6 MONTHS FOLLOW UPHEARING SCREENING No additional testingneeded. Continue tomonitor your child’shearing.
Contact your pediatrician 
if you have concerns aboutyour child’s languagedevelopment 
zA mail-out reminder is sent tothe parent. 
zCall the number on the card toschedule a follow-up hearingscreening. 
zIf you do not remember if yourchild has high-risk factors forhearing loss see page 20 
PASS DID NOT PASS 
PASS 
PASS 
PASS WITHRISK FACTORS 
6 MONTHS FOLLOW UPHEARING SCREENING No additional testingneeded. Continue tomonitor your child’shearing.
Contact your pediatrician 
if you have concerns aboutyour child’s languagedevelopment 
zA mail-out reminder is sent tothe parent. 
zCall the number on the card toschedule a follow-up hearingscreening. 
zIf you do not remember if yourchild has high-risk factors forhearing loss see page 20 
PASS DID NOT PASS 
PASS 
No additional testingneeded. Continue tomonitor your child’shearing.
Contact your pediatrician 
if you have concerns aboutyour child’s languagedevelopment 
DID NOT PASS 
SMBCYour child will receive 
an appointment for anOutpatient Hearing Screen 
at SMBC 
Outpatient Hearing 
Screening at SMBC 
Audiology Clinic before 1month-oldPASS 
No additional testingneeded. Continue tomonitor your child’shearing.
Contact your pediatrician 
if you have concerns aboutyour child’s languagedevelopment 
No additional testingneeded. Continue tomonitor your child’shearing.
Contact your pediatrician 
if you have concerns aboutyour child’s languagedevelopment
INITIAL HEARING SCREENINGPRIOR TO DISCHARGE 
PASS WITH NORISK FACTORS 
*GUAM MEMORIAL HOSPITAL/ 
SAGUA MANAGU BIRTHING 
CENTER 

FLOW CHART 

OF INITIAL HEARING 
SCREENING FOR PARENTS 
(GMHA/SMBC)* 

DID NOT PASS

Your child will need 
Diagnostic AudiologicalEvaluation (DAE). GEIS 
personnel will assist inproviding you with the nextsteps. A referral to see theaudiologist is needed froma Primary Care Physician 
(PCP) 

GMHA

Your child will receive 
an Outpatient Hearing 
Rescreen Appointment at 
the GEIS/GDOE AudiologyClinic

Outpatient Hearing 

Screening at the GEIS/ 

GDOE Audiology Clinic

before 1 month-old

DID NOT PASS 

Your child will need 
Diagnostic AudiologicalEvaluation (DAE). GEIS 
personnel will assist inproviding you with the nextsteps. A referral to see theaudiologist is needed froma Primary Care Physician 
(PCP) 

Your child will need 
Diagnostic AudiologicalEvaluation (DAE). GEIS 
personnel will assist inproviding you with the nextsteps. A referral to see theaudiologist is needed froma Primary Care Physician 
(PCP) 

HEARING LOSS DIAGNOSED 

DAE BEFORE 3 MONTHS OLD 
PASS DID NOT PASS 
• 
Enroll in GEIS before 6 months old
• 
Enroll in GPPT before 6 months old
• 
Enroll/Connect with DHH adult 
before 9 months old 
No additional testing needed.
Continue to monitor your child’shearing.
Contact your pediatrician if you have 
concerns about your child’s languagedevelopment 

TIPS FOR DIAGNOSTIC AUDIOLOGICAL SERVICES (DAE) 

MY BABY DID NOT PASS THE HEARING SCREENING, WHAT DO I DO NEXT? 

Please don’t panic. Not passing the hearing screening does not mean that your baby is deaf or hardof-
hearing. We won’t know for sure without further testing. Your baby needs a Diagnostic Audiological 
Evaluation (DAE). 

The DAE is performed by an audiologist, who is a special doctor trained to diagnose and manage hearing 
loss in infants, children, and adults. 

Don't miss the DAE appointment. Only the DAE can determine the presence or absence of hearing loss. 
Early diagnosis and treatment of hearing loss will help your baby’s speech, communication, and learning. 

WHAT TO EXPECT BEFORE YOUR APPOINTMENT... 

• 
Guam Early Intervention System (GEIS) will contact you. GEIS will assist you in scheduling an 
appointment for your baby with the audiologist. 
• 
If you have medical insurance, you will need a referral from your Primary Care Physician (PCP) or 
Pediatrician to see the audiologist. GEIS will help you figure this out, too. 
HOW TO PREPARE FOR THE APPOINTMENT... 

• 
Don’t feed your baby 2 hours before the 
appointment time. 
• 
Keep your baby AWAKE 2 hours before the 
appointment. Try not to let your baby sleep on 
the car ride to the appointment. 
• 
Bring a bottle or pacifier for your baby in the 
event he/she awakes before or during the DAE. 
• 
Bring anything you need to keep your 
baby happy and asleep once you get to the 
appointment. 
• 
Breastfeeding mothers are welcome to nurse 
their baby. We will have a private room for you. 
• 
It’s best if you do not bring other children to 
the appointment. You will be too busy to watch 
other kids and the room must be quiet during 
testing. 
AUDIOLOGICAL SERVICES 

Department of Education, Division of Special 
Education ensures that all students with 
permanent or temporary hearing impairments 
are identified and provided with comprehensive 
audiological services (i.e. hearing screening 
and diagnostic evaluation), medical referrals, 
and counseling services for families and other 
related professionals. 


NOTES 

TIPS FOR DIAGNOSTIC AUDIOLOGICAL SERVICES (DAE) 

HOW LONG IS THE APPOINTMENT? 

The appointment can take 1 – 2 hours. 

HOW IS THE DAE DONE? 

• 
The audiologist will perform some or all of these tests. 
• 
These tests are harmless. They don’t hurt. In fact, most babies sleep 
throughout the entire test procedure. 
• 
Otoscopy – The audiologist will look into your baby’s ear with an 
otoscope or special ear light to look for ear wax, infection, or debris. 
• 
Auditory Brainstem Response (ABR) - The ABR will record your baby’s 
brain activity to different sounds. Three electrodes will be placed 
on your baby’s head and earphones will be placed on each ear. The 
electrodes record brain activity and the earphones deliver clicks and 
sound to each ear separately. The ABR will provide information on 
which sounds your baby can hear. This test is done for babies 0 to 6 
months of age. 
• 
Diagnostic Otoacoustic Emission (OAE) – A probe microphone is placed 
in your baby’s ear. This probe mic will send sounds and record echoes 
from the inner ear. 
• 
The echo recordings can give us information on high-frequency 
hearing. 
• 
Tympanometry - This test is used to check your baby’s middle ear. A 
small probe is placed in the ear canal and delivers positive and negative 
pressure. The pressure change will measure how well the eardrum 
moves and if the bones and muscles in the middle-ear work. This test 
can help identify if there is an ear infection. 
DAE IS DONE, WHAT’S NEXT? 

• 
The audiologist will provide a report for you, Guam Early Intervention 
System (GEIS), and your baby’s doctor. 
• 
Additional follow-up appointments with the audiologist and/or Ear, 
Nose, Throat (ENT) doctor may be necessary based on the results. 
• 
If hearing loss is identified, hearing aid consultation, selection and fitting 
process will be coordinated by GEIS and the audiologist. 
Text was adapted from information provided by the 
Minnesota Department of Health (MDH). 


TYPES OF HEARING LOSS 

RISK FACTORS FOR 
HEARING LOSS 

• 
There is concern about your baby’s 
hearing, speech, language or 
development for any reason 
• 
Family history of hearing loss 
• 
Born before or during the 30th week of 
pregnancy 
• 
Birth weight was less than 3 lbs 
• 
Experienced a lack of oxygen after birth 
• 
Needed a machine to help him/her 
breathe 
• 
Spent 48 hours or more in the Neonatal 
Intensive Care Unit (NICU) or had 
complications while in the NICU 
• 
Was given medications that might hurt 
hearing (Ask your health care provider) 
• 
Was exposed to infection that was 
present before birth 
• 
Has head, face or ears shaped or 
formed in a different way than usual 
• 
Head injury 
• 
Infection that was present at birth or 
shortly after birth (Cytomegalovirus, 
Syphilis, Rubella, etc.) 
• 
Jaundice (hyperbilirubinemia) 
needing special procedure (exchange 
transfusion) 
• 
Was given medication for cancer 
chemotherapy 
• 
Has had an infection around the brain 
and spinal cord called meningitis 
• 
Has a condition (neurological disorder) 
that is associated with hearing loss 
• 
Frequent ear infections 
• 
Syndrome (CHARGE, down, etc.) 
Conductive Hearing Loss 

Occurs when sound is not conducted efficiently 
through the outer ear canal to the eardrum and 
the tiny bones, or ossicles, of the middle ear. 
It usually involves a reduction in sound level, 
or the ability to hear faint sounds. This type of 
hearing loss can often be medically or surgically 
corrected. 

Sensorineural Hearing Loss 

Occurs when there is damage to the inner ear 
(cochlea) or to the nerve pathways from the 
inner ear (retrocochlear) to the brain. It cannot 
be medically or surgically corrected and is a 
permanent loss. This type of loss not only involves 
a reduction in sound level, or the ability to hear 
faint sounds, but it also affects the ability to hear 
clearly and understand speech. 

Mixed Hearing Loss 

Sometimes a conductive hearing loss occurs in 
combination with a sensorineural hearing loss. 
This means that there may be damage in the 
outer or middle ear and in the inner ear (cochlea) 
or auditory nerve. 


Language Development 

Language development begins 
in the womb. The first three 
years are critical to a child’s 
growth and development. All 
children need to have access 
to language as soon as they are 
born to ensure they are able 
to communicate their needs. 
For deaf and hard of hearing 
children, receiving a diagnosis 
is essential by three months of 
age to ensure communication 
options are decided upon 
early on to assist the family to 
communicate with the child. A 
parent knows what will work 
best for the child and the 
family. It is the family’s choice 
to make, with guidance from 
professionals, the DHH Parent 
Mentors/Parent Support Group, 
and DHH Adults/Mentors 
providing the most accurate 
information for communication 
choices/options. 

As you decide which 
communication option is best 
for your child and your family, 
always remember as your child 
grows older, you may find out 
that the communication option 
chosen early on no longer works 
for you and it is okay to revisit 
and change those options to 
meet the current needs of your 
child and family. 

COMMUNICATION 
APPROACHES 

Cued Speech 

Cued Speech is a system of eight handshapes that represent 
the consonants and is used with four distinct placements 
near the mouth to represent the vowels. Cued Speech 
supplements spoken sounds so that people with severe 
hearing loss can still understand and “see” spoken English. 

Cued Speech is not sign language. It was designed to teach 
deaf children how to read. 

