Parent Challenges, Perspectives and Experiences Caring for Children Who are Deaf or Hard-of-Hearing With Other Disabilities: A Comprehensive Review

Objective: The purpose of this literature review was to explore parent challenges in caring for children who are deaf or hard of hearing with other disabilities and discuss implications for audiologists related to supporting families. Design: A comprehensive literature review was conducted, and through qualitative analysis, emergent themes were identified, and a narrative summary generated. Study sample: Nine research studies were included in this review. Combined, these studies reflect a sample of 111 children, 23 families and 41 parents. Results: Three broad themes were identified, and include parent-reported challenges related to family, professional and child variables. Sub-themes were identified within each broad theme to further describe parent experiences, such as challenges related to decision-making and planning, interprofessional collaboration, and child communication and behaviours. Conclusions: Parents of children with hearing loss and additional disabilities face unique challenges related to family, professional and child variables that could impact how they manage their child’s hearing care

Improving the Quality of Early Hearing Detection and Intervention Services Through Physician Outreach

Physicians and other health-care providers should play a central role in helping families of children with permanent hearing loss receive timely and appropriate screening, diagnostic, and early intervention services. Because the technology and procedures for ensuring timely and appropriate services for infants and young children with hearing loss have changed so dramatically over the past 15 years, many health-care providers are not well informed about the best ways to provide effective services. Audiologists can help to ensure that physicians and other health-care providers are better informed about the services needed by infants and young children with hearing loss. This article notes some of the areas where information and support is most needed and suggests resources and strategies for addressing these needs

Teaching Counseling Skills in Audiology Graduate Programs: Clinical Supervisors’ Perceptions and Practices

Background: Counseling is a critical component within audiological service delivery. Partnering with patients to support them in learning to effectively cope with their hearing challenges is a key component in achieving desired outcomes. Even though there is agreement on the foundational role counseling plays in audiology service delivery, counseling instruction varies among audiology training programs. Purpose: The purpose of this study was to investigate the perspectives and practices of supervisors in audiology graduate training programs related to mentoring students in the acquisition of counseling skills. Research Design: A cross-sectional design was used; participants completed a self-report survey. Study Sample: The survey was sent to 323 clinical supervisors in AuD graduate programs in the United States. Data Collection and Analysis: Completed surveys were received from 205 supervisors. Responses were analyzed using descriptive statistics to identify practice trends. Results: Participants reported their perceptions about importance of teaching counseling skills to audiology students, their confidence in teaching skills, their self-efficacy for supporting student learning, how they provide feedback to students, and challenges they encounter. Most participants reported their program requires a counseling course (88%; n=176). The majority of participants reported confidence in teaching counseling skills; however, fewer reported being very or extremely confident in teaching students how to talk with clients about their emotions (53%; n=109), and explaining the rationale behind specific counseling strategies (47%; n=97). Participants with more years of supervisory experience had statistically significantly higher self- ratings for teaching confidence and self-efficacy for supporting student learning in counseling than those with fewer years of experience. Conclusions: Audiology supervisors in AuD programs believe counseling is important to teach to students; however, they report variability in use of methods for providing feedback, evaluating student performance, and in their self-efficacy for supporting student learning. Future audiologists would benefit from a more systematic approach within graduate training for teaching counseling skills

Supporting play exploration and early developmental intervention versus usual care to enhance development outcomes during the transition from the neonatal intensive care unit to home: a pilot randomized controlled trial

Background While therapy services may start in the Neonatal Intensive Care Unit (NICU) there is often a gap in therapy after discharge. Supporting Play Exploration and Early Development Intervention (SPEEDI) supports parents, helping them build capacity to provide developmentally supportive opportunities starting in the NICU and continuing at home. The purpose of this single blinded randomized pilot clinical trial was to evaluate the initial efficacy of SPEEDI to improve early reaching and exploratory problem solving behaviors. Methods Fourteen infants born very preterm or with neonatal brain injury were randomly assigned to SPEEDI or Usual Care. The SPEEDI group participated in 5 collaborative parent, therapist, and infant interventions sessions in the NICU (Phase 1) and 5 at home (Phase 2). Parents provided daily opportunities designed to support the infants emerging motor control and exploratory behaviors. Primary outcome measures were assessed at the end of the intervention, 1 and 3 months after the intervention ended. Reaching was assessed with the infant supported in an infant chair using four 30 s trials. The Early Problem Solving Indicator was used to evaluate the frequency of behaviors during standardized play based assessment. Effect sizes are including for secondary outcomes including the Test of Infant Motor Performance and Bayley Scales of Infant and Toddler Development. Results No group differences were found in the duration of toy contact. There was a significant group effect on (F1,8 = 4.04, p = 0.08) early exploratory problem-solving behaviors with infants in the SPEEDI group demonstrating greater exploration with effect sizes of 1.3, 0.6, and 0.9 at the end of the intervention, 1 and 3 months post-intervention. Conclusions While further research is needed, this initial efficacy study showed promising results for the ability of SPEEDI to impact early problem solving behaviors at the end of intervention and at least 3 months after the intervention is over. While reaching did not show group differences, a ceiling effect may have contributed to this finding. This single blinded pilot RCT was registered prior to subject enrollment on 5/27/14 at ClinicalTrials.Gov with number NCT02153736

