ROUGH EDITED COPY

EHDI CONFERENCE

Supporting Early Linguistic Competence: Evidence to Practice

11:00 A.M. - 12:00 P.M. (ET) FEBRUARY 28, 2017

* * * * * CART CAPTIONING PROVIDED BY:

ALTERNATIVE COMMUNICATION SERVICES, INC.P.O. BOX 278

LOMBARD, IL 60148

* * * * * This is being provided in a rough-draft format. Communication Access Realtime Translation (CART) is provided in order to facilitate communication accessibility and may not be a totally verbatim record of the proceedings.

* * * * *

>>SPEAKER: Okay. I'm going to try this lapel mic. Can everyone hear

me okay? Not too noisy? Background noise? Clothing? It's messing up the

aesthetics of my nice new shirt.

All right. We're going to get started.

>>MS. NUSSBAUM: Good morning, everyone, close to lunch. Thank

you for coming. My name is Debbie Nussbaum. I'm a project manager at

the Laurent Clerc National Deaf Education Center. I know many of you, if not

by face, I know many of you by name. How many of you do I -- do I know

from different contacts I've had through the clears at the Laurent Clerc

Center? Good. Quite a lot. Thank you for coming and Supporting Early

Linguistic Competence: Evidence to Practice. I know that's something we all

do.

So I wanted us to start from the beginning. We're going to kind of go

on a little journey today, and we have programs from all throughout the

United States I'm going to explain a little bit.

But first I wanted us to think a little bit about all the different

presentations we've heard and all the biases we might come with, all the

information we might come with and try to disband it for a minute and let's

think about we all just landed here, let's, say from Mars, and we're at this

early intervention conference, and we're trying to figure out, what do we do?

We really don't know anything about working with deaf and hard of hearing

children, and now we have to figure it out. We don't have our biases. We

just know that this child can't hear.

So let's try to come from that, and we don't know anything, so we have

to look at what the evidence is telling us. So this presentation is going to

help us look at the evidence and -- what we're going to talk about today is a

resource that is available through the Laurent Clerc center. We launched it

last year. It's called Early Intervention Network, Supporting Early Linguistic

Competence. Has anyone had an opportunity to see this resource?

I see a few head nods, but that's one of the things is we're so -- is

we're busy doing what we're doing that we don't have time to stop and look

at the resources that are available. So what we're going to do today with

this resource is kind of unpack it for you so that if you look closely, and you

hear about, oh, that's -- that's what I can find there, then you'll go back and

look for it yourself.

So what you're going to do is in this resource -- and I'll show you where

you can find it, it talks about the work of a strategic planning group at the

Center that came together, parents, professionals from all different

backgrounds, and we spent the time that many of you don't have to do is

looking through a pile of evidence. Everything that was out there at the

time. And since then we tried to keep up with the evidence, of course. We

know it's coming faster which is a great thing but it's also harder to keep up

with.

So we're going to say, okay, let's look at the evidence. Here it is, and

I'm going to show you where you can find it so when you have to go back

and show the evidence to families you're working with and professionals

you're working with and trying to help them understand what linguistic

competence is, you'll know where to find it.

Okay. We have all this evidence. That's great. Now, what do we do?

So we spent a lot of time saying if the evidence says this, then the

recommended practices are that.

Which makes sense. That's what the evidence says, that's what we

should be doing. So we did that.

And then next we said, okay, who is doing that? And then we sent out

a survey to 250 or so programs throughout the United States and said, who

is doing -- and we got all the information, and we compiled it and that's who

we have with us here today. We have programs who are actually supporting

the evidence. We ended up with 5 factors that impact linguistic competence.

I know we all know, that there are many different things that we're talking

about other than linguistic competence for children who are deaf and hard of

hearing -- excuse me.

But it's the foundation of everything else to come. So that's what

we're focusing on for this website, not that we're ignoring the other areas,

but we really focused on linguistic competence for this.

We're from Mars, and here are our wings that we got from the plane so

we can fly all over the country and meet ear intervention providers. This

isn't a chance to get together this is a one time a year opportunity but I'm

going to show you through the network one part of the network is having

online discussion groups, so maybe we can keep in contact and talk about

topics that are of interest to all of us as well.

