TSBVI Coffee Hour:
From the Front Lines: Deaf/Hard of Hearing Early Interventionists Supporting Families
02/25/2021


>> Good morning, everyone. We're excited that you're with us. We'll start in a few minutes. We'll let everybody get in the room. As folks are coming in, please take a minute to go to your chatbox. There's a little drop-down menu where it says "To." Make sure it says "All panelists and attendees." That way when you write in the chat everyone can see your comment or question. So again the little drop-down menu in the chatbox, please make sure it says "All panelists and attendees" much. While we're waiting to get started if you want to let us know where you're attending from it's always fun to see where folks are located. You can do that in the chatbox. Ah, snowy Colorado. I heard you got snow. Maryland and Oregon. I have a friends in Roseburg, Oregon. Utah, New York. We'll get started in just one more minute. Texas, of course. Always one of my favorite parts to see where everybody is from. Before we get started, just one more time and I'll make this announcement a couple more times, but please make sure the little drop-down menu in the chatbox says "All panelists and attendees." That way everyone can see your comment or your question. Okay. Let's go ahead and get started. I have some announcements and then we'll turn the time over to our presenters. I'm really excited about this session. We have two sessions today. So today we are in partnership with the western regional early intervention conference, and also the project for New Mexico children and youth who are DeafBlind is helping to sponsor today. So today will be a little bit different where we will be talking from education of children who are deaf and hard of hearing perfect, which is going to be great. I'm excited to have this discussion and these presenters today. If you have a question or comment during the time the presenters are talking, please post that in the chatbox. And again, make sure it says "All panelists and attendees." There will be some time at the end for questions so if you have a question throughout you can go ahead and put it in the chatbox and I will be saving that to bring up at the end if we have some time. Your microphones and cameras are automatically muted so you don't need to worry about that. The handout for today's session will be shared in the chat for immediate viewing and will also be available for later viewing along with the recording of this and past coffee hour sessions shared through a link on our coffee hour page at TSBVI.edu/coffeehour. Once you're on the coffee hour web page you can scroll down to the bottom and you will see where it says visit the new TSBVI outreach coffee hour archives. And that's the a link that will take you to the recordings and handouts, et cetera. To obtain your CEUs and after represent credit, you will respond to the evaluation that will be emailed to you from our registration website, ESB works. I will give you the code at the end of the session, the end of the two hour session, you will enter that kind the certificate will automatically generate upon completion of that evaluation. So there is no opening code, just a closing code that I will give to you at about 12:55 central time. So I'm real excited to introduce our first group of presenters for our first hour, we have Kathleen Aranda Myers, Kaycee Edmonds and Jeni King join ising us from the New Mexico School for the Deaf. I will turn the time over to you guys. 

>> I forgot to unmute. Thank you for the interpreter. Hello, everyone, my name is cat Leath Aranda-Myers. I was born with a severe hearing loss and I have used bilateral hearing aids for most of my life. I have an older brother who is deaf as well. My parents' choice was to focus on spoken language with the freedom to choose any language modality when my brother and I were older. I began working with deaf and hard of hearing preschoolers when I was in high school. I am the first deaf, hard of hearing licensed social worker in the state of New Mexico. My career began as a school social worker with deaf and hard of hearing students as well as providing counseling services for a local agency for deaf and hard of hearing adults. I took a hiatus to raise my three sons and volunteered in the preschool and elementary setting, provided home day care and respite foster care. 11 years ago I lost the remainder of my hearing and became a bilateral cochlear implant implant recipient. This led to my ongoing volunteering for those who are interested in obtaining a cochlear implant solution as well as serving on the board for local non-profit hearing, speech and language center. All of this has brought me to full circle to where I am now working for the New Mexico School for the Deaf early intervention department. 

