Final Week

Arturo's life was moving along just as he had hoped. That is, until Blake got sick. The doctors didn't know at first exactly which form of cancer he had, but they knew it had already moved very fast. Blake had gone in for a routine checkup, and his doctor's hunch led to some tests which came back positive for cancer. Additional tests confirmed it as non-Hodgkin's Lymphoma. At 61, Blake was very young of heart and of body - he took care of himself and ate well. Still, the disease struck, and it seemed to Arturo like only a few days until he was gone. It was actually 5 months of trips to the hospital for treatment and the agony of watching Blake waste away in front of him. Arturo knew that he would really never get over the loss.

After Blake died, it seemed that Arturo's life gradually fell apart. He stopped directing at the theater, much to the dismay of his friends in the theater community. He stopped sleeping very well, lost much of his appetite and kept more and more to himself - he lived this way for four years. Blake had named him as a beneficiary on his life insurance policy, so Arturo did not have to worry about his finances. He took one trip to Thailand on his own and was able to get along with his signing and his capacity to connect with people.

When Arturo returned from his trip, he seemed to have difficulty catching his breath. He really didn't know what to make of it but became strangely ill -- something between a bad cold and the flu which lasted for months. He couldn't shake it. This was more reason for him to keep to himself.

At 65, Arturo got sicker and sicker. He was admitted to the hospital with a respiratory infection and died a few days later. Arturo hadn't really made any provisions for his own death, and his estate remained undeclared.

1) What happens to large sums of money that have no declared beneficiaries after someone's death?

2) What kind of mental health difficulty might Arturo have been experiencing in the last years of his life?

3) Describe the factors that led Arturo to be able to thrive throughout most of his life given his hearing impairment. What factors in his early development might have contributed to this capacity?

Week Ten

Arturo and Blake have been together for a long time. At least that's how it feels to Arturo when he thinks about it. And he is quite happy that they have been! Arturo is now in his early fifties and has continued to find an outlet for his commitment to civil rights and advocacy although in a slightly different way than when he was younger. He took up directing at a local community-run theater and feel in love with the work. He has been credited with a number of local productions and has developed a reputation as a director whose powerfully acted plays and musicals carry deep messages about the nature of society and the facts of inequality in its many forms. For his "day job," Arturo has been a part of Blake's medical practice, working in the background to support a transition to a 'paperless' office. Arturo designed a new office space that feels a little like something out of the 22nd century upon entering. As he enters his mid-fifties, he has felt better than ever about himself and his life.

Things have not always been so rosy, however. When he was 38, Arturo was coming out of a small bookstore late one night when he was attacked by two men. The men beat him and took his wallet while spouting, according to two witnesses, racial epithets. He had to be hospitalized for two days, and the crime was reported as a hate crime. The assailants were never caught, and Arturo was reminded of how fragile his hold on a good life could be even as he had overcome so much. For Arturo, however, this solidified his resolve to work harder for justice; he did not 'retreat' and cease any of his activities. In fact, it was shortly after the attack that he looked into work at the theater as he healed from his physical and psychological wounds.

1) Are there mental health professionals who work with people who have hearing impairments and may be in need of counseling for post-traumatic stress? Find individuals who are in your local area (wherever that may be) who could do this.

2)  Provide statistics on marriage/partnering regarding people who are hearing impaired. How many have a partner who is hearing impaired? How many have a partner who experiences typical audition?

3) Provide statistics regarding the number of hate crimes that take place in the United States each year. What has to occur for something to be considered a hate crime?

Week Nine

Arturo has grown into a respectful and encouraging adult now at the age of 33.  After everything that has happened in his life, Arturo has proved his ability to overcome anything that may come in between him and his dreams.  At this point and time in his life, he doesn’t believe in self-pity, and continues to learn from every situation he is put in.  He is rather tall and muscular, averaging in at about 6 feet and 2 inches, and weighing around 185 pounds.  Although having a full beard, Arturo is experiencing some premature thinning of hair on the top of his head.   

