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Kidd KM, Didden E, Harman H, Sequeira GM, Faeder M, Inwards-Breland DJ, Voss RV, Katz-Wise SL. Parents of Gender Diverse Youth: Support Sought, Received, and Still Needed. J Adolesc Health 2024; 74:1078-1087. [PMID: 37715763 PMCID: PMC10947309 DOI: 10.1016/j.jadohealth.2023.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 07/14/2023] [Accepted: 08/01/2023] [Indexed: 09/18/2023]
Abstract
PURPOSE Gender diverse youth (GDY) have improved mental health when affirmed by parents, but little is known about the support parents of GDY seek, receive, and still need. This qualitative study explored experiences of parents of GDY to better understand their support needs. METHODS Parents of GDY submitted videos and were interviewed about their journey supporting their GDY. Data collection continued until thematic saturation was reached. Audio recordings from videos and interviews were transcribed and analyzed via an inductive thematic analysis using the rigorous and accelerated data reduction technique. RESULTS In total, 25 parents of GDY (mean age 15 years, range 6-21 years) from 12 states provided video recordings and interviews; 36% were People of Color and 28% were fathers. We identified four themes and 12 subthemes. Theme 1: support through education included acknowledging ignorance about gender diversity and remedying ignorance. Theme 2: engaging community noted that support was multilayered and based around the family unit and pre-existing community. Theme 3: expanding community included acknowledgement that seeking new community was important for many to reduce feelings of isolation. It also highlighted that "safe spaces" for parents of GDY were not always safe for those of other marginalized groups, particularly People of Color. Theme 4: support in healthcare spaces centered experiences navigating medical and mental healthcare for GDY and feeling supported and unsupported in those spaces. DISCUSSION Parents identified numerous ways they sought, received, and needed support to understand and affirm their GDY. These findings will aid development of targeted support interventions for parents of GDY. Further research is needed to evaluate the impact of these interventions on GDY health.
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Affiliation(s)
- Kacie M Kidd
- Department of Pediatrics, Division of Adolescent Medicine, West Virginia University School of Medicine, WVU Medicine Children's Hospital, Morgantown, West Virginia.
| | - El Didden
- West Virginia University School of Medicine, WVU Medicine Children's Hospital, Morgantown, West Virginia
| | - Hayley Harman
- West Virginia University School of Medicine, WVU Medicine Children's Hospital, Morgantown, West Virginia
| | - Gina M Sequeira
- Department of Pediatrics, Division of Adolescent Medicine, University of Washington School of Medicine, Seattle Children's Hospital, Seattle, Washington
| | - Morgan Faeder
- Department of Psychiatry, University of Pittsburgh School of Medicine, UPMC Western Psychiatric Hospital, Pittsburgh, Pennsylvania
| | | | - Raina V Voss
- Department of Pediatrics, Divison of Adolescent and Young Adult Medicine, Northwestern University Feinburg School of Medicine, Lurie Children's Hospital, Chicago, Illinois
| | - Sabra L Katz-Wise
- Harvard TH Chan School of Public Health, Boston Children's Hospital, Boston, Massachusetts
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Yoshinaga-Itano C, Carr G, Davis A, Ching TYC, Chung K, Clark J, Harkus S, Kuan ML, Garg S, Balen SA, O'Leary S. Coalition for Global Hearing Health Hearing Care Pathways Working Group: Guidelines for Clinical Guidance for Readiness and Development of Evidence-Based Early Hearing Detection and Intervention Programs. Ear Hear 2024:00003446-990000000-00281. [PMID: 38783422 DOI: 10.1097/aud.0000000000001501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
Editor's Note: The following article discusses the timely topic Clinical Guidance in the areas of Evidence-Based Early Hearing Detection and Intervention Programs. This article aims to discuss areas of services needed, guidance to countries/organizations attempting to initiate early hearing detection and intervention systems. Expert consensus and systematic/scoping reviews were combined to produce recommendations for evidence-based clinical practice. In Ear and Hearing, our long-term goal for the Point of View article is to stimulate the field's interest in and to enhance the appreciation of the author's area of expertise. Hearing is an important sense for children to develop cognitive, speech, language, and psychosocial skills. The goal of universal newborn hearing screening is to enable the detection of hearing loss in infants so that timely health and educational/therapeutic intervention can be provided as early as possible to improve outcomes. While many countries have implemented universal newborn hearing screening programs, many others are yet to start. As hearing screening is only the first step to identify children with hearing loss, many follow-up services are needed to help them thrive. However, not all of these services are universally available, even in high-income countries. The purposes of this article are (1) to discuss the areas of services needed in an integrated care system to support children with hearing loss and their families; (2) to provide guidance to countries/organizations attempting to initiate early hearing detection and intervention systems with the goal of meeting measurable benchmarks to assure quality; and (3) to help established programs expand and improve their services to support children with hearing loss to develop their full potential. Multiple databases were interrogated including PubMed, Medline (OVIDSP), Cochrane library, Google Scholar, Web of Science and One Search, ERIC, PsychInfo. Expert consensus and systematic/scoping reviews were combined to produce recommendations for evidence-based clinical practice. Eight essential areas were identified to be central to the integrated care: (1) hearing screening, (2) audiologic diagnosis and management, (3) amplification, (4) medical evaluation and management, (5) early intervention services, (6) family-to-family support, (7) D/deaf/hard of hearing leadership, and (8) data management. Checklists are provided to support the assessment of a country/organization's readiness and development in each area as well as to suggest alternative strategies for situations with limited resources. A three-tiered system (i.e., Basic, Intermediate, and Advanced) is proposed to help countries/organizations at all resource levels assess their readiness to provide the needed services and to improve their integrated care system. Future directions and policy implications are also discussed.
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Affiliation(s)
- Christine Yoshinaga-Itano
- University of Colorado, Boulder, Colorado, USA
- University of Witwatersrand, Johannesburg, South Africa
| | - Gwen Carr
- UCL Ear Institute London, London, United Kingdom
| | - Adrian Davis
- UCL Ear Institute London, London, United Kingdom
- London School of Economics, London, United Kingdom
- Imperial College London, London, United Kingdom
- Anglia Ruskin University, Cambridge, United Kingdom
| | - Teresa Y C Ching
- Macquarie University, Sydney, New South Wales, Australia
- NextSense Institute, Sydney, New South Wales, Australia
- University of Queensland, Brisbane, Queensland, Australia
| | - King Chung
- MGH Institute of Health Professions, Department of Communication Sciences and Disorders, Charlestown, Massachusetts, United States
| | | | | | - Meei-Ling Kuan
- National Women's League Hearing Health Foundation, Taipei, Taiwan
| | | | - Sheila Andreoli Balen
- Speech, Language and Hearing Department, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
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Postma A, Ketelaar M, van Nispen Tot Sevenaer J, Downs Z, van Rappard D, Jongmans M, Zinkstok J. Exploring individual parent-to-parent support interventions for parents caring for children with brain-based developmental disabilities: A scoping review. Child Care Health Dev 2024; 50:e13255. [PMID: 38587275 DOI: 10.1111/cch.13255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 02/21/2024] [Accepted: 03/08/2024] [Indexed: 04/09/2024]
Abstract
BACKGROUND Brain-based developmental disabilities (BBDDs) comprise a large and heterogeneous group of disorders including autism, intellectual disability, cerebral palsy or genetic and neurodevelopmental disorders. Parents caring for a child with BBDD face multiple challenges that cause increased stress and high risk of mental health problems. Peer-based support by fellow parents for a various range of patient groups has shown potential to provide emotional, psychological and practical support. Here, we aim to explore existing literature on individual peer-to-peer support (iP2PS) interventions for parents caring for children with BBDD with a view to (1) explore the impact of iP2PS interventions on parents and (2) identify challenges and facilitators of iP2PS. METHOD An extensive literature search (January 2023) was performed, and a thematic analysis was conducted to synthesize findings. RESULTS Fourteen relevant articles revealed three major themes regarding the impact of iP2PS on parents: (1) emotional and psychological well-being, (2) quality of life and (3) practical issues. Four themes were identified describing challenges and facilitators of iP2PS: (1) benefits and burden of giving support, (2) matching parent-pairs, (3) logistic challenges and solutions and (4) training and supervision of parents providing peer support. CONCLUSIONS This review revealed that iP2PS has a positive impact on the emotional and psychological well-being of parents, as well as the overall quality of life for families caring for a child with a BBDD. Individual P2PS offers peer-parents an opportunity to support others who are facing challenges similar to those they have experienced themselves. However, many questions still need to be addressed regarding benefits of different iP2PS styles, methods of tailoring support to individual needs and necessity of training and supervision for peer support providers. Future research should focus on defining these components and evaluating benefits to establish effective iP2PS that can be provided as standard care practice for parents.
