Therapists and educators use innovative intervention methods to help deaf and hard of hearing children develop the language skills to succeed in life.

Childhood Speech, Language & Hearing - Multidisciplinary Team

There are a number of reasons for referring deaf and hard of hearing children to Boys Town National Research Hospital for evaluation. Many students referred to the team have complex needs that are hard to identify and address in the educational setting. These needs may include difficulties with behavior, communication or schoolwork.

The multidisciplinary team offers an in-depth evaluation of the hearing, health, communication, academic, psychological and behavioral status of deaf and hard of hearing infants, children, and youth. Because each case is unique, the team makeup is different for each child and tailored to his or her specific concerns.

When a school, family or professional requests an evaluation, an admissions process begins. This involves collection and review of background records and determination if the team is able to address the primary concerns. Upon admission, a group of professionals called a multidisciplinary team is assigned to the child. The team makes recommendations regarding staff members and assessments appropriate for the child’s particular needs with the goal of answering the referral questions. Team members have extensive experience in working with children who are deaf or hard of hearing. This enables them to evaluate the child's situation and help everyone involved, including the child, parents and teachers, to manage or overcome the difficulties they face.

Each family is assigned an advocate/manager to guide the parents through the evaluation process. The team supports families and schools by providing conferences, comprehensive reports, and school outreach visits (upon request).

Team members work closely together throughout the evaluation. They rely on a combination of test materials, teaching tasks, and informal strategies to understand the child’s needs. All team members work to identify the child’s strengths and areas of need, as well as effective educational strategies that will promote future learning.

Reasons for a multidisciplinary evaluation can include:

• Lack of progress in school
• Questions about communication development
• Need to determine the most appropriate way for a child to communicate
• Disagreement between school and home about a child's educational needs
• Need for recommendations about academic or communication goals
• Identification of effective teaching methods
• Questions about the impact of health concerns on learning
• Routine assessments required for Individual Educational Plan Development
• Concern for possible learning disabilities
• Need for an independent evaluation

Evaluations may include:

• Audiology
• Psychology and behavior
• Communication and Language
• Speech and auditory skills
• Cochlear implants
• Academics, learning and processing
• Health (Including Ear, Nose and Throat evaluation, pediatrics, and ophthalmology)

As needed, additional evaluations and consultations may be added, such as:

• Counseling and adjustment
• Occupational and physical therapy
• Genetics
• Vestibular functioning
• Radiology
• Neurology
• Augmentative communication (in collaboration with Munroe-Meyer Institute)

Referring a Child for Evaluation

The referral process consists of a few simple steps:

• The family, school or outside agency, such as a private clinic, refers the child to Boys Town National Research Hospital.
• The team coordinator collects all relevant records and creates a case summary to be presented to the team.
• The team decides on the most appropriate types of assessment to include in the evaluation.
• Parents agree on a date for the evaluation.
• The appointment clerk creates a schedule and sends it to the family and other appropriate parties.
• Students and their families come to the hospital for four days of evaluation.
• The team meets to discuss test results.
• A family conference is held to share results with parents. School representatives may be present or they may participate via a conference call.
• Feedback may include a recommendation for outreach services at the school site.
• About three to four weeks after the evaluation, reports arrive from each person who saw the student.

Frequently Asked Questions

What does a multidisciplinary team evaluation cost?

Team evaluations are individualized for each child. The cost is dependent on the types of evaluations that are necessary to answer the referral questions. It is common for the four-day evaluation to range from $1800 to $2500, depending on how many specialist appointments are required.

Who pays for multidisciplinary team evaluations?

Our history shows that evaluations are paid for by school districts (65% of the time), insurance and private pay (25% of the time), and Medicaid (8% of the time).

The team coordinator works with each family and school district to determine a cost estimate for the proposed schedule and to determine how the costs will be covered. The coordinator will work with referring agencies to ensure that the final schedule and proposed costs are acceptable.

Why is it necessary to gather all of the background records?

The goal in collecting background records is to: a) gain a full understanding of the referral questions; b) avoid duplication of testing completed elsewhere; c) identify unanswered questions by examining the full diagnostic history.

Although it takes some time to gather this information, it saves both time and expense later. Our team is able to do its best work when we have a complete understanding of the child’s history before starting a new evaluation.

How long will it take to get an appointment?

Based on our records, 55% of appointments are scheduled from 5-9 months after the referral is made. The timing of appointments are affected by: a) how quickly records are returned, b) staff schedules, and c) season of the year (e.g., summers are a popular period and need to be requested a year in advance).

Will team members be able to communicate effectively with the child?

Selected team members are skilled in the various languages and communication approaches commonly used with deaf and hard of hearing children (e.g., Auditory-oral approaches, Cued Speech, Signing Exact English, Pidgin Signed English, American Sign Language). Team members are selected based on the presenting language or communication approach to ensure that the child’s communicative needs are met. The academic specialist, who is a highly experienced educator of the deaf, works in tandem with an educational interpreter during the evaluation. The team psychologist has extensive experience with deaf and hard of hearing children, but relies on an interpreter for signing or cueing children.

How long will it take for us to get the evaluation reports?

Multidisciplinary team reports are lengthy and comprehensive. Team members make every effort to have completed reports mailed within 30 days of the final day of evaluation.

Where does the evaluation take place?

The multidisciplinary team works with children in the new Lied Learning and Technology Center. This state of the art facility offers a comfortable environment for children and families. Evaluation rooms are inviting educational environments, designed to engage the child in learning. Parents and school professionals are able to observe all evaluation activities.

Is there housing available for out of town and out of state families?

Housing information is mailed with the child’s schedule. Options include several hotels in the Omaha area and the Ronald McDonald House. Discounted rates may be available to families coming for evaluation. Let the hotel know that the child is being seen at Boys Town National Research Hospital/Lied Learning and Technology Center.

Why is the evaluation so long?

The team’s goal is to gain a comprehensive understanding of the child’s needs from multiple perspectives. This requires a series of appointments that are spread over four days. As children become comfortable in this setting, they respond in different ways. The extended time frame allows team members to try out teaching strategies and evaluate their effectiveness. The schedule also allows us to provide the child needed rest breaks from testing. All team members work to make the experience fun and interesting for the child.

Shorter evaluations are available for re-evaluations and for special circumstances. Families and schools are encouraged to raise any questions about the evaluation length prior to scheduling an appointment.

More Information

For information about starting a referral, please contact:

Mary Patterson, M.S., C.E.D.
(402) 452-5079
patter@boystown.org