System Building: An Interview with Lisa Honigfeld

By Amanda Farah Cox

Dr. Lisa Honigfeld is a medical sociologist and associate director of the Office for Community Child Health at Connecticut Children’s Medical Center. Earlier this year, she joined our Transitions Management team, focusing on the 18+ group and how teenagers manage after leaving high school.

Lisa recently visited the Ida Institute while on a research tour of the Nordic countries and answered a few questions about her work and her personal connection to transitions management.

Tell us about your background.

I’m a medical sociologist. I have spent my entire career exploring in the field and improving and working in the policy area all related to the organization and delivery of child health services.

What’s your connection to hearing healthcare?

There are two ways that I’ve gotten into this focus. One is professionally:  Our department of public health in my state gives my organization a contract to improve pediatric health providers’ care of children with hearing loss. That’s everything from the follow-up of their newborn hearing screening, to continuous monitoring of hearing, to connecting children with hearing loss to other services.

Personally, I have a 25-year-old daughter who is severely to profoundly deaf. There was no newborn hearing screening when she was born, so my husband and I had a very, very, rigorous hearing test: We banged pots and pans, we rang the doorbell, and finally, during a nap, my husband took the alarm clock and slowly went closer and closer to the crib to see if she would wake up, and she didn’t. So then we went through all the professional diagnostic testing.

Did your personal experience impact your work?

At that time, I was working at the American Academy of Pediatrics, and while I knew nothing about hearing loss, I did know that the window for learning language in children was very, very small. I brought it to our activity, to have a diagnosis and to have an intervention.

What does your work usually look like?

I work to ensure that pediatric primary health services can make a maximum contribution to children’s health and development. When the American Academy of Pediatrics says child health providers should use standardized developmental autism screening at 18 and 24 months, it becomes, “How do we get pediatricians to do that? Do we get our Medicaid program and private insurers to do that? What are the tools to do that? Once we’ve trained them, how can we monitor the implementation of that? What are the effects of that on the rest of the system if they identify children for whom there’s an autism concern? Are there enough evaluation services for them? Are there enough intervention services?” So I call it “system building” around these early childhood issues that are related to child health services.

How did you get involved with our Transitions Management project?

A book came out in the United States called The American Healthcare Paradox: Why We’re Paying More and Getting Less. I really felt like this book said it all. We put all this money into healthcare services, and we put nothing into the kinds of services that make healthcare work for people: The housing services, nutrition services, mental health services, the hearing intervention services. But the book really said nothing about children at all. I know that children live, grow, and develop across a variety of settings. I decided I would like to do an exploration of applying that thought to those ideas of social services, community services, and health services to child health services. And this book compared the United States to Scandinavian countries.

I got in touch with the authors, and they put me in touch with several folks with whom they did interviews. Sharmi [Albrechtson, Ida Institute Associate Director] was one of those. She said, “I’m a consultant to the Ida Institute.” So I looked you up online and thought, “Oh! These are my people!” For a number of reasons!

What age group do you work on in the project?

I signed up to work with the oldest age group, largely because beyond basic child development, my best contribution to this group really is as a parent and what I know. That’s what I remember most about my daughter’s transition is her latest transition to college, to the workforce.

What is your daughter doing now?

She’s a developmental specialist. She works at a private agency, and the state, when children are diagnosed with hearing loss following a newborn hearing screening, their parents get to pick an agency from which they receive their early intervention services. She teams often with a speech and language professional. She talks about how the speech and language professionals often do not really understand hearing loss at all. She brings that understanding to them.