Providing Early Intervention, Audiology and
School Support for Children with Hearing Loss
via Tele-Practice
Hear and Say Program
•

Auditory-Verbal Early Intervention Program: Birth to 6 years

•

School Support Program

•

Childr...
General Locations- eAVT Families
Queensland
•
•
•
•
•
•
•
•
•

Townsville
Yeppoon & Rockhampton
Emerald & Blackwater
Macka...
Hear and Say- eMPOWER Model
eMPOWERing Others
eMPOWER Model

Services

eAVT

Auditory-Verbal Therapy (parent guidance and
...
Hear and Say’s eAVT Program
Enrolments
o
o

>50 children
>20 % of Early Intervention Caseload; 80% school support program
...
eAVT- Weekly Webcam Lessons
• Weekly Skype/ Lync contact
with families
o Planning Session one week
o AV Therapy Lesson nex...
Benefits of eAVT (Tele-Practice)
•

Hand-over to parents is immediate

Parents get to practice skills

•

Therapists unabl...
Challenges of eAVT (Tele-Practice)
Parent learning styles
and commitment to
follow-up
Therapist’s clinical skills &
Audio ...
eAVT – Supplementary F2F Sessions
•

Face-to-face lessons/assessments each term
o
o

Home visits
Centre visits

•

Inclusi...
eAVT School Support Program
•

Recent extension of our eAVT services to school age children in regional and
remote areas o...
Video of eAVT Lesson
Orson
Age:
Hearing Loss:
Hearing Age:
Devices Worn:

2 years, 11 months
Moderate to severe sensorineu...
Video of eAVT Lesson
Orson
eAVT Research at Hear and Say
Satisfaction Study - Telemedicine AV Therapy
• 5 Auditory-Verbal Therapists completed questi...
eAVT Research at Hear and Say
eAVT

•

7 children in eAVT matched with face-to-face
•
•
•

Age at amplification
Age at enr...
eMentoring & Professional Support
eAudiology at Hear and Say
Client
Facilitator

Local Site
Programming
Hardware
Audiologist

Internet
connection

Remote Si...
Hear and Say’s eAudiology Program
Video of Tele-MAPping
Zia
Age:
Hearing Loss:
Hearing Age:

Devices worn:

9 months
Left ear: Moderate to severe
Right ear:...
Video of Tele-MAPping
eAudiology Research
Audiology and Tele-MAPping
• Remote MAPping of Cochlear Implants in Children
Rushbrooke, E. (2012). Re...
Telepractice Research and Publications
 Constantinescu, G. (2012). Satisfaction with telemedicine for
teaching listening ...
Future Directions
• Better broadband access in Rural and Remote
areas where it is needed most
• Provision of eAVT / Tele-P...
www.hearandsay.com.au
Hear & Say: bridging the “tyranny of distance”- ensuring
equitable access to all families dealing with hearing loss…

…. r...
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Michelle Ryan, Hear and Say - Hear and Say- Providing Early Intervention, School Support and Audiological Services for Children with Hearing Loss via TelePractice

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Michelle Ryan, Remote Team Leader & Outreach Coordinator: Auditory-Verbal Therapy, Hear and Say presented "Hear and Say- Providing Early Intervention, School Support and Audiological Services for Children with Hearing Loss via TelePractice" at Connected Australia 2013.

This conference is designed to help organisiations harness the opportunities that super-fast broadband will create, and explores the future impact of the NBN through the healthcare, education and consumer industries.