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Affiliation(s)
- Amber Postma
- Department of Psychiatry and Brain Centre, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Marjolijn Ketelaar
- Department of Rehabilitation, Physical Therapy and Sports; Brain Centre, University Medical Centre Utrecht, Utrecht, The Netherlands
- De Hoogstraat, Rehabilitation, Utrecht, The Netherlands
| | | | - Zahra Downs
- Department of Psychiatry and Brain Centre, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Diane van Rappard
- Department of Psychiatry and Brain Centre, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Marian Jongmans
- Department of Pedagogical and Educational Sciences, Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht, The Netherlands
- Department of Neonatology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Janneke Zinkstok
- Department of Psychiatry and Brain Centre, University Medical Centre Utrecht, Utrecht, The Netherlands
- Department of Psychiatry, Radboud University Medical Centre, Nijmegen, The Netherlands
- Karakter Child and Adolescent Psychiatry Nijmegen, Nijmegen, The Netherlands
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Szarkowski A, Gale E, Moeller MP, Smith T, Birdsey BC, Moodie STF, Carr G, Stredler-Brown A, Yoshinaga-Itano C, Holzinger D. Family-Centered Early Intervention Deaf/Hard of Hearing (FCEI-DHH): Structure Principles. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2024; 29:SI86-SI104. [PMID: 38422449 DOI: 10.1093/deafed/enad040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 08/10/2023] [Accepted: 08/11/2023] [Indexed: 03/02/2024]
Abstract
This article is the seventh in a series of eight articles that comprise a special issue on family-centered early intervention for children who are deaf or hard of hearing and their families, or FCEI-DHH. This article, Structure Principles, is the third of three articles (preceded by Foundation Principles and Support Principles) that describe the 10 FCEI-DHH Principles. The Structure Principles include 4 Principles (Principle 7, Principle 8, Principle 9, and Principle 10) that highlight (a) the importance of trained and effective Early Intervention (EI) Providers, (b) the need for FCEI-DHH teams to work collaboratively to support families, (c) the considerations for tracking children's progress through developmental assessment, and (d) the essential role of progress monitoring to continuously improve systems.
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Affiliation(s)
- Amy Szarkowski
- The Institute, Children's Center for Communication/Beverly School for the Deaf, Beverly, MA, United States
- Institute for Community Inclusion, University of Massachusetts Boston, Boston, MA, United States
| | - Elaine Gale
- School of Education, Deaf and Hard-of-Hearing Program, Hunter College, City University of New York, New York, NY, United States
| | - Mary Pat Moeller
- Center for Childhood Deafness, Language & Learning, Boys Town National Research Hospital, Omaha, NE, United States
| | | | - Bianca C Birdsey
- Global Coalition of Parents of Children Who Are Deaf or Hard of Hearing (GPODHH), Durban, South Africa
| | - Sheila T F Moodie
- Health Sciences, School of Communication Sciences & Disorders, Western University, London, ON, Canada
| | - Gwen Carr
- Early Hearing Detection and Intervention and Family Centered Practice, London, United Kingdom
| | - Arlene Stredler-Brown
- Colorado Early Hearing Detection and Intervention Program, Colorado Department of Human Services, Denver, CO, United States
| | | | - Daniel Holzinger
- Institute of Neurology of Senses and Language, Hospital of St. John of God, Linz, Austria
- Research Institute for Developmental Medicine, Johannes Kepler University, Linz, Austria
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5
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Moeller MP, Gale E, Szarkowski A, Smith T, Birdsey BC, Moodie STF, Carr G, Stredler-Brown A, Yoshinaga-Itano C, Holzinger D. Family-Centered Early Intervention Deaf/Hard of Hearing (FCEI-DHH): Foundation Principles. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2024; 29:SI53-SI63. [PMID: 38422441 DOI: 10.1093/deafed/enad037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 06/26/2023] [Accepted: 06/28/2023] [Indexed: 03/02/2024]
Abstract
This article is the fifth in a series of eight articles that comprise a special issue on Family-Centered Early Intervention (FCEI) for children who are deaf or hard of hearing (DHH) and their families, or FCEI-DHH. The 10 FCEI-DHH Principles are organized conceptually into three sections (a) Foundation Principles, (b) Support Principles, and (c) Structure Principles. Collectively, they describe the essential Principles that guide FCEI for children who are DHH and their families. This article describes the Foundation Principles (Principles 1 and Principle 2). The Foundation Principles emphasize the essential elements of ensuring that families with children who are DHH can access early intervention (EI) and other appropriate supports, as well as highlight the need for provision of EI that is family-centered. Implementation of these FCEI-DHH Principles is intended to improve the lives and the outcomes of children who are DHH and their families around the globe.
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Affiliation(s)
- Mary Pat Moeller
- Center for Childhood Deafness, Language & Learning, Boys Town National Research Hospital, Omaha, NE, United States
| | - Elaine Gale
- School of Education, Deaf and Hard-of-Hearing Program, Hunter College, City University of New York, New York, NY, United States
| | - Amy Szarkowski
- The Institute, Children's Center for Communication/Beverly School for the Deaf, Beverly, MA, United States
- Institute for Community Inclusion, University of Massachusetts Boston, Boston, MA, United States
| | | | - Bianca C Birdsey
- Global Coalition of Parents of Children who are Deaf or Hard of Hearing (GPODHH), Durban, South Africa
| | - Sheila T F Moodie
- Health Sciences, School of Communication Sciences & Disorders, Western University, London, ON, Canada
| | - Gwen Carr
- Early Hearing Detection and Intervention and Family Centered Practice, London, United Kingdom
| | - Arlene Stredler-Brown
- Colorado Early Hearing Detection and Intervention Program, Colorado Department of Human Services, Denver, CO, United States
| | | | - Daniel Holzinger
- Institute of Neurology of Senses and Language, Hospital of St. John of God, Linz, Austria
- Research Institute for Developmental Medicine, Johannes Kepler University, Linz, Austria
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6
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Szarkowski A, Moeller MP, Gale E, Smith T, Birdsey BC, Moodie STF, Carr G, Stredler-Brown A, Yoshinaga-Itano C, Holzinger D. Family-Centered Early Intervention Deaf/Hard of Hearing (FCEI-DHH): Support Principles. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2024; 29:SI64-SI85. [PMID: 38422442 DOI: 10.1093/deafed/enad039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 07/07/2023] [Accepted: 08/31/2023] [Indexed: 03/02/2024]
Abstract
This article is the sixth in a series of eight articles that comprise a special issue on Family-Centered Early Intervention (FCEI) for children who are deaf or hard of hearing (DHH) and their families, or FCEI-DHH. The Support Principles article is the second of three articles that describe the 10 Principles of FCEI-DHH, preceded by the Foundation Principles, and followed by the Structure Principles, all in this special issue. The Support Principles are composed of four Principles (Principles 3, 4, 5, and 6) that highlight (a) the importance of a variety of supports for families raising children who are DHH; (b) the need to attend to and ensure the well-being of all children who are DHH; (c) the necessity of building the language and communication abilities of children who are DHH and their family members; and (d) the importance of considering the family's strengths, needs, and values in decision-making.
