Dana Suskind is a professor of surgery and pediatrics in the Section of Otolaryngology-Head and Neck Surgery and directs the Pediatric Cochlear Implantation Program at the University of Chicago. Her research, funded by a three-year grant from the Institute of Education Science, is dedicated to addressing health disparities, specifically early language disparities, through the development of novel multimedia intervention programs that combine parent education with quantitative linguistic feedback. She has conceptualized and initiated development and evaluation of two parent-directed, home-visiting interventions: Project ASPIRE and the Thirty Million Words Project. These interventions, for parents of children with hearing loss and parents of typically developing children respectively, aim to improve child outcomes through parent enrichment of the early language environment.
Below is an inspirational interview with one of this year's general session speakers at the 2013 AG Bell Listening and Spoken Language Symposium, Dana Suskind, M.D., Professor of Surgery and Pediatrics, Director, Pediatric Cochlear Implantation Program, University of Chicago. Dr. Suskind shares her life and work and provides you with a sneak peek on Project ASPIRE that will be the focus of her symposium presentation on Saturday, July 20.
Tell us a bit about yourself and about your professional background.
At the University of Chicago, I am a Professor of Surgery and Pediatrics in the Section of Otolaryngology-Head and Neck Surgery and I direct the Pediatric Cochlear Implantation Program. My time is split between surgery and research. I definitely have the best of all worlds.
Why and how did you become interested in the field of cochlear implants?
In few specialties do you have the opportunity to impact the life of a child so profoundly. Cochlear implantation is a true modern medical miracle, the journey for the child and family incredibly exciting and gratifying. I find it an honor to be allowed, by the families, to be a part of that process.
What was the inspiration for Project ASPIRE? How did it come about? Was it a particular case that gave you the idea?
In the early days of the cochlear implant program, it became apparent that two children with cochlear implants with the same potential had very different spoken language outcomes. The difference in the children was almost invariably socioeconomic status. This began my interest in health disparities research and an attempt to identify the long-term relationship between a child’s early language environment and his/her long-term outcomes. Project ASPIRE was created to help parents gain the tools needed to enrich their children’s early language environments in order to ameliorate this problem. The project is funded by a Department of Education Institute of Education Sciences grant.
What inspires you? Who are your heroes—from everyday life as well as public or well-known figures?
The people whom I most admire are the ones who work tirelessly, day in and day out, to make sure that every child has the chance to meet his/her potential, whether parents or professionals. They are very often unsung and unremunerated financially but that does not deter them. To me, these are the greatest heroes of all.
You have mentioned that science is not an island. What do you mean by this?
Making the world a better place is definitely a group effort or, perhaps, more accurately, a team sport! While my research programs have been inspired by the children I care for, our program development is the result of the extraordinary people on my team. Project ASPIRE, for example, is the product of the hard work and inspiration of many, many people within and outside of the world of hearing loss. I am incredibly lucky to be at an incredible institution, the University of Chicago, that understands and supports the idea that research is an important tool in the clinical care of children.
Mary Ellen Nevins’ enthusiasm for the project was an essential factor in getting it started. In addition, my other wonderful collaborators, Beth Suskind, Sally Tannenbaum, Kristin Leffel, Shannon Sapolich, Marc Hernandez, Lyra Repplinger, Teresa Caraway, David Ertmer, Jean Desjardin, Christina Perigoe and many, many other professionals in the field of hearing loss in Chicagoland and around the country are essential factors in its success; each brings a unique perspective and expertise. And, most importantly, I must acknowledge the incredible parents who gave their time and their insights in the development of Project ASPIRE!
ASPIRE means Achieving Superior Parental Involvement for Rehabilitative Excellence. Did the acronym come first?
The concept for the program came first. It was actually my dear friend and collaborator, Mary Ellen Nevins, who said that she always loved the word Aspire. The acronym followed. It is a mouthful, but a meaningful mouthful!
How has your work changed the way you approach communication with your children?
The truth is, in our family, we are all talkers. Sometimes simultaneously! But, I am definitely much more conscious of my language interaction and its impact on my children's educational trajectories.
What considerations did you have when developing the program?
Project ASPIRE’s goals are to:
- Teach parents about their child’s brain and language development in the context of hearing loss.
- Teach parents that their words, how much and how they speak to their child, have the power to “build their child’s brain” and positively impact educational growth.
- Show parents how to increase and improve their language, especially as it relates to their child.
