ROUGH EDITED COPY

EDHI
Malpensa ‑ 2:15 pm CST Breakout Session
March 4, 2019

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Technology Assisted Language Intervention in Children who are Deaf/Hard of Hearing
with Tara Kelly
2:15 PM CST 

   >> I can hear now. 
   >> Cool. 
   >> Close the window. 
   >> All right. All good. 
   >> TARA KELLY: I am the statewide coordinator for deaf and hard of hearing services with Delaware program. You can read all of this. All you need to know is that I'm a TOD, an early interventionist, I have been a school principal, and now I serve the entire state of Delaware birth to 21. I oversee the family education program for 0‑3. When I'm not busy doing that, I am also the mother of dragons who look suspiciously like 18 month old little boys. For those of you who do EI and community activities, you need to hold a kid in a cart? A 10 pound bag of rice will do it. And also very fun to drum on. 
   >> Why are we here today? Can I get a quick show of hands? How many of you are professionals or parents that have experience with communication plans for 0‑3? About half of you. Everybody else involved with EI in some capacity as a professional? Okay. And any other parents who have not yet done this? Welcome. Thank you so much for coming. 
    So today the goal of this session is basically to give a little bit of an overview of how communication plans can be implemented in the 0‑3 population, specifically looking at what are the key issues that need to be discussed, what are the benefits and challenges, and how do we go from that to implementation, and look at effectiveness. Bonus points if you can figure out where the socks go in the drier when you only have one. I definitely want to know. So, let me in on that knowledge. 
    So we're not going to read all of this. Basically all you need to know when it comes to education code and what the department of education, federal and many states say that it's very important that children who are Deaf/Hard of Hearing or Deaf‑Blind have access to a variety of communication opportunities. That's our buzz word. I know some of the other sessions have done a wonderful job of talking about how we're moving from choices or options to opportunities, because it really is an opportunity, and they are always changing. So, that's important to revisit as well. And the goal of all of this, of course, is kindergarten and preschool readiness. Now there's renewed focus on that, both from the previous federal administration's focus on early childhood and learning as well as the LEAD‑K legislation that is going on. 
    
    So how do communication plans fit into the IFSP? Usually the guide word that we use are describe, guide, and document. We're looking at making sure that we've got a solid description of how the child is communicating across all of their settings in their day and with communication partners. Any of us that have worked in preschools, parents that have been to play groups with their kids see that kids communicate in a variety of ways, and it is contingent upon who they're communicating with. Mom, dad, siblings, grandparents, aunts, Uncles may understand communication in a specific way that may differ from how someone who is not as familiar with them or communicates in a different context. For example, baby sitters or a child care center, a play group or a church group. These are different settings that people should be looking at when looking at communication plans for the littles. 
    Additionally, guiding discussions with the team members around the communication opportunities that exist and best fit the child's needs at that time. The important thing to remember, a really good friend of mine used to say that it's not a parking lot. You are driving a car to a parking lot and leaving it there forever and forever, you're done, never coming back. You're basically making the choice that you think is the best in terms of the opportunities available at the time. And part of the communication plan is coming back to that and reviewing, is that working? Is it getting the desired result that we want to see? If not, what can we be doing differently? What are other opportunities available? And the most important piece of this is documentation and looking at any item in the communication plan that needs an action plan, some steps for okay, this isn't happening currently, so how are we going to get there? What are we going to do to ensure that we're going from where we are today to where we want to be and some of the goal setting that we want to do. And we will get to that in a second. Best practice would dictate that all children who are identified as being Deaf/Hard of Hearing or Deaf‑Blind would have a communication plan, and one of the challenges is that many of these states do not require this full stop. And many of the kids who do for kids who are school aged, which is age of 3 to 21 or 26. In Michigan, it's 26. Many times for 0‑3, they're kind of forgotten. So, we really want to look closely at some of the reasons why that is. Okay. 
