Lauri Nelson

Children With Cochlear Implants In the Inclusive Early Childhood Classroom

It is the first day of school and excitement has filled Mrs. Kays kindergarten classroom. Mrs. Kay is always happy for the new school year to begin. However, this year also brings some trepidation. She has a new student named Ashley who is deaf and who has a cochlear implant. This situation is very new to Mrs. Kay and she currently has more questions than answers.

Ambient noise impact on accuracy of automated hearing assessment.

Abstract Objective: The aim of this study was to determine the effect of ambient noise on the accuracy of thresholds obtained using the KUDUwave portable clinical audiometer as compared to those obtained using a GSI-61 clinical audiometer in a sound booth. Design: Pure-tone air conduction thresholds were obtained in three conditions: (1) with a clinical audiometer in a quiet sound booth, (2) with the KUDUwave in a quiet sound booth, and (3) with the KUDUwave with 40 dBA of background noise. Study sample: A total of 31 individuals ranging in age from 15 to 80 years participated in the study, 21 with normal hearing and ten with hearing loss. Results: Eighty-nine percent of thresholds obtained with the KUDUwave in quiet, and 92% of thresholds obtained with the KUDUwave in background noise were within 5 dB of those obtained with the clinical audiometer. Accuracy was poorer at 250 Hz and 8000 Hz. Conclusion: Ambient noise typical of that found in a non-sound-treated room, did not affect the accuracy of air conduction hearing thresholds obtained with the KUDUwave. The KUDUwave may be a viable method of testing when a clinical audiometer and sound booth are not available.

Audiologists’ Communication Behavior During Hearing Device Management Appointments.

Abstract Objective: The aim of this exploratory study was to describe audiologist communication behaviours during appointments for hearing device monitoring and management before and after participation in counselling skills training. Design: The study used a longitudinal design with three assessment points over 6 months. Study sample: The sample included 10 audiologists and audiology graduate students interacting in a professional setting with their clients. Results: Audiologists reported improvement in their counselling skills from pre-training to follow-up, which was consistent with objective findings that audiologist relative speaking time decreased from pre-training to post-training as well as from pre-training to follow-up. Observer-rated scores of participants’ counselling skills; however, yielded no significant differences across time. Conclusions: Some improvement was noted in audiologists’ counselling behaviour following a 1-day communication skills workshop and continued learning support. It is evident; however, that further training, such as increased training and performance feedback, is needed to maintain and enhance audiologist progress in the various aspects of counselling.

Paediatric Hearing Aid Management: A Demonstration Project for Using Virtual Visits to Enhance Parent Support

Abstract Objective: The purpose of this study was to explore the use of virtual visits to monitor hearing aid use with data logging measurements and provide parent support for hearing aid management. Design: A 6-month longitudinal case study design was used. Study sample: Four families and two providers participated. Results: Average hours of daily hearing aid use increased 3.5 h from the beginning to the end of the study period. Prior to receiving virtual visits, the parents and the clinicians generally indicated they were hopeful about the benefits of virtual visits including the frequency and convenience of the appointments but had some concerns about technical difficulties. These concerns diminished at the conclusion of the study. Conclusion: Virtual visits provided benefits to families including flexibility and timely access to support. The ability to collect data logging information more frequently was important for effective problem-solving to increase hearing aid use. Both parents and clinicians were accepting of tele-support. Parents and professionals would benefit from technology that allows them to access data logging information more easily and frequently.

