1. Re-Educating Professionals About Spoken Language Carolyn J. Brown, M.S., CCC-SLP/A CCCDP Program Director Beth Whitfield, M.Ed., Cert AVT CASTLE Program Coordinator CCCDP Otolaryngology / Head & Neck Surgery UNC School of Medicine 2005 EHDI Conference

2. W.P. BIGGERS, MD CAROLINA CHILDRENS COMMUNICATIVE DISORDERS PROGRAM (CCCDP) Otolaryngology/Head & Neck Surgery School of Medicine University of North Carolina-Chapel Hill

3. History & Purpose Initiated by W.P. Biggers, M.D. - 1992 Purpose: to provide funding for communication devices for children with hearing loss whose families do not qualify for other public programs, but do not have adequate income to obtain communication devices that are not covered by insurance.

4. CCCDP Mission To provide the best hearing possible to NC children with hearing loss whose families have limited resources To provide on-going services To increase community awareness

5. CCCDP Mission To provide educational opportunities to professionals in the childrens home communities, especially in the rural areas, where little or no services are available to help children with hearing loss learn speech and listening skills.

6. Financial Assistance Program Funded through a contract from The North Carolina Department of Health and Human Services Qualifications for Enrollment: Children under 21 years of age North Carolina residents Need for hearing devices or services not covered by other funding programs An established need for financial assistance

7. UNC Pediatric Cochlear Implant Program Harold C. Pillsbury, MD Department chair & cochlear implant surgeon Dr. Craig Buchman Medical Administrative Director and CI surgeon Dr. Carlton Zdanski - Cochlear implant surgeon

8. UNC Pediatric Cochlear Implant Program Carolyn J. Brown, MS Program Director (Audiologist & SLP) Holly Teagle, Dave Catlett, Jennifer Weinstock, Nancy McIntosh, and Debbie Gunter (CI audiologists) Hannah Eskridge (SLP) Two social research assistants: David Perry and Robert Humphreys

9. UNC Pediatric Cochlear Implant Program 445 children with CIs Ages 7 months to 18 years Educationally pro-active

10. North Carolina NHS Statistics Numbers as of January 2004 : Total annual births in NC 117,335* NC infants screened at birth 98%* Natl Average 93.3%* Natl Average 2002 (previously obtained) 69%* * Statistics obtained from website: http://www.infanthearing.org/http://www.infanthearing.org/

11. If early identification and technological advances are going to be beneficial, EARLY habilitation utilizing a strong auditory approach, which teaches parents how to develop their childs spoken language through listening, is critical.

12. Early Intervention in NC Office of Education Services Number served/ 0 to 3 (2002) 250 Communication Methodology Year TC A-O/A-V 1997-98 60% 40% 1998-99 52% 48% 1999-00 36% 64% 2000-0133.5%66.5% 2003-04 16%* 84%* * Statistics from BEGINNINGS

13. Educational Situation Most of todays professionals have been trained to use a manual methodology. With todays technology, children with even the most profound hearing loss have the potential to hear and learn to talk.

14. Educational Situation Critical shortage of professionals who have the necessary training to facilitate spoken language For many children, especially in rural areas, educational and therapeutic intervention is often still limited to sign language.

15. Other NC Programs BEGINNINGS UNC-Greensboro (A-O/B-K) Lenoir-Rhyne AVI Modules First YEARS

16. HOW IS THE CCCDP @ UNC-CH HELPING TEACHERS AND THERAPISTS PREPARE FOR TODAYS CHILDREN WHO ARE DEAF AND HARD-OF-HEARING?

17. PRIVATE GRANTS PRIVATE/PUBLIC PARTNERSHIP

18. CASTLE C enter for A cquisition of S poken language T hrough L istening E nrichment (a member of OPTIONschools)

19. The W. Paul Biggers, MD Carolina Childrens Communicative Disorders Program (CCCDP) Financial Assistance Program Pediatric Cochlear Implant Team CASTLE Early Intervention and Preschool Services AND Professional and Student Training Program Pediatric Cochlear Implant Audiology Provides funding for hearing aids, cochlear implants, and services provided at UNC for NC children with hearing loss, whose families have limited financial resources Center for Acquisition of Spoken Language Through Listening Enrichment CI audiology services including mapping, assessment, and maintenance

20. CASTLE Staff Beth Whitfield, Program Coordinator Teacher of the Deaf, Cert AVT Lillian Henderson, Erin Thompson, and Sandra Onisk, Speech-Language Pathologists Cassandra Farrington, Office Assistant

21. CASTLE Objectives 1) to increase direct intervention services 2) to increase preschool opportunities 3) to increase families opportunities to learn how to facilitate their childs language at home throughout the day

22. CASTLE Objectives 4) to increase the number of hearing- related professionals trained in auditory- based intervention 5) to increase the number of graduates in hearing-related fields who have had practical experience in auditory-based intervention 6) to increase access to auditory-based intervention in rural areas

23. CASTLE s Focus Component 1: Direct services Component 2: Professional and university student Internship Program

24. Component 1 Early Intervention Services to Children & Families: Parent Training Program: 1:1 Parent Participation Sessions – for education, guidance, and counseling Family Learning Center Library of Resources with Internet Access Ages: birth to 5 years old (Kindergarten Readiness) For all parents

25. Early Intervention Services to Children & Families: Preschool Classrooms: Parent Participation Sessions Language intensive and enriched For children with significant language delay Ages: 3 to 5 years old (Kindergarten Readiness) Individual sessions with TOD or SLP Component 1

26. Component 2 Internship Program: Professionals: Working in the field as SLP, Teacher of HI, or Audiologist Students on caseload learning spoken language Hands-on practicum to follow workshops/institutes (1:1 coaching on use of new info) Observe & learn about new technologies & medical, surgical, & audio. management of hearing loss

27. Internship Program : University Students: Practicum Placements & Clinical Clock Hours Students in NC programs in Deaf Education, Speech-Language Pathology, & Audiology Hands-on experience in auditory-oral approach Component 2

28. Internship Program Application & Self- Assessment Pre-Test Post-Test Teaching Behaviors Evaluations Notebook

29. CCCDP / CASTLE Activities School site visits Annual 2-day conferences on intervention Statewide professional workshops NC Summer Institute in AVT First annual Winter Conference (1/2005) for state-wide early interventionists Student, professional, & First YEARS internships In-services & mentoring school districts

30. Real behavioral change is seldom the result of any single developmental experience, whether it is a one-day workshop, or an intensive week-long program. …even when…real commitments to change behavior [are made], the energizing glow of the experience can fade with time. Hermez-Broome, G. (2002). In it for the long haul: Coaching is key to continued development. Leadership in Action, 22 (1), 14.

31. Research Shows… Study by Center for Creative Leadership Implemented a follow-up coaching option for its Leadership Development Program in November 1999 Study compared coached group with non- coached group via 2 interviews Hernez-Broome, 2002

32. Study Results Almost 75% of participants reported changes in behavior following the coaching program. 15% of participants reported changes in behavior without the coaching. Hernez-Broome, 2002

33. Follow-Up It is vital to continue to have support to apply new skills and information. Because of this it is vital to understand that a one-week internship at CASTLE is only the beginning of the training process. On-going coaching and mentoring is critical.

34. For More Information…. For more information please contact: Beth Whitfield CASTLE Program Coordinator 919-419-1428 email: beth_whitfield@med.unc.edu or Carolyn Brown Program Director 919-419-1449 email: browncar@med.unc.edu