    So who developing communication plans. The IFSP team, and of course, your mileage may vary depending upon where you live, if it's a district program, if it's a nonprofit, a state‑run program. By by and large, the people you can expect to see is number one, the family, always the first and foremost, the most important members of any team. The service coordinator. They may call it something different. It may be a family coordinator. But basically the person who was assisting the family with coordinating all of the services. In of your service providers. And those are some examples of who might be included. None of this is an exhaustive list, and I recognize that you all come from different areas, so it may be different where you live. The early intervention teacher of the D/HH or Deaf‑Blind will facilitate this conversation. In some places such as the great small state of Delaware where I come from, many districts do not have teachers of the Deaf/Hard of Hearing or Deaf‑Blind on their staff. In order to stay in compliance, districts will try to fill in with other providers, perhaps a speech language pathologist or educational audiologist. It needs to be season who has deep background and knowledge of deafness but also has to have experience working with the early intervention population. I was one as a teacher of the Deaf, I did not go to a program that was focused on early intervention. Most of us do not. So, it's very important to ask if the professionals involved have any experience with early intervention. 
    Child care and nursing care. These are often two of the most overlooked team members. It is critically important that if you have young children who are spending most of their day because their parents work or their family works in child care or nursing care, if it's a child that is medically fragile or involved, that there is a representative from a person who is working directly with the child or from their organization to be there and be part of the team with a communication plan. Because they are going to be responsible for implementing portions of it. And specifically, I'm also thinking about nursing care regarding children who are Deaf‑Blind, children who may have multiple disabilities. Deafness may be a very small piece of their picture, but it is very important that they are there for that part of the discussion. And also school district representatives. I know in some places, services are driven through districts. In other places, districts are kind of an after‑thought at times, but it does make for a much smoother transition if there is school district involvement from the time the child is young, just because everybody is on the same page with what's been happening and where we feel like we need to go. 
    Okay. So, how do we know what goals are? Really, we first and foremost, and as a former family educator, I cannot stress this enough. Parents cannot make an informed decision if they don't know anything about deafness. If they've never met a deaf person besides their child and that's the first person they're meeting, I would argue I have a very hard time believing that parents are making an informed decision if they have not had an opportunity to meet a diverse range of Deaf/Hard of Hearing or Deaf‑Blind individuals in different walks of life with different communication modes and different languages. Parents need that opportunity before they decide what direction they're going in. You kind of need to see what the options are and what some of the outcomes may look like before you can commit to things. So, that's very important. Representation really matters, and I include deaf and hard of hearing professionals in that. I'm very found of saying our experience is not necessarily their experience. I am a hearing person. I cannot speak to what a Deaf/Hard of Hearing experience is. So, I need to make sure that I'm finding a way for our families to access those experiences. If I were a Deaf/Hard of Hearing professional, and I had a specific life experience and specific language usage, it would also be incumbent upon me to ensure that my families have access to other Deaf/Hard of Hearing or Deaf‑Blind individuals who have a different background and different life experiences from mine to be sure they are getting complete information. Time is always of the essence. It's really important to have that conversation in a more informal setting prior to the communication plan meeting, mostly because we want to ensure that the parents feel comfortable and that there's already an established rapport and we're just interrogating them. 
    It's important to use open‑ended questions that aren't leading, basically making sure that parents feel they can give the answer that best fits them, rather than asking the question of, "You want your child to listen and talk, don't you?" It's better to ask how they envision their children interacting. And the biggest question they often see overlooked when it comes to these informal discussions with families is how do you see them connecting with deaf and hard of hearing peers and adult role models? Many times families, especially some of the families I have worked with who have chosen an auditory verbal or listening and spoken language approach will say they will be fully integrated with their hearing peers, so I'm not sure they necessarily need that. And I will always gently but supportively offer back to them, I think it's very important that your child has that opportunity. Because they need to make those decisions for themselves when they're old enough. So, giving that opportunity and access is paramount. 
    So once we have our goals, that's terrific. How do we know where we're going from there? And sometimes it feels like we're going every which way, but there are many ways to reach the same end. So, what's involved in the communication plan? We need to make sure that the child's expressive and receptive communication whether it's language, modalities, combinations of many are involved there. And it's okay for parents to say that we're choosing more than one. We need to feel that that is okay. They need to make sure that we're documenting current opportunities for direct communication throughout the day. For those of you who live in states similar to mine where it goes from urban to rural, this is where technology can be key for us for getting the families some access. Assistive technology, looking at what type of hearing or amplification the child may be using as well as any other devices such as remote mics or in the instance of children who are Deaf‑Blind or have multiple disabilities, any other adaptive devices they may need. Looking at all the educational opportunities. They should always be offered even if a parent says we always choose option A. It's always good to review and for parents to understand that they have the right to review any options available to them at any time. And once those decisions are made, we need to respect that. 
