Wendy McCracken

Universal newborn hearing screening: parental reflections on very early audiological management.

Objective: This article seeks to understand very early audiological management from a parental perspective, after the early identification of their childs hearing loss through universal newborn hearing screening (UNHS). Design: Data are taken from the national evaluation of the introduction of UNHS in England. Forty-five parents and caregivers participated in a qualitative, narrative study within which they identified key challenges generated by the audiological management of very young babies with hearing loss at home. Results: Concern centered on the virtual timetable constructed by parents after screening, the practical daily management issues and the need to establish infant rather than a child focus in audiological practice. In addition, specific challenges relating to moderate hearing loss were identified. Conclusions: Results are of particular relevance to pediatric audiologists, teachers of the deaf* and those offering early intervention services.

To What Extent Do the Characteristics of the Object of Evaluation Influence the Choice of Epistemological Framework? The Case of Universal Newborn Hearing Screening

In this article, the authors explore the role that characteristics and circumstances attendant on the object of an evaluation might play in the choice of epistemological framework underpinning research design. They consider examples from the consumer-focused evaluation of the introduction of universal newborn hearing screening in England. In particular, they look at how screen-and program-specific issues exerted influence at the levels of epistemology and method, arguing that these choices are not simply a product of values and questions that underpinned one kind of approach to knowledge production in comparison with another.

Deaf Children with Complex Needs: Parental Experience of Access to Cochlear Implants and Ongoing Support

Abstract This paper discusses the experiences of parents of deaf children with additional complex needs (ACN) in accessing cochlear implant (CI) services and achieving ongoing support. Of a total study group of fifty-one children with ACN, twelve had been fitted with a CI. The parental accounts provide a rich and varied picture of service access. For some families accessing audiological assessment for CI was problematic, for others expectations, access to a qualified teacher of the deaf to FM amplification were problematic. Where services were similar in quality and quantity to typically developing deaf children who had received a CI there were high levels of satisfaction. For all the children implantation was delayed, the level of communication skills prior to implantation was very low, and expectations were uncertain and unclear. Deaf children with ACN require at least the same access to services as typically developing children. It can be argued that this group requires a higher level of input from qualified specialists, yet findings from this study suggest some children are likely to be receiving substantially less input, and in some cases no specialist input. Recommendations for audiological and educational management are also made.

Trial of a two-channel hearing aid (low-frequency compression-high-frequency linear amplification) with school age children.

OBJECTIVE The study was designed to investigate the efficacy of a 2-channel hearing aid with low-frequency compression and high-frequency linear amplification on a group of school-age hearing aid wearers. DESIGN The study was a single-center, 2-way crossover design in which 25 children (age 6 to 15 yr) were fitted with 2-channel hearing aids for 12 wk and with their own (single-channel) hearing aids for 12 wk, refitted according to published protocols. Speech perception in quiet and in noise was measured at the end of each 12 wk period; in addition, questionnaires were given to teachers, parents, and children. RESULTS Two-channel hearing aids showed significantly higher mean scores for speech perception in noise and significantly higher composite questionnaire scores (reflecting aspects of satisfaction and benefit). Final choice of hearing aids at the end of the study by parents and children also favored the 2-channel device. CONCLUSIONS The 2-channel hearing aids appear to be an acceptable management option for audiometrically suitable children. The results provide support for the 2-channel design rationale and suggest the need for further trials.

Following Alice: theories of critical thinking and reflective practice in action at postgraduate level

This paper presents a flexible framework of principles for teaching critical thinking and reflective practice skills at the postgraduate level. It reports on a collaborative project between four UK institutions providing postgraduate programmes in deaf education. Through a critical review of current theories of critical thinking and reflective practice in higher education, the authors identified and constructed frameworks of principles for relevant skills. They selected a set of learning activities for the institutions to trial to target those skills. Students evaluated how successfully the activities promoted the skills. The investigators evaluate the methodology and provide a critique of the framework of principles. Findings reveal that the framework of principles is a robust model for the development, design and evaluation of bespoke learning activities targeting critical thinking and reflective practice skills.

Readiness of paediatric audiology services for newborn hearing screening: Findings and implications from the programme in England