Counseling in Audiology: AuD Students’ Perspectives and Experiences

Counseling in audiology is an important aspect of service delivery. How audiologists interact with patients and foster counseling relationships to help patients and families understand and live with hearing loss can impact outcomes of audiological interventions. Currently, variability exists in how graduate training programs are teaching counseling skills, and the extent to which counseling skills development is supported in clinical experiences is unclear. This article seeks to explore the perspectives related to the importance of counseling and counseling training experiences received through clinical instruction of Au.D. students beginning their final year of study, to identify where counseling training might be limited, and to examine how counseling skills might be better supported. Findings revealed that students generally appreciate the importance of counseling in audiology. Data suggest that how students are supported in developing counseling skills appears to be variable and unstructured

Effect of an Internet-Based Program on Weight Loss for Low-Income Postpartum Women: A Randomized Clinical Trial

Does an internet-based weight loss program promote long-term weight loss in low-income postpartum women in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC program)

Moderators and Predictors in a Parent Hearing Aid Management eHealth Program

Objective: Consistent hearing-aid use is essential for spoken language development of children who are hard of hearing. A recent randomized controlled trial of an eHealth hearing aid management education program found the intervention increased knowledge, perceptions, confidence, and device monitoring among parents of young children. Yet, it is not known which variables can be a point of emphasis to improve treatment outcomes. The purpose of this study was to investigate potential moderators and predictors in the eHealth program. Design: Randomized controlled trial Study Sample: Parents (N=78) of children (42 months or younger) were randomized to the intervention or treatment-as-usual (TAU) group. Results: Results revealed that high psychological inflexibility, low parent activation, and low hours of hearing aid use may moderate device monitoring frequency and knowledge; parents in the intervention improved over time compared to the TAU group. Psychological inflexibility and parent activation also predicted treatment outcomes. Conclusion: The findings suggest the need to address parent psychological inflexibility related to hearing loss management, parents’ role in their child’s hearing aid management, and reported hours of hearing aid use as part of hearing aid service delivery. Identification of barriers to hearing aid management can assist audiologists in adjusting support to improve outcomes

Significant Phonon Drag Enables High Power Factor in the AlGaN/GaN Two-Dimensional Electron Gas

In typical thermoelectric energy harvesters and sensors, the Seebeck effect is caused by diffusion of electrons or holes in a temperature gradient. However, the Seebeck effect can also have a phonon drag component, due to momentum exchange between charge carriers and lattice phonons, which is more difficult to quantify. Here, we present the first study of phonon drag in the AlGaN/GaN two-dimensional electron gas (2DEG). We find that phonon drag does not contribute significantly to the thermoelectric behavior of devices with ~100 nm GaN thickness, which suppress the phonon mean free path. However, when the thickness is increased to ~1.2 $\mu$m, up to 32% (88%) of the Seebeck coefficient at 300 K (50 K) can be attributed to the drag component. In turn, the phonon drag enables state-of-the-art thermoelectric power factor in the thicker GaN film, up to ~40 mW m$^{-1}$ K$^{-2}$ at 50 K. By measuring the thermal conductivity of these AlGaN/GaN films, we show that the magnitude of the phonon drag can increase even when the thermal conductivity decreases. Decoupling of thermal conductivity and Seebeck coefficient could enable important advancements in thermoelectric power conversion with devices based on 2DEGs

Counseling Competencies in Audiology: A Modified Delphi Study

Purpose: Counseling practices in audiology play a critical role in helping patients and families understand, accept, and adjust to the dynamic impacts ear related disorders have on their lives. The purpose of this study was to identify what competencies (i.e., knowledge, skills, and attitudes) are important for audiologists to possess to provide effective counseling in practice. Method: A modified Delphi study design was used to survey a panel of thirty-three professionals with expertise in audiologic counseling from five different countries. In the first survey round, experts were asked to respond to three open-ended prompts. Responses were condensed and revised into items experts were asked to rate during the second and third survey rounds, on a 6-point Likert scale of importance. Results: A total of 819 items were generated from the open-ended prompts. A total of 72 items were included in the second and third round survey instruments. Consensus was met on 64 audiologic counseling competency items. Conclusion: The competency items identified in this study reflect important knowledge, skills, and attitudes that are important to audiologic counseling. Items that met consensus in this study can inform competencies audiology students can acquire during graduate training. Practice guidelines in the field currently lack the necessary clarity and detail needed for implementation of counseling competencies in clinical education. Future research is needed to explore factors important for implementation of evidence-based counseling training in graduate audiology programs

Hearing Care and Management Priority Among Parents of Children with Down Syndrome: A Grounded Theory

Objective: This study qualitatively explored the factors that influence how parents of children who are Deaf or hard-of-hearing with Down syndrome prioritize hearing care and management and developed an associated theory to explain that priority. Design: Grounded theory was used for the purposes of this qualitative study. Data were collected using in-depth interviews which were analyzed using a three-tiered qualitative coding process. Study Sample: Eighteen mothers of children who are Deaf or hard-of-hearing with Down syndrome participated in this study. Results: The higher the extent of engaged professional support, perception of benefit for child, parent activation, and family engagement, the higher the priority for hearing care and management will likely be among parents of children who are Deaf or hard-of-hearing with Down syndrome. Conclusions: Understanding how parents of children who are Deaf or hard-of-hearing with Down syndrome decide to prioritize hearing care and management has implications for how hearing health providers and others provide care to parents to enhance priority for hearing-related needs