Providing EI for Deaf and Hard of Hearing Babies During COVID-19 Transcript

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Communication Access Realtime Translation (CART) captioning is provided to facilitate communication accessibility.  CART captioning and this realtime file may not be a totally verbatim record of the proceedings.

>> SARAH HONIGFELD:  Hello, everyone.  I’m so excited that you all are able to join with this NAD webinar specifically about early intervention for deaf and hard of hearing children from birth to five during this COVID‑19 pandemic.  There is such a need for information, resources and collaboration in this time.  I want to start off by explaining a little bit of the logistics about this webinar before I do introductions.  If you need live captions go ahead and use the URL for that live stream rather than Facebook automated captioning.  So again, use the live stream captions.  If you need Spanish interpretation on the Zoom platform you can click at the bottom and change the language to Spanish.  This webinar is being recorded and after its completion it will be uploaded to Facebook for later access.  Thank you to the National Deaf Education Center for providing interpretation services in English and Spanish for today’s webinar.  We appreciate that level of access.

Now I want to begin by introducing our panelists for today.  I’m very excited for the great team that we have here with us.  Again, we’ll be talking about early intervention touring COVID‑19 and we have three great panelists with us today.  Unfortunately Kimberly Sanzo won’t be with us.  We have three wonderful people I’m going to introduce.  

We have Jodee Crace with us who is the Coordinator for ASL connect for families at Gallaudet University. She’s also the coordinator for the SKI‑HI Deaf Mentoring program.  She’s worked with families for many years and now has the component that is ASL connect on line.  Hello, Jodee.

>> JODEE CRACE:  Hello.

>> SARAH HONIGFELD:  We also have with us Joseph or JoJo Lopez.  He’s a mentor for the New Mexico school for the deaf.  I believe you are in southern New Mexico, correct?

>> JOSEPH LOPEZ, III:  It is.

>> SARAH HONIGFELD:  He’s been involved with the Latino community as well so we’re grateful to have that perspective here today.  We have an additional panelist, fairly well known in our community as you may know, Dr. Laurene Simms, she’s the head of the Bilingual Office at Gallaudet University, ASL English Bilingual Consultant, and she’s a teacher in the Department of Education at Gallaudet University.  We’re excited to have her with us today.  Hello Laurene.

>> DR. LAURENE SIMMS:  Hello.

>> SARAH HONIGFELD:  Today we’ll be talking about early intervention from birth to five and how to support families in this time of quarantining in the midst of a pap pan.  So I want to start off with a question that’s for everyone and we will have the panelists answer starting with JoJo then Jodee then Laurene.  Of course this was an unexpected situation.  What was your initial reaction to the COVID‑19 crisis?  JoJo?

>> JOSEPH LOPEZ, III:  Hello.  Yes, prior to COVID‑19 I had been working with families and driving around to make those home visits in person and once the pandemic hit we realized that would have a great impact on our work as we were no long able to visit families or do in home visits.  We met with our early intervention department, and we convened and brain stormed ideas about what to do to transition to a virtual environment.  We’ve seen so many successes in that transition.  We didn’t wait.  We wanted to proceed because families were living in many places in the state.  We wanted to provide as much contact with those families as we could.  We were unable to drive to visit with those families but we were able to connect with them virtually.

>> SARAH HONIGFELD:  Thank you so much.  Let’s turn it over to Jodee.

>> JODEE CRACE:  I do work with ASL Connect which is virtual in nature.  We work with families to get ahead of the game.  So once the pandemic hit, we realized we were already set up to continue that virtual work with our families.  Many of our families were experiencing children coming home, so that of course improved the quality of their life and made things better so we were able to connect with the coordinators as well as our virtual team to make sure everyone had the services they need.  It was a new challenge for the families to manage during this time but for us as a program, this was nothing out of the ordinary.

>> SARAH HONIGFELD:  Yeah that’s a good point that you were already prepared, which is a really nice thing.  Now Laurene.

>> DR. LAURENE SIMMS:  When COVID‑19 hit it definitely had an impact to our department at Gallaudet and the broader community.  It had a socioeconomic effect on our community members.  Many members did not have technological access so there was a big economic impact for many of our families.  They may not be set up with Comcast or other internet service providers, they may have been limited to using one iPhone so we had to navigate how to create those connections, which was a challenge.  Fortunately the department had many resources.  We had packages that were mailed to the family’s home.  So of course we have to rely on the mail service, something that is not expiring from our lives so the postal service and the mail was instrumental on us getting those kids to the home.  Those kids had a DVD player which was a great thing for us to have.  Because you know we see the red box stores still at the grocery store which indicates that people still have DVD players in their homes so that was a resource that we were able to use.  We were able to show people how to use the DVDs and that gave us an idea, we were able to make a lot of adaptations.  We were able to alleviate and lessen some of those challenges.

>> SARAH HONIGFELD:  Thank you for sharing that.  We will get into more of your experiences as we go through this but I do want to go back to Jodee and ask a little bit more about your situation as you were talking about families, having more children in the house, as kids are not going to school.  Have you seen an increase, a decline or has it remained the same in terms of family involvement?  Can you speak to your experience?

>> JODEE CRACE:  Well we actually just began this program the past fall so it is still new to us.  The program is very structured.  So people know what to expect.  There is a list, a checklist that people are able to go through on how services will be delivered.  So now with additional people being at home and spouses working at home and everyone relying on the same technology because the houses of course are very busy and everyone is relying on technology our coordinators are also able to plan an email to the families ahead of time specifically what lessons will be discussed and what adaptations are needed for the age of the children in the home and how we’re able to modify and adapt our arrangements to work collaboratively with the parents.  Whereas we were working with the families remotely ahead of time we wanted to know exactly how we could best meet their needs so it was a lot of back and forth throughout this experience.  Occasionally parents would say hey, you know I’ve got a baby who is taking a nap and I’m here by myself, it’s not, is that something we can move with the schedule and of course we were able to accommodate that and sometimes people would be mobile with the screen and of course we were flexible to those needs. After the virtual session was over we would send the family a recording like what we’re doing today in Zoom so the families are able to view those materials repeatedly as they need so that’s something we’re working on air is that’s nice.  Seems families appreciate the flexibility having the able to be on a mobile device.  It’s nice to meet families where they are.  JoJo would you like to add about your experience in terms of providing support.