>> Kaycee: Good morning, everybody. My name is Kaycee Edmonds and I was born hearing. I got sick from spinal meningitis around the age of two and a half, and that caused my hearing loss. I am profoundly deaf, but all of my family is hearing. So they joined my journey at that time in learning American Sign Language, which is my primary language to communicate. I work at the New Mexico School for the Deaf as an early childhood teacher, educator, that is, teaching 18-old-months to three-year-olds, so within that range, and have done that for the last 20 years. Also I'm a part time deaf mentor and I love working with families who have deaf babies and children. I love those interactions. For the last two years I have been -- from teaching, I've been working with families in the homeschool full time. And I am also a mother myself. 

>> Jeni: Good morning, everyone. My name is Jeni King. I am an educator, an early interventionist, and I have been working in this field for 17 years. I work with families and children from birth all the way up to fifth grade in the public schools, charter schools, as well as in the deaf classroom setting as well as families, families within their homes. I was born deaf to hearing parents. And I do have a younger brother who is also deaf himself. At the age of one my parents discovered my deafness. I had a moderate to severe hearing level. And through the years that hearing level progressed to a severe hearing level. So I have been using bilateral hearing aids since the age of 1:00. I was raised bilingual in English and American Sign Language. Andouilles have access to spoken language as well. -- and I also have access to spoken language as well. 

>> Kathleen: Welcome, everyone. First of all, I would like to share some facts with you. First the New Mexico School for the Deaf early intervention department saw a marked improvement in developmental gains once deaf professionals began to see families. The second thing is skill development is enhanced by working with deaf specialists by teaching, modeling, mentoring, introducing and supporting -- I'm sorry, and exposing the use of strategies. The deaf specialist is a linguistic and social expert, for having grown from experiences navigating in society where the primary modality is hearing and speaking. The third fact -- I'm waiting for the interpreter to catch up with me. The third fact is deaf people are able to provide the deaf child with something hearing parents cannot. And the last several studies have shown that the most accessible pathway for full access to linguistic information for deaf children is through vision. Children have been found to be capable of absorbing multiple languages through multiple modalities with no negative side effects on their language acquisition and development. 

>> Kaycee: So how can all of you maximize your frontline deaf experts? We're going to ask you throughout this presentation as an audience and as you watch who are the deaf and hard of hearing experts on your team, so keep that in mind. Okay. So please join us in observing different case scenarios and stories that we share with you during our presentation and reflect on how we can use our deaf and hard of hearing frontline staff and professionals to enhance the child's family's language journey. And you might have questions along the way, which is fantastic. If you don't mind, please go ahead and use the chat feature to type in your questions as we go and then we will have some time at the end of our presentation to address those questions. So have your thinking hats on. Okay. So you can see the picture here, it is titled "Door." But first I'd like you all to be part of my team if you will. So imagine that you could be a speech language pathologist or if you're an occupational pathologist, therapist, physical therapist, you could be a foster mother in this situation. There are various roles. But essentially I want you to imagine that you are part of this scenario. So being part of my team I need to give you a little bit of background information about this family. We have this little girl who is deaf and I want to say she's about two and a half years old. She has early intervention services. She also has a family service coordinator, a speech language pathologist. She also receives developmental specialist services. And just recently a deaf mentor joined the team. There are two parents as well as two older sisters. Now, this little girl who is deaf is super sweet and friendly and she learns things very quickly and she's starting to pick up and acquire American Sign Language very fast. Of course, as the younger sibling she wants to do everything your older siblings do. Right now in her home the way her family communicates with her and what she's doing herself is by gesturing and pointing. So now that you as professionals have the background information, remember that you are going to join my meeting with this family. It is an IFSP. 