When you come to the Laurent Clerc Center website you're going to

get a few of how you can subscribe and get more resources and if you're not

familiar with the center, wear federally funded. We're guided by the

Education of the Deaf Act. On Gallaudet's campus we have Laurent Clerc

National Deaf Education Center which is birth through high school. As part of

that we have national services, and technical assistance, and resources and

we also have two demonstration schools, so it's all available to you, but you

have to know where to find it. Hopefully you'll have an opportunity -- I know

we're close up to take advantage of our exhibit booth but if you come here

and take the time to explore, like I said, free. Free resources. You can see

the resources section. We have a part called info to go where you can find

many resources, learning, on line learning, web cast. So just take the time to

look.

So exploring this early intervention network. You always have to keep

in mind the cute kids that we're looking at because we all get caught up in

what we're doing but I do have to say I really do love that picture.

And I keep using the word linguistic competence, and I think it's a word

that we had to define as a group when we were talking about it. It wasn't

just being able to say the word. It was able to use our words and language

for learning, problem solving, reading and writing, and I'm not sure how

many of you were able to attend the plenary last night but it hit me with the

words "language nutrition." Was that the word that was being used? And we

talked about feeding ourselves and our nutrition but the language nutrition

and how do we start off so that we don't have language delay? And I think

that's something we -- our goal is the same but, you know, what is the

evidence to show how we reach that point?

So once you get into this website, not only from the Laurent Clerc

Center website we have all this information about the evidence and the

factors, a whole list of additional resources on this topic, references that are

linked to other places. We tried to make sure that you could get to the

references, and I'm going to tell you a little bit about the discussion theories,

too.

I know you can't read these here but the five factors we're going to go

into in a minute.

The resource library are on all of these different topics. The

references, like I said, you can link to. And we held our first discussion

group, I think it was last May, and I'm confused because we've had a few

discussion topics.

So we took one of the factors. We had other people who were involved

in working with this factor and then we had an online discussion. And it

brought up a lot of good points, and you can go to -- when you go to our

resources go to our online learning, and you'll see the online learning

community, and go to the discussion group, and you can see what your

colleagues were saying on this topic.

The first topic was on factor 1 which we're going to talk about in a

minute, and here is the -- we're at factor 1.

So we looked at all the evidence and then some of this you might say,

this is common sense. Okay. So direct and daily access to language and

communication is essential to facilitating each child's language and

communication development. And that was another thing that I pulled from

the plenary yesterday about every child having communication partners

from the start. Someone who can provide accessible language to the child.

We have a child who can't hear. How that accessible language? What is it

going to look like? So what did the evidence show?

When you go to the website you're going to get these little sections.

One shows you the evidence. One shows you the associated recommended

practices, and one shows you the programs that we have represented here

today.

So factor 1. And, again, it might seem common sense but we have to,

like, have it in front of us and be able to tell parents, this is what the

evidence is showing. Makes sense, language happening early in a child's life

and parent-child communication. Regardless, you want to get the early

bonds set up.

So if that's the case, our programs need to be collaborative in

providing family education to understand about this direct access and daily

and accessible to communication.

So if that means visual language, that means we have to provide the

supports to help the language learn that visual language so they can

facilitate their child's visual language.

And family services and supports to spoken language as well. We want

to see how the child is doing with both. We're not -- the evidence is showing

stimulate both, both modalities, and both languages.

The first program that's going to come up with our program at the

Kendall Demonstration Elementary school our parent infant program. We

have three of our teachers today and head of our childhood education.

Debra Kushner, Brenda Perrodin.

First of all, is communication accessible to everyone? Is everyone

okay? I'm going to move out of the way.

I got a helper here. Thank you.

>>SPEAKER: Hi, everyone I'm Debra Cushner from Kendall School.

Sorry.

Technical difficulties.

We're good. We're good.

>>SPEAKER: I'm Debbie Cushner from Kendall School. It's nice to see

all of you. I'm here with part of our early intervention team. We're thrilled to

be here and we've a lot of information to go through so I'm going to move

pretty quickly. The Kendall School, what I wanted to share with you was

some of our programming strengths and why we're part of this factor in

particular for factor 1.

And one is the importance of systematic language planning, and

system language planning is what we do for all of our children in the early

childhood education program, and I'm going to focus on the birth to 3 group.

Yes, there's intentional language planning with the students from birth

through 3. We do it twice a year, fall and spring, and we assess each

language independent of the other language.