>> JOSEPH LOPEZ, III:  Sure.  Yes, I agree with Jodee.  We had a structure and foundation for home visits but then when we transitioned remotely we had to figuring out what we would do so we met with a team to brainstorm ideas and took into account our specific skill sets and specialties to support our families be on onscreen, story telling, Marco Polo is good because families can view those messages repeatedly so that was really nice.

>> SARAH HONIGFELD:  Laurene would you like to add something.

>> DR. LAURENE SIMMS:  I don’t have the experience of being on the front lines.  I am working in a supportive role provide aid to individuals working with the families so for me I don’t have direct experience with this question.

>> SARAH HONIGFELD:  I am wondering with regard to bilingual, could you speak to us about some of those barriers?

>> DR. LAURENE SIMMS:  Yes.  As was mentioned many families did not have access to the internet and without having those face‑to‑face meetings that created a challenge.  So instead we had to use videos and DVD that were more two dimensional in nature instead of the three dimensionality that we’re used to.

>> SARAH HONIGFELD:  They’re more flat that way.

>> DR. LAURENE SIMMS:  Yes three dimensional is much more natural and organic so we wanted to use those resources, but using DVD or other materials sometimes, it’s a frozen text so it’s not a back and forth or give and take and that was a concern of ours how we could promote bilingualism without a 3D environment.

>> SARAH HONIGFELD:  Real life experience is always the best.

>> DR. LAURENE SIMMS:  Yes and right now we’re making do with the two dimensional communication that is taking place and we’ve had back and forth with that.  That has had an impact to the bilingualism of our programs.  It’s doable however.

>> SARAH HONIGFELD:  I agree with what you are saying and related to the comment about using DVDs and other videos there are some families who are concerned about screen time.  The World Health Organization or the WHO has a recommendation for infants under 1 to have no screen time and the recommendation for under 5 is actually up to an hour a day.  So now during this COVID pandemic we’re becoming dependent on screens as it comes to ASL stories, zoom, YouTube and the like.  So there’s been dramatic rise in screen time.  What are your thoughts in regards to screen time, ASL language acquisition as the balance is achieved.  I’m going to open the door to everyone on this question.  Jodee.

>> JODEE CRACE:  Yes, screen time is definitely an issue and it can become a bad habit.  We’re all so enamored of our devices that it can become a bad habit when we use them too much so our focus is on the families.  We’re looking at birth to age three so we look at the WHO as well as other professional organizations for guidance pertaining to screen time.  There are advantages to using screen time.  There are educational purposes, there are specific reasons that we use screen time.  And there are skills that are developed in the brain so we want to use those for language acquisition with specific time limits, limiting that to 20 minutes at a time, repeating a 20‑minute session in the afternoon and briefly prior to bed time.  So we want to use those for beneficial reasons.  For hearing families, we’re using Englishing or Spanish that is audio based, when we’re looking at Deaf communities we’re relying heavily on visual based communication so this is an opportunity for us to connect virtually via a web call so children are able to develop those visual skills simultaneously.  The families are working on the skills at home.  We’re sort of training the eye so the parents will need to be instrumental in leading those interactions.

>> SARAH HONIGFELD:  That’s a great description.  Would anyone else like to add to this?  JoJo.

>> JOSEPH LOPEZ, III:  I would like to add.  I’ve seen a lot of families have an increase in screen time.  One barrier can be siblings in the house.  Maybe the home has an internet connection but maybe there’s a device, one phone, one iPad, or a laptop.  We know the screen size on a phone is, they’re manageable but many siblings need to attend to that if they have a school curriculum they’re working through throughout the day then the device time may be limited when it is shared.  However, family members may interact one on one for about an hour a day or we can divide it throughout the week, half hour here and half hour there and I’ve found that to be helpful because attending for a full hour is difficult and can cause fatigue if you are not used to it so provide different times has been a great addition.

>> SARAH HONIGFELD:  That’s something that my [indiscernible] did because an hour can feel a bit of overkill so splitting the hour into two 30‑minute sessions does seem to be helpful for children and families so that’s a really nice choice.  Thank you for that addition.

So Jodee asking about ASL connect I’m impressed with that family child connection and hopefully one person who is watching us today will learn more about how it is that you are supporting families and children and how you can model that eye contact, that touch, the massage as you support infants.  How do you support that attachment?

>> JODEE CRACE:  That’s a good question.  Our coordinators are already trained and aware with early intervention techniques and best practices.  So they come with that knowledge.  So with that in mind we pull videos and materials from the VL2 program.  We abbreviate specific research and sign exactly the stories to engage the eye gaze of the child.  We have the families watch the materials prior to us connecting so we can talk about that on a certain level then we can instruct the families in their best use.  We also incorporate the use of dolls where we converse with the doll and show the eye gaze and turn that so we can at least pretend with dolls or stuffed animals.

>> SARAH HONIGFELD:  Yeah, whatever works. 

>> JODEE CRACE:  Absolutely.  Frequently parents will say okay I’m going to go ahead and give this a try and the following week they’ll let us know what worked and so we practice again on those few specific techniques so we break it down into smaller components and work that part and do the sessions remotely.

