Sunday Morning Sessions |
Pragmatics in practice: practical strategies to promote pragmatic skill development in early childhood
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The importance of pragmatic skills, often thought of as the social use of language, has been well established, including the relevance of pragmatics for children who are deaf or hard of hearing (DHH; Szarkowski & Toe, 2020). Difficulties with pragmatics have been associated with challenges in the areas of peer relationships, academic skills, and lower employment rates (Toe, 2020; Thagard et al, 2012). Although many DHH children who receive early intervention acquire age-appropriate receptive and expressive vocabulary skills, pragmatic language skills frequently lag (Goberis et al., 2012). Because the foundation for pragmatic language skills is established early through caregiver/child interactions and early social experiences (Kelly et al., 2020; Mood et al., 2020), caregivers and early intervention providers are in a unique position to promote pragmatics. Yet, parents and interventionists often feel uncertain how to define and target pragmatics in “real life.” This workshop will be presented by a Deaf leader who is also a parent of a child who is DHH, a parent of a child who is DHH, an early intervention provider who supports families and children who are DHH, and two psychologists/researchers interested in pragmatics. Utilizing case examples, this hands-on workshop will provide information about pragmatic development and what pragmatics “looks like” in the early years, guide participants in understanding early pragmatic skill milestones, and generating options for incorporating activities that can be embedded within daily routines to explicitly target the promotion of pragmatic skills. Participants and presenters will be invited to share strategies for explaining pragmatics and empowering families to feel confident in supporting their child’s pragmatic skill development, and resources will be provided. Additionally, the importance of considering pragmatics during transition planning from early intervention to school-based services will be discussed and tools for assessing pragmatics will be shared (Toe et al, 2020).
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Sunday, 3/17 8:00 AM - 12:00 PM |
Horse As Interventionist: An Interactive Relationship-Focused Experience for Parents and Providers
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Sunday, 3/17 8:00 AM - 4:00 PM |
Cultural Humility: Fostering Family Engagement in Early Intervention
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With approximately one million immigrants arriving in the United States each year, the United States population has become increasingly diverse including families that speak a language other than English at home. In 2020, the Pew Research Center found the number of immigrants to the United States has more than quadrupled since 1965, which accounts for roughly one-fifth of the world’s migrants today. Immigrant families have their own cultures with unique beliefs, traditions, rituals, activities, languages, practices, and communities that differ from the mainstream American culture. To best serve diverse families, EI professionals need to understand how culture drives the activities, beliefs, expectations, and routines of families with children who have hearing differences. When EI professionals engage in self-reflection and self-examination of their own culture (Cultural humility) they are then able to enter into a relationship with the family with the intention of honoring their beliefs, customs and values (Cultural responsiveness). This trusting relationship provides a solid foundation for family engagement in early intervention. This instructional session will support participants to begin an exploration into how they can develop cultural humility and work with interpreters and cultural brokers to provide culturally responsive assessment and intervention to diverse families within the EHDI system. An overview on common cultural beliefs about hearing differences, working effectively with interpreters and cultural brokers, and overcoming challenges will be addressed. Recommendations and resources will be shared.
Due to the complex and individual nature of this topic, it will best be shared in an interactive instructional session. Participants will have a greater opportunity to share their own cultural journeys, and practice skills relevant to family-centered intervention. Participants will receive the research evidence for these practices in long-term developmental outcomes, examples of how providers can educate themselves about the culture, language, expectations of their families and modify their early intervention strategies
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Sunday, 3/17 8:30 AM - 11:30 AM |
Navigating Other People by Understanding Communication Styles
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As our communities have become polarized, the need for excellent communication has become greater. The workplace has ample opportunity for miscommunications and gaps to take place. Healthy relationships are not only needed in our personal lives but our work lives as well. When we can get along with colleagues, we can accomplish more, faster. In this session we will take a deep dive into interacting with those around us and explore ways to enhance communication so we can get the job done!
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Sunday, 3/17 8:30 AM - 12:30 PM |
The Role of Collaborative Partnerships in in Newborn Screening & Identification: Supporting Deafblind Infants & their Families
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Collaboration is the foundation for enhanced services and support for families. This presentation will highlight the benefits of state level partnerships to address critical needs in the areas of early identification of vision and hearing status and cross referral. Common risk factors and etiologies associated with deafblindness and examples of system level collaborations between state deafblind projects, EHDI Programs, family services organizations, and Part C Early Intervention will be shared. Additionally, families will tell their stories that highlight successful collaborations that created positive outcomes, experiences, and engagement. Session participants will have the opportunity to discuss ways to enhance systemic partnerships that increase early identification of infants who are deafblind so families can be supported throughout the screening, referral, and intervention process.