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Affiliation(s)
- Amy Szarkowski
- The Institute, Children's Children's Center for Communication/Beverly School for the Deaf, Beverly, MA, United States
- Institute for Community Inclusion, University of Massachusetts Boston, Boston, MA, United States
| | - Mary Pat Moeller
- Center for Childhood Deafness, Language & Learning, Boys Town National Research Hospital, Omaha, NE, United States
| | - Elaine Gale
- School of Education, Deaf and Hard-of-Hearing Program, Hunter College, City University of New York, New York, NY, United States
| | | | - Bianca C Birdsey
- Global Coalition of Parents of Children who are Deaf or Hard of Hearing (GPODHH), Durban, South Africa
| | - Sheila T F Moodie
- Health Sciences, School of Communication Sciences & Disorders, Western University, London, ON, Canada
| | - Gwen Carr
- Early Hearing Detection and Intervention and Family Centered Practice, London, United Kingdom
| | - Arlene Stredler-Brown
- Colorado Early Hearing Detection and Intervention Program, Colorado Department of Human Services, Denver, CO, United States
| | | | - Daniel Holzinger
- Institute of Neurology of Senses and Language, Hospital of St. John of God, Linz, Austria
- Research Institute for Developmental Medicine, Johannes Kepler University, Linz, Austria
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Alkhamra R, Al-Omari HM, Hani HAB. Reliability and validity assessment of a survey: Measuring satisfaction with cochlear implant rehabilitation services for children in Jordan. PLoS One 2023; 18:e0295939. [PMID: 38109288 PMCID: PMC10727441 DOI: 10.1371/journal.pone.0295939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 11/28/2023] [Indexed: 12/20/2023] Open
Abstract
BACKGROUND Assessing parental satisfaction with healthcare services is crucial, particularly for parents and their children, who are the primary recipients of these services. In the context of Arabic-speaking parents, there is a notable absence of survey instruments tailored to measure their satisfaction. This study seeks to address this gap by validating a survey designed to evaluate parental satisfaction with rehabilitation services (RSs) provided to Jordanian children who have received cochlear implants (CIs). METHODS The study included 92 participants and followed a four-step methodology: 1) a literature review and expert input; 2) cognitive interviews, pilot testing, and test-retest reliability testing; 3) data collection; 4) validity and reliability assessments. RESULTS The survey's validity was confirmed. Expert input and cognitive interviews improved content validity, and factor analysis established construct validity by revealing six factors explaining 82.33% of the variance in the survey scale. Convergent and discriminant validity were confirmed (composite reliability >0.7 and average variance extracted value >0.5). Cronbach's α exceeded 0.8 for each factor and reached 0.855 for the total scale. Survey results showed reliance on speech therapy and audiology, varied rehabilitation durations, and progress. Parents expressed overall satisfaction, particularly influenced by technical quality and efficacy/outcome dimensions. Parents' recommendations to enhance satisfaction with RSs included financial support, improved service accessibility, enhanced service delivery, specialized education, and increased public awareness. CONCLUSION This study validates an Arabic satisfaction survey, emphasizing the significance of multidisciplinary, extended rehabilitation programs, skilled professionals, and positive outcomes. It emphasizes the necessity for improved access to specialized care and collaboration among healthcare, government, and media to shape parental perceptions of RSs. While the findings indicate overall satisfaction, they also reveal challenges faced by parents, highlighting the need for comprehensive support systems. These insights assist healthcare providers and policymakers in enhancing care quality and meeting the needs of CI children's families, thereby improving the RSs experience in Jordan.
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Affiliation(s)
- Rana Alkhamra
- Department of Hearing and Speech Sciences, Faculty of Rehabilitation Sciences, The University of Jordan, Amman, Jordan
| | - Hala M. Al-Omari
- Department of Hearing and Speech Sciences, School of Rehabilitation Sciences, The University of Jordan, Amman, Jordan
| | - Hanady A. Bani Hani
- Department of Hearing and Speech Sciences, School of Rehabilitation Sciences, The University of Jordan, Amman, Jordan
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Poole LB, Carlson JS, Batsche-McKenzie K, Tate J, Shank J. Examining the Effect of a Parent-to-Parent Intervention for Low-Income Youth with Serious Emotional and Behavioral Challenges. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6435. [PMID: 37510667 PMCID: PMC10379319 DOI: 10.3390/ijerph20146435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 06/13/2023] [Accepted: 07/14/2023] [Indexed: 07/30/2023]
Abstract
BACKGROUND Numerous barriers to mental health utilization exist for families of children who present with serious emotional and behavioral challenges. Evidence-based practices that facilitate equitable outcomes across diverse populations are essential to identify. This study examined possible differential service outcomes in a Medicaid-funded, parent-to-parent intervention called Parent Support Partner (PSP). METHOD Data from four hundred and sixty-four parents who received PSP services were evaluated for possible demographic differences in service completion. Within-group analyses were utilized for an analysis of outcomes (parent change, child functioning; treatment acceptability) within a subset (N = 153) of those who completed services. RESULTS No racial disparities were found in those who completed PSP (43%) when compared to those who did not (57%). Regression analyses uncovered significant improvements in parent competence and confidence, as well as overall child functioning (global functioning across domains such as school, home, behaviors). Consistent with identifying evidence-based practices, findings were seen consistently across the diverse sample of those who completed PSP services. Improvements in parents' sense of competence and confidence were correlated with perceptions of treatment acceptability. DISCUSSION PSP is an innovative and promising intervention with demonstrated high levels of acceptability found to increase parent confidence and self-competence to advocate for treatments that can improve the mental health functioning of their child. Future investigations of factors associated with increasing PSP service completion and outcomes in larger and more diverse populations are necessary. Implications for considering and possibly adopting this evidence-informed practice within the nursing profession are provided.