>> SARAH HONIGFELD:  That’s a great answer.  I love the idea of using stuffed bears or dolls or if you were really desperate you could use a bag ever flour right?  JoJo you could add how you support families with young infants.  What do you do there?

>> JOSEPH LOPEZ, III:  Just like what Jodee mentioned we use resources on different items.  So far I have yet to work with infants however most of my children that I’ve worked with are a little bit older so I will bring toys, model planes, for example if I am giving a story where an airplane takes off I can give different ways in ASL how the plane functions.  I use my body space and model the language behavior.  I have one family that’s very active and loves to play outside.  So we’re able to connect remotely so they said you can come over.  I said unfortunately I can’t.  I’m just here in the laptop.  I wish I could dive outside of the laptop but they were able to bring the toys and dirt and sand the kids play with and bring the devices with them.  Of course the families are apologetic about the state of their homes which isn’t important to us but we want to have the connections with the families and expose them to as much language as possible.

>> SARAH HONIGFELD:  I love the idea of bringing what is enjoyable to the screen, explain what they’re doing today, getting out in the dirt playing.  That’s a wonderful idea.  I want to shift gears to a more serious topic.  We know that families do not live in a bubble.  But they’re impacted by the broader world events and what’s going on in the broader environment.  And so I would like to shift our discussion briefly to discuss the black live matter movement and how that is impacting the families that we’re working with.  So how do we as professionals support families who have been strongly impacted by today’s events, whether that’s in person, through Zoom or through personal action?  What can we do?  I’m going to start off the topic by turning it over to Laurene and then we’ll go from there.

>> DR. LAURENE SIMMS:  The Black Lives Matter movement is not new and that’s something we need to remember.  This movement has been around.  We see it much more vividly today with a more profound impact on the recent events.  The goal however of the Black Lives Matter movement focuses on justice and making sure we have equality and equal access regardless of race or ethnicity.  So we’ve seen many inequalities taking place that do have an impact on our family and we want to make sure those families are visible, seen and served as well.  The families that we serve are disproportionately affected.  George Floyd’s family of course faced many challenges and we have to keep that in mind and what our intention is when we provide services.  We continue to modify our services to our unique families’ needs.  We can see what’s taking place in society and the inequities that exist and these events are very unfortunate but they can help us all open our eyes and get a broader view of the changes that are necessary so in that sense it can become a positive.  But it does shed light on lack of resources and that is nothing new.  It’s something we’ve seen for quite some time now.  So we need to look at where our resources are allocated and where they need to be better developed.

>> SARAH HONIGFELD:  So to recap it seems like for us as professionals working in this field it’s not just about what we do for others but how we think about our own programs and services and revisiting and analyzing this on a systemic level, a group level as well as an individual level so just really take a second look at the broader system.

>> DR. LAURENE SIMMS:  Yes.

>> SARAH HONIGFELD:  Thank you for sharing that.  Would someone else like to add?  JoJo?

>> JOSEPH LOPEZ, III:  We continue to maintain an open dialogue regarding issues of racism and how they affect our department and our families.  And one thing that we have noticed is that there are many needs that are unmet.  We need to make adaptations to ensure we’re incorporating all voices and sometimes people share experiences they’ve had in workshops and we want to use them to our advantage.  We want to see how that applies to our profession and how we can face these challenges.  I think it’s critical to maintain that open dialogue.

>> SARAH HONIGFELD:  I agree, yes.  Jodee.

>> JODEE CRACE:  Yes, the experience of the Black Lives Matter movement has had an effect on me as well, talking about issues of privilege, not thinking about that everyday privilege, thinking about that is just insufficient.  However, we have to become more open, open minded and open hearted to these issues because as a coordinator I’m connecting remotely with families and since this work began I’ve looked at our role in making sure that we’re respecting of all of our family members, have those family members feel valued and I have to look at my individual role in that to make sure their culture and their lives are valued and that they do matter when our programs and interactions with those specific families and how I present lesson plans, if it’s in English if it’s an English lesson making sure the equivalent is there so the [inaudible] is achieved.  I’ve taken a look at the resources we’re using and am looking at our community members on how our actions are affecting communities so I am extending that to coordinator as well and the families they work with.  We do know that Black Lives Matter and we want to continue in those dialogues.  We were not having these conversations before.  I really appreciate this opportunity.

>> SARAH HONIGFELD:  Thank you.  Laurene would like to add something to this.

>> DR. LAURENE SIMMS:  Tawney Holmes sent me a message just prior to this.  You are all familiar with Tawney?  We had a conversation and wanted to establish a separate webinar focused on the Black Lives Matter issues with respect to the early intervention.  I think it would be wonderful to continue this conversation in that manner so we can revisit all of these topics.  I think that would be a way to approach it and have a greater discussion about the specific needs and gaps the community is facing.

>> SARAH HONIGFELD:  All three of you are making a good point that this sort of discussion, analysis and reflection is not like a one and done situation where you make a curriculum and then it’s all done.  It’s an ongoing conversation that we need to think about what we need to break down and rebuild and it’s an opportunity for individuals, groups, programs and systems to continue in the work and it’s exciting to see what is possible although of course these were unfortunate events that have brought us to this point of needing to do the work.

>> DR. LAURENE SIMMS:  And painful events.

>> SARAH HONIGFELD:  I’m going to switch gears to a lighter topic now and this question is open to all.  Can you talk about one strategy or tool that has been helpful for you to keep yourself motivated, energetic and engaged during this stay at home quarantine as people are apart from families what are you doing to take care of yourselves to keep engaged.  Should I start you off with JoJo.

>> JOSEPH LOPEZ, III:  I’m still thinking.

>> SARAH HONIGFELD:  Laurene?

>> DR. LAURENE SIMMS:  You are referring to the COVID‑19 and that impact on us as, on our work like me individually?