After attending college at New York University and earning a degree in non-profit studies, Arturo decided to permanently reside in New York.  He felt that the city would give him the best opportunity for his career to take off.  After two hard years of waiting tables at a little Italian restaurant right down the street from his apartment complex and living paycheck to paycheck, Arturo finally got the break he was looking for.  He was hired at Take a Walk in Our Shoes, a company that travels all around the United States advocating for gay rights.  Arturo realized that this career path was meant for him when he started a gay-straight alliance at his school in the 8^th grade.  Although he doesn’t make much money, he is financially stable and able to support his lifestyle in New York.

Arturo has managed to survive the harsh world as a migrant gay man, and have learned to forget what other people think of him.  With his strong and confident attitude, Arturo has found a partner, Blake.  Blake is a year younger than Arturo, but the two have hit it off.  Blake has taken the correct steps needed in learning sign language to better communicate with Arturo.  They have been seeing each other for quite some time now after meeting in the local coffee shop.  Arturo and Blake get along great, and both want the same things in life.  They both would like to get married someday, but are aware of the limitations placed on them and their relationship.  Tina is happy for Arturo and the man he has become, but Joel on the other hand is still having a hard time adjusting to Arturo’s career path and relationship.

Arturo’s hearing impairment has been the only thing holding him back from reaching his full potential.  He is developing at a normal rate with all areas of development except for his speech and hearing.  Arturo attempted again to get another cochlear implant, but was still rejected because of the problems found with his specific aural anatomy.  Because of his hearing impairment, Arturo does have slight difficulties with his speech.  However, Arturo has learned to cope with his impairment and has gladly accepted the hearing impaired community.  He isn’t afraid of his disability, but in fact sees it as a gift.  Others can talk with their mouths, but he gets the ability to talk with his hands!  

1) On average, how much does it cost to reside in the state of New York?

2) What are the limitations for gay marriage in the United States? What states allow this unity? What are the limitations for a divorce between gay couples?

3) How much money does the average student possess right after graduating college?

4) What are some famous public organizations that advocate for gay rights in the United States?

5) What are the typical developmental milestones (social, cognitive, physical) for a man in his early thirties?

Week Eight

Arturo has grown into a likable and engaging young man at age 17.  He is tall and can sport a full beard if he wants to do so. His physical appearance has been useful for him as he has been able to manage somewhat more effectively the taunts and jeers of other children and adolescents. When he was in middle school, Arturo was constantly picked on for how others perceived him. Even though he was coming to know himself as gay, he still wasn't sure, and he often felt that he had to hide. Walking through the halls from class to class, it was like that was all people could see of Arturo - his presumed sexual orientation. Even though he could not hear the taunts, he could see the looks on students' faces as he walked by.

Arturo was resilient, and, in spite of the difficulties between his parents, Arturo had been able to experience warmth, love and care. From these inner resources, Arturo was able to be creative - in the eighth grade, Arturo took the initiative to start a gay-straight alliance at his school. This also moved with his to the local high school, and Arturo grew into a respected leader in the school. In fact, some faculty members had changed their long-held beliefs about the nature of sexual orientation and those who were gay and lesbian.

Arturo sometimes forgot that he was hearing impaired; he had continued to make the ongoing adjustments in his daily life, and he had a stable identity as an individual with a hearing impairment.

1) What would some transition goals be that might be found in Arturo's IEP?

2) What services are available at most colleges and universities for students who are hearing impaired? What might a student like Arturo experience regarding accommodations for his disability were he to attend JMU?

3) Provide information about Gay-Straight Alliances in the schools. You may consider looking at GLSEN for information.

4) How does discrimination and social ostracism affect the development of children, particularly those who identify as a sexual minority?

