Kristina M. Blaiser

Parent hearing aid experiences in the United States.

BACKGROUND Children born with permanent hearing loss have the opportunity to receive services earlier as a result of newborn hearing screening (NHS). We conducted a survey to address three aspects within the early hearing detection and intervention (EHDI) process: (1) timeliness of service delivery, (2) hearing device access, and (3) hearing aid management. Parent experiences provide valuable information in identifying existing challenges for these components of the EHDI system. PURPOSE The aim was to investigate parent experiences as they access and manage hearing aids for their child. RESEARCH DESIGN A cross-sectional, population-based survey was used. STUDY SAMPLE Three hundred fifty-two completed surveys from parents of children born between 1977 and 2010 were returned from 45 states in the United States. DATA COLLECTION AND ANALYSIS Responses were obtained online and through the mail, and were analyzed using descriptive statistics. RESULTS Over time, the age of hearing loss identification has decreased to a median of 2 mo, age of first hearing aid fitting has decreased to a median of 5 mo, and the delay between hearing loss identification and hearing aid fitting has remained the same with a median of 2 mo. For children born between 2007 and 2010, the top three challenges parents reported in obtaining hearing aids were (1) paying for hearing aids, (2) accepting the need for hearing aids, and (3) wait time for an appointment. Almost one-half (48%) of the parents reported that they did not receive adequate support from their audiologist in how to check the function of their childs hearing aids. CONCLUSIONS Significant progress has been made over the past two decades in reducing the age of hearing loss identification and hearing aid fitting for children who do not pass the NHS. However, many children continue to experience delays between hearing loss diagnosis and hearing aid fitting that exceed Joint Committee on Infant Hearing recommendations. The experiences parents reported provide valuable information about areas that need further investigation to improve the process for children with hearing loss.

Culturally Consistent Treatment for Late Talkers

The authors discuss cultural influences on clinical interactions when treating late talkers, 2- to 3-year-old children with primary language delays. They use the literature to examine the cultural relevance of core components of early language treatment and propose alternative professional actions in the cases of cultural mismatches. Alternative actions include triadic or multiparty treatments, the inclusion of siblings or others, more structured tasks or group settings for language training, and shaping of culturally congruent directive language techniques. Also discussed is the need for an emphasis on social language use and professional clarity regarding links between early child language ability and later achievements in order to motivate treatment.

Pediatric hearing aid use: Parent-reported challenges

Objectives: The aim of this study was to investigate parent-reported challenges related to hearing aid management and parental psychosocial characteristics during the first 3 years of the child’s life. Design: Using a cross-sectional survey design, surveys were distributed to parents of children with hearing loss via state Early Intervention programs in Utah and Indiana. Packets contained one family demographic form and two sets of three questionnaires to obtain responses from mothers and fathers separately: the Parent Hearing Aid Management Inventory explored parent access to information, parent confidence in performing skills, expectations, communication with the audiologist, and hearing aid use challenges. The Acceptance and Action Questionnaire measured psychological flexibility, experiential avoidance, and internal thought processes that can affect problem-solving ability and decrease an individual’s ability to take value-based actions. The Patient Health Questionnaire identified symptoms of depression. Thirty-seven families completed questionnaires (35 mothers and 20 fathers). Results: Most responses were parents of toddlers (M = 22 months) who had been wearing binaural hearing aids for an average of 15 months. Both mothers and fathers reported that even though the amount of information they received was overwhelming, most (84%) preferred to have all the information at the beginning, rather than to receive it over an extended time period. Parents reported an array of challenges related to hearing aid management, with the majority related to daily management, hearing aid use, and emotional adjustment. Sixty-six percent of parents reported an audiologist taught them how to complete a listening check using a stethoscope, however, only one-third reported doing a daily hearing aid listening check. Both mothers and fathers reported a wide range of variability in their confidence in performing activities related to hearing aid management, and most reported minimal confidence in their ability to troubleshoot hearing aid problems. More than half of the parents reported child behavior and activities, such as playing outside, as a major hearing aid use challenge. Parents reported hearing aids were worn all waking hours by 35% of children and less than 5 hr/day by 31%. Almost half of the parents (47%) did not feel that they had enough time to talk about their emotions when speaking with their audiologist(s), 69% reported the audiologist did not help them know what to expect related to emotions about their child’s hearing loss, and 22% reported symptoms of depression. Conclusions: Parents reported an array of challenges, even after their child had been wearing hearing aids for a prolonged time, revealing critical implications for how to provide audiological care. Audiologists have an important role in partnering with parents to identify and jointly problem-solving challenges related to their child’s hearing aid use. Supporting parents includes not only addressing technical aspects of hearing testing and hearing aid function but also addressing parent thoughts, feelings, and emotions.

A Multisite Study Evaluating the Benefits of Early Intervention via Telepractice

This study sought to determine the effectiveness of telepractice as a method of delivering early intervention services to families of infants and toddlers who are deaf or hard of hearing. A comparison group design was applied to ascertain the child, family, and provider outcomes via telepractice compared with traditional in-person home visits. A total of 48 children and their families, along with 15 providers from 5 early intervention programs, across the country participated. Children in the telepractice group received more intervention, although the number of prescribed sessions was equal across groups. Analyses of covariance demonstrated that children in the telepractice group scored statistically significantly higher than children in the in-person group on the PLS-5 Receptive Language subscale and PLS-5 Total Language standard scores, and the groups scored similarly on other language measures. There were no statistically significant differences between groups in regard to family outcomes of support, knowledge, and community involvement. Analysis of video recordings of telepractice versus in-person home visits resulted in higher scores for provider responsiveness and parent engagement. This study supports the effectiveness of telepractice in delivering early intervention services to families of children who are deaf or hard of hearing. Further research involving randomized trials with larger, more diverse populations is warranted.