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ROUGH EDITED COPY

EHDI

2017 EHDI ANNUAL MEETING

FEBRUARY 27, 2017

4:10 – 5:30 p.m.

PLENARY II

GEORGIA PATHWAY TO LANGUAGE AND LITERACY

FOR CHILDREN WHO ARE DEAF OR HARD OF HEARING

AND

PRESENTATION OF THE ANTONIA BRANCIA MAXON AWARD

FOR EHDI EXCELLENCE

CART CAPTIONING PROVIDED BY:

ALTERNATIVE COMMUNICATION SERVICES, LLC

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This is being provided in a rough-draft format. Communication Access Realtime Translation (CART) is provided in order to facilitate communication accessibility and may not be a totally verbatim record of the proceedings

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> Michelle Esquivel: We are going to get started soon. So if you can come in and take a seat. That would be great. We'll start in about one minute. We are all so quiet. Very good at following directions. As people are filtering in, I just wanted to give you a quick overview of what's going to be happening during this next session. First, we're going to have a few announcements and some thank yous. Then we're going to segue into the final plenary session. Then after that, we'll be talking about the Maxon awards and Marcus Gaffney, my colleague from CDC will come up here to talk to you about the Maxon award and to present the award. So it's exciting.

Again, we're just going to give people a couple of minutes to filter in. Thank you to all of you here this afternoon. We know it is late in the day and you've been busy, busy, busy learning. Congratulations on another full day of EHDI. I hope that you found the sessions to be stimulating and the networking with your colleagues and peers and new friends to be exciting. As I was reflecting on the conference this year, I realized out of all of the EHDI conferences, I think I've only missed two. It's really, really thrilling to see how the conference has grown, both in the scope of the presentations that are given the and the number of people that attend. From my perspective, most importantly, the diversity represented at the meeting. Every year it seems to get more and more diverse and more and more robust. We as the conference coorganizers thank you for that.

My name is Michelle Esquivel. I'm from the American Academy of Pediatrics. We are an official cosponsor of the EHDI meeting. We have been for many years. We have had an EHDI program within the academy for almost two decades now. Most of you know about it. Many of you interact with the pediatricians who are our representatives to that. We're very proud of the work we do and we know we could never accomplish what we accomplish without you.

I think I would be remiss to not thank our colleagues at National Center For Hearing Assessment and Management for everything they do to make this conference happen every year. Let's give them a quick round of applause. NCHAM.
[Applause]
Under Karl White's unbelievable leadership, the planning for this conference starts in the summer, and again, a very diverse and multidisciplinary committee is convened, and that's the group that puts the program together, but also works on the logistics and handles the behindthescenes activity. So there is a lot that goes into putting on a meeting of this scale. I am always very in awe of Karl and his team, but also so appreciative of everything that they do.

This is our second plenary of the meeting, as you all know. As I mentioned at the outset, it is the final session for today, the final official session on the program. We're going to first thank some people as we segue into the presentation this afternoon. We could not make this conference happen and the conference would not happen without our exhibitors and sponsors. If you have not had a chance to visit the exhibit hall, please do during your time here at the meeting. Please, extend your personal thanks to those colleagues and friends in the exhibit hall. From a sponsorship perspective, we're very, very fortunate to have one platinum sponsor, two silver sponsors, and four bronze level sponsors for this year's meeting. We wanted to specifically mention who they are. Pediatrix is the platinum level sponsor this year. Thank you to Pediatrix. Our silver level sponsors are:
Otometrics Audiology Systems,
Vivosonic.
And the four bronze level sponsors, they are
Children's Healthcare of
Atlanta,
Oticon Pediatrics,
Oz Systems,
National CMV Foundation.

We really truly thanks these organizations for their generosity and their support and we also thank the exhibitors who seem to show up year after year to contribute to the fullness of this conference.

A couple of housekeeping notes for tomorrow most specifically.
If you are presenting a breakout
session, please go to the

Speaker ready room before your presentation so they can make sure your presentation is uploaded and take care of any final logistical issues that might need to be attended to.
The Speaker Room is in Chicago
E, located one floor below the
ballroom.
For those who are checking out

Tomorrow, on Tuesday, which I guess is probably a lot of the people in this room, you can bring your luggage to the bell stand and they'll store it for you for the day. Keep that in mind. I'm sure that there will be very limited ability for late checkout. So definitely take advantage of that as an option. The staff at the hotel are prepared for the influx of luggage and people.
For lunch tomorrow, The Market
here in the hotel will have
items for purchase, and the items for purchase as they've done thus far, and the
hotel is connected to a food