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Affiliation(s)
- Lindsay B Poole
- Department of Counseling, Educational Psychology and Special Education, Michigan State University, East Lansing, MI 48823, USA
| | - John S Carlson
- Department of Counseling, Educational Psychology and Special Education, Michigan State University, East Lansing, MI 48823, USA
| | - Kim Batsche-McKenzie
- Bureau of Children's Coordinated Health Policy and Support, Michigan Department of Health and Human Services, Lansing, MI 48933, USA
| | - Justin Tate
- Bureau of Children's Coordinated Health Policy and Support, Michigan Department of Health and Human Services, Lansing, MI 48933, USA
| | - Jane Shank
- Association for Children's Mental Health, Lansing, MI 48917, USA
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Curtin M, Morgan G, Cruice M, Herman R. Assessing parent interaction with deaf infants: A quantitative survey of UK professional practice. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2023. [PMID: 36708287 DOI: 10.1111/1460-6984.12849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 12/19/2022] [Indexed: 06/18/2023]
Abstract
BACKGROUND Between 90% and 95% of deaf children are born to hearing parents who often need support with how to adapt their communication. Parent-child interaction (PCI) is an important predictor of deaf children's future language development. It is therefore necessary for professionals to assess parents' strengths and needs to identify areas for intervention. Qualified teachers of the deaf (QToDs), speech and language therapists (SLTs), psychologists, and national deaf child and adolescent mental health (NDCAMHS) professionals regularly support families with deaf children. With no current evidence-based tool available to assist with the assessment of PCI in deafness, it is important to gather information on current professional practice as this may differ from known practices within research. AIMS To survey the practices of UK-based professionals in the assessment of PCI where the deaf infant is aged 0-3 years. Professionals were QToDs, SLTs, psychologists or psychiatrists and professionals working at NDCAMHS services. METHODS & PROCEDURES After a pilot phase, an 85-item survey was distributed electronically through a range of professional and social media networks. Survey items were based on a systematic review of PCI with deaf infants. Survey questions were focused on parent behaviours that were assessed, methods of assessment, goal planning and service provision. Analysis was conducted using descriptive and inferential statistics. OUTCOMES & RESULTS A total of 190 professionals from across the UK completed part 1 of the survey; this decreased to 148 in part 4. Respondents were primarily female, hearing, used spoken English and had 16 years or more experience. Results indicate that PCI is routinely assessed by a large proportion of professionals and there is a substantial overlap in which parent behaviours are assessed. Some parent behaviours are assessed that do not feature in the research. Methods of assessment are informal and predominantly consist of observation and note making, with professionals using their own skills and experience to analyse interaction. Goal setting practices were largely similar between professionals, with many jointly deciding goals with parents. CONCLUSIONS & IMPLICATIONS This survey highlights the range of parent behaviours assessed by UK professionals in PCI with deaf children aged 0-3. This survey provides valuable information about and for professionals who assess PCI and set intervention goals with parents. Information from research and professional practice is important to consider in the design of a future PCI assessment. Implications are included for future research in this area. WHAT THIS PAPER ADDS What is already known on this subject Parental involvement is one of the greatest predictors of deaf children's language outcomes. With many deaf children born to hearing parents, parents often need guidance with how to facilitate effective communication. A recent systematic review identified the range of parent behaviours and methods used to analyse PCI in international research studies, but little evidence or guidance exists on how professionals assess this phenomenon in practice. What this study adds This is the first survey to generate large, valuable practice-based evidence for the assessment of parents' communication behaviours as they interact with their deaf infants aged 0-3. The survey recruited a range of multidisciplinary professionals working on interaction within this field: SLTs, qualified teachers of the deaf, psychologists or psychiatrists, and professionals working within deaf child and adolescent mental health services. The study reports on which behaviours these professionals assess and how, and includes information on the goal setting behaviours of practitioners. Most respondents were highly experienced; the survey, therefore, reveals expert practice within the field. What are the potential or actual clinical implications of this work? We recommend the following practice: (1) incorporate a range of parent-based behaviours in PCI assessments, including establishing joint engagement and parental sensitivity, as well as communication-focused behaviours; (2) video record PCI assessments where possible to enable professionals and parents to watch and reflect together; (3) following assessment, set parent-focused goals in collaboration with families, ensuring parents' skills, particularly their strengths, are considered. All primary caregivers should be included in the process where possible; and (4) reassess PCI regularly (at least termly) to monitor and encourage families' progress. The timing of reviews should be discussed between parent and professional.
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Affiliation(s)
- Martina Curtin
- Speech and Language Therapy (Paediatrics, Community), Homerton University Hospital NHS Foundation Trust, London, UK
- Language and Communication Science, City, University of London, London, UK
| | - Gary Morgan
- Language and Communication Science, City, University of London, London, UK
| | - Madeline Cruice
- Language and Communication Science, City, University of London, London, UK
| | - Rosalind Herman
- Language and Communication Science, City, University of London, London, UK
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10
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What Are Parents' Experiences With Their Child's Hearing Aid Use in the First 5 Years? Ear Hear 2023:00003446-990000000-00108. [PMID: 36706068 DOI: 10.1097/aud.0000000000001332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVES Parents are required to make informed choices for their children regarding the use of hearing amplification after hearing loss has been diagnosed. If parents choose a listening and spoken language approach for their child where the development of age appropriate spoken language is the parents' goal, then the early fitting and frequent use of hearing aids is crucial. Within the framework of family centered care, parents have the ultimate responsibility for supporting their child's hearing aid use. However, few studies have focused on parents' insights regarding the aspects that shape hearing aid use in the early years. Thus the aim of this study was to explore parents' firsthand experiences with their child's hearing aid use in the first 5 years. Understanding parents' insights will help improve service provision to optimize outcomes for children with hearing loss. DESIGN The study utilized a prospective qualitative design to explore parents' firsthand experiences with their child's hearing aid use. Purposive sampling was used to recruit 12 parents who participated in semi-structured interviews. Parents' responses were analyzed using thematic analysis. RESULTS Three overarching themes were conceptualized, namely: (a) towards hearing aids - journey into the wilderness; (b) adjusting to hearing aids - it's the journey, not the destination; and (c) support for my child's hearing aid use - it's not where you are going, it's who you have beside you. Each theme was further divided into categories and subcategories. CONCLUSIONS This study identified that parents have much to contribute to service providers' understanding regarding the aspects that shape consistent hearing aid use in young children. Parents shared many insights such as the emotionally daunting nature of the first few months post hearing loss confirmation, the influence of family support, and the importance of building connections and understanding about hearing loss and hearing aid use within their social networks. Based on these insights, the authors provide recommendations for clinical best practice that draw upon key principles of family centered care. They consist of practical suggestions including strategic support to overcome less optimal hearing aid use and ways to facilitate parent support within their familial and communal networks.
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Barriers to and Facilitators of Early Hearing Detection and Intervention in the United States: A Systematic Review. Ear Hear 2023; 44:448-459. [PMID: 36579673 DOI: 10.1097/aud.0000000000001312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVES Early hearing detection and intervention (EHDI) is guided by the 1-3-6 approach: screening by one month, diagnosis by 3 mo, and early intervention (EI) enrollment by 6 mo. Although screening rates remain high, successful diagnosis and EI-enrollment lag in comparison. The aim of this systematic review is to critically examine and synthesize the barriers to and facilitators of EHDI that exist for families, as they navigate the journey of congenital hearing loss diagnosis and management in the United States. Understanding barriers across each and all stages is necessary for EHDI stakeholders to develop and test novel approaches which will effectively reduce barriers to early hearing healthcare. DESIGN A systematic literature search was completed in May and August 2021 for empirical articles focusing on screening, diagnosis, and EI of children with hearing loss. Two independent reviewers completed title and abstract screening, full-text review, data extraction, and quality assessments with a third independent reviewer establishing consensus at each stage. Data synthesis was completed using the Framework Analysis approach to categorize articles into EHDI journey timepoints and individual/family-level factors versus system-level factors. RESULTS Sixty-two studies were included in the narrative synthesis. Results revealed that both individual/family-level (e.g., economic stability, medical status of the infant including middle ear involvement) and system-level barriers (e.g., system-service capacity, provider knowledge, and program quality) hinder timely diagnosis and EI for congenital hearing loss. Specific social determinants of health were noted as barriers to effective EHDI; however, system-level facilitators such as care coordination, colocation of services, and family support programs have been shown to mitigate the negative impact of those sociodemographic factors. CONCLUSIONS Many barriers exist for families to obtain appropriate and timely EHDI for their children, but system-level changes could facilitate the process and contribute to long-term outcomes improvement. Limitations of this study include limited generalizability due to the heterogeneity of EHDI programs and an inability to ascertain factor interactions.