Cued Speech can be used by both children and adults, it 
relies on the primary or traditional spoken language and 
can help strengthen abilities in that language. This method 
can improve the child’s speech, help in learning the written 
language, and help in learning other languages. Cued 
Speech can be used with the auditory-oral method and the 
bilingual-bicultural method. 

The bilingual-bicultural method means the child speaks 
two languages and is part of two cultures. The child’s first 
language is American Sign Language (ASL) and English is a 
second language used mainly for reading and writing. They 
may also learn spoken language. 

The children learn about and become part of Deaf culture 
and the Deaf community and are also still part of their 
family’s culture and community. 

American Sign Language (ASL) 

American Sign Language (ASL) uses the eyes to hear. 
Hand movements, as well as facial expressions and body 
movements, are used to communicate. ASL users ask a 
question by raising their eyebrows, widening their eyes, and 
tilting their bodies forward. Fingerspelling is part of ASL and 
is used to spell out words. ASL is widely used in the U.S. and 
Canada. 


COMMUNICATION APPROACHES 

Listening and Spoken Language 

The Listening and Spoken Language approach 
to communication is an option available for 
infants, toddlers and young children with a 
hearing loss and their families. 

Children are taught language through listening. 
This approach relies on early identification of a 
hearing loss, the use of hearing devices, such 
as hearing aids, cochlear implants, and assistive 
listening devices (such as an FM system) to help 
a child learn language by listening. 

Parents are provided support and instruction 
by an early interventionist to provide them 
with the skills needed to teach their child 
with a hearing loss how to listen. Instruction 
is provided through an Auditory-Oral (AO) or 
Auditory-Verbal (AV) approach. 

Both the auditory-oral (AO) and auditory-verbal 
(AV) methods of teaching spoken language 
calls for children to use their remaining hearing 
with the use of hearing aids, cochlear implant/s 
or an FM system and both do not encourage 
the use of sign language. The main difference 
between the two methods is the auditory-oral 
(AO) method encourages the use of speech 
reading (watching the movements of the 
mouth, face, and body to understand speech) 
and the auditory-verbal (AV) approach places 
emphasis on the child’s listening abilities to 
learn spoken language. 

For Additional Resources, 
Visit Link 

https://www.babyhearing.org/parenting/ 
communication-approach 

Total Communication (TC) 


Total Communication uses both seeing and 
hearing to teach children with hearing loss 
and to encourage children with hearing loss to 
communicate with people who can hear and 
with those with hearing loss. 

Total communication teaches children to: 

• 
Use what hearing he/she has left 
• 
Use sign language 
• 
Use speech 
• 
Use body language and gestures to express 
their ideas 
• 
Use speech reading, listening, and/or sign 
language to understand others 
• 
Learn cued speech 
As children grow, they may switch from one 
way of communicating to another so that others 
may understand them better. TC also makes 
communicating less frustrating and helps give 
them language. 


C I D C E N T R A L I N S T I T U T E F O R T H E D E A F 
© Central Institute for the Deaf St. Louis, Missouri All Rights Reserved. cid.edu/professionals 
AUDIOGRAM familiar sounds 
Adapted from Northern, J. and Downs, M. (2002). 
Hearing in Children (5th ed.). Lippincott Williams and Wilkins, Baltimore, Maryland. 
z v 
n 
ng
e l u oa
r 
p
h k 
f th 
chsh 
125 250 500 1000 2000 4000 8000 
0 
10 
20 
30 
40 
50 
60 
70 
80 
90 
100 
110 
120 
Low PITCH (Frequency in Hz) High 
LOUDNESS (Intensity in dB HL) Soft Loud 
Mild Slight 
Normal (adult) 
Normal 
(child) 
Moderately 
Severe 
Profound Severe Moderate 
s 
j m g 
i 
db 
< 3 feet > 
t 
Discussed in the CID online self-study course “Pediatric Audiology: e Basics” 
C I D C E N T R A L I N S T I T U T E F O R T H E D E A F 
© Central Institute for the Deaf St. Louis, Missouri All Rights Reserved. cid.edu/professionals 
AUDIOGRAM familiar sounds 
Adapted from Northern, J. and Downs, M. (2002). 
Hearing in Children (5th ed.). Lippincott Williams and Wilkins, Baltimore, Maryland. 
z v 
n 
ng
e l u oa
r 
p
h k 
f th 
chsh 
125 250 500 1000 2000 4000 8000 
0 
10 
20 
30 
40 
50 
60 
70 
80 
90 
100 
110 
120 
Low PITCH (Frequency in Hz) High 
LOUDNESS (Intensity in dB HL) Soft Loud 
Mild Slight 
Normal (adult) 
Normal 
(child) 
Moderately 
Severe 
Profound Severe Moderate s 
j m g 
i 
db 
< 3 feet > 
t 
Discussed in the CID online self-study course “Pediatric Audiology: e Basics” 
Reproduced with permission from CID–Central Institute for the Deaf. 
23

NOW FAITH IS BEING SURE 

OF WHAT WE HOPE FOR 
AND CERTAIN OF WHAT WE 
DO NOT SEE. 

HEBREWS 11:1 

24 

02 



The Child Development 
section includes information 
pertaining to the CDC 
Milestones and Shared Plan 
of Care. 

02 


CHILDDEVELOPMENT 


Materials developed by CDC 


Child’s Name: 

DOB: Sex: Male Female 

Mother/Guardian: 

Home Address: 

Mailing Address: 

Village: Zip: 

Home Phone: Cell Phone: 

Father/Guardian: 

Home Address: 

Mailing Address: 

City: Zip: 

Home Phone: Cell Phone: 

Preferred Method of 
Communication: 

Email Home Phone Cell Phone/Text 

Primary Language(s) used at home: 

IS AN INTERPRETER NEEDED? 
If yes, please provide the following: 
Name (Interpreter) Emergency Contact 
Relationship Relationship 
Contact number Contact number 
Email 


CARE TEAM 

DATE: 

(in addition to family) 

Contact Role/Responsibility Contact Information 
Medical Summary 

Diagnosis(es): 


DATE: MEDICATIONS 
Prescribed/Over the Counter 
Medication/Dosage Reason 

Physician’s Name: Clinic: 

Signature: Date: 

FOLLOW-UP 

Date Name of Provider Reason 

Hearing Health History 

Communication Strategies 

FILL IN ALL THAT APPLY 


American Sign Language (ASL) Auditory Oral/Auditory Verbal 


Cued Speech Total Communication 

Hearing Aid(s) Cochlear Implant 
Glasses 
? 

Other strategies or 
technologies used (if any) 


DATE: DEVICES 

Hearing Aid 
Cochlear Implant 
Speech Processor 
Bone Conduction Device

Assistive Technologies 

Type of Device: 

Manufacturer: Right Ear: Left Ear: Both: 

Model: 

Serial Number: 

Warranty: Expiration Date: 

Are molds needed? Date of Visit: 

Has the aid been ordered? Date of Order: 

Other Assistive Technology: Date Fitted: 

FOLLOW-UP 

Date Name of Provider Reason 

D ATE: CURRENT LEVEL OF DEVELOPMENT 

Development Category Date Findings 

Hearing 

Vision 

General Health 

Cognition 

Language 

Communication Skills: 

Language 

Social Emotional Skills 

Behavioral Skills 

Mental Health 

Mobility 

Gross Motor 

Fine Motor 

Self-Care/Self-Help 

Other Concerns 

Family Structure 

Date Name of Provider 

D ATE: PATIENT/FAMILY PREFERENCES 
Patient Strengths: 

Patient Challenges/Dislikes: 

Patient Stressors: 

Parent/Guardian Strengths: 

Parent/Guardian Challenges: 

Please provide me with important Reading Instruction 
information about my child in the 
following ways: 

Spoken Instruction 
Hands-on Demonstration 
Video or interactive media (e.g. websites, apps) 

Family Stressors 


Is there a person who provides you with support and 

YES NOguidance regarding your child’s diagnosis as deaf or 
hard of hearing? 


Who is that person? 


What is their role for your family? 

What other supports do I/we have? Who should this plan be shared with? 
Social Worker: Phone: 

Parent Advocate: Phone: 

Family Counselor: Phone: 

Peer Support: Phone: 

Childcare Provider: Phone: 

Deaf/HH Adult/mentor/role model: Phone: 

Other (relation and name): Phone: 

YES NO 
Connected Family with Support Program 
Name of organization: Phone: 

Describe type of 


Connect with local Parent Support Program (GPPT, Other) 

support provided: 

Connect with Deaf/Hard of Hearing Adults/programs 
Care Navigator 
State EHDI Resource Guide 
Other (explain): 


Do you feel that you are aware of all the communication options YES NO 
available to you? 


YES NO 
Do you feel that you have someone to talk to that can provide 
more information? 


Our greatest concern regarding communication options and choices 

What would you like us to know about you and your family? 

Primary concern(s): 

Day-to-day Concern(s): 

Approaches Tried/Not Tried: : 

Emergency Plan: 

Other documents available (IEP, 504 plan, IFSP, etc.) 


School: 

Address: 

Grade: 

Teacher: Phone: 

Education Services Coordinator: Phone: 

DATE: GOALS 

Goals Action/Strategy Timeframe 

Patient 

Family 

Family 

Provider 

Provider 

Possible challenges to meeting goals: 

Plans to address those challenges: 


FOLLOW-UP 

Date Name of Provider Reason 

DATE: TRANSITION PLAN 
What actions will be taken: 

Who is responsible? 

Timeline: 

SIGNATURES Parent/Guardian Relationship Date 

Care Team Member Relationship Date 

Care Team Member Relationship Date 


CARE TEAM 

DATE: 

(in addition to family) 

Contact Role/Responsibility Contact Information 
Medical Summary 

Diagnosis(es): 


DATE: MEDICATIONS 
Prescribed/Over the Counter 
Medication/Dosage Reason 

Physician’s Name: Clinic: 

Signature: Date: 

FOLLOW-UP 

Date Name of Provider Reason 

Hearing Health History 

Communication Strategies 

FILL IN ALL THAT APPLY 


American Sign Language (ASL) Auditory Oral/Auditory Verbal 


Cued Speech Total Communication 

Hearing Aid(s) Cochlear Implant 
Glasses 
? 