Court. If you haven't found the food court, the hotel staff and conference staff can point you in the right direction. Finally, Marcus Gaffney, my colleagues from the Centers for Disease Control and prevention will announce the Maxon award nominees and winners after the presentation today. Without further ado, plenary session number 2. It is very rare in my history of being involved in EHDI that we have good fortune of having local people come in to give a presentation. This is very exciting. It seems like the local people are celebrities, because I see more people walk up to them, greet them, hug them than I have at a lot of these meet information my tenure working on EHDI. Thank you. For making the really long trip from your offices to the hotel for this meeting. Thank you in advance for your presentation.
> What a burden.

> Michelle Esquivel: The name of the presentation is Georgia Pathway to Language and Literacy for Children Who Are DHH, and joining us here again are our colleagues from Georgia, Dr.Brenda Fitzgerald, Stacey Tucci, and Comer Yates. I'm excited to hear their presentation. As the commissioner for the Georgia Department of Public Health, Dr.Fitzgerald is on a mission to close the “30 Million Word Gap.”

A study you may all be familiar with, by researchers Betty
Hart and Todd Risley found that
some children heard 30 million
fewer words by their 4th
birthdays than others, leading
to demonstrated lower
achievement.

Dr.Fitzgerald has helped mobilize
resources to address the gap as
a way to help improve the early

Education situation in Georgia today.
In addition to the Department of
Public Health, Georgia Tech, and
Emory University's Marcus Autism

Center are also involved in the project, as well as Emory University school of nursing. The United Way of Greater Atlanta has pledged $500,000 a year for three years to the program. So big investment, both among the public and private sectors for this effort, which is exciting. The simple practice of providing a rich language environment to babies and toddlers provides
nourishment for their brains,
setting them up for better
performance in school, and even
a higher IQ.
Please extend a warm welcome to

Dr.Fitzgerald, Stacey Tucci and Comer Yates.
[Applause]
> Brenda Fitzgerald: Thank you so much. I am absolutely delighted to be here. Delighted because I'm talking about a universal principle. There is, when you look throughout the entire living world, there is a distinction that makes us human. And that is language. The primacy of language, we know that that is important for our ability to communicate, our ability to interact with each other, and the interesting thing, as we have looked at this whole issue, it's the primacy of language that determines if we are going to be able to learn at all or not.

Our governor says that everyone in Georgia will be literate. And the interesting thing, the studies clearly show that by third grade, you can predict if a child is going to be literate. If a child is reading on level by third grade, that child most likely will be able to graduate from high school, and if they are able to graduate from high school there are all sorts of things associated with that achievement. One, college education. Two, employment. Three, better health. If you look at all those things.

The interesting thing about the third grade literacy level though is that you can predict it before that child is 8 years of age. As a matter of fact, if you step back and you refer to the 30 million word gap, and we're going to talk about that a little bit more, if you actually step back you can look at when that child is 3 and predict whether they will have third grade literacy competency or not, and whether they'll be able to go to high school, and whether they'll be able to achieve in this society. And as a matter of fact, as early as 11/2 you can predict a child's future.

So when we in public health were asked to participate in the governor's literacy initiative, what was our part? We, of course, the EHDI coordinators, are in public health in Georgia. I'm sure that is true in most of your states. But what we said is we're the people that come in contact with most of these children, and the reality is the richness of the language they're exposed to determines if they're going to be able to read or not.

So we in public health came at this from a universal perspective. We call this language nutrition, or WIC nutritionist, for example, concentrate, every one of our WIC nutritionists, our food program for pregnant women and children has also been trained in language nutrition. And their equal jobs are both language nutrition and food nutrition.

Because, it is clear that if you develop language, it actually causes physical brain development. We're going to show you some pictures in a little bit that talks about that, which leads to the ability to read, which leads to the ability to graduate from high school, which leads to success in life.

So the main thing in Georgia that is unique about us is we believe in universal access. And the interesting thing is all children develop that part of their brain that leads to literacy in the very same part of their brain. Visual language or auditory language stimulate the exact same part of the brain.

If you look at our design, you can see that across the board you can see the different categories. We realize that children with no known risk factors, they need language development. They simply need to be exposed towards it. They're exposed to 30 million words by the time they're 3 years of age, those kids are going to fly and succeed.

But we also know that there are other categories of children. If you look at the top, along my slide I'm sorry, if you look along the slide, you can I don't know exactly how to go backwards on this.
> That red thing.