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Exploring the Stories of Parents' Experiences With Infant Hearing-Loss Screening and Diagnosis in the United States. Ear Hear 2022; 44:518-529. [PMID: 36534640 DOI: 10.1097/aud.0000000000001294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVES For the past 20 years, birthing hospitals in the United States have required newborns to undergo a hearing-loss screening before leaving the hospital. Since the initial newborn hearing screening mandates, there has been much outcome research documenting the successes and barriers of the programs. However, we know little about the experiences of their parents during the time between screening and diagnosis. We propose that elucidating the parents' experiences with newborn hearing-loss screening and diagnosis-via their own stories-is a first step toward understanding their varied experiences and has the potential to ultimately improve hearing healthcare for both children and their families. Thus, to better understand the early hearing screening and detection experience from hearing parents' perspectives, we asked the following research question: what are parents' experiences with their newborns' hearing-loss screening and diagnosis in the United States? DESIGN The present study employed a prospective, cross-sectional qualitative design. Specifically, we gathered stories from 13 hearing parents who each have a child born in the United States and diagnosed with hearing loss no later than 14 mo of age between the years of 2016 and 2020. We used thematic analysis to uncover common themes across parent narratives. Saturation was reached at interview no. 4; thus no further sampling was needed. FINDINGS Two major themes emerged from the data: (1) hearing healthcare experiences and (2) parents' early experiences during the period between their child's newborn hearing-loss screening and diagnosis. Subthemes were also uncovered. Three emergent subthemes related to health-care experiences included: (1) downplayed newborn hearing screening referrals, (2) clinician-centered care, and (3) medical expenses and health coverage. The three subthemes of the second theme were as follows: (1) parent-to-parent support, (2) "mom guilt," and (3) a new reality. CONCLUSION The present study's narrative accounts from parents about their infants' early hearing detection experiences revealed several, different subthemes that emerged from the same, mandated newborn experience in US families. These findings highlight important moments throughout the hearing-loss screening and detection process, which could benefit from more effective, family-centered hearing healthcare. This knowledge also facilitates the field's move toward improved education of future and current providers and regarding family-centered approach, which could address concerns and expectations of new parents at the very start of their newborns' hearing-loss journeys.
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Holzinger D, Hofer J, Dall M, Fellinger J. Multidimensional Family-Centred Early Intervention in Children with Hearing Loss: A Conceptual Model. J Clin Med 2022; 11:jcm11061548. [PMID: 35329873 PMCID: PMC8949393 DOI: 10.3390/jcm11061548] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 03/07/2022] [Accepted: 03/09/2022] [Indexed: 02/04/2023] Open
Abstract
At least two per thousand newborns are affected by hearing loss, with up to 40% with an additional disability. Early identification by universal newborn hearing screening and early intervention services are available in many countries around the world, with limited data on their effectiveness and a lack of knowledge about specific intervention-related determinants of child and family outcomes. This concept paper aimed to better understand the mechanisms by which multi-dimensional family-centred early intervention influences child outcomes, through parent behaviour, targeted by intervention by a review of the literature, primarily in the field of childhood hearing loss, supplemented by research findings on physiological and atypical child development. We present a conceptual model of influences of multi-disciplinary family-centred early intervention on family coping/functioning and parent–child interaction, with effects on child psycho-social and cognitive outcomes. Social communication and language skills are postulated as mediators between parent–child interaction and non-verbal child outcomes. Multi-disciplinary networks of professionals trained in family-centred practice and the evaluation of existing services, with respect to best practice guidelines for family-centred early intervention, are recommended. There is a need for longitudinal epidemiological studies, including specific intervention measures, family behaviours and multidimensional child outcomes.
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Affiliation(s)
- Daniel Holzinger
- Research Institute for Developmental Medicine, Johannes Kepler University Linz, 4020 Linz, Austria; (J.H.); (M.D.); (J.F.)
- Institute of Neurology of Senses and Language, Hospital of St. John of God, 4020 Linz, Austria
- Institute of Linguistics, University of Graz, 8010 Graz, Austria
- Correspondence: or
| | - Johannes Hofer
- Research Institute for Developmental Medicine, Johannes Kepler University Linz, 4020 Linz, Austria; (J.H.); (M.D.); (J.F.)
- Institute of Neurology of Senses and Language, Hospital of St. John of God, 4020 Linz, Austria
- Department of Paediatrics I, Innsbruck Medical University, 6020 Innsbruck, Austria
| | - Magdalena Dall
- Research Institute for Developmental Medicine, Johannes Kepler University Linz, 4020 Linz, Austria; (J.H.); (M.D.); (J.F.)
| | - Johannes Fellinger
- Research Institute for Developmental Medicine, Johannes Kepler University Linz, 4020 Linz, Austria; (J.H.); (M.D.); (J.F.)
- Institute of Neurology of Senses and Language, Hospital of St. John of God, 4020 Linz, Austria
- Division of Social Psychiatry, University Clinic for Psychiatry and Psychotherapy, Medical University of Vienna, 1090 Vienna, Austria
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Maluleke NP, Khoza-Shangase K, Kanji A. An Integrative Review of Current Practice Models and/or Process of Family-Centered Early Intervention for Children Who Are Deaf or Hard of Hearing. FAMILY & COMMUNITY HEALTH 2021; 44:59-71. [PMID: 32842004 DOI: 10.1097/fch.0000000000000276] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Over the past few decades, there has been an increasing shift toward emphasizing the importance of the child's family taking an active role in the habilitation process through family-centered early intervention (FCEI) programs. Accordingly, the Health Professions Council of South Africa recommends that early intervention services following confirmation of hearing loss must be family-centered within a community-based model of service delivery that is culturally congruent. The aim of this study was to explore and document current evidence reflecting trends in FCEI for children who are deaf or hard of hearing (DHH) by identifying and describing current practice models and/or processes of FCEI for these children. This study describes our first steps in formulating a framework for FCEI for children who are DHH in South Africa. An integrative literature review was conducted. Sage, Science Direct, PubMed, and Google Scholar databases were searched for studies published in English between January 2009 and January 2019 reporting on FCEI programs for children who are DHH. Studies that focused on the following were excluded from the study: speech and language outcomes of children, youth, and adults who are DHH; education for children who are DHH; universal newborn hearing screening; professionals' roles in early hearing detection and intervention; diagnosis of hearing loss; and sign language. Kappa statistics were performed to determine agreement between reviewers. Twenty-two studies were included in the review. Cohen's kappa revealed a substantial agreement (κ = 0.8) between reviewers for data extraction and synthesis in terms of the articles that met the criteria for inclusion in the review. Findings were discussed under 5 themes: caregiver involvement; caregiver coaching/information sharing; caregiver satisfaction; challenges with FCEI; and telehealth. Generally, there is sufficient evidence for FCEI, with caregivers indicating the need for full involvement in their children's care. Methods of caregiver involvement involving caregiver coaching/information sharing need to be culturally and linguistically appropriate, with sensitivities around time and manner. This increases caregiver satisfaction with intervention programs and improves outcomes for children who are DHH. Challenges identified by the studies raise implications for early hearing detection and intervention programs, as well as Departments of Health and Social Welfare. These included logistical challenges, professional-related challenges, and caregiver-related challenges. Various aspects of FCEI have been reported in the review. Findings of these studies have significant implications for the formulation of quality FCEI programs to ensure contextually relevant and contextually responsive care of children who are DHH.
