Addressing the Unique Challenges of High-Risk Families Through a Teletherapy Program



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Addressing the Unique Challenges of High-Risk Families Through a Teletherapy Program Joy A. Murdock Kearns, M.S., CCC-SLP Clinical Program Administrator, BabyTalk

A joint partnership between Stanford University and the Weingarten Children's Center, a Redwood City, Calif., school for children who are deaf and hard of hearing. Funded by a $260,000 three-year grant, the program can serve up to 30 children at a time. It's a test case for how telemedicine can make patient's lives easier, save money, and bring specialized medical care to underserved and remote communities. Kelly, H. (2015, February 8.) Reaching deaf babies with implants, ipads and therapy. CNN. Retrieved from http://money.cnn.com/2015/02/09/technology/ipads-deaf-kids-therapy/

Thank You BabyTalk Team Members! Meg Farquhar, MSW Family Services Director, BabyTalk Otolaryngology, Stanford University Kathy Sussman, MEd Primary Investigator, BabyTalk Executive Director, Weingarten Children s Center Jan Larky, MA, FAAA Program Audiologist, BabyTalk Cochlear Implant Audiologist, Stanford Ear Institute Misha Amoils, MD Research Resident, BabyTalk Otolaryngology, Stanford University Gerald Popelka, PhD Primary Investigator, BabyTalk Professor, Otolaryngology-Head and Neck Surgery, Stanford University Nikolas H. Blevins, MD Primary Investigator, BabyTalk Chief, Division of Otology/ Neurotology, Stanford Medical Director, Stanford Cochlear Implant Center Arturo Retana Administrative/Tech Support, BabyTalk BabyTalk Providers: Jennifer Aguilar, Heather Bricker, Jan Christensen, Julie Cooper, Ahladhani Dugar, Eryn Elash, Karen Erickson, Patricia Gomez, Jenny Ignacio, Katie Knarr, Gabriela Lopez Holzman, Sharon Nutini, Stacey Platzman

Parent-Coaching Model Birth to 3 years Significant Hearing Loss No equivalent services within 1 hour drive Consultative services Parent/child ipad/facetime Therapist 5

1 Social Worker Bilingual 1 Audiologist 8 Speech-Language Pathologists 2 Bilingual 6 Teachers of the Deaf/Hard of Hearing 2 Bilingual 2 Support Personnel

Demographics From 7 CI Centers in California 7

Population Served 96 total since the program s inception (10/2012) 48 Teletherapy 48 Counseling/Consulting (5 from out-of-state and 3 from outside the US) 65 Families enrolled in California Children s Services (CCS) 26 Monolingual Spanish speaking families 87% of the families enrolled in BabyTalk are High-Risk

High Risk Families Characteristics/ Barriers Low SES Level Language/Cultural Complex Medical Dx Behavioral Issues Lack of Social Support 9

High Risk Families Characteristics/ Barriers 58% Low SES Level 30% Language/Cultural 10% Complex Medical Dx 10% Behavioral Issues 13% Lack of Social Support 10

Flexibility Implications Teamwork and Collaboration o Therapists/Social Worker o BT Team/Early Start Providers o BT Team/CI Teams and other Hearing Healthcare Professionals Social Work Component Increased

Interventions Low SES Comprehensive psychosocial assessments Orientation visit Tangible resources Ongoing social work support Language/Cultural Utilizing bilingual therapists and social worker Developing culturally appropriate therapy techniques

Interventions Behavioral Team Analysis Close partnering with Early Interventionists Participation in IFSP meetings Social Support Facilitate parent-toparent support Connect parents to local resources Medical Partner with Medical teams Supportive counseling Empowering and educating parents

Trends Highly positive family response Safety net created for families Increased parent participation (questions asked, prepared for sessions) Increased engagement between parent and child Positive feedback from medical team members and Early Start providers Increased and improved collaboration

Tele-Intervention Learning Community Event sponsored by NCHAM Training Needed by Therapists & Administrators involved with Tele-Therapy: How to coach? How to handle unexpected events? Recording sessions Behavior management Helping families prepare for sessions How to handle tech problems? How to assess the effectiveness of TI rate ourselves, observations by administrators/peers, other ideas?

Conclusions Providing tele-therapy services to families who are low-income and reside in rural areas requires a collaborative approach. For high-risk families, best tele-intervention practices should include psychosocial assessments and ongoing support services. With support, families are empowered to become successful partners with their educational and medical teams. There is still room for improvement when it comes to effective teletherapy delivery to high risk families.

Addressing the Unique Challenges of High-Risk Families Through a Teletherapy Program Joy A. Murdock Kearns, M.S., CCC-SLP Clinical Program Administrator, BabyTalk