>> SARAH HONIGFELD:  I mean how you take care of yourself.

>> DR. LAURENE SIMMS:  Self‑care.  How I take care of myself.

>> SARAH HONIGFELD:  Tools or strategies for self‑care that you use.  Like for example, I was going to say for myself I’ve actually started kick boxing every day and it helps release my stress, helps me to get those thoughts out of my mind, get me focused and get back to work so what is it for you that is our self‑care?

>> DR. LAURENE SIMMS:  I see.  The COVID‑19 has had an effect on me.  I have been home since March 13.  I have been quarantining because of my age.  I’m an older individual so I am more vulnerable.

>> SARAH HONIGFELD:  More high risk population because of age.

>> DR. LAURENE SIMMS:  Those in their 60s, 70s and 80s, I had one strong lung and I had a biking accident a while ago that puts me at a more vulnerable situation.  I am really careful with what I do and have been staying at home since March 13.  So my family want to fly to visit.  They’re on the West Coast.  They’re disappointed that I am unable to visit because I definitely don’t want to risk infection given that I’m at an increased risk.  So we have been meeting with each other remotely using face time and video phones and it has been much more quiet for me since the beginning of COVID‑19.  However I think in some ways it’s helped me to stay in touch with certain individuals and I have to be mindful of getting my exercise, go for walks in the morning.  I definitely found they had to establish a routine, I found that’s critical maintaining a routine and following a schedule is so important.  I am accustomed to engaging in that routine when I’m going to work.  I get up at a certain hour, get up and leave.  But now being home all day that routine or lack of routine, being routineless is difficult so I have to encourage myself and continue those actions.  Without that I would become a couch potato on the television which is something I adopt want to do.

>> SARAH HONIGFELD:  Come on you’ve got to reduce your zine time.

>> DR. LAURENE SIMMS:  Exactly.  So it hasn’t been easy.  When I go out I of course must wear a mask.  I wear gloves.  I’m afraid to go out to the market.  It’s nice stores are opening early for senior citizens so I am able to go and have reduced population in the stores so I can get home and wash my hands and take care of myself in that way but it’s not been easy especially from a psychological perspective.  Health and wellness‑wise I’m doing okay, maintaining connection with people although a downside is having so many meetings virtually.  It’s not a bad thing.  I get up and I am very grateful that I’m doing okay every morning when I wake.  I’m grateful and greet the day that way because I know many people are losing their lives so I maintain that gratitude but anyway yes that is how I’m managing and things are getting better.

>> SARAH HONIGFELD:  Thank you for sharing that.  Who would like to share next?  Jodee?

>> JODEE CRACE:  I was already working from home.  I was a remote worker anyway.

>> SARAH HONIGFELD:  Nothing new for you.

>> JODEE CRACE:  Yes in that sense not that much has changed however there’s an increase of many more meetings and I find myself engaging in meetings visually all day and that’s caused fatigue and straight, eye strain from having so many screens and constantly adjusting the lighting in my environment.  However at the same time I’m very aware this is a really scary time right now with Coronavirus and COVID‑19 and that fear is very present in the media and it’s critical that we be mindful of things that are going on and that we stay home.  I have my whole family here, there are six of us in the home, we’re quarantined together and they’re a little herd.  We are quarantining together.

>> SARAH HONIGFELD:  JoJo?

>> JOSEPH LOPEZ, III:  I had three to four hours a day on the road.  Since COVID‑19 I am staying home all day.  I’m having remote meetings all day.  Sometimes it can be fatiguing so I make sure I get outside and socialize because it has had an effect on my anxieties.  It has had an effect on my interaction with families.  The school allowed me to leave, I’m working from California with my family so I am able to continue my work from there and they have been hugely supportive so that’s been helpful with my mental stimulation, I’m looking at self‑care, I am starting to jog, I am getting the hang of this and I came back to New Mexico, I have quarantined by myself, I have a routine established and am able to continue that on my own.  So self‑care is key, jogging, hiking, connecting with friends remotely, making sure we get the support we need.  So right now I’m feeling pretty good.  I feel like I have a good balance of work and home and I feel like I’m taking good care of myself but I agree, that work life balance is very important.

>> SARAH HONIGFELD:  I agree.  The reason I asked this question is I’ve noticed with home visits with families sometimes we forget that families are humans too.  And they’re having to practice their own self‑care.  Often as professionals we talk about language and metrics and we forget that they have to take care of themselves too so sometimes it’s nice as professionals to take a break and remind the families of this.  Say how are you doing?  What are you doing for yourselves, to make sure families are thinking about this.  I should go outside, I should change my clothes, I should take a shower.  These are things we all must attend to not just for our own self‑care but encouraging families to do that self‑care for themselves so it’s a way of treating ourselves and treating them with compassion so it’s a nice way to start off that discussion.  I do see we have questions coming through from Facebook so what I’m going to do is read through some of those to add to our discussion.

We have one question here from Jennifer and it says what do we do with students who are deaf blind and have other needs in terms of what we can provide them and what resources are available there?  Who would like to start off with an answer?  Jodee?

>> JODEE CRACE:  Our ASL Connect focuses primarily on the parents so we instruct the parents on different strategies of how they can engage with their children, how they can elicit communication with their students if they are deaf blind or what additional needs they may have.  We are coaching parents directly so we don’t engage with the children themselves.  And that work continues remotely.

>> SARAH HONIGFELD:  True it starts with the family members, it doesn’t have to start with the child.  Of course the goal is to also engage with the child but there’s a balance there between supporting the other members of the family.  That’s true.  JoJo would you like to add to that?

