Improving Communication Among Professionals Working with Children With Cochlear Implants

Transcription

1 Improving Communication Among Professionals Working with Children With Cochlear Implants Presented by: Lindsay Zombek, MS, CCC SLP University Hospitals Case Medical Center Contributing Authors: Sandi Brotman Domoracki, MA, CCC A Jane Dunay, AuD, CCC A Kelli Halter, MS Michael Scott, AuD, CCC A, FAAA

2 OVERVIEW Creation of the Northeast Ohio Consortium for Children with Cochlear Implants (NOCCCI) The NOCCCI Communication System Ideas for creating a similar system in your area

3 Model of Communication in Northeast Ohio Prior to NOCCCI Cochlear Implant Team Surgeon Mapping Audiologist SLP Child with Cochlear Implant Early Intervention Developmental Specialist Hearing Specialist Teacher School Educational Audiologist Classroom Aide SLP Principal School Staff

4 Model of Communication in Northeast Ohio With NOCCCI CI Team Professionals Other Professionals Early Intervention Professionals School Professionals

5 To truly represent children with cochlear implants, efforts were made to invite professionals representing multiple communication modalities: Auditory Oral Auditory Verbal Bilingual Bicultural (American Sign Language) Cued Speech Total Communication

6 Invitations were sent to wide variety of professionals: Cochlear Implant Teams Universities Private Clinics/Practices Agencies Schools HUGE RESPONSE: 80 attendees representing 25 agencies!

7 Attendees were greeted with two ground rules: Participants should feel free to share ideas and thoughts Edits/critiques/judgment statements are prohibited

8 Brainstorming Session Results WHAT IS WORKING WELL : We have two nationally renowned cochlear implant (CI) teams serving the greater Cleveland community We receive quick response from Cleveland s cochlear implant teams to requests for information Our area s educational audiologists are top notch We have wonderful speech language pathologists in our area Our Regional Infant Hearing Programs are a tremendous resource for families There is mutual respect for all communication methodologies

9 Brainstorming Session Results WHAT IS WORKING WELL Continued: Kudos to caregivers/parents/families; thank you for all of your hard work We have great teachers of the d/deaf it is wonderful knowing our kids have such great teachers Universal Newborn Hearing Screening has made an amazing difference allowing us to identify children earlier American Sign Language interpreters provide audiologists wonderful information about children Cleveland s CI teams provide resources (support groups) for families Terrific resources and support groups are available for families

10 Brainstorming Session Results WHAT IS NOT WORKING WELL : Many schools do not know what to do with children with cochlear implants (CI) Educators do not all understand how to help a child in the classroom proceed through the hierarchy of listening skills Schools have no prior knowledge of when a child will be implanted CI teams do not know whom to contact in each child s school/district School systems do not know whom to contact (Which CI team? What professional?) Schools need to assume responsibility for making themselves part of the CI team Caregivers are extremely lost when they receive the diagnosis, please tell them available options

11 Brainstorming Session Results WHAT IS NOT WORKING WELL : Technology changes every day it is very hard for educational audiologists to keep up Need release of information/information exchange form/shared formal communication protocol Down time: Lost/broken equipment particularly affects districts far from CI teams IFSP/IEP process: transition should be smoother In an ideal world, CI teams would have educational consultants on staff Families are falling through the cracks only go to the mapping session with no other support/s Kids do not have the follow up in school

12 Brainstorming Session Results WHAT IS NOT WORKING WELL : Social economic status & parental education level really affect a child s success with a CI We need more diagnostic therapy prior to cochlear implantation (other issues such as cognition, we need to provide caregivers with realistic expectations) When a child is identified with hearing loss, where do they go, should they be funneled into a practice with hearing loss/ci experience? Emotional issue for families; not a scientific issue. CI teams need to explain how CI will impact daily life (cost of cords, additional therapies, cost of parking) People are recipients for life! Option model with CI s? Need documentation of child s abilities/benchmarks, unnecessary duplication of services, look at this as process: Auditory skills development hierarchical checklists Proximity to CI centers. Children need consistency!

13 Many concerns were raised by participants. All but four concerns could be grouped into two categories: COMMUNICATION EDUCATION

14 COMMUNICATION CONCERNS Schools have no prior knowledge of when a child will be implanted CI teams do not know whom to contact in each child s school/district School systems do not know whom to contact Schools need to assume responsibility for making themselves part of the CI team We need a release of information/information exchange form/shared formal communication protocol IFSP/IEP transition needs to be smoother We need more diagnostic therapy prior to cochlear implantation Option model with CIs? Unnecessary duplication of services

15 EDUCATION CONCERNS Many schools do not know what to do with children with cochlear implants Educators do not all understand how to help a child in the classroom process through the hierarchy of listening skills Technology changes every day it is very hard for educational audiologists to keep up CI teams should have educational consultants on staff Caregivers are lost when they receive the diagnosis, tell them what options are available Kids do not have appropriate follow up in school When a child is identified with a hearing loss should they be funneled into a practice that has hearing loss/ci experience? Option model with CIs? Auditory skills developmental hierarchical checklist Families are falling through the cracks: only go to the mapping sessions with no other support/s

16 Other Concerns Down time: Lost and broken equipment This problem impacts districts that are far from CI teams Socioeconomic status and parental education level greatly affect a child s success with a CI. Proximity of families to CI centers. These children need consistency! This is an emotional issue for families/parents/caregivers. It is not a scientific issue. The CI teams need to explain how the CI will affect their daily life (cost of cords, therapies, cost of parking). People are recipients for life.