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Affiliation(s)
- Ntsako P Maluleke
- Department of Speech-Language Pathology and Audiology, School of Health Care Sciences, Sefako Makgatho Health Sciences University, Pretoria North, Gauteng Province, South Africa (Ms Maluleke); and Department of Speech Pathology and Audiology, School of Human and Community Development, University of the Witwatersrand, Johannesburg, South Africa (Prof. Khoza-Shangase and Dr Kanji)
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Abstract
Supplemental Digital Content is available in the text. If the benefits of newborn hearing screening and early intervention are to be fully realized, there is a need to understand the challenges of hearing aid management in infants. The aim was to investigate longitudinal changes in hearing aid use and hearing aid management challenges in very young infants.
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Birdsey B, Joseph L. Plurality of perspective: Doctor-parents of deaf children in a low-to middle-income country. Int J Pediatr Otorhinolaryngol 2021; 142:110610. [PMID: 33477015 DOI: 10.1016/j.ijporl.2021.110610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 12/30/2020] [Accepted: 12/30/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Pediatric deafness is an important consideration in neurodevelopment. Early identification and intervention are major factors in seeing that deaf children reach their full potential. Often, it is the medical professionals who themselves have limited knowledge about hearing loss or the consequences of delayed language acquisition. These knowledge gaps can negatively influence the timeous and holistic care that children with hearing loss require. With a dual experiential expertise gained through both parenting children with disabling hearing loss and being medical doctors, the purpose of this study was to better understand the field of pediatric hearing loss through doctors' insights gained as parents. STUDY DESIGN Interpretative Phenomenological Analysis was the approach used for this qualitative enquiry. Five South African participants with children between the ages of two and ten years, were selected using purposive sampling and an in-depth semi-structured interview used as the data instrument. Thereafter, three levels of thematic analysis were conducted. RESULTS Generally, doctors have limited knowledge of pediatric deafness. Perceptions towards deafness are typically through a medical-model lens, while appreciation of Universal Newborn Hearing Screening is lacking. Through exploring the various gains of parenting a deaf child, participants acknowledged the power of the lived experience in changing their own practice as both parents and practitioners. CONCLUSION Doctors need to know more about pediatric deafness. The pathway of care from identification to intervention in South Africa needs revision. Exposure to the lived experience is a powerful means of enabling expert insights to influence such change in a practical and meaningful way.
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Affiliation(s)
- Bianca Birdsey
- Department of Pediatrics and Child Health, 1 Jan Smuts Avenue, Braamfontein 2000, Johannesburg, South Africa.
| | - Lavanithum Joseph
- Discipline of Audiology, School of Health Sciences, University of KwaZulu-Natal, Private Bag X54001, Durban, 4000, South Africa.
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Nickbakht M, Meyer C, Scarinci N, Beswick R. Family-Centered Care in the Transition to Early Hearing Intervention. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2021; 26:21-45. [PMID: 32783059 DOI: 10.1093/deafed/enaa026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 07/07/2020] [Accepted: 07/14/2020] [Indexed: 06/11/2023]
Abstract
This study aimed to explore and compare families' and professionals' perspectives on the implementation of family-centered care (FCC) (Moeller, Carr, Seaver, Stredler-Brown, & Holzinger, 2013) during the period between diagnosis of hearing loss (HL) and enrollment in early intervention (EI). A convergent mixed-methods study incorporating self-report questionnaires and semistructured in-depth interviews was used. Seventeen family members of children with HL and the 11 professionals who support these families participated in this study. The results suggested that the services engaged during the transition period partially adhered to the principles of FCC, including the provision of timely access to EI services and provision of emotional and social support. However, areas for improvement identified include strengthening family/professional partnerships, shared decision-making processes, collaborative teamwork, program monitoring, and consistency in the provision of information and support. Qualitative and quantitative research findings also indicated a lack of consistency in service provision during the transition period.
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Affiliation(s)
- Mansoureh Nickbakht
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Carly Meyer
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- The HEARing CRC, Melbourne, Australia
| | - Nerina Scarinci
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- The HEARing CRC, Melbourne, Australia
| | - Rachael Beswick
- Children's Health Queensland Hospital and Health Service, Healthy Hearing, Brisbane, Australia
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Mood D, Szarkowski A, Brice PJ, Wiley S. Relational Factors in Pragmatic Skill Development: Deaf and Hard of Hearing Infants and Toddlers. Pediatrics 2020; 146:S246-S261. [PMID: 33139438 PMCID: PMC11215649 DOI: 10.1542/peds.2020-0242d] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/31/2020] [Indexed: 11/24/2022] Open
Abstract
In this article, we review relational factors in early childhood believed to contribute in unique ways to pragmatic skill development in deaf and hard of hearing (DHH) infants and toddlers. These factors include attending to infant interactions with caregivers and others, supporting development of theory of mind through play and use of mental state language (ie, describing one's own or others' thoughts, feelings, and beliefs), and providing accessible opportunities for social interaction. On the basis of a review of the literature and clinical experience, we offer prescriptive strategies for supporting DHH children's development in these areas. To improve outcomes for DHH children, medical care providers and allied health professionals have a responsibility to support the development of young DHH children's pragmatic abilities by understanding these variables, coaching caregivers regarding their importance, and facilitating referrals for support when necessary.
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Affiliation(s)
- Deborah Mood
- Section of Developmental Pediatrics, Department of Pediatrics, University of Colorado, Aurora, Colorado;
- Contributed equally as co-first authors
| | - Amy Szarkowski
- Children's Center for Communication/Beverly School for the Deaf, Beverly, Massachusetts
- Boston Children's Hospital, Boston, Massachusetts
- Harvard Medical School, Harvard University, Boston, Massachusetts
- Contributed equally as co-first authors
| | | | - Susan Wiley
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, Cincinatti Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio
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Hussain S, Pryce H, Neary A, Hall A. Exploring how parents of children with unilateral hearing loss make habilitation decisions: a qualitative study. Int J Audiol 2020; 60:183-190. [PMID: 32787641 DOI: 10.1080/14992027.2020.1804080] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE This study sought to explore the decision making needs of parents managing the hearing and communication needs of children with unilateral hearing loss. DESIGN An inductive, qualitative method was used. The data were analysed using a constant comparative approach, consistent with Grounded Theory method. STUDY SAMPLE Twenty one families participated in interviews yielding data on twenty two children. Each of these families had at least one child with unilateral hearing loss. The age range of the children varied from four months to sixteen years old. All parents were English speaking and received care from National Health Service Audiology departments across the United Kingdom. RESULTS Parents valued professionals' opinions, but information provision was inconsistent. As their children mature, parents increasingly valued their child's input. Parent-child discussions focussed on how different management strategies fit their child's preferences. Parents were proactive in obtaining professional advice, and integrating this with their own iterative assessment of their child's performance. CONCLUSIONS Decision making is an iterative process. Parents make nuanced decisions which aim to preserve a sense of what is normal for them. Clinicians need to recognise the parental view, including where it may contrast with a medicalised or clinical view.
