Achieving Successful Outcomes In a TeleIntervention Program

For well over a decade, family-centered early intervention services have been delivered through models of teleintervention (TI) to children who are Deaf and Hard of Hearing (DHH) and their families. Ongoing outcome data continue to demonstrate the viability, effectiveness, and positive impacts these services provide to both the service providers and the families served. However, to establish a successful TI program, careful planning is required, and barriers and potential roadblocks must be reduced or eliminated. When these challenges are adequately addressed, TI programs are more likely to achieve its primary goal of delivering appropriate family-centered early intervention

Pediatric Hearing Device Management: Professional Practices for Monitoring Aided Audibility

Objective: The purpose of this study was to explore professional practices for monitoring aided audibility for children who are deaf or hard of hearing (DHH). Design: A cross-sectional survey design was used to identify providers’ self-reported practice patterns for monitoring aided audibility for children who use hearing aids, cochlear implants, and bone-conduction hearing aids. Three surveys were used. Study Sample: Practicing audiologists, speech-language pathologists, and deaf educators providing services to children birth to six years of age who use hearing technology were recruited to participate. A total of 184 surveys were included in the analysis (96 hearing aid; 47 cochlear implant; 41 bone conduction hearing aid). Results: Practice gaps were identified, including infrequent use of parent questionnaires to explore how children are hearing at home and in other environments, lack of loaner equipment for some children when hearing devices were being repaired, and inconsistent monitoring of data logging to identify challenges with hearing aid use. Conclusions: Children who are DHH and their parents rely on professionals to provide evidence-based practices. This study revealed practice gaps related to monitoring audibility, suggesting opportunities for training to address provider confidence and consistent implementation of monitoring practices

Training the Next Generation of Practitioners In Early Intervention and Telepractice: Three University Models

The COVID-19 pandemic continues to shape the provision of family-centered early intervention services for children who are Deaf or Hard-of-Hearing and their families. In programs, schools, and centers, direct in-person contact with families have been significantly curtailed as a means to limit the exposure to and spead of the virus. Emergency remote learning has lead to an increase in telepractice, also referred to as teleintervention, as the designated model of service provision. Most early interventionists, speech-language pathologists, and teachers of the Deaf were not sufficiently trained to suddenly implement emergency remote teaching or telepractice services, but service providers had no option but to forge ahead, often with limited or no prior knowledge and experience with the provision of services using only telecommunications technology. Fortunately, however, some university training programs have integrated telepractice into their curricula and practica experiences for many years, and three of those programs are profiled here

Getting Started with Home Visits: Recommendations for Serving Families of Children who are Deaf or Hard of Hearing

The successful implementation of newborn hearing screening programs across the United States has facilitated timely diagnosis of hearing loss and referral to early intervention (EI) services for families of children who are deaf or hard of hearing (DHH), thus increasing the potential for improved language development outcomes. As new parents engage in EI services that involve professionals entering their home, the effectiveness of the early interventionists’ engagement, knowledge, coaching skills, and ability to provide emotional support can substantially influence families’ experiences. This article provides graduate students and new early interventionists an overview of key concepts related to home-based EI services, including (a) establishing the parent-professional partnership, (b) the parent coaching model, (c) auditory development priorities, and (d) goal-oriented services. Tables containing websites, assessments, and other materials and intervention resources are provided to support content depth and service delivery competence in each concept area. The final section outlines the flow of a typical home visit. An example of a completed Family Session Planning Guide and a hypothetical example of dialogue between the parents and the EI provider as they establish the child and family goals and identify strategies for meeting those goals. Also included is a Family Session Planning Guide template

Telepractice-Based Assessment of Children who are Deaf/Hard-of-Hearing: Focus on Family-Centered Practice

Ongoing assessment and progress monitoring is considered best practice to serve children who are Deaf/Hard-of-Hearing (DHH) yet logistics related to provider shortages, distances between families, and illness make regular assessment difficult if not impossible. In the last ten years, telepractice has become a more commonly used service delivery model for serving children who are DHH and their families, however, many providers lack the training needed to adequately assess this population (Behl & Kahn, 2015). With explicit planning of the assessments and tools needed on both sides of the camera, providers can create a shared framework to collect the information needed to create a family-centered, comprehensive assessment plan that empowers families to engage collaborative decision-making needed to optimize the outcomes of their child. This paper outlines a tutorial of provider considerations to incorporate family-centered practices as a central aspect of assessment via telepractice and provides an example of how assessments can be administered with the use of technology

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

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 DHH children 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 learning spoken language

Provider Perspectives in Serving Children Who Are Deaf or Hard of Hearing and Their Families using Tele-Intervention

Purpose: In the second of a two-part survey series, this cross-sectional survey study explored professionals’ perceptions of tele-intervention (TI) services for young children who are deaf or hard of hearing. Using Likert rating scales and open-ended questions, the survey queried professional’s confidence in providing TI services, including their views and recommendations. Data were collected March-May 2020, not realizing the survey release would coincide with the Covid-19 pandemic and the influx of unexpected virtual services. For this reason, data were stratified between those who had been providing TI services for more than versus less than three months. Responses for in-person providers were also evaluated for additional context. Methods: Responses from 123 participants who provided TI and 21 participants who provided in-person services (n=144) were analyzed using descriptive statistics. Cronbach’s alpha showed high internal consistency for all Likert scales; items of each subscale were sum-scored to examine relationships across queried areas of service delivery. Results: Provider perceptions of TI services were largely favorable. However, providers with more than three months’ experience were significantly more confident in coaching and supporting parents through TI, including more overall favorable views of a TI delivery than providers with less than three months of TI experience. There were no differences in provider confidence in coaching and supporting parents between providers with more than three months’ TI experience using TI delivery and in-person providers using in-person delivery. Conclusions: Experienced providers reported confidence in service delivery and positive views of the TI model. Programs seeking to implement virtual services should consider TI training, with a commitment to TI longevity to improve provider efficacy and confidence in TI services

Pediatric Amplification Management: Parent Experiences Monitoring Children’s Aided Hearing

Objective: Investigate parents’ experiences monitoring aided hearing for children who use hearing aids, bone conduction hearing aids, and cochlear implants. Design: A cross-sectional survey design, using three survey instruments, was used to collect parent data. Study Sample: A total of 178 parents of children birth to six years were included in the analysis (81 hearing aid; 61 cochlear implant; 36 bone conduction hearing aid). Results: Surveys explored hearing device use and monitoring. Variability was found for hearing aid use, and many parents reported being unaware if their child’s device has data logging capability. Parents varied widely in how often they check hearing device function, and approximately half did not have access to loaner hearing devices when repairs were required. Variance was observed in how often professionals explore how children are hearing at home through use of parent-report questionnaires, and related to audiology-specific services aimed at monitoring and maintaining audibility during routine appointments (e.g., checking program settings when new earmolds are received, frequency of earmold replacement, checking datalogging). Conclusion: This study revealed variability in hearing device use, and monitoring for audibility by professionals and parents. Implications from this study suggest parent-professional parternships would benefit from better understanding of barriers/facilitators for parent learning and implementation of key monitoring tasks

Parents’ Perspectives about Tele-Intervention Services for their Children who are Deaf or Hard of Hearing

Purpose: In the first of a two-part survey series, this cross-sectional survey study explored parent perceptions of tele-intervention (TI) services for their young children who are deaf or hard of hearing. Using Likert rating scales, the survey queried parent confidence in understanding their child’s language development, perceptions of the coaching and support they received, the parent-professional partnership, and overall views and recommendations. Data were collected March-May 2020, not realizing the survey release would coincide with the Covid-19 pandemic and the influx of unexpected virtual services. For this reason, data were stratified between those who had received TI services for more than versus less than three months. Responses for in-person services were also evaluated for additional context. Methods: Responses from 48 participants who received TI and 18 participants who received in-person services (n=66) were analyzed using descriptive statistics. Cronbach’s alpha showed high internal consistency for all Likert scales; items of each subscale were sum-scored to examine relationships across queried areas of service delivery. Results: Ninety-six percent of all respondents were highly or mostly satisfied with their TI services and 90% would definitely or probably recommend TI to other families. Overall positive findings were found across Likert scale queries, with no differences between parent perceptions of TI and in-person services, nor between TI for more than versus less than three months. However, findings also highlighted areas in which TI and in-person providers could improve intervention effectiveness, including coaching and supports to optimize parent confidence in understanding and facilitating their child’s language and communication goals. Conclusions: Parent perceptions of the TI delivery model were favorable. Implications and recommendations for both TI and in-person providers are discussed