As well as evaluating the newborn hearing screen itself, the government-funded evaluation of the implementation of a Newborn Hearing Screening Programme (NHSP) in England is assessing the impact of the screen on follow-up services. In the UK context, these are principally paediatric audiology, education, and social services. This article presents results from a mixed method research study involving paediatric audiology services specifically. Results demonstrate significant variety in current practice with regard to routine tests and procedures, considerable variability in number of current referrals and time allocated to caseloads, and considerable variability in expectations of how the numbers will change following newborn screening implementation. The challenges of and opportunities afforded by NHSP which were identified by respondents, highlight the urgent need for further training. The study has implications for paediatric audiology services that are yet to start NHSP in the UK, as well as for services and professionals in other countries. Sumario Además de evaluar la propia prueba de identificación auditiva en recién nacidos, la evaluación financiada por el gobierno del Programa de Tamizaje Auditivo en Recién Nacidos (NHSP) en Inglaterra está valorando el impacto del procedimiento de identificación sobre los servicios de seguimiento. En el contexto del Reino Unido (U.K.), estos son: audiología pediátrica, servicios de educación y servicios sociales. Este artículo presenta los resultados de un estudio de investigación de metodología mixta, que involucra, específicamente, a los servicios de audiología pediátrica. Los resultados demuestran una variedad significativa en la práctica clínica actual en relación con las pruebas y procedimientos rutinarios, una considerable variabilidad en el número actual de referencias y el tiempo requerido para los casos, así como una considerable variabilidad en las expectativas de cómo cambiarán las cifras posteriormente a la implementación del tamiz neonatal. Los retos y las oportunidades ofrecidas por el NHSP identificadas por los encuestados, destacan la urgente necesidad de entrenamiento adicional. El estudio tiene implicaciones para los servicios de audiología pediátrica que aún no han iniciado el NHSP en el UK, así como para servicios y profesionales en otros países.

The Impact of Universal Newborn Hearing Screening Education Perceiving the Role of Social Services

This article presents results from qualitative interviews with 27 education services working as the lead agency with deaf children and families in sites where the universal newborn hearing screening programme (NHSP) is being piloted in England. This segment of data focuses specifically on how the social work role and practice is perceived by teachers of the deaf. It demonstrates the difficulties encountered in multi-agency working in the absence of specialist deaf child social workers: the perceived impact of deaf child referrals not satisfactorily fitting within any consistent organizational structure within social services; the poor liaison between education and social services over newly identified deaf children; the effects of parental information based on a limited understanding of the social work role and duties. The findings are set within current government initiatives to improve multi-agency working with disabled children and deaf children under three

Review of the Visiting Teachers Service for Children with Hearing and Visual Impairment in Supporting Inclusive Educational Practice in Ireland: Examining Stakeholder Feedback through an Ecological Systems Theory.

Abstract In line with recent developments in inclusive practice in Ireland, children with sensory needs are increasingly educated in mainstream rather than specialist provision. Educational supports are provided by a range of practitioners and include input from the visiting teachers service for children with hearing and visual impairment. This paper reports on findings from the first national review of the service. The review process included desktop research, meetings with a range of key stakeholders as well as a national invitation for written submissions (n = 1372). The findings serve to illustrate the multi-faceted nature of the role of the specialist teachers who work in the service and the range of influences that impact on their work in facilitating inclusive educational practice. To support a holistic analysis of their role, an ecological systems theory is drawn upon as a lens through which to examine the inclusive educational ‘supports’ identified within the review. Mapping the array of educational supports onto an ecological systems theory enables an appreciation of the multiple sources of influence and interconnections in relation to the role. The paper has significance for service providers seeking a theoretical framework that affords potential for comparison of activities across professional roles, settings and contexts.

Outcomes of cochlear implanted children with cerebral palsy: A holistic approach.

OBJECTIVE Analyze the progress of hearing and language in a group of children with cerebral palsy (CP) who have received cochlear implants (CI) and compare their progress in the clinical and functional domains. METHODS This is a prospective transdisciplinary study developed within a tertiary referral center, with a group of nine cochlear-implanted children with CP, two- to seven-year-old. The assessments undertaken included audiological, language, and communication assessments complemented by the assessment of functional abilities and the level of independence as evaluated by the Pediatric Evaluation of Disability Inventory (PEDI) and Gross Motor Function Classification System (GMFCS). RESULTS The outcomes varied, as two children achieved hearing comprehension in open-set evaluations. These children presented the same type of CP, athetosis, but with different functional skills and GMFCS levels. Only one of the subjects had any spoken language at the single-word level. CONCLUSIONS A holistic view of change and development is central to understanding progress made in children with CP who received cochlear implants (CI). The functional evaluation of these children with CP is a useful tool for monitoring their progress and measuring their outcomes with CI.

The Views, Verdict and Recommendations for School and Home Sex and Relationships Education by Young Deaf and Hearing People.

The purpose of this survey study was to explore the views of young deaf and hearing people (16–25 years old) on school and home sex and relationships education (SRE). The study addressed a critical knowledge gap in the research literature on deaf youths perception of SRE. The small-scale study explored young deaf peoples experiences of SRE and the challenges they had faced when learning about sexuality and relationships. Recommendations on how to improve school SRE lessons were also obtained. Data were collected from 81 young people (n = 27 deaf, n = 54 hearing). Overall, deaf participants indicated greater levels of satisfaction with school SRE than hearing respondents. More deaf young people than young hearing people felt that the school had provided them with enough opportunities to learn about sexuality and relationships. The deaf group showed a preference for school SRE lessons to start at a later age than the hearing group. Mothers and friends were the two sources most frequently consulted in both groups. Teachers and school nurses were a third source frequently used by the deaf group. The views of deaf and hearing youth on their own SRE are important for the development, implementation and delivery of the school SRE curriculum. The studys findings can provide educators with valuable insight on the needs of a minority group who are particularly vulnerable to sexual exploitation and sexual misinformation due to their sensory loss and associated factors.