We work as a team to do these assessments so in regard to looking at

American Sign Language, we use the BCSL that's developed by VL2. Looking

at spoken language, the speech and language therapists have the tools that

they use for that. And we as a team come together to look at both

languages. We look at this in relation to what we planned for in the spring,

and progress being documented again -- looking at it in the fall and progress

being documented into the spring, and of course, parents are included as

part of this process and documentation.

We've gotten a lot of positive feedback from everyone about how

much this process has helped in looking at languages separately and what

we provide in the program.

Of course, we want to support each language, so in looking at the

support of ASL, we have fluent ASL users in the classroom and environment

at all times, and wonderful deaf role models available to everyone and to

families.

Provide free sign language classes Wednesday evenings and Saturday

mornings for all families and for the greater D.C. area. We're proud of that,

and I'm sure you're familiar with the shared reading program. That's another

program we access.

In addition our parents are participants in the classes on Wednesday

and -- and join in our two-year-old class, and through that are guided through

activities that pertain to development of ASL. Storytelling, surprise boxes

and those kinds of things.

In relation to English we also have to support that, we have a staff

audiologist in and out of classroom, checking things and working with

families independently and with the classroom. We have SLP's that join our

Monday, Wednesday/Tuesday, Thursday, and 2-year-old class and integrate

into the classroom to provide services that are documented all on their ISSP.

And, again, there's the opportunity for guided activities and coaching

for families when they're participating.

Challenge. I'm sure we all share the same channel. If your child signs

he won't speak. We need to share the evidence that's available to everyone

that that's not true. Families, teachers, schools, medical people. Share the

evidence.

And also one thing that really has been helpful for us is to have

families meeting other families, seeing that how children progress over time,

building relationships, and that, I think, is one of the key, and best things we

can do for our families in regard to supporting language development, and

I'm going to pass it over to Brenda.

>>SPEAKER: Also talking about how using natural ASL in the

classroom. We all come together and there's a wide variety of parents,

hearing and deaf. It's a natural environment. And it's also includes a lot of

fun activities. During home visits, again, we use a natural environment and

the main challenge is, you know, parents often are concerned about how

they will learn ASL. When we're in the home, we're there interacting with

them in a variety of ways. Communicating with them in whatever way

possible.

And we don't focus on one language. We incorporate, you know, as

was -- during the talk yesterday, a dad talked about giving opportunities for

sign language, English, spoken language, a variety of different exposures.

We challenge our parents not to just pick one thing, to just use natural

communication, and that will -- that will come. The ASL will come. We want

to develop confidence in them. They will know before we do what they need,

and we will communicate through expression, through body language, and

we are there to reinforce and support the parents in that journey, and hope

them feel okay in their learning of ASL.

>>SPEAKER: Hi there. I'm Senoa Goehring.

And these are awesome teachers. I'm not really able to sign because

of my hand injury. So we're the team. All three of us together.

>>SPEAKER: Thank you, guys.

>>MS. NUSSBAUM: The second factor you can find in the network

talks about a collaborative, ongoing process. It should be used to explore

modalities, technologies, and strategy.

>>SPEAKER: To support the development of linguistic competence.

Okay. Again, it seems common sense, but in the plenary this morning,

Dr. Knutt talked about no more one golden provider who happens to be the

first person that the child came in contact with, child and family, and that

person is responsible for the child's whole early intervention process. We

still see -- I work as a coordinator of cochlear implant education center and

get calls all the time about families waiting to get the cochlear implant, and

it's a whole year until maybe they're getting the implant, and how many

months? And we all know what the process is, and we're holding up

language. So this talks about having people who can collaborate to get

families the information they need.

So the evidence, again, the recommended practices and the two

programs that we're going to be talking about who are going to come up

with the m center, Karen Hopkins, and Dinah Beams from Colorado CHIP

about how the collaborative process that they use.

So what is the evidence -- just hold on one second.

Karen, you were right, I said when you see your name I said come up.

But I want to go through the evidence really fast. Sorry about that.

