Christopher Lind

Hearing and vision impairment and the social networks of older Australians

Two hundred and forty self‐selected community‐based older people were tested for vision and hearing acuity, and reported on their hearing and vision difficulties and social networks. Social network size, proximity and frequency of contacts were used as dependent variables in the analysis of the effects of any sensory loss on social structure. Neither objectively measured sensory loss nor self‐reported sensory difficulties were associated with significant changes to network size, however, people with sensory losses were found to have more intense networks with fewer contacts outside their immediate inner circle.

Autonomous motivation is associated with hearing aid adoption

Abstract Objective: To use the self-determination theory of motivation to investigate whether different forms of motivation were associated with adults’ decisions whether or not to adopt hearing aids. Design: A quantitative approach was used in this cohort study. Participants completed the treatment self-regulation questionnaire (TSRQ), which measured autonomous and controlled motivation for hearing aid adoption. Sociodemographic data and audiometric information were also obtained. Study sample: Participants were 253 adults who had sought information about their hearing but had not consulted with a hearing professional. Participants were categorized as hearing aid adopters if they had been fitted with hearing aids 4–6 months after completing the TSRQ, and as non-adopters if they had not. Results: Multivariate logistic regression was used to examine associations between autonomous and controlled motivation, sociodemographic and audiometric variables, and hearing aid adoption (n = 160). Three factors were significantly associated with increased hearing aid adoption when the influence of other variables was accounted for: autonomous motivation, perceived hearing difficulty, and poorer hearing. Controlled motivation was not found to influence hearing aid adoption. Conclusion: These empirical findings that link autonomous motivation to decisions of hearing help-seekers have implications for the ways practitioners may evaluate motivation and could inform discussions with clients about hearing aid adoption.

Using Relationships as a Tool: Early Childhood Educators' Perspectives of the Child-Caregiver Relationship in a Childcare Setting.

Childrens early years are critical for development and many children access out-of-home care during this time. Services offering high-quality childcare afford an opportunity to impact positively on childrens development, including acquisition of communication skills. A strong, responsive relationship between child and carer is important in facilitating childrens communication development. For infants who are not yet verbal, early childhood educators (ECEs) need to be highly sensitive to the childs communication, and they need to develop a relationship with the child to interpret their signals and facilitate their communication. This study investigated the perspectives of ECEs on their relationships with infants in their care. Individual semi-structured interviews with ECEs were conducted and the interview data were triangulated with videoed observational data. The results demonstrate that these ECEs use the relationship with the children in their care as a tool for provision of optimal learning experiences across multiple developmental domains.

A conversation analytic view of continuous discourse tracking as a rehabilitative tool

Abstract Objective: With increasing focus on the consequences of aural rehabilitation for the everyday conversational difficulties arising from adult acquired hearing impairment, this study aimed to compare patterns of repair behaviour arising in conversation and a widely used aural rehabilitation tool, continuous discourse tracking (10), in order to better understand the procedure’s role in the assessment and training of repair behaviour. Design: A parallel case study design was adopted. Communication dyads undertook a 20-minute conversation followed by a 20-minute session of tracking. The interactions were audio-recorded, transcribed, and analysed for patterns of repair according to current conversation analytic conventions (40). The research questions were addressed via both qualitative and quantitative methods. Study sample: Three communication pairs (dyads), each comprising an adult with acquired hearing impairment and their chosen familiar communication partner, participated in this study. Results: Analysis revealed that patterns of repair were constrained by the task requirement in tracking for the receiver/hearing-impaired adult to repeat text segments spoken by the sender/familiar communication partner with 100% accuracy. Conclusions: Whilst tracking has a number of useful conversational qualities, it may have only limited ecological validity when applied to the evaluation and training of repair behaviour.

A long-term follow-up of children and adolescents referred for assessment of auditory processing disorder

Abstract Objective: This study investigated whether young adults (between 18 and 30 years at the time of the project) who were assessed for auditory processing disorder (APD) in childhood (between 7 and 16 years) experience persistence of listening and communication difficulties. Design: Participants completed a mixed methods questionnaire focusing on common areas of complaint in APD and two open-ended questions exploring participants’ past and present experiences with listening and communication difficulties. Study sample: Ninety-seven of the 722 potential participants returned completed questionnaires, of whom 66 had been diagnosed with APD (APD group) at the time of their auditory processing assessment and 31 had not met diagnostic criteria (NAPD group) at that time. Results: Substantial commonality was noted in the reported listening and communication difficulties between the APD and NAPD participants. Volunteered comments aggregated into four major content themes which included: listening and communication difficulties; participants’ sense of self; change; and participation. Members of the APD group reported greater communication difficulty than NAPD group members, irrespective of environmental listening conditions. Conclusions: Young adults with a prior referral for, and in some cases a diagnosis of, APD as children continue to experience auditory processing difficulties across a range of daily situations.