>> Infant child family service review, a six-month review. And the entire teams have come together at the home visit and we are discussing some concerns in how this girl is progressing. So I'm going to now jump in to the "Door" scenario. At this meeting mom does share some concerns about the door being problematic in the house. So the team carefully listens to mom and her concerns. And mom states that she often goes to the door, opens the door and gets upset and often has temper tantrums. And she will do this quite often while at home. So mom is trying to figure out why she is going to do the door over and over again, and closing it and being upset. She really is getting angry. So mom can't figure out why. This has been happening for awhile. So as we listen -- next slide, please. So as we listen to mom, think about, reflect. Next. So what perhaps from our perspective do we think is missing? The team is thinking while listening to mom. Maybe it's an easy solution. So people start to brainstorm, maybe it's a language opportunity. We can use language strategies. We can model language. So someone might throw out the idea, well, why don't -- why doesn't mom model "Don't touch the door." You need to ask mom before you go open the door. Don't touch it, don't go there. So we can offer language strategies, language modeling. And as mom is listening to our strategies, let's suppose that mom responds and says do you know what? I've already tried those strategies. I have told my daughter don't touch the door, you don't need to go to the door, nobody is at the door. Where do you want to go? The door's not safe if you open it by yourself without mom. So she's saying that she is trying to explain to her daughter all of these things, but that her daughter continues to try and open the door and when she doesn't get what she wants, she gets upset. The one important thing that I started to think about in this scenario is when she went to the door she never tried to go outside or leave or run away. She would just open it and then close it and then become upset. So with that information let's think about this. What is the connection to the door? Why does she have interest in the door and what causes her to get upset? Let's remember what mom emphasized, that she doesn't try and leave or runaway when she opens the door, so what can we do as a team to support mom in this situation? We can continue to ask questions to gather information trying to get at what might this little girl want. And maybe we don't get information because mom doesn't know. Mom's not sure either. Now, I do see some comments in the chat that maybe she wants to go outside and play. That's a good question. But when she opens the door she doesn't go outside. She's not trying to get out. So it is an important question to think about. We can ask the mom and the family are there any daily routine changes that have happened? Have there been cancellations of home visits? Perhaps people were expecting someone to come and they didn't come? Has someone been sick in the family and the little girl is wondering about that? So just think. So now is a good time to think in this kind of situation. How? Who? Who can we really take advantage of in terms of their expertise? Well, a deaf and hard of hearing person like myself, do you have a friend, a teacher, a colleague? Now, the reason you want to maximize a deaf professional is because they have the same lived experience as this little girl. So for myself working with this family, I want to share a little bit about what I brought in terms of my perspective to this scenario. I told you as part of my introduction my entire family was hearing. And when my family members would open the door, I remember as a teeny-tiny little girl thinking, oh, someone is always at the door and I want someone to appear at the door when I open it. And every time I opened the door, nobody is there. My sister would go to the door, open the door and sure enough her friend would be there to come over and play. And I always thought to myself, well, I want my friend to come and play too. And every time I opened the door wanting my friend to be there, my friend was never there. So why was my mom, my dad, my sister always having somebody come to the door for them, but not for me? I thought whoa, they must have magic and my magic must be broken. That's what I used to think as a little girl. And I continue continued to try and figure out highway can I make my magic work so somebody is at the door when I open it? So when I heard the mom talking about it this came to me from my own experience. Now, think about as a hearing person where you're privileged to know when someone's at the door because of the doorbell. Maybe somebody knocks and I never knew that. It was not explicitly taught or communicated to me. So this is probably something that this little girl is going through. So coming back to this scenario and her opening the door, I as a deaf professional can bring this perspective as the team tries to strategize and support this family through this moment in their journey. We can suggest that they maybe use the window if there's a window near the door to look out and see if someone is coming towards the door, to feel the door so the little girl can learn that she can use her other senses to touch the door and sense when somebody is there. Maybe maybe the little girl has some hearing ability and we can help her make connections to the keys jangling in the door or the doorbell ringing and helping her understand what that sound means. So with everybody's caseload some families and some children do have access to sound and we should take advantage of that opportunity to talk about different strategies in terms of like auditory training. Families can play games like let's knock on the table or knock somewhere in the house and see where we can identify where that sound's coming from. So children who are deaf or hard of hearing can make explicit connection to what they're hearing and what that means. We don't live in their house so we want to work around what works for the family. So that brainstorming session is really important and the deaf perspective as part of that brainstorming session is equally important so that we can develop some nice outcomes and strategies to meet those outcomes. So you all are part of my team, right? So I want you to think. I'm going to let you think about what do you do in this situation. I'll give you a few seconds to think. So I want you all to think about how we can assist the family so that the family can help their daughter. So perhaps something you're already thinking about is should the early intervention team maximize a deaf and hard of hearing frontline professional to come in and bring their experience, their perspectives? There are some comments coming in about using visual technology. Great idea. This is a great way to develop strategies through that brainstorming session. Get light, get light technology. Get the daughter to understand when a on dog barks that even means that somebody's at the door. What else? I hope that this door scenario helps you think about, how, who, where and why. You might take advantage of bringing in a deaf and hard of hearing specialist and professional into the mix. Thank you for listening. Kathleen? 