>> JOSEPH LOPEZ, III:  Again with home visits I’m able to point things are three dimensional and things are easier but working remotely we’re having to figure out how to hand those situations in our families and engage in feedback and see what may have worked and what didn’t as we’re doing this coaching.  So it is the similar as what Jodee mentioned we’re focusing on working with the families making sure they know what to do.  I have two families that have Deaf children with low vision so I would typically bring resources and materials but I’m unable to do so remotely so I ask what they have available in the home, we brainstorm so parents know how to directly engage and make those connections.  It has definitely been a challenge.

>> SARAH HONIGFELD:  For sure.  Laurene would you like to add to that?

>> DR. LAURENE SIMMS:  I’m not sure if this is similar with our college students who are deaf blind but we do have CDI, certified deaf interpreters who provide tactile services wearing gloves and masks.  We are definitely in need of PPE that personal protection equipment for those resources and that has been a challenge.  We’ve also been innovative in our use of technology.  So that we are able to continue our work in that way.  We’re still working on some of that.  There are some areas that we’ve seen successes and some things that we’re still working on so it’s involved a continued dialogue looking at specific avenues to success.  In the fall we may continue remotely so we’re beginning to develop those plans because we need to continue our education for those deaf blind individuals.  Those individuals depend on CDIs and tactile interpretation.  And so, we have to figure out how we can make that happen, at the same time reducing the risk of contagion.  So as you mentioned it has been a challenge working with parents and working directly with the students.

>> SARAH HONIGFELD:  Yeah I mean, technology has so much potential in terms of using robotic gloves.  I can’t even imagine all of the electronics and all of the components of that but I’m hoping that progress could be made, that that could come down the pike.

>> DR. LAURENE SIMMS:  Absolutely.

>> SARAH HONIGFELD:  So Laurene is starting the conversation regarding face‑to‑face communication.  One person had had a question about reopening.  Do your places of business have reopen plans?  And if not do you have any thoughts or ideas about what reopening might look like for that birth to age five age range?  Jodee?

>> JODEE CRACE:  We follow the state governors in their plans for closing.  They are making the plans for reopening in phases and that is of course up to the family’s comfort level once those states reopen.  Once states reopen if families are comfortable with home visits if the governor has deemed that okay of course our work will continue remotely as it always has.

>> JOSEPH LOPEZ, III:  As for now we don’t have an answer to that but we do know there’s a process in place for what we will do and before that, we’ve developed a survey to ask the family members if things reopen what are your feelings about having in home visits?  So we want to engage with families and get feedback regarding continuing remotely until the COVID‑19 crisis has passed and we’re a hundred percent ready.  So for our families we continue to engage in check ins to make sure everyone is healthy in the home, if anyone has a fever, if anyone is coughing.  If everyone is healthy we would be able to proceed with a visit.  If they have a family member who is sick we want to avoid that.  Again as Jodee mentioned once the governors make decisions we’ll follow that as well as the family, infants and toddlers program we will proceed forward once we get the green light.  For now we’re collecting feedback from families and are eager to return to face‑to‑face visits and we’ll have to play it by ear and see how things go.

>> SARAH HONIGFELD:  Laurene?

>> DR. LAURENE SIMMS:  DC is on a similar schedule.  We are a hot spot right now.  We had a decline in numbers but we have yet to receive a, to achieve our peak at this point so we are still on lock down in DC.

>> SARAH HONIGFELD:  Yeah we still haven’t heard about what’s coming down the pike come fall.  We’re waiting for a governor’s announcement in Massachusetts regarding that.  I am seeing questions coming up. One person wants to know about assessments and how those can take place virtually.  Thoughts?

>> JOSEPH LOPEZ, III:  Regarding assessments, during COVID‑19 crisis of course prior to this we would sit down with families and talk about their plans and those conversations are taking place remotely which has been a challenge for us of course but we like to ask family members what their plans are and we have certain checklists that we go through.  We have a lengthy checklist that we coordinate with our family and engage with various team members so the key is team work and collaboration to share ideas so we can approach our families in that way.

>> SARAH HONIGFELD:  Other thoughts about assessment?

>> JODEE CRACE:  Sure.  When we have our ASL assessments we do base analysis or at levels.  So the first time we meet remotely we record the session and we just have a natural dialogue.  We work on practicing finger spelling our name, talking about the age of the child and we have a bit of a back and forth conversation that is recorded.  Then we go through our several weeks of curriculum and are able to see the language development and the acquisition increases from our initial session.  So that’s one of our ways of assessing those tools to see how parents are progressing.  Additionally we do conduct surveys after each session to see what people liked, what they’re comfortable with, what was too easy, what made sense, what didn’t and then we practice on those specific areas and make adaptations and adjust.  So we make sure the families’ references are tailored to.

>> SARAH HONIGFELD:  So you are able to make notes based on your observations of the recordings that you have had.

>> JODEE CRACE:  Right.

>> SARAH HONIGFELD:  Would anyone else like to add?

>> JOSEPH LOPEZ, III:  No I’m good.

>> SARAH HONIGFELD:  I see we have so many questions coming in.  I am eager and excited that we have so much participation.  One thing that I was wondering about someone wanted to know about how are different fields working and how we’re able to manage meetings with other early intervention professionals be it looking at the IFSPs or having meetings for IEPs that will be beginning.  So how are we managing collaborations with different team members?

>> JOSEPH LOPEZ, III:  Okay.  We do collaborate as a team again through these virtual meetings.  In terms of IFSPs there are a number of agencies involved and they have their own preferences when it comes to different platforms.  Some like to use Zoom, others prefer to use Google Hangouts.  Others use Adobe Connect.  Often we reach out, agree on a date, set up something so the team can get together so they can have the discussion.  There are challenges because explanations need to be made about what it means to bring in an interpreter, the role of the interpreter, making sure that it is clear, making sure people understand that I am a deaf support professional.  It’s been a good experience for these hearing agencies to understand what it looks like to have a deaf professional involved.  Additionally on our team we already have meetings set up every two weeks where we come together for example every other Monday to have brainstorming discussions so it’s great we have that team meeting in place.