Other strategies or 
technologies used (if any) 


DATE: DEVICES 

Hearing Aid 
Cochlear Implant 
Speech Processor 
Bone Conduction Device

Assistive Technologies 

Type of Device: 

Manufacturer: Right Ear: Left Ear: Both: 

Model: 

Serial Number: 

Warranty: Expiration Date: 

Are molds needed? Date of Visit: 

Has the aid been ordered? Date of Order: 

Other Assistive Technology: Date Fitted: 

FOLLOW-UP 

Date Name of Provider Reason 

D ATE: CURRENT LEVEL OF DEVELOPMENT 

Development Category Date Findings 

Hearing 

Vision 

General Health 

Cognition 

Language 

Communication Skills: 

Language 

Social Emotional Skills 

Behavioral Skills 

Mental Health 

Mobility 

Gross Motor 

Fine Motor 

Self-Care/Self-Help 

Other Concerns 

Family Structure 

Date Name of Provider 

D ATE: PATIENT/FAMILY PREFERENCES 
Patient Strengths: 

Patient Challenges/Dislikes: 

Patient Stressors: 

Parent/Guardian Strengths: 

Parent/Guardian Challenges: 

Please provide me with important Reading Instruction 
information about my child in the 
following ways: 

Spoken Instruction 
Hands-on Demonstration 
Video or interactive media (e.g. websites, apps) 

Family Stressors 


Is there a person who provides you with support and 

YES NOguidance regarding your child’s diagnosis as deaf or 
hard of hearing? 


Who is that person? 


What is their role for your family? 

What other supports do I/we have? Who should this plan be shared with? 
Social Worker: Phone: 

Parent Advocate: Phone: 

Family Counselor: Phone: 

Peer Support: Phone: 

Childcare Provider: Phone: 

Deaf/HH Adult/mentor/role model: Phone: 

Other (relation and name): Phone: 

YES NO 
Connected Family with Support Program 
Name of organization: Phone: 

Describe type of 


Connect with local Parent Support Program (GPPT, Other) 

support provided: 

Connect with Deaf/Hard of Hearing Adults/programs 
Care Navigator 
State EHDI Resource Guide 
Other (explain): 


Do you feel that you are aware of all the communication options YES NO 
available to you? 


YES NO 
Do you feel that you have someone to talk to that can provide 
more information? 


Our greatest concern regarding communication options and choices 

What would you like us to know about you and your family? 

Primary concern(s): 

Day-to-day Concern(s): 

Approaches Tried/Not Tried: : 

Emergency Plan: 

Other documents available (IEP, 504 plan, IFSP, etc.) 


School: 

Address: 

Grade: 

Teacher: Phone: 

Education Services Coordinator: Phone: 

DATE: GOALS 

Goals Action/Strategy Timeframe 

Patient 

Family 

Family 

Provider 

Provider 

Possible challenges to meeting goals: 

Plans to address those challenges: 


FOLLOW-UP 

Date Name of Provider Reason 

DATE: TRANSITION PLAN 
What actions will be taken: 

Who is responsible? 

Timeline: 

SIGNATURES Parent/Guardian Relationship Date 

Care Team Member Relationship Date 

Care Team Member Relationship Date 


CARE TEAM 

DATE: 

(in addition to family) 

Contact Role/Responsibility Contact Information 
Medical Summary 

Diagnosis(es): 


DATE: MEDICATIONS 
Prescribed/Over the Counter 
Medication/Dosage Reason 

Physician’s Name: Clinic: 

Signature: Date: 

FOLLOW-UP 

Date Name of Provider Reason 

Hearing Health History 

Communication Strategies 

FILL IN ALL THAT APPLY 


American Sign Language (ASL) Auditory Oral/Auditory Verbal 


Cued Speech Total Communication 

Hearing Aid(s) Cochlear Implant 
Glasses 
? 

Other strategies or 
technologies used (if any) 


DATE: DEVICES 

Hearing Aid 
Cochlear Implant 
Speech Processor 
Bone Conduction Device

Assistive Technologies 

Type of Device: 

Manufacturer: Right Ear: Left Ear: Both: 

Model: 

Serial Number: 

Warranty: Expiration Date: 

Are molds needed? Date of Visit: 

Has the aid been ordered? Date of Order: 

Other Assistive Technology: Date Fitted: 

FOLLOW-UP 

Date Name of Provider Reason 

D ATE: CURRENT LEVEL OF DEVELOPMENT 

Development Category Date Findings 

Hearing 

Vision 

General Health 

Cognition 

Language 

Communication Skills: 

Language 

Social Emotional Skills 

Behavioral Skills 

Mental Health 

Mobility 

Gross Motor 

Fine Motor 

Self-Care/Self-Help 

Other Concerns 

Family Structure 

Date Name of Provider 

D ATE: PATIENT/FAMILY PREFERENCES 
Patient Strengths: 

Patient Challenges/Dislikes: 

Patient Stressors: 

Parent/Guardian Strengths: 

Parent/Guardian Challenges: 

Please provide me with important Reading Instruction 
information about my child in the 
following ways: 

Spoken Instruction 
Hands-on Demonstration 
Video or interactive media (e.g. websites, apps) 

Family Stressors 


Is there a person who provides you with support and 

YES NOguidance regarding your child’s diagnosis as deaf or 
hard of hearing? 


Who is that person? 


What is their role for your family? 

What other supports do I/we have? Who should this plan be shared with? 
Social Worker: Phone: 

Parent Advocate: Phone: 

Family Counselor: Phone: 

Peer Support: Phone: 

Childcare Provider: Phone: 

Deaf/HH Adult/mentor/role model: Phone: 

Other (relation and name): Phone: 

YES NO 
Connected Family with Support Program 
Name of organization: Phone: 

Describe type of 


Connect with local Parent Support Program (GPPT, Other) 

support provided: 

Connect with Deaf/Hard of Hearing Adults/programs 
Care Navigator 
State EHDI Resource Guide 
Other (explain): 


Do you feel that you are aware of all the communication options YES NO 
available to you? 


YES NO 
Do you feel that you have someone to talk to that can provide 
more information? 


Our greatest concern regarding communication options and choices 

What would you like us to know about you and your family? 

Primary concern(s): 

Day-to-day Concern(s): 

Approaches Tried/Not Tried: : 

Emergency Plan: 

Other documents available (IEP, 504 plan, IFSP, etc.) 


School: 

Address: 

Grade: 

Teacher: Phone: 

Education Services Coordinator: Phone: 

DATE: GOALS 

Goals Action/Strategy Timeframe 

Patient 

Family 

Family 

Provider 

Provider 

Possible challenges to meeting goals: 

Plans to address those challenges: 


FOLLOW-UP 

Date Name of Provider Reason 

DATE: TRANSITION PLAN 
What actions will be taken: 

Who is responsible? 

Timeline: 

SIGNATURES Parent/Guardian Relationship Date 

Care Team Member Relationship Date 

Care Team Member Relationship Date 


FAMILIES PLAY AN 
IMPORTANT ROLE 
IN THEIR CHILD’S 
DEVELOPMENT 

To schedule a Free 
Developmental Screening 
or for more information on 
early childhood development 
call (671) 300-5776/5816 



The Family Support section 
provides information 
for organizations and 
programs that aid 
individuals with disabilities 
and their families. 

03 


FAMILY 
SUPPORT 


ARE YOU A PARENT 
WITH A CHILD WHO IS 
DEAF/HARD OF 
HEARING? 

YOU ARE NOT ALONE... 
WE UNDERSTAND... 


For more information, please contact 
Guam’s Positive Parents Together, Inc. at (671) 777-7991 
gpptguam@gmail.com 


GUAM’S POSITIVE 
PARENTS TOGETHER, 
INC. (GPPT) 

In early 2007, a group of parents who have 
children with differing disabilities came 
together and started Guam’s Positive Parents 
Together, Inc. GPPT is a tax exempt, FOR 
IMPACT organization whose mission is to 
support and empower families who have 
children with disabilities. 

GPPT parent volunteers are here for parents 
and families who may just need to talk to 
someone who is walking in similar shoes. 
Raising a child is not easy and even more 
challenging to raise one with a disability. We 
know! And we are here to listen, share our 
experiences and provide available resources 
to you that may help make it just a little 
easier. 

In early 2018, we formed a Parent Support 
Group for parents of Deaf or Hard of Hearing 
(DHH) children. The primary purpose 
is to give parents of a newly identified 
DHH child support from another parent 
who has been there and understands the 
emotional challenges; provide information 
and resources; engage and encourage our 
new parents to join our Parent Support 
Group; empower parents to advocate for 
their DHH child, and educate parents on 
how to navigate the early intervention and 
educational system. We also work closely 
with other Guam DHH providers to assist our 
parents. 

CONTACT 

PHONE: 

(671) 777-7991 

EMAIL: 

gpptguam@gmail.com 



HUNTERSPEAKS 
ORGANIZATION 

ABA 

ABA is short for applied behavior analysis and is often described as 
the "gold standard" for autism treatment. ABA is a science that uses 
research based interventions to look at how behavior is affected by 
the environment and how it impacts learning. ABA therapy focuses 
on improving functional skills for real world application such as 
communication, social skills, self-care, and play while also reducing 
behaviors that can interfere with learning. 

HunterSpeaks is a 501(c)(3) nonprofit 
organization aimed at providing 
medically necessary autism treatment 
to affected children on Guam. Our 
autism programs and trainings are 
based on the principles of Applied 
Behavior Analysis (ABA). 

HunterSpeaks Organization offers 
evidence based therapy for individuals 
with autism and related disorders in a 
variety if settings: center, home, and 
community. 

ABA is proven to be the most effective 
method of teaching children on the 
spectrum, and has been endorsed by 
the Surgeon General, the American 
Academy of Pediatrics, and the 
Association for Science in Autism 
Research. 

Our compassionate staff received 
extensive training to ensure your child 
gets the personalized and effective 
treatment they need to develop age 
appropriate language, social, and 
independent living skills. 

Source: https://www.hunterspeaksguam.org/learn 


AUTISM 
COMMUNITY 
TOGETHER 

ACT’s mission is to promote family education and community 
partnerships which are accepted and respected as beneficial 
for everyone - the child, the family, and the schools - in order 
to ensure a successful and supported education, community 
awareness and participation 

zAtmosphere of increased awareness and 
acceptance of individuals with Autism Spectrum 
Disorder (ASD). 
zSupport to individuals, their parents, or 
caregivers and families living with ASD 
zAssistance to find information, referrals to 
community resources, help navigate their way 
zTraining, workshops, information on topics that 
help individuals & families living with ASD 
zAdvocacy for effective services and unique 
needs of individuals and families living with ASD 
zFamily Fun events and activities 
CONTACT 

FACEBOOK: 

#autismguam 

PHONE: 

(671) 687-1284 

EMAIL: 

autismcommunityguam@gmail.com 

NOTES 


Do you want to know who you 
are? Don’t ask. Act! Action will 
delineate and define you. 

THOMAS JEFFERSON 


CONTACT 

Juan & Vicky Arriola 
Tel: (671) 472-6114 

Josie & Vince Guerrero 
Tel: (671) 888-5792 

Helen & Mike Middlebrook 
Tel: (671) 477-6706 

Nacrina Mendiola 
Tel: (671) 789-7610 

David & Maruxa Atienza 
Tel: (671) 789-9887 

Chris Walke & Kerry Cutting 
Tel: (671) 734-9633 

DOWN 
SYNDROME 
ASSOCIATION 
OF GUAM 

If your doctor has said your baby may have 
Down Syndrome you have many reasons to be 
sad, depressed, or scared. Having a baby is hard 
enough, but having a baby with Down Syndrome 
can be overwhelming. 