I say this about children with cochlear implants but if you've seen one

child with a cochlear implant you've seen one child with a cochlear implant,

and I say that about all of our children that we're serving. So we don't know

what the outcomes are going to be. Even with certain characteristics in

place, they can hear, they're wearing their hearing aids, and cochlear

implants. Spoken language? We don't know. We don't know. If we don't

know if we're fitting these children. If they're visual learners or if they're

going to have additional learning disabilities so it's important that we have a

collaborative process, and with distance education, and Internet. If we don't

have someone in our neighborhood we need to find someone we can

collaborate with.

And having a collaborative, dynamic family-centered

assessment-driven process that's not just based on one service provider's

idea of what they think should be happening.

So you can read more about it in the evidence but I want to get the

opportunity first now, Karen, and then we'll have Dinah.

>>SPEAKER: It takes me longer to get where I was going so I was

trying to get ahead of things. I'm Karen Hopkins the director of Early

Childhood and Family Services in Maine which is a birth to 5 program but

we're going to talk about birth to 3 program right now.

So what we've done in Maine is we've developed one process for all

children birth to age 3 no matter where they live. We had a single point of

entries with our child development services which is our Part C agency in

Maine, and we're developed a memorandum of understanding where we go

in together. So the service coordinator works with the early interventionist

and deaf educators to support families.

We have a six-visit process that happens with families and in had that

six visits all communication options and approaches are explained. Deaf

adults are brought in, hard of hearing adults are brought in, parents and

specialists from all brought in so parents get a lot of perspective, and

support in a family-centered way.

One thing we've spent time doing is slowing the process down while

hurrying it up and getting it done in six visits. What we didn't want is

families on a first visit to check the box, and say I want signing or cued

speech or listening and spoken language. We wanted it to be more of a

process of mindful of where families are in their journey. Some of our

strengths are strong ties with the medical community. We talk to

audiologists and physicians to spread our message, and communities

agencies, and I would add Hands & Voices we've had a lot of cooperation

with the Guide by Your Side Program. Our MOU with the Part C program.

The one state system has been amazing to have families in northern Maine

and southern Maine get the same process, and service provision and

monitoring is amazing to watch these families go through the process and

own it themselves. We have six months process monitoring that happens, so

we really stress with families that what they start with on the very first ISSP

is not necessarily what they have to keep doing.

So with progress monitoring, and observations and input from other

professionals and families and deaf adults, families have the right and

flexibility to change their minds, and I think in years past it wasn't the way.

Families started with one thing, and kind of felt they had to stick with it,

working or not, so we're really trying to make sure families understand it's a

journey, and it's their journey -- journey and their right to change it the way

they want to change it.

We have a what we call a community of practice in Maine where all

providers that work with deaf and hard of hearing children birth to age 3

work in collaboration with and contract with the Maine Educational Center for

the Deaf regardless if they're ASL specialists, cued speech specialists,

listening and spoken language specialists and we all work on one team and

support this model. Our families transitioning and doing what is right for

their children. We meet, and have a wonderful discussions, and we have

deaf and hard of hearing members in this practice, and we're adding family

members, and I looked around the table, and said we don't have parents.

We wrote our states MRSA grant, and put a funding for parent, and

deaf and hard of hearing involvement, so fingers crossed that that comes

through so we can expand it. Flexibility is the key to our model. We do

tele-intervention more and more because we are a big state, 7 hours from

one end to the other. So trying to support families in the far northern

regions of Maine through consultation models. They have a provider up

there that works for us, but being able to bring in a variety of families and

deaf adults and different perspectives to that family through

tele-intervention -- tele-intervention, and our challenge has been doing this

in a timely and family-centered way. Being able to take a step back and look

at where that family is in the process and not rush them through it but trying

to do it in six or seven visits to get all of this in.

What we didn't want is families to do it in one visit. We wanted to give

them a little bit more time, and how we've done this is providing neutral

responses, listening to the family, and their needs and what they're saying,

guiding and not telling families what to do, providing services and support

without a rigid agenda, following their agenda, even if it slows down our

process.

And the communication approach is making sure they're neutral and

balanced and unbiased. We have protocol developed so the script is the

same no matter where they are in the state and the process of bringing

people in is the same, and connecting other families to families has been

fabulous.

It's all fabulous, and it's all challenging but it's our process and where

it's where we are, and I think you're on to Colorado. Whew that was fast.

>>SPEAKER: Thank you, Karen. I just wanted to mention that the

six-point protocol that Karen mentioned is --

I just wanted to mention that your six-point protocol is if people are

interested, it is a handout that's attached to the intervention work if you

want to learn more about that. And the other group from Kendall, if you go

to their part there have numerous video clips showing how to facilitate direct

access to both ASL, and spoken language in captions so you can use that for

captioning families as well.

Next this is Dinah Beams, program coordinator from CHIP, and if

there's more you want to add, please go ahead.

>>MS. BEAMS: Yes, I'm the program coordinator for the Colorado

Home Intervention Program, fondly known as CHIP. We are housed at the

Colorado School for the Deaf and the Blind as part of their outreach program.

We are a family-centered service providing in-home early intervention

services to children birth to 3. So in any given month we're going to be

serving between 325 and 340 children in the state of Colorado.

Like -- and that's birth to 3. Like most states, we have challenges with

the more rural populations which we will talk about in a moment. I don't

think there are many states that don't have some of those challenges. It just

may be the difference between when I lived in North Carolina, the challenges

were the islands and so I would go over a bridge, and then drive, and then

take a ferry, and then drive, but in Colorado it's over the mountains and

through the woods. So a little bit different challenge but still some of the

same components to that.

So what are some of the strengths I see in our program? And I really

want to kind of dovetail on what Karen just shared because we have a lot of

the same strengths that I'm going to be mentioning very quickly, but our

implementation may look a little bit different. So as I said, it's a

family-centered model that has a strong emphasis on parent education, so

that includes the parent coaching, model that a lot of you are very familiar

with, the primary service provider model that a lot of our states are using

through their Part C system.

One of the bigs things we have is a single point of entry. To me this is

critical, and I know this is something that a lot of states don't have in their

system. The start in of average time for start is 2 months of age, and it's

been that for a long period of time. Somewhere between 7 weeks of age,

and 10 weeks of age, so right around that 2-month period.

We have a system of nine CO-Hear coordinators around the state.

Each one lives and works within a region of the state, so the referrals come

directly to them from that audiologist. So that's our single point of entry. So

as Karen was sharing how their process gets started, in our state this

information, this technical support is provided to the parents right after

diagnosis, and we typically get the referral the same day the child is

diagnosed from that audiologist.

The CO-Hear coordinator goes in multiple times before we are a part of

that IFSP team. Because of the way the funding is it up, the services are set

up, we actually have an opportunity to have a number of conversations with

the family prior to that IFSP being written.

One of our other strengths is that we're a data driven intervention

system. We have had a comprehensive family assessment that we have

utilized for about 25 years now with our children who are deaf and hard of

hearing in our state.

We firmly believe in a assessing all children. We do it every six

months. We have assessment packages that we use in our Spanish speaking

population as well as our English speaking population. We have a video

language sample that we take and we are able to analyze that for the

families that are using ASL, for the families that are speaking Spanish for the

families speaking English.

We cannot analyze the video for Mandarin or some of the other

languages so I'll just -- I'll hasten to add that.

We also have an assessment packet for our children that are really

impacted, those children with significant support needs because we found

our traditional assessments weren't really appropriate for them.

All of our intervention is delivered by highly qualified professionals, so

our intervention services are with someone with a CHIP program, master's

degree, teacher of the deaf, SLP, and experience working with kids who are

deaf and hard of hearing. We have a curriculum that we use throughout the

state. So a lot of what we're trying to do is make thing as much alike around

the state as possible while still honoring those individual differences of

children and family and local control.

And fostering connections with parents. We want to connect the

parents with deaf and hard of hearing adults. We want to connect them with

Colorado Families for Hands & Voices so that's another thing that we try to

do.

Challenges: Things we've learned.

Identifying and involving stakeholders was trying to establish and

implement collaborative programs. I feel like all of us talk a lot about

collaboration, philosophically we believe in collaboration, but my picture is a

lot of times no one says I'll be the person who is going to step out and get it

started. Somebody has to say, I'm going to be that person.

And so in our state I have told the CO-Hear coordinators, myself, we're

going to be that person. We're going to be the one to reach out to our child,

to our pediatric audiologist. We're independent going to wait until people

come to us. And I still believe in relationships and not just paper

collaboration but real relationships getting to know people and developing

that trust. Sometimes it takes awhile. Sometimes we're coming from really

different places. I feel that's a big challenge.

Another thing is identifying leadership team of stakeholders, to really

involve that community. How services look in Gunnison, Colorado is not the

same as they look in Denver or Steamboat Springs, and you can identify your

own communities that are like that.

So really making sure we have the buy in from the people in that

community I think is really important.

Incorporating distant learning which Karen talked about, establishing a

single point of entry which I've already talked about.

>>MS. NUSSBAUM: Thank you, Dinah. Moving on to factor 3, which

addresses early exposure to accessible language through sign is beneficial to

language acquisition. And we've had discussion about using the word sign,

whether it's American Sign Language, why doesn't it say American Sign

Language? We want to talk now just about -- we know that ASL might not be

become the child's language but we want to know that some sign is used

preferably American Sign Language, but some sign. That's what the

evidence is showing. Some visual access to language.

The evidence, again, if the evidence is saying what, what are the

recommended practices? And we'll have two programs that I won't introduce

yet. I'll tell you in a minute.

So what does the evidence say? These children are deaf so it is of

benefit to use visual language to establish early, timely language

foundations. Don't wait.

The evidence is showing that use of the visual language sets up a

symbolic language system that can be transitioned or supported by the

visual language.

The evidence also shows if you don't use the spoken language if you're

only using visual language, of course, that's not going to be developed. That

makes sense but you also have to use spoken language but the visual can be

a support and bridge in developing spoken language.

And for the naysayers who say hearing families cannot learn American

Sign Language, they can. They have to be given the supports and that might

become a challenge for some programs and some jurisdictions, but with

distance education, and with tele-intervention, we have greater avenues to

facilitate that than we did before.

What's most important is to develop a program philosophy that reflects

what this evidence says, documenting the benefits of early visual language.

That's what the evidence is saying we need to make sure children have the

access. We don't know what their spoken language outcomes will be.

And then we have to provide supports for facilitating visual language

development. So first, we have two programs first I'm going to have Kathy

Vesey from Massachusetts come and talk about their sign language program,

and Emily Wielding coming from New Mexico, and she's going the talk about

their program.

>>SPEAKER: Hello. Hello. Thank you. I'm from Massachusetts, and I

work at Gallaudet University Regional Center. I used to. And this program is

specific to Massachusetts, but we're also provide sign language classes for

the families in Rhode Island. And I left some brochures on the back table for

anyone if you would like to take them.

Basically we have deaf professionals who go into the home and work

with the families. The first class always has an interpreter and they sign

English, but we have spoken language interpreters for families that use

spoken language other than English. And I can't say enough about the

impact on the families when they have deaf adults going into the home on a

regular basis, weekly for awhile. So they are able to see the nice relationship

that's established between the family, the panic the first class when they

don't know what to do when they don't have an interpreter, let's say, to

when they start picking up sign language.

And then we practice with different families. Our practice is to be able

to match with them as much as possible what it is they may need. We do --

they do great with a bag of tricks. We also work a lot with families who are

children who have medical needs involved. If their medically fragile, we're

able to assist them as well.

We have our own curriculum that we use, but all of the teachers use

what happens in the home, what naturally happens in the home in that

environment with the family to help model for the children language. And

then we model for the families how to work with their kids in a home

environment. And then they will -- and then if the -- if the families head out

to the zoo, let's say, we can provide them language that they may need to

expose the children to that language before the zoo event or maybe if they

have a medical appointment or a dental appointment, then we can help

prepare the families with the language that happens in those contexts.

We encourage families to include other people as well, not just the

parents or whoever the baby-sitter is or the neighbor or folks that are close

to the children, grandparents, extended families. And few of the classes

we've had as large a number as 22 people in the home taking class. So

there may be 6 to 8 people more likely but we have had as much as 22.

And sometimes we have to find another location for the class because

the home is too small to accommodate everyone that wishes to be included.

We're working with the families where they are. And we are flexible.

Sometimes we provide class in the library or we've even worked in shelters.

Sometimes we are challenged with a large group. Some people take

off right away and they're able to pick up language quickly, sign language,

and other folks struggle. So we developed strategies to be able to keep

everyone engaged at the level they are.

We provide most of the materials accessible in Spanish, and we're

finding a lot more families that are speaking Arabic now, and that's another

challenge for us is to be able to develop and deliver materials accessible to

them. So we're having to work with translation agencies and work with

interpreters from other spoken languages. Because it's critical for us to be

culturally sensitive to where the family is.

For example, maybe we wouldn't send a man to all particular home,

but we need to know what's going on in that home, and what their cultural

values are.

We have an advisory board that meets periodically, and it's important

to include the consumers, EI professionals, the teachers, and we're able to

address different situations that come up and find solutions. And I think

that's it.

>>MS. NUSSBAUM: Great. We have 15 minutes left, so I'm going to

go have Emily come up and share, and I'm just going to briefly talk about the

evidence so I can have our other programs share their information.

>>SPEAKER: Hello. Hello, everyone.

I'm Emily. Sorry, the interpreters can't see me.

I began my career as an early intervention specialist 17 years ago, and

then I got into teaching and now I'm the new deaf mentor coordinator at the

School for the Deaf, and it's very nice to have that experience from where I

started my career and then come back to early intervention and really look

at how we can support that through early intervention, early childhood

education, and that whole system.

I work with the deaf mentoring program, and it's located through the

School for the Deaf. We are an early support system. There are two sister

programs, the Deaf Mentor Program and parent infant program, and they

really work together, and they work early childhood education and so forth

but we start together as partners in that journey.

We work statewide. We have certified specialists. Our deaf mentors

are developmental specialists. They are considered developmental

specialists within the system. And that's critical because on the IFSP, we can

be identified as providing services. You're all familiar with IEP's, the IEP

follows the child, and similar with the IFSP. We follow the child. We have

SLP's, OT's, PT's, teachers of the deaf, deaf mentors are all part of that IFSP

team, so that gives you an idea of how it works.

We have a memorandum of understanding with the Department of

Health so that our deaf mentors can provide these specialist services that

are designated in the IFSP.

And as I mentioned before, we are there to provide that foundation in

partner in the parent and the parent Parent-Infant Program so we work with

changes throughout the state.

And we are a free service. Going to home visits welcomely -- weekly.

Some of the families ask for four times, maybe six times a month. We go

anywhere. Home based visits. Center based visits. Day cares. Some

families, as we said earlier, are visited in shelters, and I'm aware -- that's

where some of them have been screened as well.

To give you the idea of what a deaf mentor's role is, we follow the sky

high mentoring curriculum, and we partner with the IFSP, and follow the

family's desires, whatever those might be.

For example, if a child has a goal for feeding, for example, might have

a feeding tube, then the role is to give that family visual language on how

the feeding take place, give them tips on how they can help thrive and strife

in that situation and they can develop the ASL needed to communicate

around those -- those issues. And then we'll let you refer to the website for

more information.

>>SPEAKER: Ongoing monitoring of its effectiveness. And how

integral that is to choosing the communication strategies, and how you affect

your services. I'm going to let you have an opportunity at a later point to

look at the evidence, and I'm going to have Amy from Hear Wisconsin talk

about how they do that within their program.

I'm from a nonprofit private nonprofit organization, and we are unique

in that we are not centered necessarily around a communication choice. We

work only with individuals that are deaf and hard of hearing, and we offer

services through the life span. However, we're very proud that we have a

full team that has specialists that are able and capable to coach and guide

families in a visual language as well as coach and guide families in a spoken

language.

I'm here today to talk a little bit about the evidence and some advice

for amplification and technology. We really stress the importance of early

use of technology. If a family is wanting their child to develop auditory skills

and some spoken language.

So we really understand and try to impart the importance of that early

fitting and then the next step which is appropriate monitoring and

assessment of the use and functioning of that technology.

One of the things that we -- I'm just going to kind of --

>>MS. NUSSBAUM: I'm sorry, I'm --

>>SPEAKER: It's all right. I'm going to talk a little bit -- okay. Yeah.

That's all right.

So, like I said, we have a comprehensive team, and we are very

fortunate that we can use a coaching model within our EI program, and we

have a high level of family involvement that is required, much like the other

presenters have been talking about today, and really the families are the

key. The families are our guide to telling us how we need to make our plans

for the family, the language plans, and the use of all the resources that may

be available, so we do a lot of talking, discussion the families and we have a

process that is similar to what Maine does in terms of some of those first

visits are just education-based with the families having the opportunity to

explore different opportunities, and meet with additional individuals.

Our services are diagnostic in nature so we're always looking at how

are thing going? What is happening? Like I said, we use a coaching model.