Deaf Education Services in Southern Regions of Vietnam: A Survey of Teacher Perceptions and Recommendations

Abstract Purpose This survey study explored teacher perceptions regarding services for children who are deaf or hard of hearing in southern regions of Vietnam, including educational successes and challenges, the availability and use of hearing technology, and teacher recommendations for improving child outcomes. Method Using a cross-sectional survey design, hard-copy surveys were sent to professionals who provided services to children with hearing loss ages 3–9. Ninety-eight surveys were distributed and seventy seven surveys were returned, resulting in a return rate of 79 per cent. Simple statistics were used to describe the quantitative survey results; content analysis was completed on open-ended survey comments. Results Access to hearing aids and hearing aid repairs are substantial barriers for many families. Survey respondents expressed desire for more training in hearing technology and effective teaching strategies. Twenty-six per cent of children in preschool and kindergarten used listening and spoken language as their primary mode of communication compared with 7 per cent of children in first to fourth grade who used listening and spoken language. Conclusions Expansion of early identification programmes beyond high-risk cases, with increased access to hearing technology and early intervention services from highly trained professionals were recommended to optimize listening and spoken language outcomes of children who are deaf or hard of hearing.

A Review of Internet Resources Related to Spoken Language Intervention for Spanish-Speaking Parents of Children who are Deaf or Hard of Hearing

Objective: The purpose of this study was to identify website information related to hearing loss, hearing technology, and spoken language development available to Spanish-speaking parents of children who are deaf or hard of hearing (DHH). Design: An exploratory, descriptive design was used to determine the presence or absence of parent education information on a variety of websites. Study Sample: The study explored Internet resources provided by national, state, and parent support organizations in the United States. Results: A total of 53 organization websites were identified that had information for parents of children who are DHH and learning spoken language, eight of which were international. Fifteen content areas were reviewed for each website. Of the 53 websites, 25 had information in Spanish. Conclusions: Results of the current study revealed website resources are often fragmented and less in-depth for Spanish speaking parents with children who are DHH and learning spoken language.

Parent perceptions of their child’s communication and academic experiences with cochlear implants

Abstract Objective: To explore parent perceptions of communication and academic experiences of cochlear implant (CI) recipients under the age of 18. Design: Cross-sectional survey design. Two surveys (K-12, birth-5) queried parent perceptions of the impact of CI on communication, listening in various environments and academic achievement. Surveys contained 16–23 multiple choice and/or Likert ratings, plus four open-ended questions to assess reasons for obtaining a CI, satisfaction with CI and suggestions for professionals. Study sample: Surveys were sent to 156 parents of CI recipients; 81 surveys returned; response rate 52%. Results: According to parent report, 95% of K-12 children and 100% of preschool children used spoken language as their primary mode of communication; majority of K-12 children performed same as or better than peers across academic subjects; 99% of respondents were pleased with their decision to obtain a CI. The most important reasons reported for choosing CIs were for their child to use the same language as their families and to effectively communicate in hearing society. Satisfaction with CI was better in quiet than in noise. Respondents stressed the importance of audiologists having excellent skills in CI management and programming. Conclusions: Respondents were positive about the benefits of obtaining CI for their child.

Pediatric Hearing Aid Management: Parent-Reported Needs for Learning Support.

Objectives: The aim of this study was to investigate parent learning and support needs related to hearing aid management for young children, and factors that influence parent-reported hours of hearing aid use. Design: A cross-sectional survey design was used to collect survey data in seven states. The child’s primary caregiver completed a demographic form, a questionnaire to explore parent learning and support needs as well as their challenges with hearing aid use, and the patient health questionnaire to identify symptoms of depression. Three hundred and eighteen parents completed the questionnaires. Results: Responses were analyzed for 318 parents of children (M = 23.15 months; SD = 10.43; range: 3 to 51) who had been wearing hearing aids (M = 15.52; SD = 10.11; range: <1 to 50 months). Even though the majority of parents reported receiving the educational support queried, approximately one-third wanted more information on a variety of topics such as loaner hearing aids, what their child can/cannot hear, financial assistance, how to meet other parents, how to do basic hearing aid maintenance, and how to keep the hearing aids on their child. The most frequently reported challenges that interfered with hearing aid use (rated often or always) were child activities, child not wanting to wear the hearing aids, and fear of losing or damaging the hearing aids. Forty-two percent of parents reported that, on good days, their child used hearing aids all waking hours. Multiple regression was used to compare the effect on parent-reported typical hours of hearing aid use based on good days for the variables of (1) presence of depressive symptoms for the parent, (2) child age, (3) family income, (4) primary caregiver education level, (5) presence of additional disabilities for the child, (6) degree of hearing loss, and (7) length of time since the child was fitted with hearing aids. There were statistically significantly fewer hours of reported hearing aid use when parents reported mild to severe symptoms of depression, lower income, less education level, and when children had mild hearing loss or additional disabilities. Conclusion: Although parents reported overall that their needs for hearing aid education and support had generally been met, there were important suggestions for how audiologists and other service providers could better meet parent needs. Hearing aid use for young children was variable and influenced by a variety of factors. Understanding parent experiences and challenges can help audiologists more effectively focus support. Audiologists are more likely to meet the needs of families if they take care to provide access to thorough and comprehensive education and ongoing support that is tailored to address the unique needs of individual families.