5) Provide information regarding identity development of people with disabilities. How do people come to understand themselves as having a disability? (Hint: Look at 'identity development and disabilities')

Week Seven

Arturo has grown into a kind and gentle boy in late childhood. Just after he turned 9, his parents had scheduled him to get a cochlear implant, but the doctors found problems associated with some specific part of his aural anatomy. He was unable to get the implants and was on antibiotics for several months. Though disappointed, Arturo did fine with signing and lip-reading.

Arturo was a boy who enjoyed the movies - he couldn't get enough of them! He was able to read the subtitles and follow along; he was particularly fond of movies from the 50s and 60s. He watched everything he could, and Tina was often seen leaving the public library with stacks of movies. In addition, Arturo was a generous child - he was always looking out for others. He was well-liked at school, and other kids tended to look after him. He just had that kind of personality that was simply likable. People seemed to want to be around him, and he was able to find ways to communicate with the variety of friends he had.

At age 11, Arturo had already started to show some signs of puberty. His parents were not expecting him to start adolescence so soon, but there it was. By the time he was 12, Arturo had gotten much taller and looked like he might benefit from learning to shave.

For his part, Arturo began to take an interest in his quickly-developing sexuality in ways that were surprising to Tina, and particularly Joel. Arturo mentioned often that he was interested in boys, and Tina welcomed him and his burgeoning sexuality. Joel, on the other hand, was not happy. Not only had he had to "deal with" the fact that Arturo was from another country, now he was going to have to cope with Arturo possibly being gay.

Joel's work had slowed down gradually over the last few years, placing the household on a slim financial footing and increasing the stress that all experienced. While the family had never been wealthy by income or assets standards, their situation was particularly precarious now. Joel had little by way of a safety net, and the family had nothing in savings. The stress continued to increase as Joel and Tina tried to figure out how to keep making house payments.

Arturo's pre-adolescent adolescence was another challenge for Joel and Tina, and the two were increasingly unable to contain their differences with regard to Arturo. As an outgoing and relatively confident adolescent, Arturo did not need to hear in order to feel the tension in the home. In fact, many days, he was glad he couldn't hear the specifics of the verbal fights that he could discern.


1) How unusual is Arturo's early puberty? Provide statistics regarding the start of puberty for children in the United States.

2) Provide information regarding early-developing boys and social expectation. Are boys like Arturo likely to have an easy time or a difficult time with peers? Why?

3) When do most children "come out" with regard to a different-from-the-majority sexual orientation? On what factors does this depend?

4) Describe accommodations Arturo has in school as a child with a hearing impairment. What is found in his IEP?

Week Five/Six

Because Arturo is so comfortable with his foster family, social services is really pushing the family to consider adopting him.  Tina is still very fond of the idea of adopting him, despite his nationality.  She and Joel have talked a lot about the situation and Joel has become more accepting to the possibility of adopting Arturo.  While they have been considering this decision, Arturo’s biological mother has gotten wind of this news.  She is very upset with the situation because she is still working hard to get Arturo back.  However, despite working numerous hours with her migrant labor job, she still barely has enough money for herself to live off of.  Caring for Arturo at this time is not a possibility for her.  Although Joel sometimes loses his patience with Arturo, he does not want him to go back into the care of his biological mother.  Tina has also made him see that Arturo is a good child that comes from a hard background; Arturo cannot be blamed for his situation.  Although still a little reluctant to adopt him, Joel agrees.  He sees how happy Tina has been since Arturo has been in their lives. 

Arturo will begin the Head Start program at the local public school nearby.  Tina and Joel feel that Arturo’s social skills will improve if he becomes socially involved with other children his age.  Also when he starts school, he will receive an IEP on his hearing impairment.  He will have a speech therapist work with him on his speaking skills.  He will also continue to learn sign language to communicate effectively while he is still developing his speech. 

