Deaf-Blind Child Census - Exceptional Children

0. Eligible to receive services from the Deaf-Blind project1. No longer eligible to receive services from the Deaf-Blind projectLiving SettingIndicate the living setting in which the individual resides the majority of the year. Livingsettings include:1. Home: Parents2. Home: Extended family3. Home: Foster parents4. State residential facility5. Private residential facility6. Group home (less than 6 residents)7. Group home (6 or more residents)8. Apartment (with non-family person(s)9. Pediatric nursing home555. OtherIf “Other “is indicated, please specify in the space provided on the surveyCorrective LensesPlease indicate whether the child/student wears glasses or contact lenses by coding as:0. No1. Yes2. UnknownAssistive Listening DevicesPlease indicate whether the child/student wears hearing aids or uses an FM system or otherassistive listening device by coding as:0. No1. Yes2. UnknownAdditional Assistive TechnologyPlease indicate whether the child/student uses any additional assistive technology (other thancorrective lenses or assistive listening devices) by coding as:0. No17