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Sunday, 3/17 8:30 AM - 12:30 PM |
IDEA and Advocacy for Parents and Professionals - Learning Enough to Make a Difference
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What makes a parent a successful advocate for their child who is deaf/HOH? What helps a provider successfully advocate for their student? Legal protection is available for parents of children with disabilities; sadly not all parents are aware of it. This presentation offers both parents and professionals the basics to successfully work with schools for their child’s educational future. Protection of the parent/school relationship is the most important aspect of successfully advocating for a child with disabilities. Professionals can easily educate parents in this model of parent/school relationship building without jeopardizing their position. IDEA protects parents; it’s up to the parents to protect their relationship with school personnel. In this session participants will have the opportunity to rewrite sections of the IEP that have missing pieces. Firsthand examples will be provided throughout the session from an advocate who has been teaching this session and advocating for students for over 15 years, beginning with her new 21-year-old daughter.
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Sunday, 3/17 8:30 AM - 1:30 PM |
Untangling the Complexity of Pediatric Audiology
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Pediatric Audiology is the practice of testing pediatric patients to determine their current auditory function in order to provide appropriate intervention options for communication. This presentation will provide audiologists with the tools to “think outside the box” about complex pediatric audiology patients. The use of subjective audiology measures (i.e. case history and functional assessment) and objective diagnostic tests to make thorough diagnosis will be discussed. Additionally, presenters will explain how to use all available pieces of the puzzle to make appropriate recommendations for patient focused, family-centered intervention. Case studies will be reviewed to provide examples of thinking outside the box with complex cases.
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Sunday, 3/17 9:00 AM - 11:00 AM |
Sunday Afernoon Sessions |
Exploring EHDI Data: Unveiling Novel Parameters for State-to-State Comparison
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Exploring EHDI Data: Unveiling Novel Parameters for State-to-State Comparison.
Introduction
Hearing loss in the newborn is seen to hamper linguistic development and social skills. Early intervention has proved to minimize hearing loss-related outcomes. The Early Hearing Detection and Intervention (EHDI) state program, supported by the Centers for Disease Control and Prevention (CDC), aims to mitigate these challenges. Our study delved into EHDI data spanning 2014 to 2020, aiming to compare states and assess program effectiveness. Through the creation of novel parameters and visualizations, we added depth to the analysis, shedding light on variations and potential improvements within the program.
Methods
We collected the EHDI data from the year 2014 to 2020 shared by the CDC for 50 states including the District of Columbia. We identified 25 variables from the EHDI data for our calculations using RStudio 2023.06.0+42. We did not account for any missing data. We calculated 27 additional parameters. The national average was calculated based on available state data in a year. Parameters were visualized to have a comparison of states' performance and EHDI program effectiveness. Finally, all visualizations were hosted on a public website for EHDI professionals to explore and utilize.
Results
We found that the state of California has the best screening service under the EHDI program where 99.5-99.6% of newborns are screened each year. Out of the total screened infants Hawaii has been reported as the state with the highest prevalence of infant diagnosed with hearing loss with the exception of 2020 where Idaho also reported 3 in 1000. We also found that the highest percentage of infants who did not pass inpatient screening (NPIS) at the time of birth were from the states of North Dakota (11.9%, 2020) except in years 2017 and 2018 where the state of Alabama reported the highest percentage with 61.1% and 52.1% respectively. Upon investigating those infants who did not participate in this program considering three main reasons, we found that West Virginia for years 2014, 2016, and 2017 had the highest prevalence of loss to follow-up. The District of Columbia had the highest prevalence in 2015, 2018, and 2019, and South Dakota in 2020.
Conclusion
This study looked at EHDI data – where available – from 2014 to 2020 from 50 states and the District of Columbia and discovered differences in newborn hearing screening rates, hearing loss prevalence, inpatient screening failure percentages, and among other parameters. These findings highlight potential program enhancement areas, states requiring special attention, informing targeted interventions to improve EHDI effectiveness across the country.