Arturo has been in school for five years and is now eight years old.  He is in the third grade and is really enjoying school.  Despite his hearing difficulties, he is doing extraordinarily well with the help of an aid who signs things to him that he doesn’t fully understand.  Arturo’s pediatrician has recently informed Tina and Joel about a cochlear implant.  This will allow Joel to hear again, however, it is very costly.  Both, Tina and Joel, feel that Arturo could benefit from this implant.  However, Arturo seems to be doing just fine with sign language.  His speech has also remarkably improved.  He is also very accustomed to his hearing aid that he received when he began school at age four. 

1) Provide statistics regarding the number of children in Virginia who are adopted by the first foster family with whom they are placed. 

2) What are typical developmental milestones for an 8 year old? What evidence is there that Arturo has not met any of those? To what extent is Arturo a "typically developing" child, and to what extent is his development thus far atypical? 

3) Evaluate the relative justice of Arturo's adoption and the severance of parental rights of his biological mother. Should one bad decision on her part result in the permanent dissolution of her family? Why or why not? (You should know that a court would have had to terminate the biological mother's parental rights at some point in order for Arturo to be adopted).  

DECISION POINT:

Do they get the cochlear implant?

Week Four

Little to nothing is known about Arturo’s biological family or origins. Arturo’s mother speaks little English and has managed to subsist on the little cash she gets from her migrant labor – that and an informal network of people who assist her here in the States. All that we know is that Arturo was born in the U.S. and was taken from his mother by Social Services. His mother visits with him once a month for 2-3 hours when she is able to find work in the local area.

The foster family lives in a relatively rural area and is in the lower range of middle income. The foster mother works in food service at a local university and the father owns a small trucking company. Both have completed high school and have lived in the local area all of their lives. They have been able to arrange for one of them to care for Arturo most of the time, and when one of them is not available, they have been able to leave Arturo with the mother’s mother who lives next door. Joel, the foster father, was ambivalent about taking in Arturo given his country of origin. He knew, however, that the family needed the money, so he reluctantly agreed. Tina, the foster mother, had been wanting a child ever since she miscarried just after the two were married. She didn’t care that Arturo was from Mexico and loved him like she was his own flesh and blood. There are no other children that live nearby.

Arturo’s hearing has come to test out in the “highly impaired” range. Since he is in foster care and is technically in the custody of the state, he qualifies for Medicaid. Now at age four, Arturo has been able to participate in some therapeutic services, and he has been developing in his use of sign language. His spoken language has been much slower to develop, and he struggles to articulate basic sounds.

Behaviorally, Arturo is a willful child and has a strong sense of initiative. He seems to “know what he wants when he wants it.” Pediatricians long ago ruled out any other disorders, and Arturo appears to be otherwise happy and healthy with the exception of his hearing loss which is thought to have been caused by early and frequent ear infections from the time he was an infant. Arturo sometimes gets on Joel’s last nerve with what Joel considers to be his “refusal to mind” him. This is frustrating to Joel, and more than once he has restrained himself from using corporal punishment with Arturo. Add that to the fact that Joel has his prejudices about “foreigners,” and, even though he agreed to take the boy in, his patience is wearing thin. Tina has noticed that her husband has a much shorter fuse with Arturo than she does, and she doesn’t like it. She knows that taking Arturo in was her idea, and the placement has lasted a lot longer than they both thought. Still, she loves Arturo and wants the best for him. The foster care social worker has asked the two about adoption, but Joel hasn’t been open to considering it.  

1) Describe services that Arturo might have received and might receive under IDEA Parts B and C. Describe the transition between the parts of IDEA that takes place and the age at which it does so.

2) In a small town, are support groups available for parents who have foster children? What services are provided for these parents? (You may use Harrisonburg as an example of a small town/rural area).

3) Cite research that presents evidence of the dangers of corporal punishment. Is there any research to support it? Is corporal punishment generally recommended for children in foster care? Why or why not?

4) How might Arturo receive assistive technology devices through Medicaid? Does Medicaid pay for such devices? How does a child qualify?

DECISION POINT ::: Do Joel and Tina adopt Arturo?