WE KNOW. WE’VE BEEN THERE. 
WE’RE DOING IT. WE’RE THE DOWN 
SYNDROME ASSOCIATION OF GUAM. 

DSAG is a group of parents who have children 
with Down Syndrome and we know the 
difficulties and joys of caring for a child with 
Down Syndrome on Guam. 

• 
Down Syndrome is the most common 
genetic disease. Approximately 1 in every 
1000 babies is born with Down Syndrome. 
• 
Down Syndrome is also called Trisomy 21 
because the condition occurs when there 
are three 21st chromosomes in the cells of 
the body. 
• 
Down Syndrome is a developmental 
disability. Having an extra chromosome 
in each cell changes the way the cell, and 
the whole body works. It changes the way 
a person can use the information around 
him, which makes learning a challenge for 
children with the condition. 

GUAM 
SYSTEM FOR 
ASSISTIVE 
TECHNOLOGY 

GSAT SERVICES/PROGRAMS 

GSAT Demonstration & Resource 
Center 

GSAT is a center, available to the community, 
where visitors can visit, learn, and make an 
informative decision in selecting the best AT to 
meet their needs. 

• 
AT Device Demonstrations 
• 
Equipment Displays 
• 
Annual Assistive Technology 
Conference & Fair 
AT Device 30-day Lending Library 

The GSAT center allows the community an 
opportunity to test and try any device 
available at the center. In addition, devices 
can be taken home, to school, or even to the 
workplace for a 30-day period, free of charge. 

• 
Information and Referral 
• 
Training on AT Devices & Software 
• 
Database Library of Products & 
Services 
CONTACT 

Leah Abelon (V) Phone: (671) 735-2490/1 

AT Center Coordinator TDD: (671) 735-2491 
Fax: (671) 734-8378 
Email: leah.abelon@guamcedders.org 
Website: www.gsatcedders.org 

AT Recycling & Equipment 
Exchange 

GSAT, with the help of community partners, 
attempts to repair and refurbish old or used AT 
devices which are later available to the 
community for purchase. 

• 
Collection of used AT equipment 
• 
Listing of AT devices for sale or 
exchange 
Alternative Funding Programs 

GSAT’s loan programs provide the community 
a means to purchase AT or pursue home-
based employment. 

• 
Low interest rates and flexible 
payment terms 
• 
No credit history required 
Address: House #19, Dean Circle, 
University of Guam 


8 REASONS TO SAY YES TO 
EARLY INTERVENTION 
FOR YOUR CHILD 
WHO IS DEAF/HARD OF 
HEARING (D/HH) 
…WHAT ARE YOU 
WAITING FOR? 

Adapted with permission from the Hands & Voices Family 
Leadership in Language and Learning (FL3) Center 

http://handsandvoices.org/fl3/resources/8reasons-ehdi.html 

Link to original document 

https://www.handsandvoices.org/fl3/resources/pdfs/SayYestoEI.pdf 


01 

Early Intervention is worth the time 

Early Intervention (EI) will help you incorporate 
language development and needed supports for your 
child into your daily routines. Research shows early 
involvement can help you and your child on the path 
to future success. 


02 

We are in this together 

Feeling overwhelmed or isolated? Professionals and 
other parents of D/HH kids can share this journey with 
you and support you. A whole community is ready to 
embrace you. Hearing other families’ experiences can 
help you think ahead through your own journey. 

03 

Early Involvement will help your 
other family members 

As you understand your own child’s needs through 
EI, your child’s siblings, extended family, friends and 
neighbors can learn to better communicate with 
and include your child . If your circle of support is small, 
EI helps build a larger circle to surround your family. 

04 

There is more to this than just 
‘google it’ 

With a seemingly endless world of resources, articles, 
videos, online support, podcasts, and more, where is 
the wisdom? A personal connection to EI providers 
can help you process the information available at your 
fingertips with what you know and can try with your 


own child. 

"Designed by Macrovector_Official / Freepik" 


You may feel like you don’t know anything about 
what being D/HH might mean for your child. You 
may not see your family as part of this world. A “new 
normal” can be a life of joy, and better than imagined. 
05 
You don’t know what you don’t know. Having support 
through EI helps you learn important questions to ask and 
how to find answers in what works for your child. You will 
be able to answer the questions most pressing to your 
child’s needs. 
You will ask better questions 
06 
You can adapt services to be in line with your family’s 
values and goals for your child’s future, provided in your 
language and cultural context. A system is in place to 
ensure that EI providers and programs are a match to 
your family and child’s needs. 
You can do this in the context 
of your own family’s values 
07 
You will become your child’s best advocate in the 
school years by learning about deafness, language 
and development through EI. Your advocacy will light 
the path for your child’s success. 
You will gain confidence that you 
are your child’s best advocate 
08 
Facing your fears will 
bring freedom 
88

THE IMPORTANCE OF 
EARLY INTERVENTION (EI) 
FOR CHILDREN WITH A 

HEARING LOSS 

Language is the foundation of learning. Hearing loss 
can affect an infant’s speech, language and social 
skills. It is important for infants identified with a 
hearing loss to receive early intervention (EI) services 
as early as six months of age or sooner! The earlier 
your child receives EI services the sooner you, your 
child, and family can communicate with each other. 

Early intervention services for infants and families 
vary, however, each intervention service plays an 
important role in the growth and development of 
your child. The more services your child and family 
receive, the better the outcomes will be for your 
child. Research shows that children who receive 
early intervention services before six months of age 
can greatly improve the child’s development. 


Early Intervention Services 

Professional Services - Guam Early Intervention 
System (GEIS), Guam Department of Education 
(GDOE), Division of Special Education 

• 
Newborn Developmental 
Screening 
• 
Developmental Evaluation 
• 
Hearing Evaluation 
• 
Speech/Language Evaluation 
Services 
• 
Physical/Occupational Therapy 
• 
Transition Services 
• 
Family training, counseling, and 
Home Visits 
• 
Medical, Nursing, and Nutritional 
Services 
• 
Vision Services 
• 
Special Instruction 
• 
Social Work Services 
• 
Transportation 
• 
Assistive Technology 
• 
Play-based Therapy 
Hearing Devices (Hearing Aids, Cochlear 
Implants, etc.) 

Join a Parent Support Group (See page 80-84) 

Meet Deaf and Hard of Hearing Adults 


THE WAY TO GET STARTED 

IS TO QUIT TALKING AND 
BEGIN DOING. 

WALT DISNEY 

90 

04 



This section gives an 
overview on different laws 
in the area of disabilities 
and personal experiences by 
individuals with disabilities 
or their parents. 

04 


CHILDADVOCACY 


The Vocational Rehabilitation Act of 1973, Title V, was passed 
to prevent discrimination against people with disabilities in the 

504

United States. This law protects any person who (1) has a physical 
or mental impairment which substantially limits one or more 
of such person’s major life activities, (2) has a record of such 
impairment, or (3) is regarded as having such an impairment. 
Students can receive related services under Section 504 even if 
they are not receiving special education. 

IDEA 

First passed in 1975, IDEA was originally called, “The Education of All Handicapped Children Act”. 
Congress passed the bill which provides federal financial assistance to state and local education 
agencies to ensure special education and related services are provided to eligible children with 
disabilities, including free appropriate public education (FAPE) to children with disabilities with an 
emphasis on special education and related services aimed to meet their unique needs. Schools are 
required to find and evaluate students suspected of having disabilities, at no cost to families. This 
is called Child Find. Child Find is a legal obligation for schools to find all children ages 0-21, who 
may have disabilities and who may be entitled to special education services. So that parents or legal 
guardians have a voice in their child’s education, the law provides specific rights and protections for 
families at every point of the process Parents and legal guardians have a say in the decisions the school 
makes for your child, and the school must get your consent before providing services to your child. 
IDEA provides early intervention services for infants up to age three and special education services for 
children ages 4 through graduation or age 21, whichever comes first. 

ADA 


The Americans with Disabilities Act (ADA) became law in 1990. The ADA 
is a civil rights law that allows access for all persons with disabilities in all 
areas of public life, including jobs, schools, transportation, and all public 
and private places that are open to the general public. The purpose of the 
law is to make sure that people with disabilities have the same rights and 
opportunities as everyone else. The ADA gives civil rights protections to 
individuals with disabilities similar to those provided to individuals on the 
basis of race, color, sex, national origin, age, and religion. 

In 2008, the Americans with Disabilities Act Amendments Act (ADAAA) 
was signed into law and became effective on January 1, 2009. The ADAAA 
made a significant number of changes to the definition of “disability.” The 

Act stresses that the definition of disability should be understood to be in 
favor of wide coverage of individuals to the greatest degree allowed by the 
terms of the ADA and in general, shall not require wide-range evaluation. 


Comparison of Pertinent Areas of Section 

IDEA PART B, 504 & ADA 

Areas IDEA Section 504 ADA 
Type Education Act Civil Rights Law Civil Rights Law 
Title The Individuals with 
Disabilities Education 
Act (IDEA) (2004) 
The Rehabilitation Act of 1973 Americans with 
Disability Act of 
1990 (ADA) & ADA 
Amendments Act, 2008 
Responsible 
Entity 
Special Education General Education Public and Private 
Schools 
Funding State, local, and federal 
funding (IDEA funds 
cannot be used with 
students who are only 
eligible under 504) 
No federal funding-state and 
local school responsibility 
No federal funding- 
Public and private 
responsibility 
Administrator Special Education 
Director or designee 
Section 504 Coordinator (for 
entities with 15 employees or 
more) 
504 Coordinator 
may oversee ADA 
responsibilities 
Service Tool Individualized 
Education Program 
• 
Appropriate Academic 
Adjustments 
• 
Accommodations and/or 
Services 
Reasonable 
Accommodations and 
Legal Employment 
Practices 
Purpose To provide educational 
rights and benefits for 
children with disabilities 
including the right 
to a free appropriate 
public education, an 
IEP designed to meet 
the child’s unique 
needs, and procedural 
safeguards. 
• 
To protect the rights of 
individuals with disabilities 
from discrimination in 
programs and activities that 
receive Federal financial 
assistance from the U.S. 
Department of Education; 
• 
To empower individuals with 
disabilities to maximize 
employment, economic self-
sufficiency, independence, 
and inclusion and 
integration into society. 
• 
To provide a clear 
and comprehensive 
national mandate 
for the elimination 
of discrimination 
against individuals 
with disabilities; 
• 
To prohibit 
discrimination 
on the basis 
of disability by 
state and local 
governments. 