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Sunday, 3/17 12:30 PM - 2:30 PM |
Tools to leverage cross-sector systems that enhance language acquisition and kindergarten readiness for children who are DHH
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This session will dive deeply into the emerging roles of state EHDI programs as participants in cross-sector systems that are collectively responsible for language acquisition and kindergarten readiness. The session will begin with a peer learning session, where participants will use visual tools to capture their current level of cross-sector systems participation in these efforts. Grounded in this context, the session facilitators will then provide a high-level systems thinking overview using the iceberg and other systems thinking core concepts. This portion of the session will provide a tool participants can use in their own work to help develop a shared understanding of the state’s current approaches to language acquisition and kindergarten readiness. Session facilitators will then turn to two tools that are intended to help cross-sector collaborators see the ‘big picture’ system they are working to enhance from multiple angles: 1) Whole System Maps allow collaborators to inventory programs, services and resources within the system they want to strengthen, and; 2) the 5 R’s is a method to see the system in which collaborators are working (either independently or as partners) by using a conversation guide to prompt for what success looks like (results), roles, resources to support change, and rules and relationships that must be understood or changed to improve outcomes. Finally, participants will be exposed to Appreciative Inquiry, which enhances systems change efforts by framing the challenge from the outset as a positive goal to be achieved and builds on existing systems strengths rather than focusing on gaps. Once all tools have been described (with examples), participants will select which of the method(s) they would like to apply to their own work. Small groups will be formed, and session facilitators will guide participants as they begin to apply the tools to their own contexts.
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Sunday, 3/17 12:30 PM - 4:30 PM |
Baby Flow through the EHDI System: An Examination of Data and Performance Measures
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The EHDI 1-3-6 model states that all infants should have their hearing screened by 1 month of age; all infants that do not pass their hearing screening should have an audiologic evaluation by 3 months of age; and all infants diagnosed with permanent hearing loss should be enrolled into early intervention services by 6 months of age. Each EHDI jurisdiction in the United States uses these guidelines to track its progress towards reaching the 1-3-6 benchmarks. However, there have been different denominators used to calculate the 1-3-6 performance measures. This presentation will provide insight on the differences in denominators being used for these performance measures and how to interpret what each of the calculations represent. For each of the 1-3-6 measures, we will examine two different denominators being used across EHDI systems and organizations:
- Screened by 1 month: All infants born reported by EHDI-IS versus All infants screened
- Diagnosed by 3 months: All infants not passing hearing screening versus All infants receiving an audiologic evaluation
- Enrolled in early intervention by 6 months: All infants with a permanent hearing loss diagnosis versus All infants enrolled into early intervention services
From a public health perspective, it is important to follow the entire population through the EHDI process, therefore, using the first denominator in each category above ensures all infants eligible to move to the next step are captured, while the latter denominators focus more on timeliness of services received. Both formulas provide relevant information, but it is important that EHDI systems and organizations are aware of the differences between the calculations so that the numbers can be interpreted appropriately. By only using the timeliness measures to monitor program performance, infants lost to documentation or lost to follow-up (LTD/LFU) are not captured when discussing the EHDI system performance. Infants are categorized as LTD/LFU when the following reasons are selected for not reaching the next step in the EHDI process: families contacted but not responsive, unable to contact the family, or unknown. By understanding this population of infants and their barriers to care, EHDI systems can make programmatic changes to target this population to improve and strengthen their follow-up efforts.
We will use data collected from CDC’s annual Hearing Screening and Follow Up Survey (HSFS) in 2021 to demonstrate the outcomes of using different denominators. Additionally, we will use iEHDI (patient level data) sociodemographic data to describe the LTD/LFU infants at each stage of the EHDI process to help demonstrate how EHDI programs can gain insight on the population of infants not receiving their recommended services. The following learning objectives will be addressed during this presentation:
1. Participants will be able to describe the differences in the denominators being used at the 1-3-6 benchmarks.
2. Participants will be able to interpret the different calculations generated with the denominators.
3. Participants will be able to analyze their LTD/LFU infants at each stage of the EHDI process.
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Sunday, 3/17 1:00 PM - 3:00 PM |
"SALAM": An Open Door Approach to serve Diverse Muslim families of children who are DHH. What to do after the door is open?
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As practitioners, many of us provide services to families who are Muslim and have children who are deaf or hard of hearing. Once we get in the door, then what? Muslim families come from a variety of rich linguistic, cultural, regional, religious, and ethnic backgrounds. There are distinct correlations and differences between religious (Islam) and familial beliefs and cultural practices. This session will equip practitioners to work with Muslim families using social, religious, and cultural best practices. Through interactive discussions, role plays, and real-life scenarios, participants will be given a unique view into a different culture and tools to support Muslim families and children in accessing interventions and education through equity and inclusivity.
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Sunday, 3/17 1:00 PM - 3:30 PM |
Family Support and Leadership: the Blueprint for Success
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In 2022, HRSA released the Blueprint for Change: A National Framework for a System of Services for Children and Youth with Special Health Care Needs. (PEDIATRICSVolume149, numbers7, June2022:e2021056150B) The 4 critical areas center around the issues families consider most important to strengthen the system of services: health equity, quality of life and well-being, access to services, and financing services. Drawing from the work of the Blueprint for Change, this session will bring to life the four areas for EHDI stakeholders, focusing on the role of family and D/HH leaders in addressing the unique needs of families with children who are D/HH.
