Providing Early Intervention Training in a Local Control

Providing Early Intervention Training in a Local Control State National EHDI Conference Salt Lake City, UT March 26, 2007

Nancy Hatfield Amber Roche Director, Early Childhood Genetic Services Specialist Washington Sensory Disabilities Services Nhatfield@psesd. org 425/ 917 -7828 V/TTY Washington State Dept. of Health, Genetic Services Amber. roche@doh. wa. gov 253/ 395 -6743

80, 000 births 69 birthing hospitals

Our Part C Challenges: No single point of entry n No State mandate for hearing screening n County-level Part C services n Gaps in specialty services n Cuts in Part C funding n

Our Strengths: • Several strong EI models • Strong state EHDDI program • Inter-agency cooperation • Many enthusiastic stakeholders • Commitment from county Part C

EHDDI in WA • Hospital Screening • Tracking & Surveillance • Best Practices Guidelines • EHDDI Summits Timeline 2000 2007

Hospital Screening n Technical assistance to birthing hospitals to initiate & maintain Universal Newborn Hearing Screening programs v Contract with Children’s Hospital & Regional Medical Center (Seattle) n Purchased hearing screening equipment v Partnership with Northwest Lions Foundation; contract with MSR Northwest

Screening Rates 1998 -2006 1998 -2005: data reported by hospitals via survey (includes military hospitals) *2006: Hearing screening rate obtained from screening results reported to EHDDI Tracking System (does not include military hospitals).

Tracking & Surveillance Contracted with Limelight Technologies n Used existing Newborn Screening data system to populate EHDDI Tracking system n Data sent from hospitals via modified blood spot cards n

BIRTH First Hearing Screen Second Hearing Screen Diagnostic Evaluation Early Intervention By Hospital Discharge or One Month of Age: Hearing Screen n By Three Months of Age: Diagnostic Evaluation n By Six Months of Age: Early Intervention n

Best Practices Guidelines Stakeholders’ meetings: 2001 - 2003 n Through a consensus process, developed: n v Protocol for Newborn Hearing Screening v Protocol for Diagnostic Audiologic Assessment (and. . . )

Best Practices Guidelines (cont. ) v Best Practices Guidelines in Early Intervention for Children with Hearing Loss Available on DOH EHDDI Website: www. doh. wa. gov/cfh/mch/Genetics/ehddi/default. htm

EHDDI Summits. . . Leavenworth Summit (Sept. 2003) n Skamania Lodge (Aug. 2005) n Proposed: Alderbrook (November 2007) n

EHDDI Summit Goals Leavenworth: Appropriate intervention, family support, decrease loss to follow-up n Skamania: Develop community plans to ensure that infants with hearing loss meet the 1 -3 -6 goals; decrease loss to follow-up n

EHDDI Summit Outcomes Evaluation: What did participants learn? n Recommendations n Follow-up actions n v. Participants v. EHDDI Program

Getting to the “I” in EHDDI Our Charge: To help under-served parts of Washington State provide early intervention services to support families with babies newly diagnosed with hearing loss.

Underlying Principles: EI training will support best practices n Content: speech, language, listening & learning n Focus: Individual counties n Common set of EI - DHH resources n Buy in from EI specialty providers n

Specialty DHH Service Areas HSDC/PIP, Listen & Talk, Family Conversations WA School for the Deaf Other Whatcom Underserved San Juan Okanogan Skagit Stevens Island Clallam Snohomish Chelan Jefferson Douglas Kitsap Grays Harbor Pend Oreille Ferry Lincoln King Spokane Mason � Thurston Pacific Kittitas Adams Pierce Lewis � Benton Skamania Clark Franklin Yakima Cowlitz Wahkiakum Grant Klickitat Whitman Garfield Walla Asotin Columbia

Cooperating Agencies

Development of EI Training n Evaluation and selection of training materials (e. g. , Ski*Hi Curriculum, videos) n Criteria for inviting counties n Mayflower Hotel meeting: 2004 (Input from DHH program providers)

1 or more per county

Sequence of EI Training Invite ~8 targeted counties per year n Hold orientation meeting n Follow-up training menu: n v Distance training events (e. g. , IVC or online coursework) v Session at Infant & EC Conference v Deaf/HH Family Weekend (May 2006) v On-site coaching

A Word About “Coaching” n n n Criteria: experience, follow best practices, no current affiliation Work on county teams’ priorities May model EI family support, assessment, training of community

August 2004: Pack Forest Summer Institute n n n Participants from 8 invited counties 8 families with infants & toddlers who are deaf/ hard of hearing Modeled EI services Presented content Panel discussions

Follow Up Training: 2004 -05 n Four 3 -hr interactive videoconferences: 1. 2. 3. 4. n n “Seeing: Visual Communication” “Listening: Auditory Communication” “Expressing: Spoken & Signed Comm. ” “Deaf/HH Children w/Special Needs” On-site coaching Deaf/HH Family Weekend (May 2005)

County Self Assessment n n What are our strengths? What are our challenges? Where are we losing babies to follow up? How do our EI services for families measure up?

EI Training: 2005 -06, 2006 -07 Kick-off meeting (1 day) n On-site coaching n Infant & Early Childhood Conference n Deaf/HH Family Weekend (May) n Content via on-line course (40 hrs. ): “Facilitating Outcomes: Language, Learning, Speech & Listening” n

Participating Counties: 2004 - 2007 2004 -05 2005 -06 2006 -07 Declined 2007 -08? Whatcom San Juan Okanogan Skagit Stevens Island Clallam Snohomish Chelan Jefferson Douglas Kitsap Grays Harbor Pend Oreille Ferry Lincoln King Spokane Mason Kittitas Grant Pierce Adams Thurston Pacific Lewis Cowlitz Benton Skamania Wahkiakum Clark Franklin Yakima Klickitat Whitman Garfield Walla Asotin Columbia

Lessons Learned IMPACTS ON: • County systems • EI services to families • Infants & toddlers (Based on annual evaluations and twoyear follow up survey)

Early Hearing-loss Detection, Diagnosis, and Intervention Website: www. doh. wa. gov/cfh/mch/Genetics/ehddi/default. htm EHDDI Follow-Up Staff Amber Roche ehddi 2@doh. wa. gov Phone (206) 418 -5613 Fax: (206) 418 -5415 Amber. Roche@doh. wa. gov Phone (253) 395 -6743 Fax (253) 395 -6737

Website: www. wsdsonline. org Nancy Hatfield, Ph. D. Nhatfield@psesd. org Phone (425) 917 -7828 V/TTY Fax (425) 917 -7838