>> Kathleen: Hello, everyone again. Today I will be sharing a case scenario of a dinosaur and just like Kaycee said, how can we best utilize your deaf and hard of hearing frontline expert. So here is a little bit of the story. Of in a home visit the parent and I were chatting about her child's current outcomes of early visual cues, ASL and spoken language. Her son is three years old. His family is bilingual, with Spanish being the primary language in the home, followed by English. Her family's choice, incorporation of visual cues and ASL is to be utilized with spoken bilingual language. Suddenly the boy began talking up a storm with his hands flying, gesturing as he showed his mom and I the toys and his excitement, especially his cars and a dinosaur. His words in Spanish and English were overlapping into a total blend without clarity. As we heard him say, [Babbling] Mom then voiced his dinosaur. I then asked mom, did you understand what he said? Mom said, she did not comprehend his words except for bede or verde in Spanish, which is green. She also shared that the family members do not understand him due to the fact that he likes to talk as well as use gestures, some sign at a rapid speed with spoken words that are unclear. So how can we best utilize your frontline expert who is deaf and hard of hearing in this particular case? How does -- how does one support the parent of a deaf and hard of hearing child and the child himself. How can the family utilize someone like myself? First let's think about how is the child hearing the word? Well, let's consider how he was pronouncing the word. Basically he is depending on his auditory skills and what he was repeating was dinea. Therefore let's consider what sound is the child missing based upon his attempts and his hearing loss, he is likely missing a soft sound of the consonant such as S. As a hard of hearing deaf adult myself this is actually quite common for me and I don't pronounce every WordPerfectly, but therefore he has missed portions of the word which then leads to the challenge because he's trying to pronounce a three syllable word. So during this is he even using hearing technology? Does he have technology to assist with his hearing? Well, also during this session the child was not utilizing his hearing aids. He is a bilateral hearing aid user with a moderate hearing loss. The parents shared he usually wears about 30 minutes perhaps, if we're lucky two hours maximum a day. Technology, whether it is a hearing aid, a BAHA, cochlear implant, assistive devices, all of those can be beneficial to supporting auditory language as well as spoken language depending on the type of hearing loss and many other variables. I then shared with the parent how I depend on my hearing technology to help with my spoken language. During this session the parent and I discussed and I coached the mom on ways to encourage her child to wear his Harold for longer periods during the day -- his hearing aid for longer periods during the day to support and enrich what he may benefit from hearing. What is the child saying? All of you who are listening today, what did you gather from the story? How can you utilize your deaf and hard of hearing frontline interventionist? From my observation as a hard of hearing person, this was evident to me. Due to personal and professional experiences, I have learned to fill in the blanks and understand the various communication tools the child is incorporating. First he was using Spanish, English, gestures and signs. So let's consider how he communicated with the spoken language he was using Spanish, bede, verde in Spanish, also green. But in English he was saying dinea for dinosaur. He was also gesturing and pointing to his toy dinosaur and he was signing green. Green. So next slide, please. How is he hearing? In this situation let's consider how he hears to help support his outcomes that we identified earlier. First of all, he is hearing auditorially. He is also using his vision and therefore he is hearing with his vision. But in this particular case the child is using a combination of visual and auditory. So what are observation, opportunities have you identified for your interventionist to support the parent to embed practical strategy into the child outcomes and daily routines? Language or rhythm. Language and rhythm with a hard of hearing deaf child, how can we use that? Well, modeling, coaching, rhythm