COMPARISON OF PERTINENT AREAS 

Areas 
Population 
Free 
Appropriate 
Public 
Education 
(FAPE) 
IDEA 

• 
Identifies 13 categories 
of qualifying conditions: 
• 
Autism 
• 
Deaf Blindness 
• 
Deafness 
• 
Emotional disturbance 
• 
Hearing Impairment 
• 
Mental Retardation 
• 
Multiple disability 
• 
Orthopedically 
impairment 
• 
Other health impaired 
• 
Specific learning 
disability 
• 
Speech or language 
impairment 
• 
Traumatic Brain Injury 
• 
Visually impaired 
including blindness 
Requires the school to 
provide an IEP designed 
to meet the child’s unique 
needs and from which the 
child receives educational 
benefit (i.e. “appropriate 
education”). 

Section 504 

ADA 

• 
Identifies students as disabled so long as 
she/he meets the definition of qualified 
persons with disabilities (e.g., “has a 
physical or mental impairment; has a 
history of impairment; or is believed to 
have a disability that substantially limits a 
major life activity such as caring for one’s 
self, performing manual tasks, seeing, 
hearing, eating, sleeping, walking, standing, 
lifting, bending, speaking, breathing, 
learning, reading, concentrating, thinking, 
communicating, and working”). 
• 
Determination must be made without 
considerations for “mitigating measures”. 
• 
Applies to all employers, schools and 
educational programs, nursing homes, 
mental health centers, and human service 
programs that receive or benefit from 
Federal financial assistance. 
• 
Requires the 
provision of regular 
or special education 
and related aids 
and services that 
are designed to 
meet individual 
educational needs 
as adequately as the 
needs of persons 
without disabilities 
are met. 
• 
“Appropriate” 
means an education 
comparable to the 
education provided 
to nondisabled 
students. 
Americans with Disability 
Act of 1990 (ADA) & ADA 
Amendments Act, 2008 

• 
Addresses education in 
terms of accessibility 
requirements but does 
not require individual 
entitlement for FAPE. 
• 
Public entities cannot use 
employment practices that 
discriminate on the basis 
of a disability. 
Both require the provision of a free appropriate 
public education to eligible students, including 
individually designed instruction. 


COMPARISON OF PERTINENT AREAS 

Areas IDEA Section 504 ADA 
Eligibility A student is only eligible 
to receive special 
education and/ or 
related services if the 
multidisciplinary team 
determines that the 
student has a disability 
under one of the thirteen 
qualifying conditions 
and requires specially 
designed instruction to 
receive FAPE. 
• 
A student is eligible 
so long as she/he 
meets the definitions 
of qualified person 
with disabilities, i.e., 
currently has or has 
had a physical or 
mental impairment 
which substantially 
limits a major 
life activity, or is 
regarded as disabled 
by others. 
• 
The student is not 
required to need 
specially designed 
instruction in order 
to be protected. 
• 
Mitigating measures 
cannot be used to 
exclude students. 
• 
A person is eligible so 
long as she/he meets the 
definition of qualified 
person with disabilities, 
i.e., currently has or 
has had a physical or 
mental impairment which 
substantially limits a 
major life activity, or is 
regarded by others as 
having a disability. 
• 
Mitigating measures 
cannot be used to 
exclude a person. 
• 
ADAAA (2008) aligned 
ADA and 504 definitions 
of disabilities. 
Accessibility 
Requires that accommodations and 
modifications must be made to provide 
access to FAPE; IEP students automatically 
protected under 504. 
Requires that public 
and private programs be 
accessible to individuals 
with disabilities and 
that “reasonable 
accommodations” are 
provided to students with 
disabilities. 
Undue Size of the program and Consideration is given Size of the business and its 
Hardship its budget, type of operation, 
nature and cost of 
accommodation. 
for the size of the 
program, extent of 
accommodation, and 
cost relative to school 
budget. 
budget, type of operation, 
nature and cost of accommodation. 
Procedural Comprehensive system No written notice Makes provisions for public 
Safeguards of safeguards including 
written notice prior to 
any change in placement 
and the right to an 
independent evaluation 
at public expense. 
requirement for 
placement change. 
notice, hearings, and 
awarding attorney fees. 


COMPARISON OF PERTINENT AREAS 

Areas IDEA Section 504 ADA 
Consent Requires written 
consent before 
initial evaluation and 
placement. 
Does not require consent but a 
school district would be wise to 
do so. 
Consent not required. 
Due Process 
Both statutes require schools to provide impartial 
hearings for parents or guardians who disagree with 
the identification, evaluation, records or placement of 
students with disabilities. 
Due process hearing 
can be initiated by 
either party. The court 
may allow the prevailing 
party, other than the 
United States, a reasonable 
attorney’s fee. 
Delineates specific Requires that the parent have 
requirements. an opportunity to participate 
and be represented by counsel. 
Other details are left to the 
discretion of the school district. 
Policy statements should clarify 
specific details. 
Enforcement Enforced by the U.S. 
Office of Special 
Education Programs, 
U. S. Department of 
Education, Office of 
Special Education 
Programs, with 
oversight by the 
U.S. Department of 
Education. 
• 
Enforced by the U.S. Office 
for Civil Rights. 
• 
State Department 
of Education has no 
monitoring, complaint 
resolution, or funding 
involvement. 
In education, enforced 
by the U.S. Office for 
Civil Rights (each Federal 
agency has its own 
504 regulations that 
apply to its programs). 

Adapted with permission from the Hands & Voices Educational Advocacy Guidebook 

https://www.handsandvoices.org/resources/products.htm#astra 


CALEB’S 
STORY 
FEATURED STORY CALEB’S 
STORY 
FEATURED STORY 
98 


My son, Caleb Suzuki, fell ill with meningitis and 
was hospitalized in ICU for two to three weeks. 
This was a trying time for my family and me. 
While in the hospital, Caleb required a regiment 
of antibiotics, which led to a recommendation 
from his physician for further testing of his vision 
and hearing. My husband and I followed up with 
the recommendation for a hearing screening and 
had Caleb screened at Chief Brodie Audiology 
Office. At this screening, I found out that Caleb 
would require a sedated Auto- acoustic Brainstem 
Response (ABR), which Guam did not have at the 
time. We then went off-island to have Caleb’s 
vision, and hearing screened. The evaluation 
revealed that Caleb had a profound hearing loss. I 
had a mixture of emotions when I received the news of 
Caleb’s profound hearing loss. The thought of him never hearing 
my voice was overwhelming news. I remember purchasing a sign program 
shortly after learning of Caleb’s hearing loss. I was determined to provide 
Caleb with as many resources available for children to develop language skills 
for effective communication. When we returned home, bags of different sign 
language resources were delivered, and I felt so excited and a bit worried. I 
didn’t know where to begin. The Early Intervention Program and Special 
Education Program really have assisted in the little man he is today. 

He entered the Special Education Preschool Program at three years of age 
and is currently a fifth-grader at P.C. Lujan Elementary School. He is proficient 
in American Sign Language (ASL). He has excellent teachers! He is currently 
mainstreamed into the fifth-grade class and has an interpreter. 

My goal for Caleb is to have him attend Gallaudet University in Washington D.C. 
I am doing my best to set a strong foundation for him to reach this goal. He is a 
fearless young man who is ready to take on the world. 

I would like to see more parents of children with hearing loss be active in 
the community and expose their children to more experiences. There is a 
whole wide world out there that I want Caleb to be a part of. Caleb is a very 
social person, and he thinks everyone knows how to sign. I believe the more 
interactions Caleb has with the Deaf Community and the community at large, 
the more confident he will be, which will enable him to accomplish his dreams! 

99 


PARENT 
REFLECTIONS 

100 


AS A 
FAMILY 

WITH JAMAE QUENGA (JQ) 

Q. What is it like parenting a deaf or 
hard of hearing child? 
JQ Challenging 
Q. What has been the most challenging 
part of your family’s journey? 
JQ The challenging part is communicating 
with our daughter. She can’t let us 
know how she feels if she’s hurting, or 
what she wants and needs. 
Q. What is the most rewarding part of 
your family’s journey? 
JQ The most rewarding part is that we 
love our daughter unconditionally no 
matter what. Her father and I were 
always doing things that came our 
way. We did things for just us. Then, we 
had our daughter. She was the most 
precious beautiful little human being 
we could’ve imagined. We do things as 
a family of three. We experience things 
as a family and we are stronger as a 
family. 
Q. Joyful moments… 
JQ Joyful moments are with our daughter. 
She may not hear or talk, but she gave 
us the meaning of life and she gave 
us the meaning of love. Her dad and 
I didn’t know we can love such an 
amazing little human...until we had her. 

Q. 

JQ 

Q. 

JQ 

Q. 

JQ 


What do you want your child to 
know? 

He and I would love for her to know 
that anything is possible if you set your 
mind on it. 

What would you like to tell parents 
who have just been told their child is 
deaf or hard of hearing? 

I would tell them that it will be a 
challenge but in the end nothing else 
matters than loving your child and 
protecting them, and teaching them 
that they can do anything even though 
they may be deaf or hard of hearing. 

Final thoughts… 

Every day we learn something new 
from her and for her. Just be patient 
and in time you will learn to find a way 
to communicate with your child your 
own way. 


THE 
LANGUAGE 
OF LOVE

 WITH ANN MARIE D. CRUZ 
(AMC) AND JOHN CRUZ (JC) 

Q. What is it like parenting a deaf or 
hard of hearing child? 
AMC Jescilla has other disabilities which is 
sometimes referred to as Deaf Plus. 
She is profoundly deaf, intellectually 
and physically challenged, so for me, 
I think it’s a bit more challenging. 
Although already an adult, Jescilla’s 
vocabulary is still more like a toddler. 

So, although not easy, there are still 
many joys she brings to our lives every 
day. I feel that she is a gift from God 
and that she has brought so much love 
and affection to our family because we 
see that she loves life even if she is not 
able to do what everyone else gets to 
do. 

Oh! there are the hard times. She has 
her tantrums and there are extremely 
hard times and I still, every now and 
then wonder why. But when all is said 
and done, I feel extremely blessed for 
being given such a beautiful soul to be 
mom to. 

Q. What has been the most challenging 
part of your family’s journey? 
AMC The lack of services. In order to get a 
proper diagnosis for Jescilla, we had 
to travel off island. In order to be 
active in her education and because 
planning her education requires more 
interaction with the school, I’ve had to 
miss work. In order to provide a safe 
place for her after aging out of school, 
we’ve turned to family to care for her 
while I work because there are not 
enough programs for our adults with 
disabilities. 

Specifically, for her deafness, it’s the 
lack of free and effective learning 
environments to learn ASL for the 
families. 


Q. What is the most rewarding part of 
your family’s journey? 
AMC I think I touched on it earlier, that she 
is a gift from God and has brought so 
much love and affection to our family. 
She has also taught us patience and 
understanding. To be more accepting 
of the challenges we are given in life, 
to know that we can get through 
the toughest times and to be more 
accepting and open with others. 


PARENTAL REFLECTIONS 

Q. Joyful moments… Q. 
AMC The first moment when we noticed 
she loves music and dancing. It was at 
a party and there was a DJ with lights 
and a dance floor. She communicated 
AMC 
that she wanted to go to the dance 
floor by pointing to the dance floor and 
so we took her onto the dance floor 
and she started to dance. We realized 
that she probably felt the vibration 
from the large speakers. 
That was exciting but my most joyful 
moments are when she is laughing, 
giving me hugs and kisses which 
happens very often. 


Q. 

AMC 

Q. 

AMC 

What would you like to tell parents 
who have just been told their child is 
deaf or hard of hearing? 

YOU DIDN’T DO ANYTHING WRONG! 

Acceptance is harder than most people 
think but the sooner you do, the better 
for your child. Get your child enrolled 
in all the services possible and learn as 
much as you can. Connect with other 
parents who have a deaf or hard of 
hearing child, service providers and 
advocates. 

It’s so very important for your baby to 
start experiencing language, whether 
it’s hearing it or through sign, on their 
first day of life outside the womb. If I 
could go back in time, that would be 
the one thing I would change… focus 
on talking to Jescilla a lot more than I 
did. 

There are going to be hard times and 
you’re going to feel like you’ve failed 
but there are more good times, than 
bad and as long as you are an advocate 
for them, are patient and understanding 
but most of all, love them, you will not 
fail. 

What do you want your child to 
know? 

That I did everything I could to make 
sure she was happy and healthy. But 
most of all, that I love her. 

Final thoughts… 

Love, love, love your child. Play 
with them, laugh with them, dance 
with them and don’t stop talking to 
them, even if they can’t hear you. Be 
animated when you talk by using a lot 
of facial expressions and gestures. 

NOTE 

Anna Marie Cruz (AMC) 


PARENTAL REFLECTIONS 

Q. 

JC 

What is it like parenting a deaf or 
hard of hearing child? 

Challenging because we must learn a 
new language to communicate with 
our child. Of course, in the beginning, 
it will take a lot of work both for the 
child and the parent to establish the 
best method of how to communicate 
with your child. Lots of effort is put 
into seeing if the child will be able 
to utilize hearing aids to see if they 
would be able to hear to be able to 
understand what is said, even if it was 
a little. Learning Sign Language either 
ASL or SEE Sign takes more time to 
learn. More so if your child has more 
disabilities than just being deaf. In 
our case, deafness is only one of our 
child’s disabilities along with mental 
and physical disabilities. The level of 
learning is also dependent on how 
much your child’s cognitive abilities are. 
We are a bit more challenged because 
our child has multiple disabilities which 
makes her deafness not the primary 
disability. 

But with doing things daily to reinforce 
what your child is learning in school, 
helps tremendously. Once you start 
seeing the communication start 
working, it is so rewarding. 


Q. What is the most rewarding part of 
your family’s journey? 
JC Seeing your child’s development 
and results from all the hard work. 
We’ve really learned to appreciate all 
the people that provided services in 
so many disciplines and how much 
they affect in improving our child’s 
development. Seeing the growth and 
being able to communicate with our 
child is very rewarding. 
Q. What do you want your child to 
know? 
JC That she will always be loved through 
all the good and bad times. Her being 
a child with Special Needs just makes 
us so humble and appreciative of what 
is important in life. She taught us this 
with how much she loves to live life 
regardless of her disabilities. 
Q. Joyful moments… 
JC There are so many. First time we were 
able to start communicating, seeing 
her learn how to feed herself, taking 
long unassisted walks, and participating 
in Special Olympics are just a few. 
Q. Final thoughts… 
JC I hope that some of this would help 
other parents that are new to caring 
for a child with Special Needs be more 
prepared to what’s ahead. 

NOTE 

John Cruz (JC) 


 WIL AND EVELYN TOPASNA (W & ET) 
#BLESSED 
WIL AND EVELYN TOPASNA (W & ET) 
#BLESSED
Q. 

W & ET 

Q. 

W & ET 

What is it like parenting a deaf or 
hard of hearing child? 

The first word that comes to mind 
is blessing. Gatbo is the first in both 
our families to be hard of hearing. 
We did not know what to expect, 
but we were always ready for any 
challenges. Although we experienced 
many challenges along the way, Gatbo 
has shown such a strong sense of 
perseverance. We as his parents simply 
took his lead and encouraged him to 
do his best. 

What is the most rewarding part of 
your family’s journey? 

Many rewards! 

Gatbo is a wonderful young man, 
who shows good confidence and 
perseverance. Our family all encourage 
and support Gatbo in every way 
possible. Maybe it is because we are his 
parents but, many people tell us that 
Gatbo has a special spark that makes 
them feel a sense of happiness. 

We are fortunate to have found a 
supportive family support group that 
we can always rely on for emotional 
support, educational support and more 
(GPPT) Guam Positive Parents Together. 

Q. 

W & ET 

What has been the most challenging 
part of your family’s journey? 

The hardest part was at the beginning. 
We knew early on that Gatbo was 
having hearing issues. At that time 
(2007), there were no audiologist 
that were knowledgeable of infant 
hearing assessments. The ones that 
were available were not helpful, they 
tried, but we did not make the progress 
needed to for an infant. Gatbo received 
hearing aids late in life (in our opinion) 
because of this delay (3-4 years old). 
We were very fortunate that we could 
afford to pay for it ourselves. I worry 
about the children and families that are 
not able to afford needed hearing aids. 

As Gatbo started school, a new 
challenge was seeing that sometimes 
people would judge him before getting 
to know him. We can recall clearly, one 
of his early teachers, kept assuming 
Gatbo was not “smart”. We would have 
to remind her often that he may have 
not have heard her or other factors. It 
took years after he left her class that 
she realized that he was a smart and 
talented boy. This experience shaped 
how we respectfully prepare teachers 
for the challenges Gatbo faces. 

105 


PARENTAL REFLECTIONS 

Q. Joyful moments… 
W & ET Again many joyful moments! We would say we 
are just happy when people see Gatbo for who he 
is. When they do not judge him before they get 
to know him. It is joyful when people recognize 
Gatbo the way we see him. He really is quick 
witted, funny, respectful, and athletic person. 

Q. 

W & ET 

Q. 


W & ET 

What would you like to tell 
parents who have just been 
told their child is deaf or 
hard of hearing? 

We would say your child is 
a blessing, love them, seek 
what makes them happy. 
Encourage your child to 
always do their best in all 
that they do. Seek help 
when needed because we 
can not do it alone and that 
is okay. 

What do you want your child to 
know? 

We want what many parents want their 
child to know, strive to be happy with 
yourself in the most respectful of ways. 

NOTE 

 Wil and Evelyn Topasna (W & ET ) 


1 
2 
3 
4 
5 
2 
3 
4 
5 
1 
2 
3 
4 
5 

TASHAUNSTOPPABLECRUZTASHAUNSTOPPABLECRUZ
Tell us about yourself.

 I was born in rainy Seattle, Washington. I am 
bilaterally profoundly Deaf and was diagnosed at 
six months old. Both of my parents sign and my 
mother is actually an ASL interpreter now! Both of 
my parents began learning sign when they found 
out I was Deaf. I attended an all-Deaf classroom 
from preschool to 5th grade. Then, I went into 
the mainstream out of my own choice. (I didn’t 
feel school was challenging enough for me.) I 
was the only Deaf student at my high school. 
It was a bit lonely and looking back, I do wish I 
was more involved with the Deaf community. 
But I had great friends and my parents were very 
supportive. I then went on to attend University of 

Washington and graduate with a bachelor’s degree 
in psychology. I was attending graduate school 
at Gallaudet (the world’s only university that is 
entirely ASL-based) for a Master’s in international 
development but due to a variety of reasons, 
decided to come to Guam to be with my then-
fiancé. 

My now-husband is a Navy submariner and is 
stationed in Guam for the next 2.5 years. Our 
wedding was postponed due to the current world 
events, so we decided to just get married at 
Gov. Flores Beach in Tumon October 2020. We 
originally met in high school. 

108 



What do you do for fun? 

Normally, I’d travel. I’ve visited almost all the 
states, most of them alone. My dream is to visit 
many countries. I love meeting new people and 
experiencing different cultures. It’s especially fun 
to meet Deaf people in a new country because 
then I get to learn some of their sign language and 
learn about their experiences living there. Flights 
are limited now though, so I’ve been fostering and 
rescuing some of Guam’s 60,000+ stray dogs! I 
also love (attempting) to surf, although to people 
on the shore watching, it probably looks more 
like falling off the board repeatedly ;) I also have 
the Guam Trails book and it is my goal to make it 
through the whole book. I also just hang out at 
home being lazy scrolling through social media. 

What is the most challenging thing 
in your life and why? 

This is too broad for me to answer! Some days it 
feels like it’s finding the missing socks the laundry 
ate and other days it’s somebody who walks away 
from me because they realize I’m Deaf and don’t 
want to take the time to talk to me. 

On a very general scale, it’s the unfair systemic 
oppressions and low expectations facing Deaf 
people. Things like…. the Governor’s broadcasts 
not being captioned (but they now provide 
transcripts so that’s a big improvement), applying 
to a job only to be told I can’t apply (illegal, by the 
way!), realizing many interpreters on Guam are 
not actually qualified to interpret, meeting a Deaf 
child or adult whose family can’t communicate 
with them at all, wanting to attend an online Navy 

so much more. 

it feels like I’m not getting through to people or 
that the “system” is just too big to change, but 
then I remember that every small effort does make 
a difference. It’s amazing to see what people can 
accomplish together. 
lecture only to realize it’s completely audio-based, 
not understanding people because of masks, and 
It’s not being Deaf that is challenging, it’s the way 
society is structured that is challenging. 
Final thoughts: 
Please don’t put limitations on what your child 
can or can’t do. A diagnosis does not predict 
your future- you never know what the future 
holds. Please correct people who hold mistaken 
assumptions about what a diagnosis may mean-
the more people that are educated, the better for 
all of us. Please try everything to communicate 
with your child- communication is essential. Last, 
be gentle with yourself- it’s okay to have bad days 
(or even weeks!) I’m always glad to talk to any of 
you, should you want advice, to vent, or to ask 
questions! 
109 
Joyful memories/moments: 

Being at Gallaudet was joyful because I didn’t have 
to type or write everything- I was able to just sign 
to everyone. That was amazing to experience. 

