Gina Wermuth - Member of the Month

IDA is so happy to honor Gina Wermuth as our member of the month. We appreciate her membership, her voice and participation in our events committee, and her dedication to all the early start families she serves. IDA interviewed Gina to hear more about her journey and current work in early intervention.

Gina’s journey to early intervention
Gina is a California native, born in Berkeley, and grew up in St. Helena. She started college in Santa Barbara, completed a degree in Linguistics at Santa Cruz, and then went on for a Master’s in Speech- Language Pathology at San Jose State. Before her career as a speech therapist, Gina taught English in Italy and worked in software development for voice recognition. Gina began her journey to early intervention through her work as a speech-language pathologist at an outpatient clinic. Gina loved working with infant and toddler clients and how that age is such an important window for language development. Gina began to realize that the medical model being used at the clinic where these young children were brought to a room without their parents for therapy was not developmentally appropriate. She began to research what is best practices for working with infants and toddlers, and that is when she became a vendor with her local regional center so she could work with families in their natural environments. Gina worked as a bilingual service provider in Marin County before moving to her current location in Ukiah.

Journey that brought Gina to IDA
When Gina started working as a regional center vendor, she realized that often speech and language developmental delays were often a surface symptom of a broader developmental, relational or environmental issues. She wanted to understand what the root problem was and understand how to work across other disciplines and broaden her lens. Gina attended the IDA annual conference in Sacramento and as she put it, it was like a “breath of fresh air” to be in a professional community for the first time, with an implicit holistic approach to development. Gina has been an active IDA member, attending chapter meetings and our event committee, especially during the pandemic when events and meetings were offered online.

Rural communities and early intervention
Gina reflected on how much she enjoys the small-town environment and personal relationships with the regional center where she lives in Ukiah, a rural town in Mendocino County. Some of the challenges of providing services in a rural environment are the lack of economic opportunities and poverty which has diminished the pool of available service providers. As Gina relayed even families native to the area with a support system have ended up moving to other states in search of better opportunities for jobs, affordable housing, and quality school systems. Another problem in rural settings is a lack of specialized medical care available nearby, which is often necessary for the early intervention children we serve.
Although teletherapy is available for some clients, broadband internet is often not available and if available it is very expensive. Although there are new infrastructure plans to run new fiberoptics which will improve access, right now telehealth is not a viable option for many families.

DDS Promoting Service Access & Equity Grant
IDA congratulates Gina on recently receiving the DDS Promoting Service Access & Equity Grant. Gina shared that the Service Access and Equity grants are supporting creative programs across California to create equity and reach families that are not effectively reached through traditional child find activities. The idea for the grant came to Gina when she was working with the Redwood Coast Regional Center to find out what was available to do more targeted support in the more isolated parts of Mendocino County, specifically in the immigrant and native American communities where families are disconnected from Early Start. The grant proposed that the main barriers that needs to be addressed are that in these isolated communities ’referrals are very low, providers need to travel a great distance, and families are facing hardships that make it difficult sometimes to be available consistently at the same time for appointments or feel comfortable having someone come to their home. There was not a bridge or continuity between the face of Early Start, who the people are, nor was there flexibility to provide services in the way that the families can receive considering the structure of their lives and their environment.

The grant is focused on a far northeast part of Mendocino, Round Valley, with an approximately 80% Native American population. The goal was for an early start provider to be able to have a consistent presence in the community to build familiarity and trust, and to do outreach with families and with other agencies in the community that serve those families. In addition, the grant addressed the need for flexibility for meetings to occur at different times and in different places in the community rather than only at set times and only in the home. The ultimate goal of the grant is to promote early start participation and balance out the under-representation. The grant aims to achieve these goals through a community presence and also through providing a less formal process for entering Early Start. Gina discussed the sensitivity of the government’s role in breaking apart families in Native American communities which has created a barrier to trust in other government programs such as Early Start. The grant provides time to build a bridge by partnering with trusted leadership in the Native American community to build familiarity and trust and by working outside the IFSP process to give families time to enter early start when they are ready.

Critical Partnerships
Gina created partnerships with several different agencies that serve families in the community and provided ideas and support for the grant. A critical partnership to the success of this grant was the Round Valley Indian Health Center, as many of the Early Start referrals come through primary care visits. However, the tribal health clinic does not have pediatrics, therefore developmental screenings are not being conducted. As Covid has affected medical staffing, referrals are also not necessarily coming consistently from nearby health clinics where children are being seen for their well-child visits. In addition, due to Covid, some children have missed their well-child visits altogether preventing any screenings or observations of developmental delays. The grant will allow Gina to partner with medical providers at the Round Valley Indian Health Center to carry out developmental screenings during well- child visits.
 
Another vital partner was the Round Valley Indian Tribes Family Resource Center which provides a variety of programming and resources for families and children in the community. FRC leadership contributed enthusiastically to identifying gaps in current services available, and how the grant might be used to fill some of them. Promoting relationships by attending social events that build familiarity and trust were offered and suggested. The FRC also provides a meeting space that families are already familiar with. The leadership and staff of the tribal Head Start was particularly enthusiastic about infusing their program via the grant and sees a place for Gina to train their birth to three childcare program and Head Start teachers in bringing awareness to families, teachers, and early care staff about development, services available, and referral to early start when there are concerns. In addition, insights and invaluable ongoing partnership was provided by the local school district program specialist who’s lived and worked in Round Valley for 45 years, starting as a special education teacher. She started a birth-to-five collaborative that has met for 20 years and is made up of local agencies that meet to coordinate and serve families. Gina shared how many very caring people were available as partners, although under-resourced systemically and structurally they continue to value relationships with specialists from outside the community who seek to support and enhance the impressive array of homegrown services and programs already in place.

Advice for new early intervention clinicians
Gina’s advice for someone entering early intervention is to partner and identify mentors to learn from, which can sometimes be hard since early intervention is such a fragmented program. Gina still draws on the advice and information from her pediatric internship as a graduate student with an experienced early intervention speech therapist. Gina feels that finding a person with a deep understanding of early intervention work is key. Gina added that it is important for new clinicians to understand that Early Intervention is really about working with the families and with the parents, and it is different from direct service with children as it is in other settings. Gina found that the most helpful thing for her was connecting with transdisciplinary fields through events and training. She believes in the importance of finding a way to connect with other disciplines and seek training that is broader than their primary discipline.

Perspectives on Early Intervention in California
Gina shared her perspectives from her many years of early intervention experience in Northern California on what she thought we were doing well in California and areas that were still in need of improvement. She felt that we needed to continue efforts as part of the SSIP (Part C State Systemic Improvement Plan (SSIP)) around social-emotional development, to address the providers in early start who are still using the medical or educational models, which are not aligned with early start’s goal of addressing families through a developmental lens. In addition, she thought that California could follow the model in other states, such as VA and NY, where providers need to obtain a certificate through a standardization process to be a Part C provider. Although there is an infrastructure in place with WestEd training modules in partnership with Early Start, California is not yet requiring vendors to prove that they’ve taken the courses and have the core competencies for early start before they can become vendors.