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Affiliation(s)
- Saira Hussain
- Department of Audiology, School of Life and Health Sciences, Aston University, Birmingham, UK
| | - Helen Pryce
- Department of Audiology, School of Life and Health Sciences, Aston University, Birmingham, UK
| | - Amy Neary
- Department of Audiology, School of Life and Health Sciences, Aston University, Birmingham, UK
| | - Amanda Hall
- Department of Audiology, School of Life and Health Sciences, Aston University, Birmingham, UK
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Blake L, Bray L, Carter B. "It's a lifeline": Generating a sense of social connectedness through befriending parents of disabled children or children with additional need. PATIENT EDUCATION AND COUNSELING 2019; 102:2279-2285. [PMID: 31327482 DOI: 10.1016/j.pec.2019.07.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 07/01/2019] [Accepted: 07/10/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVES This study explored the influence of a parent-to-parent peer support scheme on the wellbeing of parents of disabled children or children with additional need who joined a befriending scheme. METHODS A longitudinal concurrent mixed methods (qualitative and quantitative) research design collected data (telephone interviews, Footsteps Tool, Resilience Scale-14) with 33 befriendees (1:1 or group support) and 33 befrienders at time-point 1 (TP1). TP2 data were collected from 20 befriendees and 16 befrienders 6-9 months after recruitment. RESULTS There was some improvement on average scores between TP1 and TP2 on both tools. The strongest evidence of change - 'a sense of positivity and hope' and 'connection, belonging and sharing' - was in the parents' reports of how the scheme helped them to build secure and valued social connections within a community of other parents who understood their lives. CONCLUSION Both the befriendees and befrienders reported the sense of hope and a feeling of belonging as key benefits that resulted from the social connections they gained from the scheme. PRACTICE IMPLICATIONS Social connectedness is likely to be a more useful concept than resilience in examining change.
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Affiliation(s)
- Lucy Blake
- Faculty of Health and Social Care, Edge Hill University, Ormskirk, UK
| | - Lucy Bray
- Faculty of Health and Social Care, Edge Hill University, Ormskirk, UK
| | - Bernie Carter
- Faculty of Health and Social Care, Edge Hill University, Ormskirk, UK.
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Nickbakht M, Meyer C, Scarinci N, Beswick R. A qualitative investigation of families' needs in the transition to early intervention after diagnosis of hearing loss. Child Care Health Dev 2019; 45:670-680. [PMID: 31209907 DOI: 10.1111/cch.12697] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 05/21/2019] [Accepted: 06/07/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Families of children with hearing loss must make a number of decisions during the transition from diagnosis of hearing loss to enrolment in early intervention and thus require a wealth of information and support. This study aimed to investigate families' needs during this period and explore how these needs might differ for families of children with hearing loss who have additional disabilities. METHODS An exploratory qualitative study incorporating semistructured in-depth interviews and thematic analysis was used. A total of 28 participants from two groups were involved: (a) family members of children with hearing loss (n = 17) and (b) professionals who support these families during the transition period from diagnosis of hearing loss to enrolment in early intervention (n = 11). RESULTS Analysis of qualitative data revealed four major themes: (a) families require information that meet their specific needs; (b) families require supportive professionals to "walk the journey" with them; (c) some families want to connect with other families who "are in the same boat"; and (d) professional support needs differ for children with hearing loss who have additional disabilities. CONCLUSIONS Families and professionals in this study identified a wide range of family needs during the transition to early intervention. The results highlighted the importance of providing individualized services and considering families' needs when providing family-centred services.
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Affiliation(s)
- Mansoureh Nickbakht
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Carly Meyer
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia.,The HEARing CRC, Melbourne, Victoria, Australia
| | - Nerina Scarinci
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia.,The HEARing CRC, Melbourne, Victoria, Australia
| | - Rachael Beswick
- Healthy Hearing, Children's Health Queensland Hospital and Health Service, Brisbane, Queensland, Australia
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Spaulding SE, Yamane A, McDonald CL, Spaulding SA. A conceptual framework for orthotic and prosthetic education. Prosthet Orthot Int 2019; 43:369-381. [PMID: 31199192 DOI: 10.1177/0309364619852455] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Variables that influence orthotic and prosthetic patient outcomes beyond direct care are poorly conceptualized for orthotic and prosthetic students. Restructuring educational curricula around important clinical reasoning variables (i.e. factors that may influence outcomes) could improve teaching, learning, and clinical practice. OBJECTIVES To propose an orthotic and prosthetic education framework to enhance the development of orthotic and prosthetic students' clinical reasoning skills. STUDY DESIGN Scoping review. METHODS We conducted a scoping review, identified variables of orthotic and prosthetic usability, and performed a qualitative thematic analysis through the lens of orthotic and prosthetic clinical educators to develop a conceptual framework for orthotic and prosthetic education. RESULTS Sorting of variables identified from the literature resulted in three thematic areas: (1) the state of functioning, disability, and health (International Classification of Functioning, Disability and Health); (2) orthotic and prosthetic technical properties, procedures, and appropriateness; and (3) professional service as part of orthotic and prosthetic interventions. The proposed orthotic and prosthetic education framework includes these three areas situated within the context of patient-centered care. CONCLUSIONS A conceptual framework was developed from variables identified in peer-reviewed literature. This orthotic and prosthetic education framework provides a structure to explore orthotic and prosthetic clinical reasoning and advance our teaching and assessment of students' clinical reasoning skills. CLINICAL RELEVANCE The proposed orthotic and prosthetic (O&P) education framework is intended to promote conversation about variables (e.g. health condition, procedures, services, and O&P principles) that influence O&P clinical practice outcomes and further advance our teaching and assessment of students' clinical reasoning skills.
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Affiliation(s)
- Susan E Spaulding
- 1 Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
| | - Ann Yamane
- 1 Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
| | - Cody L McDonald
- 1 Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
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Ashcraft LE, Asato M, Houtrow AJ, Kavalieratos D, Miller E, Ray KN. Parent Empowerment in Pediatric Healthcare Settings: A Systematic Review of Observational Studies. THE PATIENT 2019; 12:199-212. [PMID: 30328069 PMCID: PMC6397702 DOI: 10.1007/s40271-018-0336-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Parent empowerment is often an expressed goal in clinical pediatrics and in pediatric research, but the antecedents and consequences of parent empowerment are not well established. OBJECTIVE The objective of this systematic review was to synthesize potential antecedents and consequences of parent empowerment in healthcare settings. ELIGIBILITY CRITERIA The inclusion criteria were (1) studies with results about parent empowerment in the context of children's healthcare or healthcare providers; and (2) qualitative studies, observational studies, and systematic reviews of such studies. INFORMATION SOURCES We searched the databases of PubMed, Web of Science, and Google Scholar (2006-2017) and reference lists. INCLUDED STUDIES Forty-four articles met the inclusion criteria. SYNTHESIS OF RESULTS We identified six themes within consequences of empowerment: increased parent involvement in daily care, improved symptom management, enhanced informational needs and tools, increased involvement in care decisions, increased advocacy for child, and engagement in empowering others. Six themes summarizing antecedents of empowerment also emerged: parent-provider relationships, processes of care, experiences with medical care, experiences with community services, receiving informational/emotional support, and building personal capacity and narrative. We synthesized these findings into a conceptual model to guide future intervention development and evaluation. STRENGTHS AND LIMITATIONS OF EVIDENCE Non-English articles were excluded. INTERPRETATION Parent empowerment may enhance parent involvement in daily care and care decisions, improve child symptoms, enhance informational needs and skills, and increase advocacy and altruistic behaviors. Parent empowerment may be promoted by the parent-provider relationship and care processes, finding the right fit of medical and community services, and attention to the cognitive and emotional needs of parents. CLINICAL REGISTRATION NO PROSPERO 2017:CRD42017059478.
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Affiliation(s)
- Laura Ellen Ashcraft
- Department of Critical Care Medicine, University of Pittsburgh School of Medicine, 4200 Fifth Avenue, Pittsburgh, PA, 15260, USA.
