Family-Centered Care in the Transition to Early Hearing Intervention

Family-Centered Early Intervention Deaf/Hard of Hearing (FCEI-DHH): Foundation Principles

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.

Exploring the Stories of Parents' Experiences With Infant Hearing-Loss Screening and Diagnosis in the United States

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.

Minimum Data Set for Families of Children With Hearing Loss: An eDelphi Study

PURPOSE

Assessing the unique needs of each family following the diagnosis of a hearing loss is central to the delivery of family-centered hearing health care. Therefore, the aim of this study was to develop a Minimum Data Set (MDS) that could be used in the design of a needs assessment tool for families of children with hearing loss transitioning to early intervention.

METHOD

A list of potential items for the MDS was prepared. In a two-round electronic Delphi study in Australia, hearing researchers (N = 15 in Round 1; N = 9 in Round 2), clinicians, and professionals working in early intervention for children with hearing loss (N = 85) were asked to review the potential items and to rate the importance of items using a Likert scale.

RESULTS

Consensus was reached on 32 main items to be included in the MDS across six categories, including informational support (13 items), professional support (five items), peer support (one item), skills and knowledge (seven items), financial support (three items), and methods of information provision (three items). Eight optional items that could be considered for inclusion in the MDS were also identified.

CONCLUSIONS

The proposed MDS could support hearing professionals in identifying families' needs in order to provide individualized information and support. Future research is needed to conduct a pilot study to evaluate the needs assessment tool in terms of usability, feasibility, and therapeutic effects.

Exploring Parent Support Needs during the Newborn Hearing Diagnosis Pathway

Universal newborn hearing screening (UNHS) facilitates early detection of permanent congenital hearing loss in newborns. In recognition of specific needs among parents, support services have been established within some UNHS programs, including the Victorian Infant Hearing Screening Program (VIHSP). Despite this, there is limited research about how to best support parents in the context of well-established UNHS programs. This project aims to retrospectively explore parental support needs between the newborn hearing screen and enrolment into early intervention services. We used semi-structured interviews with parents three- to- six-months post confirmation of their newborn’s diagnosis of bilateral moderate-profound sensorineural hearing loss. Data were analysed using inductive content analysis. Thirteen parents of ten children were interviewed. Parents described high satisfaction with the support they received. Some parents felt unprepared for a diagnosis of hearing loss, having been reassured that transient causes such as middle ear fluid caused the hearing screen result. Parents reported mixed responses regarding the value of parent-mentor support along the pathway and some parents described needing additional psychological input to adjust to their child’s diagnosis. These findings provide insights into how a well-established UNHS program, VIHSP, supports parents along the hearing diagnosis pathway and how support can be further enriched.