is a great visual and auditory strategy to support the child in acquiring language. Rhythm can also provide the opportunity of wait time. To slow down his words, spoken and signed. Breaking down the syllables. Support was provided to the parent in identifying potential strategies to embed those language opportunities for her child. First with demonstrating the sign dinosaur. We need to have that. Therefore mom tried the following strategies. First she said the word in Spanish. Then English slowly. Then she verbally spoke and signed dinosaur with a wait time to ensure mouth movements to allow her son to visually see the shape and the sound shape and the pattern of that shape. Moment also tried basic hand clapping, again, visual and auditory rhythms, dine-no-saur. This allows a wait time. The other strategy mom tried, she got the toy, she pointed to it and she labeled it dinosaur. And she also used the toy dinosaur in three movements to match the syllables. After mom attempted all these strategies with her son, the ideal strategy discovered was actually to use a combination of auditory, spoken language, visual cues and ASL. So what we created together, mom and I, was the use of the arms. We did D-i-no-and the S, which is a soft consonant sound, dinosaur, dinosaur. We can speed it up, we can slow it down and we shared this with her son. Language enrichment. We want to move beyond oh cue dinosaur the mom initiated earlier. This is often a common generic thing used by adults in response to a child's attempts to communicate. So let's all of us consider how can we incorporate all community modalities that the parent has chosen? How do we again utilize the deaf or hard of hearing interventionist for language enrichment? First of all, we have to make sure that it's age appropriate for the child. The following areas are a way your deaf and hard of hearing interventionist can help support enriching language. First we label the object, which is dinosaur. In this particular family's case, spoken, visual and ASL modality. We then can describe the dinosaur. It's not just a green dinosaur. The dinosaur is green, it's got four legs, it's spikey with a long tail and of course I would be signing this. It's really important to use action words. Use visual cues and gestures, ASL, facial expression. For instance, a dinosaur stomps on the trees and the trees shake and the dinosaur eats the trees. And the dinosaur has big teeth. It's really important for this child to use auditory sounds, plus use playful sounds and pair it with the sounds and the visual cues. The dinosaur clomps, clomps, and he roared, ahhh! Or however you want to do it. It's really important to incorporate games and pictures to advance their co-cab Larry beyond -- vocabulary beyond dinosaur. This promotes language development and enrichment. It's really important to make it creative and fund after working with all of these young children and pulling the parent in to also learn how to play. A lot of parents have a hard time with that. Make language fun by using what the child is interested in, pair the child with someone who has a hearing loss for social interaction. This is crucial because it helps the child develop a positive self-esteem and know he is like many others. So wrapping up, this dinosaur case scenario provides a small peek of how you can utilize your deaf and hard of hearing frontline professionals to support the child and the family's outcome. These outcomes are supportive from our unique perspective and it allows the family to have a deeper understanding of where the child may be coming from or what the child may be -- may need.. About three weeks later I observed in another home visit session which obviously is on Zoom, you know, due to the pandemic, the child was actually wearing his hearing aids and he was imitating mom's slower pace of spoken language bilingual language as she used visual and rhythm cues with him. He took off running and returned with his toy and he signed green dinosaur. Then he reached for his arm, using rhythm and using spoken language very quietly, he said dine-no-saur, just like that. Mom looked at me, she was just astounded. He was she was teary eyed. So was I, I have to be honest, with his signs and spoken clarity. Thank you for listening to the case scenario of dinosaur. I hope you guys grab some information here. And I'm going to be turning this over to Jeni. 