> Brenda Fitzgerald: All right. If you look along the back
> Comer Yates: That was southern for something technical.

> Brenda Fitzgerald: Wasn't that helpful? If you look, there may be increased risk, moms are working, dads are working. We are applying special techniques to them. For those children, the next category are medical factors. We look at children who are deaf and hard of hearing as those children that we need to perhaps apply some special techniques and to be especially careful about what we do so that they can have this universal access to language.

Trauma factors, we're working with the juvenile justice system. We're working with foster parents. We're working with DFAX, because we know children that have traumatic factors in their life interrupt this normal brain development.

The last are those children, for example, who have autism, that do not develop normally. Those children need special access. But the important message is the place in the brain this is developed is absolutely the same.

This is a list of our partners. You can see it's pretty broad, from the public point of view it's not only public health, Department of Education, juvenile justice. From the Atlanta Speech School, Marcus Autism Center, the OBGYN Society, the Georgia chapter of the American Academy of Pediatrics. All of these are partners in this quest to have universal language development in Georgia.

So I'm going to ask Comer to talk a little bit about how Georgia came to this place, what we knew we were going to do with children who are deaf and hard of hearing.
> Comer Yates: All right. Thank you, Brenda. Welcome to Atlanta, everyone. We're thrilled y'all are here. Grateful that you would come to our city. I'm really sorry that Kenny Moore, the state director for the schools for the deaf, was called away a little while ago to an urgent family matter in Florida. Those of you from Georgia, can you raise your hands? They could give an affidavit that everyone else here has gotten the short end of the stick.
[Laughter]
With Kenny gone, we're the cochairs of the Georgia Pathway to Language and Literacy. Kenny is the man. He is the most thoughtful, kind, decent person I know, and humbling inner way. I will try to do justice. We feel like we're joined at the hip anyway, to Kenny's message today.

Before I talk specifically about our work together, it's important that you're in Atlanta and important that the next to last day of Black History Month, and I can offer a lot of technical information about the brain and about language and literacy, but if you're wondering what Georgia Pathway is all about, in a sense it really comes from the words of a native son. In fact, Atlanta native Martin Luther King who said, in thinking about our work, think about this phrase, All life is interrelated. We're all tied together by a single garment of destiny.

I will never be what I ought to be until you're what you ought to be, and you'll never be what you ought to be until I'm what I ought to be.

That really is the moral basis, ethical basis for Georgia Pathway, that Kenny and I came together about seven years ago when we recognized the destructiveness of looking at a child's acquisition of a modality as the finish line for children, and necessarily that focus on modality led to the mud wrestling I would call it between the modalities and that focus, in that focus we lost sight of what really mattered.

When I use the word voice, it has nothing to do with listening to spoken language or with American Sign Language or anything else. What it means for us at the speech school is that a child is going to read proficiently by the end of the third grade, because if she is not reading proficiently by the end of third grade then her ability to decide her own future and chart her own course in life and making a difference in other people's lives is going to be severely challenged.

So Kenny and I came together around the idea that what matters is language, and this destination of third grade reading proficiency. We think about our children who are deaf and hard of hearing as a group of children who are together with our other children on this path from birth to 8 while the brain is plastic enough to' choir literacy, that some of our children need particular additives. We're all on the same path. Not one path, not here or there, but one path towards this destination and starting point of life, of third grade reading proficiency.

So we started that work a number of years ago, then in 1913 1913?
[Laughter]
Let's see, Woodrow Wilson was inaugurated in 1913, and it was the year before that arch Duke was assassinated to start World War I. Let's fast forward 100 years. We're a little mind in Georgia.
[Laughter]
But to 2013. Dr.Fitzgerald was at a conference for the first time, spent three days as our public health commissioner who has some responsibilities, never left the room to hear about where we were with Pathway. She listened to this as we talked about the system. She heard about parents receiving the diagnosis of a child being deaf and hard of hearing and in this period of time of trying to somehow remediate what some people would see as a physical disability and respond to that. She sat there for three days. In the end, she said something, she said it a minute ago, she said, You guys are missing the whole point. It's the primacy of language that matters. People need to know from birth, even before the diagnosis of being deaf or hard of hearing, that the most important thing can happen for your child's early brain development is access to language, specifically 11 million words a year, 30,000 words a day for this neural construction to happen with these 100 billion neurons that sit in our brains at birth, very few of them attached together, and those synapses that either form or not form and be pruned away if we haven't been sure about the primacy of language.