I remember coming to Guam Dec. 2019 directly 
from Gallaudet. I went from a 100% ASL-immersed 
environment with Deaf people/advocates for 
the Deaf doing amazing things every day, to 
an environment where many people believed 
I couldn’t drive or work because I was Deaf. In 
January 2020, it was joyful finally getting to meet 
members of the Deaf community and also finding 
out that CEDDERS/EHDI existed! I was very happy 
because while trying to do it all alone is doable, 
it’s lonely. Having communities that understand 
my experiences/are open to learning and want to 
make a difference in our community is amazing. 

What is the most rewarding 
thing in your life and why? 

Other than my friends/family, it is advocacy in 
various forms. Martin Luther King, Jr. said, “The 
time is always right to do what’s right.” Some days, 



INDIVIDUALIZED FAMILY 
SERVICE PLAN (IFSP) 

What is an IFSP? 

• 
An IFSP is a personalized road map of the services your child and family will receive in the early 
intervention system and how and when these services will be provided. 
• 
The IFSP takes your child's current level of functioning and needs and focuses on what you need 
as a family to best support your child. It builds on the individual strengths of each family member. 
• 
Early intervention (EI) services are provided in the most natural setting for the family, where you 
and your child are most comfortable. This setting is usually in your home or some other place in 
your community, like a park or community center. 
• 
It is a written plan developed with input from your family. You must give written permission for 
the plan to go into action. 
• 
Your child and family must receive services within 30 days of you signing the IFSP. 
Who develops the IFSP? 

• 
Parent(s) or legal guardian(s). 
• 
Other family members (grandparents, aunts, uncles, siblings, if you request it). 
• 
An advocate outside the family, if you request it. 
• 
A service coordinator who puts the IFSP into action. 
• 
Professionals directly involved in assessments/evaluations of your child’s needs. 
• 
Those who would be providing the EI services to your child and family. 
Other Specialists that may be involved in the IFSP based on the needs of your child: 

• 
Medical practitioner (audiologist, psychiatrist, neurologist, etc.) 
• 
Child development specialist 
• 
Social worker 
• 
Therapist (occupational, physical, speech-language pathologist, psychologist) 

IFSP NOTES 

Other Helpful Tips 

• 
IFSP team reviews the plan every six months. 
• 
The IFSP must be updated at least once a year. 
• 
You and the team review your child’s progress and family’s 
situation. This review will help decide what changes to make 
to the goals or other parts of IFSP if needed. 
Updates to the IFSP 

• 
While developing the IFSP, keep a binder/folder of meeting 
notes, progress reports, notes on how to improve the IFSP (a 
record of phone calls and the discussion to include dates and 
times). 
• 
You may ask for an additional review at any time if you feel 
the IFSP is not serving your child’s best interests or if there has 
been a significant change or event in your child’s life (such as 
hospitalization). 
• 
Before your child’s third birthday, the IFSP team will meet to 
form a transition plan. During this meeting, one of two things 
may occur: 
• 
Your child has progressed to the point at which 
he/she is no longer eligible for services, or he/she 
still needs help, and the team will develop a plan 
to transition into an Individualized Education Plan 
(IEP) upon your child’s third birthday. 
• 
Transition planning should begin at least 90 days 
before your child’s third birthday. This planning 
period will help prepare your child for a seamless 
move from an EI program to a pre-school or a 
community program. If your child qualifies, an 
Individualized Education Program/Plan (IEP), 
signed by you, should be in place before your 
child’s third birthday. 

INDIVIDUALIZED EDUCATION 

NOTES

PROGRAM/PLAN (IEP) 

Who develops the IEP? 

The IEP is developed by a team that includes critical school 
staff (counselor, teacher, special education teacher, school 
administrator, psychologist, audiologist, etc.), you, and your 
child. The team will review your child’s assessment information 
and design an educational program to address his/her needs 
based on the identified disability. 

The IEP team must hold an IEP within 30 calendar days after it is 
established through a full evaluation that your child has one of 
the disabilities listed in the IDEA and needs special education and 
related services. 

The IEP should be reviewed annually to update the goals and 
ensure the services continue to meet your child’s needs. IEPs can 
be changed at any time on an as-needed basis. If you think your 
child needs more, fewer, or different services, you can request a 
meeting with the team to discuss your concerns. 

Other Considerations 

• 
Parents/legal guardians have a right to choose where their 
children will attend school (public, charter, private, religious, 
or home). 
• 
Children with disabilities whose parents decided to send 
them to private schools do not have the same rights as 
children with disabilities enrolled in public schools. 
• 
Children placed by public agencies in private schools 
when the public school cannot provide free appropriate 
education (FAPE) do not have the same rights as children with 
disabilities placed in private schools by their parents. 
• 
The two significant differences parents/legal guardians, 
teachers, school staff, private school representatives, and 
your child need to know about placement in a private school 
are: 
• 
Children with disabilities placed in a private school by 
their parents/legal guardians may not get the same 
services they would receive in a public school. 
• 
Not all children placed in a private school will get 
services. 

INDIVIDUALIZED FAMILY SERVICE 
PLAN AND THE INDIVIDUALIZED 
EDUCATION PROGRAM 
COMPARED 

There are some significant differences between an IFSP and an IEP. This chart will help to 
inform you of these differences and avoid confusion as you discuss services for your child. 

IFSP 
Used in early intervention for children ages birth through 
3 and their families 
IEP 
Used in special education for children ages 3 through 21 
Includes information about the child’s present levels of 
development 
Includes information about the child’s present levels of 
educational performance and participation in developmentally 
appropriate activities 
With the family’s approval, it may also include information 
regarding the family’s resources, priorities, and concerns 
related to the development of their child 
Includes information about the family’s concerns for 
enhancing the child’s education 
After the team determines a list of priorities and concerns, 
the family determines which outcomes will be included 
on the IFSP 
The IEP team, including the parents or guardians and 
related service providers who work with the child, 
determines the goals 
Includes the major outcomes desired for the child and 
family, as well as the methods, timelines, and a plan to 
measure progress 
Includes measurable annual goals, academic and 
functionally, designed to: 
• 
Enable the child to be involved in and make progress 
in the general curriculum; 
• 
Describe how progress will be measured and how 
often 
• 
Describe how progress will be reported to the family 
Includes the natural environments where services will be Describes services provided in the least restrictive 
provided environments (LREs) and an explanation of the extent, 
if any, that the child will not participate with typically 
developing children 
Includes the early intervention services and supports Includes the special education, related services, 
necessary to meet the unique needs of the child and supplemental aides and services, modifications, 
family in order to achieve the identified outcomes and supports to be provided to help the child 
make progress and participate in developmentally 
appropriate activities 
Team membership includes: 
• 
A parent or parents of the child 
• 
Other family members as requested by the parent 
• 
An advocate or person outside the family, if parent 
requests that the person participate 
• 
Service coordinator 
• 
A person or persons involved in conducting 
evaluations and assessments 
Team membership includes: 
• 
A parent or parents of the child 
• 
Regular education teacher 
• 
Special education teacher 
• 
A representative of the school district who can 
• 
commit resources 
• 
A person who can interpret results of the evaluations 

Reprinted with permission from PACER Center, Minneapolis, MN, 

(952) 838-9000. www.pacer.org. All rights reserved. 

The Education section 
provides information for 
the Guam Department of 
Education, colleges, and 
universities. 

05 


EDUCATION 


ACADEMIA 

ABOUT ADA 

The American with Disabilities Act (ADA) was 
enacted in 1990 to prohibit discrimination for those 
with disabilities in , public activity, education, and 
more. One aim of the ADA was to make educational 
institutions more accessible for individuals 
with disabilities. This aim covers “reasonable 
accommodations” and includes physical changes to 
an educational institution’s buildings, including the 
following: 

Installing accessible doorknobs and hard-ware 
Installing grab bars in bathrooms 
Increasing maneuverability in bathrooms for 

wheelchairs 
Installing sinks and hand dryers within reach 
Creating accessible parking spaces 
Installing accessible water fountains 
Installing ramps 
Having curb cuts, sidewalks, and entrances that are 

accessible 
Installing elevators 
Widening door openings 

GEIS 

CONTACT 

GUAM DEPARTMENT OF 
EDUCATION 

Office 

Address: 500 Mariner Ave, 
Barrigada, 96913, Guam 
Tel: (671) 300-1547 

HIGHER EDUCATION 
INSTITUTIONS 

University of Guam 

ADA Accommodation Services 
Student Counseling & Advising 
Services 
Student Center Rotunda Office #4 
Tel: (671) 735-0277 
Fax: (671) 734-2442 

Guam Community College 

Accommodative Services 
Student Services & Administration 
Building (Bldg 2000), 
Room 2138 or 2139 
Tel: (671) 735-5597 

Pacific Islands University 

172 Kinney’s Road 
Mangilao, Guam 96913 
Tel: (671) 734-1812 
Fax: (671) 734-1813 

CONTACT 

The Guam Early Intervention 
System (GEIS) is a program Tel: (671) 300-5776 / 5816 
designed to coordinate early 

Website: https://www.gdoe. 

intervention services for families 

net/District/Department/3


with children ages birth to three 

Guam-Early-Intervention


(0-3) that may need services due 

Services 

to a child's developmental delay, 
disability, or special need. 


GDOE 
DIRECTORY 
Division of Special Education Contact Information 
Administrative Office Tel: (671) 300-1322/2293 
Email: sped@gdoe.net 
Assistive Technology/Speech & Tel: (671) 300-1322/2297 
Language 
Audiological Services Tel: (671) 300-2254 
Autism Tel: (671) 300-1322 
Compliance Office Tel: (671) 300-1324/1327 
Data Office Tel: (671) 300-1322 
Deaf & Hard of Hearing Program Tel: (671) 300-1322 
Emotionally Disability/Psychological Tel: (671) 300-1322/2298 
Service 
Guam Early Intervention System (GEIS) Tel: (671) 300-5776/5816 
Occupational Therapy/Physical Tel: (671) 300-1322/2297 
Therapy/Leisure Education 
Parent Services Tel: (671) 300-1321/2292 
Preschool/Elementary School Tel: (671) 300-1322/2294 
Programs/Private School 
Transition Services Tel: (671) 300-1322 
Transportation Dispatch Tel: (671) 300-2292 
Vision Services Tel: (671) 300-2297/1322 

Department of Education Programs Contact Information 
Guam Head Start Program Tel: (671) 475-0484 
Fax: (671) 477-1535 
Academics & Arts Tel: (671) 477-0631, (671) 300-5332 


 
118 

06 



CALENDAR 

06 



MONTH 

SUN MON TUES WED 

THUR FRI SAT THUR FRI SAT 
NOTES 


 
122 


THINGS MAY COME TO 

THOSE WHO WAIT, BUT 
ONLY THE THINGS LEFT BY 
THOSE WHO HUSTLE. 