>> Jeni: So I hope listening to these scenarios so far, Kaycee and Kathleen, the scenarios help you with your on own home visits and the work you do with families. The scenario that I would like to say is having to do with my work and me seeing various families. Right now often through telehealth, that is Zoom. So I want to help you in observing my scenario as well and I have titled it "Say what." To give you background information, it is meal time for this family and the child is sitting in their high chair with the little tray in front of them. And mom has brought over some food. And has cut up the pieces small and has put it on the child's tray. Next to the tray is another larger table that the family usually sits at. So as the family starts to eat, the little child starts to eat food too off the tray using his hands. And as the family is eating, mom turns to their child and says more? Do you want more? And starts to use the sign for more. The baby looks at her and then continues to start eating. And mom continues to sign "More." So little by little, there's less and less food on the tray and mom continues to sign do you want more? Well, the child at that moment sees the mom and sees her sign more and then looks at the bigger table where there is more food, but mom puts child's hand down as child starts to reach towards the table for more food. And this happens a couple of times. Mom signs more, child reaches out to the big table for more food and mom puts hands down and says no, I want you to sign more. So at this point after it's happened a few times, the child starts to get a little bit upset and then mom starts to get more upset and mom's a little bit frustrated in terms of what to do at this point. So he decides to take her child out and comfort them by bringing the child to her chest and comforting them. Now, the baby kind of reached more for food, towards the big table still, and she brought the baby to her and patted them on the back. So that gives you sort of the scenario of what I observed. For some reason I can't proceed to the next slide. Oh, there we go. Okay. So let's move on to the reflection part as a team. There are a couple of strategies that we can use when seeing and observing these observations during our home visits with families. It's important that we sit back and observe the family's natural interaction, specifically in this case it was between mom and baby, but if dad's around or other siblings, we want to see everybody as a whole and their interactions with the child. That will help us to reflect and that is the other strategy. We observe and we reflect. And then we have some coaching strategies that come into play. So with the recent story that I shared with you, similar to Kaycee's story as well, we can use coaching strategies. So how do we utilize our frontline expert who are deaf and hard of hearing? We have to think about how do we support the family and the child's language development based on what we saw in that one moment. Go on and think about the different perspectives as well, and we want to maximize perspectives from our deaf and hard of hearing professionals to try and increase the language journey that the family is going through. Some coaching questions that we can use with families are sometimes what we use within our own team, right? You can bring what your team is discussing to your home visits and your work. So that sets the stage for the next future visits that come and serves as a guide in terms of where we're going and what we're working towards. So here are a few coaching questions that I would like to bring to the scenario. What observations can you pick from in terms of the child's environment in this scenario? We should look and consider the child's age, what their language level is. What does it look like when they're communicating? What are the interactions between mom and child, what does that look like? How does mom pull language from their child and how can we support mom in doing so? So the example with food is food was left on the tray, so if mom is trying to model language by signing -- getting the child to sign more, how can we help the environment sort of fit what she's trying to accomplish? What does early visual and early communication look like? Things to think about with the child, what does their signing level look like or spoken language? What does their communication look like and what is their response to mom signing "More," if that's one at all? Now, remember in this scenario the child reached towards food, eye contact was made with mom and then made toward the food. Is that a sign of early visual communication? The child also Leander forward I noticed during this observation. So these are all cues that tell us how we can best support language development. Another consideration is how long should we wait for the child to respond? And it varies because every child is different and unique in their own way in terms of how they process information, in terms of their response time, so that's something to keep in mind as well. And how can language be modeled? What does it mean? What does it look like when mom is trying to get the mom to sign "More" over and over again with one word, is there maybe a way to show other signs, alternative signs? So if I sign "More" and the child signs "More," maybe in order to get them to that next level is using your hands to guide their hands in making -- demonstrating that sign. That sort of is an in between step that allows the child to transition to doing it more independently. And in terms of early visual communication like I explained the child reached out towards the table and obviously that was a form of expression so how can we teach mom about acknowledging that as a success? And do parents have enough vocabulary in terms of language modeling? So we can also think about maybe that's an area that we can support as well. So coaching the family is an important aspect of this scenario, I found. And working with my team and bringing those strategies then to the family was very beneficial for all. So thank you for listening in on my scenario. 