>> SARAH HONIGFELD:  That’s nice.  Maintaining contact with team members is so critical.  We’re used to seeing one another every day and now we don’t see each other in the office so it’s important to make time for those conversations.  Those conversations are important.

Jodee or Laurene for remote learning has how it had an effect on our team members and other professionals that you may be working along side?

>> DR. LAURENE SIMMS:  Yeah it’s been quite interesting.  I would say similar to what JoJo’s experience has been on zoom and even for this, seeing the various boxes on the screen, it’s odd because sometimes there’s greater control of turn taking which I find quite fascinating because there’s more limited discussion. Sometimes in person people will just have at it and go on and on and on.

>> SARAH HONIGFELD:  I agree.

>> DR. LAURENE SIMMS:  So some of that is just not happening when we’re having meeting on Zoom.  It’s like whose turn is it now?  One person is speaking at a time, the floor is given to people, having recorded sessions is amazing.  In real life you captain have that recording.  That’s not a possibility.  Of course everyone has to consent to this and the purpose is clear.  It’s not like they’re being broadcast to whoever but if you are talking about being able to save those recorded files that’s one benefit to having professional meetings in a controlled platform where the conversation is being controlled.  And I’ve noticed that and I think that’s something we need to keep with us moving forward but we’ll see what happens.

>> SARAH HONIGFELD:  That’s interesting.  Jodee would you like to add?

>> JODEE CRACE:  With ASL Connect we have a connection with the Southeast REAL, the Regional Early Acquisition Learning something.  So it’s nine states in the south eastern part of America which is Florida, Tennessee, Georgia, Mississippi, Alabama and some others.  And so they collaborate with ASL Connect which is us for families to learn American Sign Language.  What I have recognized, which is so powerful, in this collaboration with this group of states and the people who live there, they are becoming our liaisons.  Because I don’t live there.  You know I don’t live in Alabama.  So I don’t have access to everything that is there in person.  So they’re becoming our liaisons.

For example a woman named Suzanne who lives in Alabama is able to actually help bring families in and connect them with us and that is a huge help because it’s focusing on teaching and I’m also able to see potential red flags that can be identified when it comes to babies who might have additional needs.  Just through this observation that can be communicated to Suzanne, hey, could you reach out to this family when it comes to their IFSP team member whether it’s a speech language pathologist or another therapist, just bring it to the discussion that another provider might have overlooked.  When you have Deaf eyes on the scene you take note of different things.  We’ve been able to work these liaisons in these other states so that’s a great thing.

>> SARAH HONIGFELD:  That’s very nice.  I think I’ve had a similar experience to what JoJo stated.  Where people are speaking, where in person we point to who is speaking and it’s difficult to follow a conversation. Those reminders of identifying who is speaking prior to the comment being made and that can be really important.  It’s interesting, we have more availability of interpreters.  It’s more easy for us to fill the needs of our interpreter requests so in the past we may have struggled with scheduling and availability but now we’re able to fill the needs quickly.  I wonder if you have had a similar experience, JoJo.

>> JOSEPH LOPEZ, III:  Yes I agree with that 100 percent when it comes to interpreter availability, meeting with families.  I’ve had to request interpreters two weeks ahead of time and work that out.  I live in the southern part of the state where interpreter availability is not as much because more interpreters live in the northern part of the state but now as we’re doing these Zoom meetings everything is run are much more smoothly so that’s a definite benefit as well.

>> SARAH HONIGFELD:  That’s great.  An individual asked another question.  Wanting more examples of strategies and tools on how you are able to do and conduct your home visits.  What tips do you have?  What activities are you using?  What examples can you provide those hand on activities?  Who would like to start?

>> JODEE CRACE:  This is for virtual encounters?

>> SARAH HONIGFELD:  Yes for remote learning.  Jodee if you want to start.

>> JODEE CRACE:  Sure I am proud to do my promotion on something called TIP, the TIP Sheet.  I will show you a little visual here.  So are we able to do this on the shared screen?

>> SARAH HONIGFELD:  We would have to wait for the individual behind the scenes to share that screen but I am familiar.  We can explain where to find that document maybe.

>> JODEE CRACE:  So Sarah, myself and the SKI‑HI mentoring program coordinator,s you know I wear a couple of different roles.  But in addition to my ASL Connect responsibilities I have a role at the SKI‑HI Deaf Mentoring program and we work together to identify some of the best practices.  So we made a TIP sheet for facilitating video visits in families’ homes.  So we convinced them in like a top 10 tip sheet.  So we can send the link in the chat box for the SKI‑HI website.

>> SARAH HONIGFELD:  We can post materials on the website after we wrap up the webinar so those who are interested would be able to download this from SKI‑HI Deaf Mentoring’s page.  It’s a great tool, it’s wonderful strategy for those direct connections so that we’re able to see those strategies in person.  I’m wondering if there are other strategies or tips or ideas that you have in how to Crete an engaging home visit for students.  For example one individual that I’m working with comment, they’re from California and they had a really cool idea.  What they’re doing is they would pack like what Laurene mentioned, using the postal service, the mail, whether it’s a doll, Play Dough, different items they would ship to the family, the family would receive those and the individual as well as the family would both have the same materials so they can play together using the same materials and the child is able to follow along using the same items.  So then the remote setting is less of an issue because we’re working with the same tools.  I thought that was a neat idea.  It’s another way for us to support families who may be lacking resources at this time, funding is tight, they may not be able to get out and purchase these materials.  If we can support families this way that’s a great thing we can do.  JoJo another example?