- University of Pittsburgh School of Social Work, Pittsburgh, PA, USA.
| | - Miya Asato
- Department of Pediatrics, University of Pittsburgh, School of Medicine and Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA, USA
| | - Amy J Houtrow
- Department of Pediatrics, University of Pittsburgh, School of Medicine and Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA, USA
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Dio Kavalieratos
- Section of Palliative Care and Medical Ethics, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Elizabeth Miller
- Department of Pediatrics, University of Pittsburgh, School of Medicine and Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA, USA
| | - Kristin N Ray
- Department of Pediatrics, University of Pittsburgh, School of Medicine and Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA, USA
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Lima MCDO, Souza ASD, Santos IRDD, Carvalho WLDO, Brazorotto JS. Análise da efetividade de um programa de intervenção para famílias de crianças com deficiência auditiva. Codas 2019; 31:e20180116. [DOI: 10.1590/2317-1782/20182018116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 10/30/2018] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivo Avaliar a efetividade de um programa de intervenção para famílias de crianças com deficiência auditiva. Método Pesquisa de intervenção, com delineamento longitudinal e análise estatística inferencial. Foram realizadas 20 sessões de intervenção, durante oito meses; destas, 19 ocorreram em situação de grupo e uma sessão foi individual. Para a análise dos dados pré e pós-intervenção, foram aplicados instrumentos específicos e realizado o registro em vídeo da interação da família com a criança após quatro e oito meses. Resultados Houve mudança clínica positiva confiável nas interações comunicativas das famílias com seus filhos, após 8 meses de intervenção. A necessidade de informações das famílias se modificou ao longo da intervenção e diminuiu para todas as famílias. Conclusão verificou-se a efetividade da proposta de programa de intervenção para famílias de crianças com deficiência auditiva.
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Ching TY, Scarinci N, Marnane V, Sjahalam-King J, Button L, Whitfield J. Factors influencing parents' decisions about communication choices during early education of their child with hearing loss: a qualitative study. DEAFNESS & EDUCATION INTERNATIONAL : THE JOURNAL OF THE BRITISH ASSOCIATION OF TEACHERS OF THE DEAF 2018; 20:154-181. [PMID: 30872975 PMCID: PMC6411083 DOI: 10.1080/14643154.2018.1512393] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To explore the factors influencing parents' choice of communication mode during early education of their child with hearing loss. DESIGN Qualitative descriptive analysis of semi-structured interviews of parents of children with hearing loss. STUDY SAMPLE Fourteen parents of children who participated in the Longitudinal Outcomes of Children with Hearing Impairment study. RESULTS Four themes emerged from thematic analysis of the interview data: (1) parents draw on a variety of experiences and information to make decisions; (2) parents' preferred outcomes for their children drive their choices; (3) child's preference and proficiency drive parental choice; and (4) parents' fears and worries influence decisions. Parents required unbiased, descriptive information as well as evaluative information from professionals, so that they could consider all options in making a decision that met their needs. They required continual support for implementation of their choices as they adjusted to their children's changing needs. CONCLUSIONS Decisions around communication mode are rarely made in isolation, but occur within a larger decision-making matrix that include device choices, early intervention agency choices and "future-proofing" the child's future communication options.
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Affiliation(s)
- Teresa Yc Ching
- HEARing Cooperative Research Centre
- National Acoustic Laboratories
| | | | - Vivienne Marnane
- HEARing Cooperative Research Centre
- National Acoustic Laboratories
| | | | - Laura Button
- HEARing Cooperative Research Centre
- National Acoustic Laboratories
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Brand D, Zaidman-Zait A, Most T. Parent Couples' Coping Resources and Involvement in their Children's Intervention Program. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2018; 23:189-199. [PMID: 29672722 DOI: 10.1093/deafed/eny011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 03/29/2018] [Indexed: 06/08/2023]
Abstract
Parental involvement is vital to the implementation of intervention programs for deaf and hard-of-hearing (DHH) children. The current study examined the dyadic relationships between mothers' and fathers' coping resources and their involvement in their child's intervention program. In addition, the moderating roles of parent's gender and family religiosity on the associations between coping resources and involvement were examined. Seventy Jewish couples of parents of DHH children, representing various levels of religiosity, completed questionnaires regarding involvement in their child's intervention program, child acceptance, parental self-efficacy, and perceived social support. Multilevel modeling analyses were used to test actor-partner interdependence. The findings indicated significant actor effects for child acceptance, parental self-efficacy, and social support. All were positively associated with parental involvement. Gender was found to moderate the actor effect of child acceptance. Partner effects were found only for mothers, for child acceptance, and social support. Fathers' child acceptance and social support were negatively associated with mothers' involvement. Religiosity did not moderate neither actor nor partner effects. These results have important implications for planning intervention programs that are sensitive to each of the parent's needs.
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Bagatto MP, Moodie ST. Relevance of the International Classification of Functioning, Health and Disability: Children & Youth Version in Early Hearing Detection and Intervention Programs. Semin Hear 2016; 37:257-71. [PMID: 27489403 PMCID: PMC4954788 DOI: 10.1055/s-0036-1584406] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Early hearing detection and intervention (EHDI) programs have been guided by principles from the Joint Committee on Infant Hearing and an international consensus of best practice principles for family-centered early intervention. Both resources provide a solid foundation from which to design, implement, and sustain a high-quality, family-centered EHDI program. As a result, infants born with permanent hearing loss and their families will have the support they need to develop communication skills. These families also will benefit from programs that align with the framework offered by the World Health Organization's International Classification of Functioning, Disability and Health: Children & Youth Version (ICF-CY). Within this framework, health and functioning is defined and measured by describing the consequences of the health condition (i.e., hearing loss) in terms of body function, structures, activity, and participation as well as social aspects of the child. This article describes the relevance of the ICF-CY for EHDI programs and offers a modified approach by including aspects of quality of life and human development across time.
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Affiliation(s)
- Marlene P. Bagatto
- National Centre for Audiology, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Sheila T. Moodie
- National Centre for Audiology and School of Communication Sciences and Disorders, Faculty of Health Sciences, Western University, London, Ontario, Canada
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Henderson RJ, Johnson AM, Moodie ST. Revised Conceptual Framework of Parent-to-Parent Support for Parents of Children Who Are Deaf or Hard of Hearing: A Modified Delphi Study. Am J Audiol 2016; 25:110-26. [PMID: 27249168 DOI: 10.1044/2016_aja-15-0059] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Accepted: 12/28/2015] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND A scoping review of the literature was conducted, resulting in the development of a conceptual framework of parent-to-parent support for parents with children who are Deaf or hard of hearing. This is the 2nd stage of a dual-stage scoping review. PURPOSE This study sought stakeholder opinion and feedback with an aim to achieve consensus on the constructs, components, and design of the initial conceptual framework. RESEARCH DESIGN A modified electronic Delphi study was completed with 21 handpicked experts from 7 countries who have experience in provision, research, or experience in the area of parent-to-parent support. Participants completed an online questionnaire using an 11-point Likert scale (strongly disagree to strongly agree) and open-ended questions to answer various questions related to the descriptor terms, definitions, constructs, components, and overall design of the framework. RESULTS Participant responses led to the revision of the original conceptual framework. CONCLUSION The findings from this dual-stage scoping review and electronic Delphi study provide a conceptual framework that defines the vital contribution of parents in Early Hearing Detection and Intervention programs that will be a useful addition to these programs.
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Affiliation(s)
- Rebecca J. Henderson
- Health & Rehabilitation Sciences Program, Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada
| | - Andrew M. Johnson
- Health & Rehabilitation Sciences Program, Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada
| | - Sheila T. Moodie
- Health & Rehabilitation Sciences Program, Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada
- National Centre for Audiology, Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada
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