>> Kathleen: So thank you, Kaycee and Jeni for sharing your stories. And here is the slide I don't have use your deaf and hard of hearing frontline experts? I have a few thoughts. Often we are the first language model for the family and the child and we have unique experiences that we bring to providing insight to those families. We also have a wide range of experiences with hearing technologies and equipment that we personally use. And in addition we also have a variety of experiences in terms of learning languages through different modes. We experience deafness firsthand. And lastly, we offer a diverse educational background and knowledge as well as our own professional experiences. So again, I do want to emphasize and encourage all of our participants today to think of all the WH questions and of course how. So who are your deaf and hard of hearing frontline experts? Why are we going to include deaf and hard of hearing experts? When should we include these deaf and hard of hearing professionals? Where should they be implemented? What can be utilized from their unique experiences and perspectives? And how can we take advantage and leverage their expertise in various scenarios? So these are all great questions to ponder. I know we're running out of time so I'm going to share some quotes on the screen. I will share two. One quote that I absolutely love is "Dream big little one. The sky is not your limit." And in our particular field my very most favorite is the last quote "Play is often talked about as if it were a relief from serious learning, but for children play is serious learning, play is truly the work of childhood," by Fred Rogers. 

>> Kate: I would like to just make a suggestion. We don't really have a lot of time for questions, but if you all have questions for Kathleen, Kaycee or Jeni, if you would put those in the chat we will make sure that they get those questions and they can get in contact with you. Their contact information has also been shared in the handout so we'll make sure that that's there. But if anybody has a quick question that they want to put in the chat, go ahead and we'll see if we have a minute to answer, otherwise we'll make sure that these three awesome professionals can get the questions and get their answers to you. Okay. It doesn't look like any questions at the moment. [Laughter]. Did y'all have any other information that you wanted to share to wrap up? 

>> No. 

>> No, our contact information again is in the handout so if you want to reach out to any of us or if maybe you think of questions later, our information is there so we're very easy to get ahold of. 

>> Kate: There is a question that I think we have time for. So Lorraine asked: What if any obstacles you have faced in joining a team? 

>> Kathleen: I'll go ahead and answer that one. I've actually been very fortunate to not have any obstacles because we have a terrific staff and team with NMSD and they are very conscious of all the need that think any of us may need, whether spoken or signed, equipment or so forth. So that's my answer. I don't know if Jeni or Kaycee want to jump in. 

>> Kaycee: Well, I work in the metro area here in New Mexico, and in terms of obstacles, I think most of the time initially when we talk about home visits, it's communication, right, getting -- figuring out what's going to work in that particular home or with the family, but usually families are very quick to learn and we develop a very strong relationship. We don't even need an interpreter because we're able to figure out our own communication. And then we're able to work together to support their deaf and hard of hearing child. It just takes time. It takes time to build that rapport to really connect and bond with the family, and it usually works out beautifully. 

>> Kathleen: I would like to jump in. Somebody asked a quick question. Trying to struggle to find deaf and hard of hearing adults who support early intervention in their state. On the handout there is where to contact us. You can contact our director, JoAnne Coren, she is a great resource and she can certainly guide you on that question. And that was for, I believe, Marie, what I could see on the chat. 

>> Kate: And then Marcella asked do you have a Navajo speaking deaf and hard of hearing expert? 

>> Kaycee: We do. We do have one expert, and I believe they work in the northwest part of the state of New Mexico. And I believe she works as a mother of a deaf adult and she does -- she's fluent in Navajo, English, as well as ASL. So we do have one professional working in that area. And Spanish as well, right, thank you, Kathleen. We do have Spanish-speaking professionals as well. 

>> Kate: Well, thank you so much. Thank you for sharing your experiences. I think as someone that works in the blind and visual impairment field, there was so much crossover about concept development. So this is really good for me to think about my own practices and how this translates into that. So we're going to take just a couple of minutes. We're going to switch over to our next presenter. We will be switching interpreters and get everybody on board. So we'll take a break for just a couple of minutes, come back. Hopefully we'll have our next interpreter on the line here pretty quick. So let's say two minutes come back and we will continue on with our second hour with Nanette Thompson. So we'll see you all in like two minutes. Thank you again to Kaycee, Kathleen, Jeni. [Short break].