Performance Feedback to Increase Use of Counseling Skills

Counseling is a critical component of audiological care and when implemented purposefully can yield multiple benefits for patients. Professional guidelines indicate that counseling is within the scope of practice for audiologists, yet research has shown that audiologists feel unprepared and are not comfortable providing adjustment counseling. This may be due to inadequate counseling training in audiology graduate programs. To identify ways to address this counseling training gap, this study examined the use of performance feedback to increase counseling skills among audiology graduate students. In this study, participants ( n  = 5) were recorded during clinical session encounters, and recordings were coded for time spent counseling. A licensed clinical psychologist reviewed the recordings and provided individual performance feedback to participants over the course of the study. Time spent counseling increased by the end of the study, although improvement varied across participants. Results suggest that performance feedback can be used as a method to increase counseling skills in audiology students. However, factors, such as participant motivation, feedback timing, and prerequisite counseling skills, may influence response to feedback. More research is needed on ways to maximize gains from feedback, as well as other methods to improve counseling skills in audiology students.

Pediatric Hearing Aid Management: Challenges Among Hispanic Families

Background: Hearing aid fitting in infancy has become more common in the United States as a result of earlier identification of hearing loss. Consistency of hearing aid use is an area of concern for young children, as well as other hearing aid management challenges parents encounter that may contribute to less‐than‐optimal speech and language outcomes. Research that describes parent hearing aid management experiences of Spanish‐speaking Hispanic families, or the extent of their needs, is not available. To effectively support parent learning, in a culturally sensitive manner, providers may benefit from having a better understanding of the needs and challenges Hispanic families experience with hearing aid management. Purpose: The purpose of the current study was to describe challenges with hearing aid management and use for children from birth to 5 yr of age, as reported by Spanish‐speaking parents in the United States, and factors that may influence hearing aid use. Research Design: This study used a cross‐sectional survey design. Study Sample: Forty‐two Spanish‐speaking parents of children up to 5 yr of age who had been fitted with hearing aids. Data Collection and Analysis: Responses were obtained from surveys mailed to parents through early intervention programs and audiology clinics. Descriptive statistics were used to describe frequencies and variance in responses. Results: Forty‐seven percent of the parents reported the need for help from an interpreter during audiology appointments. Even though parents received information and were taught skills by their audiologist, many wanted to receive more information. For example, 59% wanted to know how to meet other parents of children who have hearing loss, although 88% had previously received this information; 56% wanted to know how to do basic hearing aid maintenance, although 71% had previously received instruction. The two most frequently reported hearing aid use challenges were fear of losing the hearing aids, and not seeing benefit from the hearing aids. Hearing aid use during all waking hours was reported by more parents (66%) when their child had a good day than when their child had a bad day (37%); during the previous two weeks, 35% of the parents indicated their child had all good days. Conclusions: Hispanic parents wanted more comprehensive information, concrete resources, and emotional support from the audiologist to overcome hearing aid management challenges. Understanding parents’ perspectives, experiences, and challenges is critical for audiologists to provide appropriate support in a culturally sensitive manner and to effectively address families’ needs.