ABRAHAM LINCOLN 

123 


MONTH 

SUN MON TUES WED 

THUR FRI SAT THUR FRI SAT 
NOTES 


1 
2 
3 
4 
5 
2 
3 
4 
5 
1 
2 
3 
4 
5 
126 


IF YOU CAN’T FLY, THEN 
RUN, IF YOU CAN’T RUN, 
THEN WALK, IF YOU CAN’T 
WALK, THEN CRAWL, BUT 
WHATEVER YOU DO, YOU 
HAVE TO KEEP MOVING 
FORWARD. 

MARTIN LUTHER KING JR. 


MONTH 

SUN MON TUES WED 

THUR FRI SAT THUR FRI SAT 
NOTES 


1 
2 
3 
4 
5 
2 
3 
4 
5 
1 
2 
3 
4 
5 
130 


IF I CANNOT DO 

GREAT THINGS, I CAN 
DO SMALL THINGS IN 
A GREAT WAY.

 MARTIN LUTHER KING, JR. 

131 


MONTH 

SUN MON TUES WED 

THUR FRI SAT THUR FRI SAT 
NOTES 


1 
2 
3 
4 
5 
2 
3 
4 
5 
1 
2 
3 
4 
5 
134 


ALTHOUGH THE WORLD 

IS FULL OF SUFFERING, 
IT IS ALSO FULL OF THE 
OVERCOMING OF IT. 

HELEN KELLER 


MONTH 

SUN MON TUES WED 

THUR FRI SAT THUR FRI SAT 
NOTES 


 
138 


OUR GREATEST FEAR 

SHOULD NOT BE 
OF FAILURE BUT OF 
SUCCEEDING AT THINGS 
IN LIFE THAT DON’T 
REALLY MATTER. 

FRANCIS CHAN 

139 


MONTH 

SUN MON TUES WED 

THUR FRI SAT THUR FRI SAT 
NOTES 



 
142 


LIFE IS NEVER FAIR, AND 
PERHAPS IT IS A GOOD 
THING FOR MOST OF US 
THAT IT IS NOT. 

OSCAR WILDE 

143 


MONTH 

SUN MON TUES WED 

THUR FRI SAT THUR FRI SAT 
NOTES 


146 


SUCCESS IS NOT FINAL; 

FAILURE IS NOT FATAL: 
IT IS THE COURAGE 
TO CONTINUE THAT 
COUNTS. 

WINSTON S. CHURCHILL 

147 


MONTH 

SUN MON TUES WED 

THUR FRI SAT THUR FRI SAT 
NOTES 

 
150 


I FIND THAT THE HARDER 

I WORK, THE MORE LUCK I 
SEEM TO HAVE. 

THOMAS JEFFERSON 


MONTH 

SUN MON TUES WED 

THUR FRI SAT THUR FRI SAT 
NOTES 


 154 


A SUCCESSFUL MAN IS 

ONE WHO CAN LAY A FIRM 
FOUNDATION WITH THE 
BRICKS OTHERS HAVE 
THROWN AT HIM. 

DAVID BRINKLEY 

155 


MONTH 

SUN MON TUES WED 

THUR FRI SAT THUR FRI SAT 
NOTES 

 
158 


EVERYONE SAYS FORGIVENESS 

IS A LOVELY IDEA, UNTIL 
THEY HAVE SOMETHING TO 
FORGIVE. 

C.S. LEWIS 

MONTH 

SUN MON TUES WED 

THUR FRI SAT THUR FRI SAT 
NOTES 

 
162 


OPPORTUNITY IS MISSED 

BY MOST PEOPLE BECAUSE 
IT IS DRESSED IN OVERALLS 
AND LOOKS LIKE WORK. 

THOMAS EDISON 

163 


MONTH 

SUN MON TUES WED 

THUR FRI SAT THUR FRI SAT 
NOTES 


 
166 


IF WE WISH TO FREE 

OURSELVES FROM 
ENSLAVEMENT, WE MUST 
CHOOSE FREEDOM AND THE 
RESPONSIBILITY THIS ENTAILS. 

LEO BUSCAGLIA 


MONTH 

SUN MON TUES WED 

THUR FRI SAT THUR FRI SAT 
NOTES 


170 


CONCENTRATE ALL YOUR 

THOUGHTS UPON THE 
WORK IN HAND. THE SUN’S 
RAYS DO NOT BURN UNTIL 
BROUGHT TO A FOCUS. 

ALEXANDER GRAHAM BELL 


MONTH 

SUN MON TUES WED 

THUR FRI SAT THUR FRI SAT 
NOTES 

 
174 


WHETHER YOU THINK 

YOU CAN, OR YOU 
THINK YOU CAN’T – 
YOU’RE RIGHT. 

HENRY FORD 

175 


MONTH 

SUN MON TUES WED 

THUR FRI SAT THUR FRI SAT 
NOTES 

 
178 


THE MAN WHO MOVES 

A MOUNTAIN BEGINS 
BY CARRYING AWAY 
SMALL STONES. 

CONFUCIUS 

179 


MONTH 

SUN MON TUES WED 

THUR FRI SAT THUR FRI SAT 
NOTES 

 
182 


NEVER LET SUCCESS GET 

TO YOUR HEAD; NEVER 
LET FAILURE GET TO YOUR 
HEART. 

ANONYMOUS 

183 


MONTH 

SUN MON TUES WED 

THUR FRI SAT THUR FRI SAT 
NOTES 


186 


TO THINK TOO LONG 
ABOUT DOING A THING 
OFTEN BECOMES ITS 
UNDOING. 

EVA YOUNG 

187 


MONTH 

SUN MON TUES WED 

THUR FRI SAT THUR FRI SAT 
NOTES 


190 


WHEN YOU PASS THROUGH 

THE WATERS, I WILL BE 
WITH YOU; AND THROUGH 
THE RIVERS, THEY SHALL 
NOT OVERWHELM 
YOU; WHEN YOU WALK 
THROUGH FIRE YOU SHALL 
NOT BE BURNED, AND 
THE FLAME SHALL NOT 
CONSUME YOU .

ISAIAH 43:2 


MONTH 

SUN MON TUES WED 

THUR FRI SAT THUR FRI SAT 
NOTES 


194 


FAITH IS TAKING THE FIRST 

STEP EVEN WHEN YOU 
DON’T SEE THE WHOLE 
STAIRCASE. 

MARTIN LUTHER KING JR. 


MONTH 

SUN MON TUES WED 

THUR FRI SAT THUR FRI SAT 
NOTES 


198 


NOW THIS IS THE LAW OF 

THE JUNGLE—AS OLD AND 

AS TRUE AS THE SKY; 
AND THE WOLF THAT SHALL 
KEEP IT MAY PROSPER, BUT 
THE WOLF THAT SHALL 
BREAK IT MUST DIE.

 AS THE CREEPER THAT 
GIRDLES THE TREE-TRUNK 
THE LAW RUNNETH 
FORWARD AND BACK— 
FOR THE STRENGTH OF THE 
PACK IS THE WOLF, AND 
THE STRENGTH OF THE 
WOLF IS THE PACK. 

“THE LAW OF THE WOLVES”, RUDYARD KIPLING 


MONTH 

SUN MON TUES WED 

THUR FRI SAT THUR FRI SAT 
NOTES 


202 


YOU WILL NEVER PLOUGH A 

FIELD IF YOU ONLY TURN IT 
OVER IN YOUR MIND. 

IRISH PROVERB 

203 


MONTH 

SUN MON TUES WED 

THUR FRI SAT THUR FRI SAT 
NOTES 

206 


TRY NOT TO BECOME A 

PERSON OF SUCCESS, BUT 
RATHER TRY TO BECOME A 
PERSON OF VALUE. 

ALBERT EINSTEIN 

207 


MONTH 

SUN MON TUES WED 

THUR FRI SAT THUR FRI SAT 
NOTES 


210 


I AM NOT A PRODUCT 

OF MY CIRCUMSTANCES. 
I AM A PRODUCT OF MY 
DECISIONS. 

STEPHEN COVEY 


MONTH 

SUN MON TUES WED 

THUR FRI SAT THUR FRI SAT 
NOTES 


214 


THERE IS NO TRAFFIC 

JAM ALONG THE 
EXTRA MILE. 

ROGER STAUBACH 

215 


MONTH 

SUN MON TUES WED 

THUR FRI SAT THUR FRI SAT 
NOTES 


218 


THERE ARE TWO PRIMARY 

CHOICES IN LIFE: TO 
ACCEPT CONDITIONS AS 
THEY EXIST, OR ACCEPT 
THE RESPONSIBILITY FOR 
CHANGING THEM. 

DENIS WAITLEY 

219 


MONTH 

SUN MON TUES WED 

THUR FRI SAT THUR FRI SAT 
NOTES 

222 


THE BEST WAY TO FIND 

YOURSELF IS TO LOSE 
YOURSELF IN THE SERVICE 
OF OTHERS. 

MAHATMA GANDHI 

223 


MONTH 

SUN MON TUES WED 

THUR FRI SAT THUR FRI SAT 
NOTES 

226 


ATTITUDE IS A CHOICE. 

HAPPINESS IS A CHOICE. 
OPTIMISM IS A CHOICE. 
KINDNESS IS A CHOICE. 
GIVING IS A CHOICE. 
RESPECT IS A CHOICE. 
WHATEVER CHOICE YOU 
MAKE MAKES YOU. CHOOSE 
WISELY. 

ROY T. BENNETT 

227 


MONTH 

SUN MON TUES WED 

THUR FRI SAT THUR FRI SAT 
NOTES 

 
230 


IF I HAD EIGHT HOURS 

TO CHOP DOWN A TREE, 
I’D SPEND SIX HOURS 

SHARPENING MY AXE. 

ABRAHAM LINCOLN 

231 


MONTH 

SUN MON TUES WED 

THUR FRI SAT THUR FRI SAT 
NOTES 

 
234 


IN ANY MOMENT OF 

DECISION, THE BEST THING 
YOU CAN DO IS THE RIGHT 
THING TO DO, THE NEXT 
BEST THING IS THE WRONG 
THING, AND THE WORST 
THING YOU CAN DO IS 
NOTHING. 

THEODORE ROOSEVELT 

235 


MONTH 

SUN MON TUES WED 

THUR FRI SAT THUR FRI SAT 
NOTES 


238 


“I HAVE THE RIGHT TO DO 

ANYTHING,” YOU SAY – 
BUT NOT EVERYTHING IS 
BENEFICIAL. “I HAVE THE 
RIGHT TO DO ANYTHING” 

– BUT I WILL NOT BE 
MASTERED BY ANYTHING. 
1 CORINTHIANS 6:12 

239 


This publication is supported by the Health Resources and Services 
Administration (HRSA) of the U.S. Department of Health and Human 
Services (HHS) as part of an award totaling $250,189.00 with 0% 
financed with non-governmental sources. The contents are those of 
the author(s) and do not necessarily represent the official views of, nor 
an endorsement, by HRSA, HHS, or the U.S. Government.