17 NOCCCI Mission Statement The purpose of NOCCCI is to improve communication among stakeholders involved with children with cochlear implants (including but not limited to early interventionists, school personnel, speech language pathologists and cochlear implant audiologists) in order to create a strong team that can work together to help children with cochlear implants gain their optimal achievement levels.

18 The NOCCCI Communication System Teamwork Communication Forms Education Growth

19 Teamwork Members met with a willingness to put philosophical differences aside to work together for a common goal. This group continues to be action based to allow for the discovery of common goals and workable solutions.

20 Communication Forms Three Communication Exchange Forms: Information Exchange and Release of Information Form (EOI/ROI) Cochlear Implant Center to School Communication Form: CI Equipment Information Checklist School to Cochlear Implant Center Communication Form

21 All forms available: Hard copy/ disk upon request At NOCCCI s website:

22 Flowchart A Flowchart was created to help people navigate the communication form system

23 ROI/EOI Form This form initiates the NOCCCI process. It allows all preferred contact information of all members of the child s team to be on one sheet as well as consent for communication between these members. The form also establishes a contact person who then can appropriately distribute information to appropriate members in his/her agency (CI team contact, school contact, early intervention contact, etc).

24 ROI/EOI Form

25 Cochlear Implant Center to School Communication Form This form is used by the CI Center audiologist to communicate CI settings, fitting and usage parameters, and additional vital information to school personnel and other providers working with the child

26 Cochlear Implant Center to Schools Communication Form

27 School to Cochlear Implant Center Communication Form This form is used by school personnel to highlight student progress, potential indicators for program adjustment, and red flags.

28 School to Cochlear Implant Center Form

29 Education Educator Forums Have a Great School Year with a Child with a Cochlear Implant in Your Classroom! Topics: What is a cochlear implant Cochlear implant surgery and surgical considerations How do I know if the cochlear implant is working What is an assistive listening device How do I prepare for a student with a cochlear implant How do I support the student s academic/iep goals Therapy strategies for speech language pathologists Classroom based strategies for teachers Hands on interaction with cochlear implants and assistive listening technology

30 FORUM Participants: 200 first year, 230 second year, 70 third year Presenters: On average, 14 professionals per year!

31 COST TO PARTICPANTS: First Year = Free Second Year = $10 Third Year = $15 Included: 6 continuing education hours Presentations from professionals from the local community Face to face collaboration with local professionals Opportunity to talk with representatives from cochlear implant companies and FM system companies Notebook with presentations Snacks Parking

32 Funding for Forum Significant support from the Ohio School for the Deaf Presenter fees from manufacturers of cochlear implants, hearing aids, and FM systems Presenters volunteered their time and provided handouts Utilized student volunteers from local universities to keep cost lower

33 Growth Website: All forms available on website as well as information about upcoming events General meetings twice a year Development of committees to address additional areas of need Creation of a governing board, bylaws, articles of incorporation to set the stage for efficient decision making processes NOCCCI is fluid; NOCCCI continuously adapts to the needs and interests of stakeholders and children with cochlear implants.

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35 NOCCCI Outcomes Many outcomes, both predicted and unexpected Increased communication between CI teams, schools, and early interventionists Stronger sense of community among professionals Ability to educate others and learn from each other Ability to share resources (time, knowledge, and skill) to foster better outcomes in students Created a more streamlined approach to the management of speech, language, hearing, and education services for the children we collectively follow

36 Challenges for Future How do we foster continued growth of forums How do we keep the teachers involved/meet the current needs of teachers How do we spread NOCCCI statewide How do we continue to grow while remaining true to our grassroots beginning

37 Tips for Creating a Communication System Include people from a diverse group of workplaces (clinics, agencies, schools, universities, etc). All of these professionals bring a unique perspective Put personal philosophies aside (include multiple types of communication modalities and educational approaches) Include local professionals (national presenters have a lot to offer, but professionals benefit most from contact with someone who knows the child directly)

38 Tips for Creating a Communication System Create an open environment Communication is dependent on people being able to express their concerns and not feel critiqued. The NOCCCI System works because it meets the needs in our area. Your area may have its own concerns and challenges. The goal is an EFFICIENT system to make communication natural and easy for members of a child s team.

39 Questions? Further information about NOCCCI is available at For additional information or questions, send an e mail to lindsay.zombek@uhhospitals.org THANK YOU!