And in that we are also not only assessing the development of language,

we're assessing the development of functional auditory skills, and how that

may relate to their technology, and the need for any kinds of adjustment or

changes in the current technology or to a different type of technology. So in

addition to our language and communication assessments we also have

some tools that we use for following and tracking auditory skill development.

Some of those tools are available commercially, and through different --

different companies, and manufacturers of hearing aids or cochlear implants

such as the little ears program.

We also use the IT-MAS which is available commercially and we also

use an auditory skills checklist that is available.

So one of the things, too, that we do, too is focus on the use of that

technology within meaningful interactions and having opportunities for that

child to use and integrate listening into their communication and their

learning. Much like anything else, language needs to be relevant, and it

needs to happen for a reason. So we go beyond just the audiogram, the

audiograms give us just the beginning piece of the information in terms of

what a child is able to access, but then it's up to us to help the families

understand how their child is functioning and using that sound that the

technology is able to access and what kind of adjustments may need to be

needed and made then.

We also have a tele-intervention program that is very beneficial for

helping those families that are not geographically close to us, and we follow

the exact same kinds of protocols and expectations for our tele-intervention

families as we do for our families that we see in person. All right. I'm

going -- we are -- our contact is on the website. Please feel free to contact us

at any time should anyone have questions or want more information.

Thank you.

>>MS. NUSSBAUM: Thank you, Amy. Now we've talked about and you

heard various times about planning, language and communication planning.

Now Janet Digeorge is going to talk to you that's available to you different

than the school programs. It's a tool you can use for language planning.

>>SPEAKER: If half the people used half the resources half the time

that have already been created, our kids would be doing twice as good. I'm

still waiting for somebody to quote me on that. There are so many good

resources out there. Hands & Voices. I'm so pleased in the -- that we're

going to be partnering with the Laurent Clerc Center in our cooperative

agreement. There's so many good resources in the Laurent Clerc Center so

we're so pleased to be doing that.

In 1997 for the first time in the Individual Disabilities Education Act,

special considerations for deaf and hard of hearing students was added to

the law. That requires IEP teams to look at those specific needs of deaf and

hard of hearing students which included the language and modality used by

the children. Access to peers and role models, conversations about

appropriate school placement. Proficiency of staff, and extracurricular

activities. This is the life blood that we as parents go into the educational

services to ensure the integrity of. A group at CDC of parents, professionals

and collaborators got together and had a discussion about creating a plan

that could be utilized by families in the ISSP process, and based on those five

characteristics of the communication plan that some states have adopted

and by law are required and others use the clause out of the IDA ensures

that the communication plan is a tool families can use to process with their

IFSP teams to mic sure that the considerations of deafness are considered.

I know in this group it's sort of a duh. But we know that families are

often going through this process of creating resources and their intervention

without expertise in the room. So we know for the IFSP communication plan

that it had to integrate the idea that where families are at in this process

may not be set in stone. There are still -- they're still exploring so the

communication plan is really a two fold plan, to make sure these

conversations happen, and also to help families with the professionals that

they're working with to make decisions about the needs of their children. It's

also available in Spanish, and I think someone of the interesting things, like,

so many resources that have been developed, unless you have a system to

ensure it's use it sometimes just sit on the shelf. So the way we're

suggesting its use is through legislative mandate, similar to some of the Deaf

Child's Bill of Rights, voluntary use. I hope that you will go and look at this --

the development of this plan. It can really help to ensure that the things that

we talk about that are important for families by law are actually happening in

their services, and that we're also disseminating this to parents to be able to

use at their IFSP meetings, really, to follow the IDEA regulations.

So thank you. Is that good?

>>MS. NUSSBAUM: Perfect.

I'm so impressed that we were able to hear from all the experience

that's in this room that are supporting this project, and I'm excited. If you

want to find out more about the work that these programs are doing to

support the evidence, you can go to the network, and they will also lead to

where you can participate in our future on line discussions.

If you've not subscribed to getting Laurent Clerc Center newsletters

and alerts you can do that on the front page so you can find out about these

discussions when they pop up. I want to thank everyone who participated. I

know it was hard. A lot of you were giving other presentations and we had

just a lot to learn from each other, and networking and keeping in touch is

what we need to do. Thank you.

(APPLAUSE)

(END OF MEETING)