Conversation repair: Ecological validity of outcome measures in acquired hearing impairment

Abstract Objective Everyday conversation is the most widely reported difficulty arising from adult acquired hearing impairment (HI), yet no clinical method currently exists by which direct observation of conversational ability can be measured. This review of recent research argues that specific patterns of conversation repair arise in interaction involving adults who have acquired HI and that they may be of utility in assessing the outcome of intervention. Methods This brief review paper presents a summary of data on the conduct of repair in free and unstructured conversations between HI adults and their frequent communication partners using Conversation Analysis as the guiding theory and analytic method. Results Results indicate that certain types of repair are influenced by one participant in the conversation having an acquired hearing impairment. Further, these patterns of repair behaviour are resolved in concert by the participants in the conversation. Discussion Patterns of repair behaviour may be used as criterion variables in assessing the need for and outcome of audiological intervention, including implantation, hearing aid fitting and/or conversation-based therapy. Previous research has shown that these measures are both consistent across time in the absence of intervention and that they are sensitive to intervention. Conclusion These findings support the potential for conversationally-oriented therapy models of assessment and intervention and suggest a framework by which clinical tasks might be analysed with respect to their conversation ‘reality’. This initial evidence needs to be supported by investigations across larger samples of adults with acquired hearing impairment.

What factors are associated with autonomous and controlled motivation for hearing help-seekers?

BACKGROUND Hearing impairment is prevalent in older adults. Motivation is important in peoples choice to seek help for their hearing and whether to adopt or not adopt hearing aids. PURPOSE To investigate associations between sociodemographic and audiometric characteristics and autonomous and controlled motivation among a sample of hearing help-seekers. RESEARCH DESIGN A quantitative approach was taken for this cross-sectional cohort study. STUDY SAMPLE A total of 253 adult first-time hearing help-seekers were recruited to the study. DATA COLLECTION AND ANALYSIS Participants provided sociodemographic information and completed questionnaires adapted from self-determination theory that measured autonomous motivation (motivation that originates from within the self and is aligned with personal values and beliefs) and controlled motivation (motivation that stems from external pressures such as rewards or punishment, or conflicted inner feelings such as guilt or shame). RESULTS Participants with higher autonomous motivation scores were younger, wanted hearing aids more, and reported greater hearing difficulty in everyday life than those with lower scores. Participants with higher controlled motivation scores were more often referred to the service by others and wanted hearing aids more than those with lower controlled motivation scores. Controlled motivation scores were not associated with perceptions of hearing difficulty in everyday life. CONCLUSION Relationships among motivation and sociodemographic factors highlight the importance of characterizing autonomous and controlled motivation in first-time hearing help-seekers. Attention to personal characteristics in order to understand motivational processes involved in rehabilitation decisions such as hearing aid adoption may aid in consultations.

Hearing and Cognitive Impairment and the Role of the International Classification of Functioning, Disability and Health as a Rehabilitation Framework

The International Classification of Functioning, Disability and Health (ICF) has been applied widely in the literature to describe and differentiate the broad implications of hearing impairment (HI) and cognitive impairment (CI) on communication. As CI and HI are largely age-related conditions, the likelihood of comorbidity of these conditions is high. In the context of an aging population, the prevalence of comorbidity is likely to rise, yet much of the clinical assessment and intervention in HI and CI occur separately. The benefit of addressing the dual impact of these conditions is of increasing clinical importance for all clinicians working with older adults and for audiologists and speech pathologists in particular. In this article, the ICF model will be applied to explore the everyday implications of HI and CI. Furthermore, the clinical implications of the ICF model are explored with particular respect to communication assessment and intervention options. The potential benefit of combining activity- and participation-focused interventions currently offered for HI and CI independently is examined.

Decision-making and outcomes of hearing help-seekers: A self-determination theory perspective.

Abstract Objective: To explore the explanatory power of a self-determination theory (SDT) model of health behaviour change for hearing aid adoption decisions and fitting outcomes. Design: A quantitative approach was taken for this longitudinal cohort study. Participants completed questionnaires adapted from SDT that measured autonomous motivation, autonomy support, and perceived competence for hearing aids. Hearing aid fitting outcomes were obtained with the international outcomes inventory for hearing aids (IOI-HA). Sociodemographic and audiometric information was collected. Study sample: Participants were 216 adult first-time hearing help-seekers (125 hearing aid adopters, 91 non-adopters). Results: Regression models assessed the impact of autonomous motivation and autonomy support on hearing aid adoption and hearing aid fitting outcomes. Sociodemographic and audiometric factors were also taken into account. Autonomous motivation, but not autonomy support, was associated with increased hearing aid adoption. Autonomy support was associated with increased perceived competence for hearing aids, reduced activity limitation and increased hearing aid satisfaction. Autonomous motivation was positively associated with hearing aid satisfaction. Conclusion: The SDT model is potentially useful in understanding how hearing aid adoption decisions are made, and how hearing health behaviour is internalized and maintained over time. Autonomy supportive practitioners may improve outcomes by helping hearing aid adopters maintain internalized change.