Thorsten Burger

Parental Distress: The Initial Phase of Hearing Aid and Cochlear Implant Fitting

The results of previous cross-section studies suggest that childhood hearing impairment may lead to parental psychosocial stress. The present study investigated whether modifications in parental psychic state can be ascertained in connection with the childs treatment events and the childs hearing and speech status, in a prospective study design. Data were available on 116 fathers and mothers regarding the pre—cochlear implant examination or hearing aid fitting of their child. In the course of the childs treatment, parental quality of life improved from a low to a normal level. Among children who were at the stage of pre-examination for a cochlear implant, better hearing and speech capacity was linked to more severe impairment of the parental state. It is emphasized that the parents whose children showed comparatively good language development at the time of pre-examination for a cochlear implant were especially subjected to stress.

A comparison between parents of children with cochlear implants and parents of children with hearing aids regarding parental distress and treatment expectations

OBJECTIVE The aim of the present study was to compare the parents of children with a hearing aid (HA) and children with a cochlear implant (CI) regarding their psychological distress, their expectations from treatment, their family climate, and the way they first obtained information on HA/CI. METHODS 154 parents (return quota 41%; 81 mothers and 73 fathers) of 90 children with a HA and 103 parents (return quota 59%; 57 mothers and 46 fathers) of 57 children with a CI were interviewed by means of a questionnaire. RESULTS Both groups of parents felt distressed, particularly at the time of diagnosis. Their psychological well-being was gradually stabilized in the further course of rehabilitation. Due to the operation associated with it, fitting with a CI brought on a phase of heightened parental psychological distress compared with less invasive treatment with a HA. Regarding family climate, more distress was found in parents of CI children than in parents of HA children. Expectations from therapy appeared realistic in both parental groups; however, after CI fitting, the parents of the CI children showed heightened expectations by comparison with the parents of the HA children. CONCLUSIONS The results of our study suggest that the parents of hearing impaired children fitted with a HA or a CI may be divided into two subgroups with divergent psychosocial parameters. For the counseling of the parents of hearing impaired children in clinical practice, it would seem important to take these specific differences into consideration.

Mental health problems in adolescents with cochlear implants: peer problems persist after controlling for additional handicaps

The aims of the present multi-center study were to investigate the extent of mental health problems in adolescents with a hearing loss and cochlear implants (CIs) in comparison to normal hearing (NH) peers and to investigate possible relations between the extent of mental health problems of young CI users and hearing variables, such as age at implantation, or functional gain of CI. The survey included 140 adolescents with CI (mean age = 14.7, SD = 1.5 years) and 140 NH adolescents (mean age = 14.8, SD = 1.4 years), their parents and teachers. Participants were matched by age, gender and social background. Within the CI group, 35 adolescents were identified as “risk cases” due to possible and manifest additional handicaps, and 11 adolescents were non-classifiable. Mental health problems were assessed with the Strengths and Difficulties Questionnaire (SDQ) in the versions “Self,” “Parent,” and “Teacher.” The CI group showed significantly more “Peer Problems” than the NH group. When the CI group was split into a “risk-group” (35 “risk cases” and 11 non-classifiable persons) and a “non-risk group” (n = 94), increased peer problems were perceived in both CI subgroups by adolescents themselves. However, no further differences between the CI non-risk group and the NH group were observed in any rater. The CI risk-group showed significantly more hyperactivity compared to the NH group and more hyperactivity and conduct problems compared to the CI non-risk group. Cluster analyses confirmed that there were significantly more adolescents with high problems in the CI risk-group compared to the CI non-risk group and the NH group. Adolescents with CI, who were able to understand speech in noise had significantly less difficulties compared to constricted CI users. Parents, teachers, and clinicians should be aware that CI users with additionally special needs may have mental health problems. However, peer problems were also experienced by CI adolescents without additional handicaps.

Psychic stress and quality of life in parents during decisive phases in the therapy of their hearing-impaired children.

Objective: This study was performed to analyze psychic stress and quality of life in the parents of children with hearing impairment in the course of various phases of treatment. Design: At three measuring points over a course of 12 months, the degree of parental stress and the quality of life was surveyed prospectively. In addition, the children’s hearing and speech status was surveyed. Parents whose children were treated with hearing aids or cochlear implants were the target of this survey. At the outset of the study, data of 123 parents were available. The average age of the children was 38 months. Results: It was not possible to demonstrate generally heightened psychic stress in any phase of treatment. Differentiation into subgroups must be performed, as parental stress depends on possible changes of treatment and the child’s speech status. Initially, quality of life was clearly reduced but gradually became statistically insignificant. Conclusions: The results point out the necessity of supporting the parents with counseling and psychosocial support, especially in the initial fitting phase and in the various decision and orientation phases.

Health locus of control and preventive behaviour among students of music

The present study investigated health locus of control, preventive behaviour and previous playing-related health problems of music students; 326 students of music (58% female, mean age 22 years) filled in the Locus of Control Inventory for Illness and Health (Lohaus and Schmitt, 1989) and the Epidemiological Questionnaire for Musicians (Spahn, 1998). It was shown that previous playing-related problems, being a string instrumentalist or a singer as well as high powerful others locus of control (LOC) and low external chance LOC, were predictive factors for the utilizing of preventive measures. It was not possible to confirm that a high internal LOC, in and of itself, furthers preventive behaviour. For prevention programmes at universities of music, it would seem important that previous health problems are actively ascertained at the commencement of the course of study, as they are an important point of departure for further, differentiated preventive counselling measures.