>> JOSEPH LOPEZ, III:  Sure.  One example is I have created flash cards for labeling things so for teaching those signs, I’ve actually mailed out flash cards.  So now it wouldn’t be like meeting people in person but I can drop off materials and go so that families have this resource that they can use as a hands on material as we interact virtually.

>> SARAH HONIGFELD:  Laurene?

>> DR. LAURENE SIMMS:  Yes that tactile experience can be so meaningful.  And sometimes we have to go back to these old fashioned tools, and honestly in my time that was the only thing we had, is we work with those materials.  So we have to get back to that a little bit.  There’s a structure that can be followed as you talk about categorizing different areas for the family to work with.  So items can be loaned out or given to families and then as the next group comes in those same materials can be loaned out and brought back which is really great.  Children love these hands on activities so this is another way to reduce that screen time.

>> SARAH HONIGFELD:  Absolutely.  That concept of having a toy bag but making sure re‑balance the amount of materials we’re bringing and that we have that visual environment.  It’s so nice to have approaches where we’re able to share and collaborate, we’re able to keep the materials for uses with the family.  It’s such a great idea.  Same idea with the flash cards.  It’s something that’s easy to create and the families with use them remotely.  Siblings can get involved.  It’s such a great idea.  One person was curious about families who may want use English as their first language.  How are they able to connect remotely if they’re still acquiring those ASL skills and they don’t have a foundation in English.  What does communication look like in those families.  JoJo would be a great person to start off with this question.

>> JOSEPH LOPEZ, III:  Yes.  Thank you for asking that.  So in the past I have worked with trilingual interpreters who have helped to bridge that gap.  At the same time when you are in an environment you can point at things.  This has been my first time actually working with a family that had a new baby, just 23 months and that family was not fluent in English.  It was a challenge which I was glad to work with.  We did bring in a trilingual interpreter, this was my first time experiencing this through a Zoom call and the first time I met the family so I was being taught Spanish from this family as well.  It was a nice interchange.  Sometimes they would say something I didn’t quite figure it out, I would use the internet to look up a word or ask a friend what does this word mean in Spanish to help bridge the gap.  It was a challenge and sometimes there were words that were not understood.  So it was that back and forth of written Spanish and written English in the midst of us using ASL and this was great for me to think about what I could create with pictures that had Spanish and English so that the family could continue as they’re practicing on English and American Sign Language and I’m learning Spanish as well.  It was a really rich and challenging experience and I will continue to support this family.  And things have been going good so far.

>> SARAH HONIGFELD:  I love the idea of collaborating with the family, they’re teaching you and you are teaching them.  I think it’s perfect.  Using technology to connect may not be the best but we can look at Google and proceed with the session, it’s an advantage of having the technology that we are able to use today.

>> JOSEPH LOPEZ, III:  The incorporations of gesture in Spanish culture is so much stronger so we were able to use different gestures.  The key really in the midst of it all is connection.  That’s what will lead to success.

>> SARAH HONIGFELD:  That’s really nice.  Would anyone else like to add about families who don’t use English as a primary language, how we provide support for them. 

>> JODEE CRACE:  For ASL Connect we’re provide an 8 week program, 30 minute lessons, in both English and Spanish.  So if families request we can email that to the family so they can pull that out and know what to expect, know what we will cover and so on and so forth.  You know as you talk about families having their own word so that you can sign and point between the material you have and the material they have, now again, we have yet to receive a request from a family that doesn’t know any English.  We do have some families who are fluent Spanish users who know some English and we’ve had success with gesturing and pointing and toward the end the lessons become more conversational but in brief that’s the gist of what we’re doing.

>> SARAH HONIGFELD:  That’s wonderful.  I think our next question has to do is now that we’re working remotely what we’re seeing in the children’s home environment, the context that they’re living in, if we see something uncomfortable, a situation, abuse or neglectful situations, have we seen those issues and how would we handle that type of situation given that we have full access to see into their home environment at this point?  I know it’s a very tough question.

>> JODEE CRACE:  It is tough.  I mean, we are only seeing 30 minutes typically and we see this perfect picture of a family’s life, where you know, things could be brushed to the side.  We won’t know.  So, we haven’t seen those issues but sometimes you might see a parent’s affect.  And if it seems like there’s something off there or if we see there’s stress there we will try to check in and say are you okay?  We know it’s a stressful time, talk to people about what they’re doing to relax.  So trying to think about self‑care and encouraging that in our video sessions, because we know that parents are stressed already as parents and then they have a Deaf child and that can be an additional stress in the midst of a pandemic is an additional stressor so we’re trying to work with them during this time.

>> SARAH HONIGFELD:  Absolutely.  Would any of you like to add to those thoughts?  I know for my program we follow the rules and guidelines as in school so we’re all mandatory reporters so regardless of where we see an event take place we’re required to report it, like Jodee said week check in with the family member to see if they’re undergoing stress or provide that sympathetic ear to check in with them but we check with the family before we jump in and refer out to another source.  Okay I’m looking at our additional questions.  I see some good questions.  One question asks about technology.  Specific technology and resources that you find yourself using more often.  Has HIPAA been an issue in maintaining HIPAA compliance and what are you currently using for your remote sessions?

>> JODEE CRACE:  So for ASL Connect we do have a consent form.  So there’s consent to engage in a virtual session and they’re aware that we do keep everything confidential and what is recorded is kept secure in terms of ASL Connect.  Also, parents sign permission forms in terms of giving access as to who can view these recordings.  There’s an option to check do not share or there’s another option you can share but please ask first.  Or there’s additionally an option you can use this for program development, for internal training use.  So again, this is the agreement that’s made between each parent and ASL connect and that’s how we work when it comes to confidentiality.

>> SARAH HONIGFELD:  JoJo or Laurene what platforms do you find yourselves using to engage with team members or families having to do with HIPAA compliance and being respectful of the family’s right to privacy?