    Again, making sure that the child will have full and consistent access throughout their day, and then any supports and services that the family may need to access the resources available to them. And here's the other piece I often see missed in 0‑3 plans. The plan for monitoring. Who is doing what? How will this be monitored? What types of assessments do we plan to use? Are we collecting data? And if so, who's doing that? Because that should be reviewed every time we come together. 
    I've included some communication plan templates here. I'm going to say that the reason I picked them, and again, this is far from an exhaustive list. I really like the ones that are specifically ‑‑ and by the way, I'm going to e‑mail all of this to all of you, and it's posted. I'm sorry that it was a late post, but it's up there now. And you will have my contact info as well. The CDC plan I really liked because it focuses not just on the child, but the different things that the family needs in order to best support their child. So, it's a very wholistic approach. The Pennsylvania early intervention plan; I know they had a specific session about that this morning. It is very good at breaking down specific concerns for kiddos 0‑3. I like the update that Ohio just did as well. 
    Okay. So, communication plan benefits. What do we get out of creating the plan? There is a sense of shared responsibility so that team members know how to assist in the development and implementation of responsive child and family‑centered goals. There is the expertise from the deaf professional that many would not have without that person present. It can be a living history. This becomes especially important as children move through different program placements, and sometimes families move whether it's out of region or out of state, sometimes even out of country. And it can really serve to create a smoother transition from early intervention to sight‑based services. Our goal is to ensure full and early access to communication. 
    So some of the challenges that we've looked at. Many states don't require communication plans, and those that do generally focus on the 3‑21 or 26 if you're in Michigan population. 0‑3s, we don't get a whole lot of love sometimes with that kind of stuff. Communication plans that are not early intervention specific sometimes don't specifically look at the supports that families need and the strategies that they need to access services. Sometimes people will write plans as if it's geared towards the program that the child is currently in rather than their individual need across all contexts. 
    There's a lot of insufficient training and lack of action planning for some of the plans depending on the experience level of the people who are creating and part of the team. And unfortunately, I know this is a problem for everything, but inconsistent and reduced funding leads to staff turnover. If you are constantly having to retrain people, it's hard to get consistency and quality in those plans.  So once you've got a plan, what needs to happen? This, I kind of love this graphic, because we know that the goal is the arrow. How are we going to get there? It is cyclical planning. 
    So they need to be completed and shared with all of the team members, and they need to be reviewed every six months for kids that are 0‑3. That is different than most of our EIP kiddos. For some children, it may need to be more often, kids with progressive losses, more fragile, or going through the imp plantation process and their equipment needs are changing. 
    Action plan items need to be monitored. There needs to be data collection and discussion. And if we're finding that what we're doing is not yielding what we're hoping in terms of outcomes, it's time to revise, and that's the best part of the communication plan. It's a living document. It's supposed to be flexible. Nothing is etched in stone. And again, data from our communication plans can help smooth those transition to sight and school‑based services. So, on this, you've got some resources. Far from exhaustive. That is my contact info. And I think we finished with a minute left for questions. I do apologize that we were not able to go more into the CDC and PA plan. 
   >> [ Off mic ]. 
   >> We have a really small Deaf community in the state of Delaware. So, basically we often will tap folks who work at our school for the deaf. If there are folks who work for the state office, we try to connect to as many deaf and hard of hearing individuals as we can from a variety of socioeconomic backgrounds. Typically I would bring a person or a couple of people to a visit. We would do two or three of the visits prior to the date of our communication plan and IFSP review. We have to bring people to the parents if the parents are not able to go to the individuals. 
   >> [ Off mic ]. 
   >> TARA KELLY: I know many places have deaf mentors who are paid, but ours is volunteer. Sorry, folks. Any other questions, please feel free to e‑mail me. I apologize again about the short nature of the presentation. 
   [ Applause ]