For more information, please visit the conference website: http://www.connectedaustralia.com.au/2013

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Michelle Ryan, Hear and Say - Hear and Say- Providing Early Intervention, School Support and Audiological Services for Children with Hearing Loss via TelePractice

  1. 1. Providing Early Intervention, Audiology and School Support for Children with Hearing Loss via Tele-Practice
  2. 2. Hear and Say Program • Auditory-Verbal Early Intervention Program: Birth to 6 years • School Support Program • Children with hearing aids and cochlear implants (and a few who are unaided) • Mild to profound hearing loss (including unilateral hearing loss) • Implantable Technologies Program o o o candidacy assessment cochlear implants & other implantable devices post implant services
  3. 3. General Locations- eAVT Families Queensland • • • • • • • • • Townsville Yeppoon & Rockhampton Emerald & Blackwater Mackay & Moranbah Tannum Sands & Gin Gin Bundaberg Hervey Bay & Maryborough Gladstone Cecil Plains & Tara Interstate (Northern NSW/NT) International Singapore Papua New Guinea Qatar • • • • Walgett (NSW) Lawrence (NSW) Manilla (NSW) Darwin (NT)
  4. 4. Hear and Say- eMPOWER Model eMPOWERing Others eMPOWER Model Services eAVT Auditory-Verbal Therapy (parent guidance and coaching) provided via web-conferencing medium eAudiology Audiology services (including diagnostics and TeleMAPping) provided remotely via a dedicated medium. eTraining & Education (inc. eMentoring) Hear and Say professional training programs provided online through a dedicated medium eAlumni Communication, education, advocacy and peer support using on-line tools such as social media eParent Support Parent education and peer support through web-based presentations and access to online resources/ materials
  5. 5. Hear and Say’s eAVT Program Enrolments o o >50 children >20 % of Early Intervention Caseload; 80% school support program Experience o o o Efficacy o o o o o o 1998 → 2013 1 skilled staff member → 10 skilled team members Broadened skill base from Bris only → Bris/ Twba/ Cairns/ Sunshine Coast (QLD wide) Equivalent outcomes as those attending centre-based programs Families not disadvantaged by distance Parent satisfaction -meets individual needs of families Competent and skilled professionals Positive feedback from professionals (internal and external) Sustainability
  6. 6. eAVT- Weekly Webcam Lessons • Weekly Skype/ Lync contact with families o Planning Session one week o AV Therapy Lesson next week o Email contact between • Sessions run for 45 to 60 mins • Recorded for education/ mentoring • Lesson boxes provided (monthly rotation)
  7. 7. Benefits of eAVT (Tele-Practice) • Hand-over to parents is immediate Parents get to practice skills • Therapists unable to step-in/take over Therapists perfect their skills at guiding and coaching parents • Relies on provision of parent feedback , online and/or at end of session • Gradual increase in parent confidence and autonomy Dedicated Planning Sessions Time to discuss progress and any issues or parent concerns • Teaches parents to choose goals and plan subsequent activities, with facilitation and support online as required Empowers parents
  8. 8. Challenges of eAVT (Tele-Practice) Parent learning styles and commitment to follow-up Therapist’s clinical skills & Audio and video quality for skills in guiding and coaching observing parent skills and parents child responses Bandwidth Broadband access Access to Technology Funding
  9. 9. eAVT – Supplementary F2F Sessions • Face-to-face lessons/assessments each term o o Home visits Centre visits • Inclusive setting visits (local) • Parent Education Sessions • • Group Social Skills Sessions Family Gatherings/ Networks • Liaison with rural/remote professionals • • • • Therapists Advisory Visiting Teachers (HI) Class Teachers Learning Support Staff
  10. 10. eAVT School Support Program • Recent extension of our eAVT services to school age children in regional and remote areas of Queensland • Independent Schools & Education Queensland Schools (depending on location of enrolled children) • Flexibility of Services: • • • • • Regular planning sessions and lessons via videoconference (webbased) Regular consultations/ meetings via videoconference (web-based) Supplementary Face-to-Face visits (school visits) Auditory-Verbal Therapy and/or Educational Audiology support Assessments (Face-to-Face in Centre/ at school) • Support of VidKids funding