This interactive session will provide key strategies and practical insights to ensure that the EHDI system is strategically focusing on the four areas of the Blueprint, building upon what has been done, and what family-based organizations in partnership with state/territory EHDI programs can do to ensure a strong and healthy system.
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Sunday, 3/17 1:00 PM - 4:00 PM |
Creating Meaning Together: Understanding EI from a Social Model
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How we understand the world around us is a complex combination of many influencing factors. Some factors are internal: senses, emotions, mental and physical abilities. Some factors are external: people, policies, language, media. These influences combine to help us create meaning. As early intervention professionals and parents, together we form ideas about what being DHH means for each of our children. Holler et al. (2021) talked in their study with occupational therapists about how understanding a social model of disability impacted their practice. They found that having this understanding leads to more positive perceptions of disability, more “everyday” application of services, and a focus on ability. As early intervention professionals, we strive to meet the best practice guidelines including using everyday routines and supporting families where they are. The 2013 Joint Committee on Infant Hearing (JCIH) supplement to the 2007 position statement includes a goal regarding training for EI providers. Goal 3 states that EI professionals should have “qualifications and core knowledge and skills to optimize the child’s development and child/family well-being" (p.1328). This instructional session will provide opportunities for each of us, in our varied roles, to better understand how a social model perspective can help us meet those guidelines. As a group, our session goals are to: Begin to understand the social construction model Reflect on our beliefs about disability/deafness Reflect on how we participate in constructing disability/deafness with families Examine barriers in early intervention systems Brainstorm what we can do to improve our personal practice There will be assorted opportunities provided to learn throughout this session. Small group discussion, personal reflection, and large group discussion. Upon completion of the session, each participant should have some concrete ideas for how a social model understanding can improve their interactions with families and encourage best practice in their area. Holler, R., Chemla, I., & Maeir, A. (2021). Disability orientation of occupational therapy practitioners in physical rehabilitation settings: Tension between medical and social models in theory and practice. American Journal of Occupational Therapy, 75, 7504180010. https://doi.org/10.5014/ajot.2021.042986 Joint Committee on Infant Hearing. (2013). Supplement to the JCIH 2007 position statement: Principles and guidelines for intervention after confirmation that a child is deaf or hard of hearing. Pediatrics, 131(4), e1324-1349. https://doi.org/10.1542/peds.2013-0008
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Sunday, 3/17 1:00 PM - 4:00 PM |
Using Narrative Medicine to Inform Best Practices in Early Intervention
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While writing my book, Remedies for Sorrow, which is about our daughter who was born deaf due to congenital CMV, I realized that our daughter's providers either listened intimately or remained vaguely detached from our family. Those who impacted our lives knew our family’s detailed story—and often, we knew some of theirs. As I came across the field of narrative medicine in my research, I realized its tenets could be applied to any field--audiology, early intervention, even parenting itself. When we listen to and tell the story of illness as cultural,
personal, and complex, both provider and patient are transformed. In this talk, I'll discuss the three (quite simple) ways to implement narrative medicine, in what I'll call "narrative early intervention”; use writing exercises for participants to fully articulate their experiences; and give providers new enthusiasm for the paramount work of shaping a child's world through communication.
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Sunday, 3/17 1:30 PM - 3:30 PM |
Consensus Process, Building Team Inclusion and Alignment
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The Consensus Process is not a “majority rules” process, and it is not about unanimous agreement (although that would be a nice outcome). Consensus is the cornerstone for team building and inclusion. It represents a model for conflict resolution. The better a team is aligned, the better a team can succeed. This instructional session will go over all the consensus tools and will spend time trying them out and practicing during the session.
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Sunday, 3/17 2:00 PM - 4:30 PM |
Instructional Sessions are included in the EHDI Annual Conference for sessions/topics that do not fit into the standard breakout session format. Consider proposing an Instructional Session only if one or more of these considerations apply:
Proposals will be considered, reviewed, and selected by the 2025 EHDI Annual Conference Planning Committee and the EHDI Conference Co-Organizers. Criteria for selecting Instructional Sessions will align with the broader abstract submission criteria.
Please note: Each instructional session must have a minimum of 10 registrants, or the session will be canceled. Decisions about holding the session based on number of registrants will be made approximately one month prior to the conference start date.
Instructional Session abstracts will be reviewed and scored according to the following criteria by the EHDI Conference Planning Committee: