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

Psychosocial experiences of parents of young children who use hearing devices: a scoping review

Objective: The purpose of this scoping review was to provide information about the research base related to psychosocial experiences of parents of young children who are deaf or hard of hearing (DHH) and use hearing devices. A scoping review identifies trends and gaps in available evidence and this information can be used to inform practice and identify areas in need of further research. Design: A scoping review was conducted in June 2020 to identify English-language peer-reviewed journal articles published through May 31, 2020. Study sample: Nine articles were found that investigated psychosocial factors of parents of children birth through five years who are DHH and use a hearing device. Results: Four psychosocial areas were explored in the identified studies: stress (n=5), self-efficacy (n = 2), depression (n = 1), and one explored both depression and psychological flexibility. None of the studies investigated an intervention to address parent psychosocial factors interfering with treatment adherence. Conclusions: There is a scarcity of research related to psychosocial barriers parents of young children who use hearing devices experience. Research is needed to identify effective interventions and to demonstrate the effect of addressing parent psychosocial barriers on spoken language outcomes for children. Providers have opportunities to use validated screening tools to assess for parent barriers and to individualize support for parents within the care plan for children identified with hearing loss

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

Intervention Research to Increase Pediatric Hearing Device Use: A Scoping Review

Purpose: This study is a scoping review examining interventions to increase hearing device use for children. Method: Online databases were used to identify peer-reviewed journal articles published prior to November 1, 2021, yielding 1,288 after duplications were removed. Four articles met the inclusion criteria after articles were screened by title name and abstract and subsequent full-text screening of six articles. A qualitative analysis was conducted to identify features of the intervention studies related to the participants, design, intervention, key findings, and limitations. Results: The included studies were published between 1982 and 2021, and in all four studies, the children used hearing aids. All four of the studies used a longitudinal design to address hearing aid use problems, with the timeframe ranging from approximately one month to six months and had variable success in increasing use time. None of the studies included a protocol, such as counseling skills, for addressing internal challenges that interfere with hearing aid use. Conclusions: Review of the limited research in this area found variable effectiveness for the interventions studied. There is an urgent need for research in this area to inform clinical practice and provide evidence-based interventions to address malleable factors that interfere with audibility for children who use hearing devices

Hispanic Parents’ Beliefs, Attitudes and Perceptions Toward Pediatric Hearing Loss: A Comprehensive Literature Review

Objective: The purpose of this review was two-fold: (a) to understand research findings about Hispanic parents’ beliefs, attitudes, and perceptions related to hearing loss after having children who are deaf or hard of hearing, and (b) to inform future research needs that could expand audiologists’ ability to provide patient-centered care with this population. Design: A comprehensive review of the literature was used to identify relevant articles for the review. Study Sample: Five research articles met the inclusion criteria. Results: Three primary themes emerged: (1) deafness causality, parents tended to describe the cause of the hearing loss in terms of religion and folk beliefs; (2) cultural attitudes, parents reported having paternalistic views related to the care of their child and experiencing community stigma, and (3) cultural values, parents described how personalism, familism, fatalism, and respect informed their perspectives. Conclusions: This comprehensive literature review found that limited research has been done to understand beliefs, attitudes, and perceptions of Hispanic parents toward pediatric hearing loss. Synthesis of five studies revealed important cultural factors for audiologists to consider in the provision of patient-centered care. Beliefs related to the cause of hearing loss, cultural values, and integration of children within the Hispanic community, may be critical elements for audiologists to address when promoting parental engagement

Factors Associated with the Psychosocial Wellbeing Among Parents of Children who are Deaf or Hard-of-hearing

Purpose: To identify factors associated with low psychosocial wellbeing among parents of children who are deaf or hard-of-hearing. Method: A cross sectional survey that included instruments to measure psychological distress, functional impairment, and psychological inflexibility. Two hundred and ninety-six parents completed the survey. Results: Analyses revealed that lower income, presence of additional disabilities, younger child age, and psychological inflexibility were factors associated with low parent psychosocial wellbeing. Conclusions: Parents of younger children who are deaf or hard-of-hearing with low income, have children with additional disabilities, and higher psychological inflexibility may experience lower psychosocial wellbeing. Clinicians serving families may need to provide additional and/or different support for parents in adapting to and managing their child’s hearing loss

eHealth Education and Support for Pediatric Hearing Aid Management: Parent Goals, Questions and Challenges

Purpose: To investigate parent goals, questions, and challenges that emerged during coaching phone calls in an eHealth program designed to provide education and support for hearing aid management. Methods: Coaching phone calls were audio-recorded, transcribed and qualitatively analyzed for emergent themes within the categories of goals, questions, and challenges. Results: Emergent themes revealed parent goals were focused on self-efficacy, routines, device care and child development. Emergent themes for questions revealed parents asked questions related to the device care, audiology appointments, confirmation of learning, and child development. For challenges emergent themes revealed parents’ own struggles (e.g., with emotions), issues related to working with their audiologist, child factors and anticipated challenges. Conclusion: The eHealth intervention allowed parents to raise questions and discuss their challenges in a supportive environment. Supportive accountability helped participants identify and address barriers to hearing aid management based on their priorities and current challenges. Providing supplemental learning support, in addition to routine audiology visits, can help parents develop more effective hearing aid management routines

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

A Systematic Review of the Effects of LENA-based Feedback on Parent-Child Language Interactions in Families with Young Children

Enhancing parent language interactions with children beginning in infancy is important because it results in better language abilities, social skills, and academic outcomes in children. A number of researchers have suggested that parent language interactions with children could be enhanced by giving parents feedback about their language interactions using the Language Environment Analysis (LENA) system. The LENA system records communication exchanges between a child and the adult caregiver and provides an automated analysis of adult word count, child vocalization count, and conversational turn count. We did a systematic review of the studies that investigated the use of LENA-based feedback to enhance parent language interactions with children. Although most previous studies have concluded that LENA-based feedback improves parental language interactions with children, methodological factors and confounding of treatment components in almost all of these studies make it impossible to know whether quantitative feedback from interactions recorded by the LENA system enhances parent language interactions with children. The designs and results of previous studies are discussed to suggest how future research can better address this important issue

Well-being of Parents of Children Who Are Deaf or Hard of Hearing

Purpose: The purpose of this study was to explore factors influencing the well-being of parents who have children who are deaf or hard of hearing (DHH) and to compare their experiences to non-clinical samples. Method: A cross-sectional online survey was used to collect data (N = 296). Results: Data analyses revealed the majority of parents of children who are DHH were functioning similarly to or better than the non-clinical samples in our comparison and within the non-clinical range for the included measures. No relationship was found between factors related to child age or timing of services (age at diagnosis, time between diagnosis and amplification fitting, age fit with hearing technology, child’s current age) and parent psychosocial functioning. Conclusions: While most parents are likely to be functioning well, knowing when a parent is experiencing challenges has important implications for clinical practice, including supporting parents in finding solutions when sub-optimal daily intervention practices are occurring. Audiologists can incorporate strategies to identify parents that may be experiencing challenges into their routine practice