  11. 11. Video of eAVT Lesson Orson Age: Hearing Loss: Hearing Age: Devices Worn: 2 years, 11 months Moderate to severe sensorineural hearing loss 2 years, 6 months (hearing aid) 5 months (cochlear implant) Left ear: hearing aid Right ear: cochlear implant
  12. 12. Video of eAVT Lesson Orson
  13. 13. eAVT Research at Hear and Say Satisfaction Study - Telemedicine AV Therapy • 5 Auditory-Verbal Therapists completed questionnaires • 13 of 17 parents completed questionnaires Questionnaire Topic Outcome Audio and video quality during lessons  Equipment/Software use  General parent-therapist interaction and communication during lessons  Service delivery and convenience  Overall satisfaction with eAVT program  Constantinescu, G. (2012). Satisfaction with telemedicine for teaching listening and spoken language to children with hearing loss. Journal of Telemedicine and Telecare.
  14. 14. eAVT Research at Hear and Say eAVT • 7 children in eAVT matched with face-to-face • • • Age at amplification Age at enrolment in AVT Level of hearing loss • No significant differences in language outcomes at 2 years post amplification • Language scores for both groups in average range • Telepractice is an effective service delivery method for AVT • Hear and Say eAVT Program is successfully ensuring an equitable listening and spoken language service for children with hearing loss in rural and remote Queensland to those living in metropolitan areas. Constantinescu, G., Waite, M., Dornan, D., Rushbrooke, E., Brown, J., McGovern, J. et al. (submitted). A pilot study of telepractice delivery for teaching listening and spoken language to children with hearing loss.
  15. 15. eMentoring & Professional Support
  16. 16. eAudiology at Hear and Say Client Facilitator Local Site Programming Hardware Audiologist Internet connection Remote Site
  17. 17. Hear and Say’s eAudiology Program
  18. 18. Video of Tele-MAPping Zia Age: Hearing Loss: Hearing Age: Devices worn: 9 months Left ear: Moderate to severe Right ear: Severe to Profound 8 months (hearing aid) 2 weeks (cochlear implant) Left ear: hearing aid Right ear: cochlear implant
  19. 19. Video of Tele-MAPping
  20. 20. eAudiology Research Audiology and Tele-MAPping • Remote MAPping of Cochlear Implants in Children Rushbrooke, E. (2012). Remote MAPping for Children with Cochlear Implants. Maters Thesis, the University of Queensland, Brisbane, Australia (Journal Article in Press) • Aim of the project was to validate the remote MAPping procedure • Results showed no significant difference between MAP levels obtained remotely vs. F2F • Satisfaction survey demonstrated a high level of satisfaction with the remote procedure.
  21. 21. Telepractice Research and Publications  Constantinescu, G. (2012). Satisfaction with telemedicine for teaching listening and spoken language to children with hearing loss. Journal of Telemedicine and Telecare.  Constantinescu, G., Waite, M., Dornan, D., Rushbrooke, E., Brown, J., Ryan, M., McGovern, J., & Hill, A. (submitted). A pilot study of telepractice delivery for teaching listening and spoken language to children with hearing loss.  Constantinescu, G., & Dornan, D. (2013). International Applications of Telepractice in Speech-Language Pathology. In K.T. Houston (Ed.), Telepractice in Speech-Language Pathology. Plural Publishing.  Rushbrooke, E. (2012). Remote MAPping for Children with Cochlear Implants. Masters Thesis, the University of Queensland, Brisbane, Australia.  Rushbrooke, E., Hickson, L., Henry, B. & Russel, T. (submitted). Remote Mapping of Cochlear Implants in Children.
  22. 22. Future Directions • Better broadband access in Rural and Remote areas where it is needed most • Provision of eAVT / Tele-Practice services to families in Metropolitan areas • Sickness • Mobility • “Home-based” services • mHealth and applications in AV therapy • Recording and monitoring of parent-child interactions • Growth of Tele-MAPping service provision
  23. 23. www.hearandsay.com.au
  24. 24. Hear & Say: bridging the “tyranny of distance”- ensuring equitable access to all families dealing with hearing loss… …. regardless of location Michelle Ryan (Remote Team Leader, Speech Pathologist, LSLS Cert AVT) michelle@hearandsay.com.au

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