Your website states that "Project ASPIRE is a weekly, interactive, multimedia DVD program conducted in a group setting that utilizes a ‘best-practices’ curriculum." Can you please elaborate on that and provide us with an overview of one such weekly session?
Project ASPIRE is an evidence-based, early intervention curriculum combining education, behavior change strategies and the technology of the LENA word pedometer. Using the one-on-one home visiting model, therapists make 10 weekly visits to review a variety of topics related to the development of listening and spoken language. Parents are considered equal partners and encouraged to actively participate in the discussion. Each review ends with a videomodeling exercise that gives parents a chance to practice the key strategies discussed that week and get constructive and immediate feedback on the activity. Once a week, the LENA is used by parents to record 10 hours of their child’s language environment. The resulting data provide concrete quantitative and qualitative linguistic feedback that is reviewed by both the therapist and the parent in order to set goals for the next recording day. Our goal is to have parents understand their role in helping their child develop and reach his/her potential by instilling both the tools and the confidence to do so.
Parents are central to the success of their children. Please describe Project ASPIRE’s most successful strategies for motivating parent participation and engagement.
The core belief of Project ASPIRE is that parents are their child’s first and most important teacher. Equally important is that all parents have the ability to significantly and positively impact their child’s future. This is the foundation of Project ASPIRE from the first module and throughout the program.
The ASPIRE curriculum is deeply and deliberately rooted in science. More than a simple belief that all parents want their children to succeed and when given the tools, will use them, we use science as the foundation of Project Aspire and to help Project Aspire achieve its goals. Parents who are enrolled in the program learn to understand the science behind neuroplasticity and the importance of the critical language period. And it works. They learn to transform scientific knowledge into action.
Motivational Interviewing (MI) is just one evidence-based method that we have integrated into Project ASPIRE. Its aim is to nurture intrinsic motivation for change instead of relying solely on external motivators. By utilizing MI strategies in conjunction with other intervention techniques, Project ASPIRE home visitors foster the parents’ sense of internal motivation and support the parents’ ability to increase their positive linguistic behaviors.
Describe some of the interactive multimedia components of Project ASPIRE's programs.
Animation is used as an appealing teaching method to illustrate the overarching concepts foundational to the curriculum. One of my favorites shows parents that, while they can grow their baby’s brain through language, the hearing device has to be on and working for it to work. The animation shows words, when the device is on, going through the ear and into the brain, lighting up neurons and connections; when the cochlear implant/hearing aid is off, the words don’t go into the brain and no new connections are made.
The video is designed to give parents real-life applications for key concepts. For instance, we don’t just tell parents that talking about what you’re doing as you do it is a great way to surround children with lots of language; we show them what it looks like when they do it.
Multimedia components like these give parents the opportunity to understand high-level concepts in a relatable and easy-to-remember fashion.
How did you ensure that Project ASPIRE's programs are culturally and linguistically appropriate? Describe some of the challenges you had and how you addressed them.
Our goal is not to change parenting styles. We understand that all families have family-specific parenting strategies and we respect that choice. Our aim, rather, is enriching whatever is in place in the home. We equip parents with the tools and knowledge that they can apply in their own way in support of their child.
Project ASPIRE is a parent-directed curriculum and recognizing cultural diversity was a key consideration in the development process. We wanted every parent who participated in the program to feel represented in its content. Our animated cast of characters and the families who participated in the video component are a true reflection of this.
Achieving diversity in the animation was simple. Achieving diversity in the video was significantly more challenging since our goal was not only cultural diversity but developmental diversity as well. Given that hearing loss is a low-incidence disability, and our bar for diversity was set so high, we had to travel the country to capture the desired cross-section of families and children. While both time-intensive and expensive, the end result was well worth the effort.
How is Project ASPIRE assessed? Please give us a short overview of results that you have so far.
Developing Project ASPIRE was an intensely iterative process. Formative testing with various stakeholders, i.e., parents, early intervention therapists, academic experts from multiple disciplines, was a priority. The feedback we received was invaluable. Now that we’ve started the pilot, we continue to ask for input from both parents and therapists with an eye toward making future iterations of the curriculum stronger. It’s too early to comment on results, but we are committed to Project ASPIRE’s success.
Give us an update on Project ASPIRE. What stage is it in and what are next steps?
We are currently in the midst of a pilot study with 32 families to test the Project ASPIRE curriculum. The next steps include evaluation of the pilot, a longitudinal study and continued development of a Spanish version of the curriculum.
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