>> JOSEPH LOPEZ, III:  Can everyone see me?  Okay.  Just making sure.  So we typically do use Zoom and again we use the password function on that platform.  And agencies do have their own security and password protections that they use for those different platforms.  When it comes to documentation for IFSPs or assessments we do not use email.  We upload this information to a shared file with very strict access limitations and then we send a link out so that families or other responsible professionals can receive access.  And we will get a ping saying that they have read and received that.  So we use the shared file function which has been quite helpful for us.

>> SARAH HONIGFELD:  Great.  Laurene would you like to add anything?

>> DR. LAURENE SIMMS:  I am still struggling, because many of these solutions don’t work for families of different socioeconomic levels so it’s still an access issue when we think about these different options with technology.  It’s just not there.  And I mean really this is what the issue with Black Lives Matter is all about.  There’s a huge percentage of people impacted in this way and they’re out, as we think of Deaf babies they’re even more out.  So this is something that still needs to be worked on and that I am still struggling to work through and think through but I do see the enormous lack of resources and lack of access there.

>> SARAH HONIGFELD:  I know in my state of Massachusetts the Department of Health that early intervention is under they established a grant for early intervention programs they could provide funding so we could purchase laptops to disseminate to families so if we had a specific program or family that didn’t have access to an iPad or mobile device we could send them that item so the early intervention program could apply for that funding and that has been immensely helpful and I’m fortunate that my state was able to enact that.  I know not all states have been able to do so.

>> DR. LAURENE SIMMS:  There’s the whole piece of being able to afford the internet.  Because the device is one piece but the internet service itself can be so expensive.

>> SARAH HONIGFELD:  I believe Comcast is providing free internet for students are they not.

>> DR. LAURENE SIMMS:  I know Gallaudet has been providing hot spots to provide free wi‑fi through a hot spot.  That’s okay for certain people but when you talk about more rural areas it’s a lot harder to get that connection.  I’m thinking about it as it pertains to families but also college students.  The semester is over now but we realize there’s this assumption and this assumption about how communication will work as people are in their home areas.  That’s another issue for another time.  We’re trying to focus on what we do have.  And so the question seems to be more about what is there which is completely fine.

>> JODEE CRACE:  You mentioned being that I mentioned the Southeast REAL, the regional center, so we’re using our liaison who I mentioned who lives in Alabama and Suzanne is looking for families who have reduced means to prioritize them in giving the iPads we have out as well as the wifi hot spots so we’re hopeful to be able to send those through the school.  So this is still new for us and we’re testing to see what works but we’re also looking at providing free iPads to certain families.  We found one family sold an iPad we had given them so we want to make sure we’re doing things correctly, we had to rewind and back track to make sure we became more mindful of where those devices were being sent out to.

>> DR. LAURENE SIMMS:  I totally understand that.

>> SARAH HONIGFELD:  With the quarantine situation and everyone staying home we’ve seen frustrations and things work and we back up and proceed in a different way when things don’t go as planned.  As we wrap up and the question I will ask prior to us closing is since COVID‑19 and the quarantine, have you seen a lack of families receiving services and if you have noticed gaps in families getting services what strategies and tips do you have to make sure those families are getting what they need?  I know that’s a big question!

>> JOSEPH LOPEZ, III:  Okay.

>> SARAH HONIGFELD:  JoJo.

>> JOSEPH LOPEZ, III:  What I have noticed is that there is a big need when it comes to internet access.  Like I was saying many of the families they live with, they don’t live in town, I mean they work with.  They live in rural areas and struggle to connect to the internet.  Also there are families in poverty who are depending on hot spots but they’re hitting their data limits regardless.  The company may be providing this but it might have already been used up.  So that is a challenge.  Some families are choosing not to because of these frustrations and struggles and so we are making phone calls for 20 minutes saying how are you doing checking in that way rather than having a video call so we’re always trying to check in with families to ask if there’s anything they need if there’s any way I can support them to let them know we’re here for them to support them even if they choose not to engage in virtual meetings so we’re trying to reach out and be transparent with families but the internet is the biggest gap that I’ve noticed.

And secondly, for me, connecting.  I miss the personal connection with a family.  The first time I typically meet a new family I get to say hello and see their face.  This is now a barrier.  It is nice to see them on a screen but there’s a different connection where you are in person they can show me this is here, that’s there.  It’s just harder to have that connection when you are not in person.

>> SARAH HONIGFELD:  Lack of human connection, of course.  Yes.

>> JODEE CRACE:  So for ASL Connect our structure is already there.  We have our predictable lessons so there’s no I guess uncertainty there.  It’s a very structured and predictable situation when it comes to having these visits.  It’s not like a home visit where you are entering a home and backup and go the other way.  That’s definitely much more challenging.

>> SARAH HONIGFELD:  That’s true.  For sure.  Laurene.

>> DR. LAURENE SIMMS:  Yeah I would just say the same challenge that has been mentioned.  I would say my answer is similar to what JoJo has to say.  When you talk about these areas that are further out that don’t have the same internet connection and my heart really goes out for babies as I think about their support for language acquisition in this critical time and the impact that’s going to have on their schooling and beyond.  We do try.  We continue to work at our goals.

>> SARAH HONIGFELD:  Absolutely.  This has been such an enjoyable conversation and I feel I have learned so much by listening to all of your collective experiences and comments and I thank you all for sharing today, your comments, opening your mind and heart to the conversation for our participants to watch again.  Thank you so much to the national deaf education conference for providing interpreting English and Spanish, and we so appreciate having this conversation, so I think we’ll proceed with wrapping up our webinar for today.  I will allow just a few more minutes for the interpreter and captioner because I know they’re operating with processing our comments so I will wrap up at that time.  Thank you.