Deirdre Curle

Cochlear Implantation among Deaf Children with Additional Disabilities: Parental Perceptions of Benefits, Challenges, and Service Provision.

Although increasing numbers of children with additional disabilities are receiving cochlear implants (CIs), little is known about family perspectives of the benefits and the challenges of cochlear implantation in this pediatric population. This study examines perceptions among parents of deaf children with additional disabilities regarding satisfaction with service provision, benefits, and challenges of the CI process. This was a mixed-methods study, which included a survey and interviews. Twenty-three families of deaf children with additional disabilities participated in this study, and 17 of these parents participated in in-depth interviews regarding their childs experience with the CI, including benefits and challenges. Interviews were analyzed through inductive thematic analysis. Parent-perceived benefits of cochlear implantation included childrens improved sound awareness, communication skills, and greater well-being compared to preimplantation status. However, the majority of families felt that they and their children were not receiving enough services. Major challenges included managing funding; coping with limited availability of specialized services, particularly in rural areas; and continuing concerns about the childs communication, social skills, and academic performance. Results suggest that children with additional disabilities benefit from CIs, but they and their families also face unique challenges that professionals should consider when working with these families.

Health-Related Quality of Life Among Young Children With Cochlear Implants and Developmental Disabilities.

Supplemental Digital Content is available in the text. Objectives: We developed a framework for objectively comparing hearing aids, independent of brand, type, or product family. This was done using a large dataset of commercially available hearing aids. To achieve this, we investigated which hearing aid features are suitable for comparison, and are also relevant for the rehabilitation of hearing impairment. To compare hearing aids objectively, we distinguished populations of hearing aids based on a set of key hearing aid features. Finally, we describe these hearing aid subpopulations so that these could potentially be used as a supporting tool for the selection of an appropriate hearing aid. Design: In this study, we used technical (meta-)data from 3911 hearing aids (available on the Dutch market in March 2018). The dataset contained about 50 of the most important characteristics of a hearing aid. After cleaning and handling the data via a well-defined knowledge discovery in database procedure, a total 3083 hearing aids were included. Subsequently, a set of well-defined key hearing aid features were used as input for further analysis. The data were split into an in-the-ear style hearing aid subset and a behind-the-ear style subset, for separate analyses. The knowledge discovery in databases procedure was also used as an objective guiding tool for applying an exploratory cluster analysis to expose subpopulations of hearing aids within the dataset. The latter was done using Latent Class Tree Analysis, which is an extension to the better-known Latent Class Analysis clustering method: with the important addition of a hierarchical structure. Results: A total of 10 hearing aid features were identified as relevant for audiological rehabilitation: compression, sound processing, noise reduction (NR), expansion, wind NR, impulse (noise) reduction, active feedback management, directionality, NR environments, and ear-to-ear communication. These features had the greatest impact on results yielded by the Latent Class Tree cluster analysis. At the first level in the hierarchical cluster model, the two subpopulations of hearing aids could be divided into 3 main branches, mainly distinguishable by the overall availability or technology level of hearing aid features. Higher-level results of the cluster analysis yielded a set of mutually exclusive hearing aid populations, called modalities. In total, nine behind-the-ear and seven in-the-ear modalities were found. These modalities were characterized by particular profiles of (complex) interplay between the selected key features. A technical comparison of features (e.g., implementation) is beyond the scope of this research. Conclusions: Combining a large dataset of hearing aids with a probabilistic hierarchical clustering method enables analysis of hearing aid characteristics which extends beyond product families and manufacturers. Furthermore, this study found that the resulting hearing aid modalities can be thought of as a generic alternative to the manufacturer-dependent proprietary “concepts,” and could potentially aid the selection of an appropriate hearing aid for technical rehabilitation. This study is in line with a growing need for justification of hearing aid selection and the increasing demand for evidence-based practice.

Complexity: An interpretative phenomenological analysis of the experiences of mothers of deaf children with cochlear implants and autism:

The purpose of this study was to explore the experiences of parenting a child with a dual diagnosis of childhood deafness and autism spectrum disorder who underwent cochlear implantation. Experiences of these parents are rarely discussed within the literature. Interpretive Phenomenological Analysis was used to examine nine mothers of boys (4–9 years old) for understanding their parenting experiences. Three superordinate themes were identified: complexity, personal and family sacrifices and parent–professional partnerships. These themes provide a rich account of mothers’ interpretations of their experiences, and reflect the numerous challenges they face. This study helps expand the literature on cochlear implantation for children with autism spectrum disorder, and discusses implications for clinical and educational practice.

The Transition From Early Intervention to School for Children Who Are Deaf or Hard of Hearing: Administrator Perspectives

Although the transition from early intervention (EI) to school is a significant milestone in the lives of young children, little research to date has investigated this transition among children who are deaf or hard of hearing (D/HH). The aims of this study were to investigate the organizational policies, procedures, and guidelines that facilitate or hinder the transition from the EI system to the school system for children who are D/HH from the perspective of program administrators. Using the Enhanced Critical Incident Technique methodology, 146 incidents were extracted from 10 interviews and sorted into 10 helping, 9 hindering, and 5 wish list categories. Findings are consistent with the Ecological and Dynamic Model of Transition (Rimm-Kaufman & Pianta, 2000), which conceptualizes the transition to school as being influenced by the pattern of interactions between the individuals, groups, and institutions connected to the child.

Contextual Action Theory Framework in Counseling Families of Children with Disabilities

Parents of children with disabilities face unique challenges in planning, parenting, and providing care for their children. The presence of a disability in a child has far-reaching effects across the family system. In this chapter, Contextual Action Theory is presented as a useful framework for professionals who work with families of children with disabilities or special needs, providing a way to increase understanding of parents’ action, and enhance the family centered approach through interaction and collaboration. First, we present a hypothetical narrative of a family with a child who has a disability, taking part in a language-based early intervention therapy program. Next, we discuss the case as an example of embedding Contextual Action Theory in a habilitative therapy setting. Last, we present possible steps and suggestions for implementing Contextual Action Theory in practices that serve families of children with disabilities or special needs. Contextual Action Theory offers potential as an established integrative and conceptual framework with a distinctive, relational view on implementing family centered services and enhancing professionals’ work with families. The theory can guide professionals in early intervention and other therapeutic settings in creating and maintaining parent–professional relationships and joint actions. This, in turn, will strengthen families by increasing their awareness of their own actions and goals, supporting their needs, and enhancing their well-being.

An Examination of Web-Based Information on the Transition to School for Children Who are Deaf or Hard of Hearing

Abstract Both prior to and during the transition from early intervention (EI) to school, parents of children who are deaf or hard of hearing (d/hh) need crucial information about the transition process and school services. Given the ubiquitous nature of computers and Internet access, it is reasonable to assume that web-based dissemination of information would be a highly efficient tool for parents. However, little is known about how organizations use websites to provide information on school entry. An investigation of government, outreach programme, EI agency, and school district websites in the Canadian province of British Columbia was conducted to examine the availability, accessibility, and content of information on the transition to school for d/hh children. Roberts’ website evaluation tool was used to assess the websites, while thematic content analysis was used to examine the content of web-based documents that described the transition process. Results indicate that the majority of agencies involved in the transition offer scant web-based information for this transition, with limited availability, particularly in rural areas, and limited accessibility, particularly for individuals with disabilities or with lower English literacy skills. The little information that was available emphasized the importance of teamwork, parent involvement, and joint decision-making regarding services and placement. This article highlights the need for government and outreach programmes, early intervention agencies, and school districts to provide richer and more accessible web-based content for families of children with hearing loss who are transitioning from EI to kindergarten.