Hearing aids: expectations and satisfaction of people with an intellectual disability, a descriptive pilot study

Hearing Loss Diagnosis and Management in Adults with Intellectual and Developmental Disabilities

Hearing loss is a common concern in patients with intellectual and developmental disabilities (IDD), and early detection and intervention are crucial to prevent negative impacts on communication, cognition, socialization, safety, and mental health. Despite a lack of the literature specifically focused on hearing loss in adults with IDD, there is a substantial body of research demonstrating the prevalence of hearing loss in this population. This literature review examines the diagnosis and management of hearing loss in adult patients with IDD, with a focus on primary care considerations. Primary care providers must be aware of the unique needs and presentations of patients with IDD to ensure appropriate screening and treatment. This review highlights the importance of early detection and intervention, as well as the need for further research to guide clinical practice in this patient population.

"We forget about peoples' hearing loss": identifying key aspects of hearing aid and communication training in residential care homes

OBJECTIVES

The first objective was to assess the feasibility of training on hearing aids and communication strategies by support workers in residential care via a cascade training model using two different training packages. The second was to identify key elements of these packages to inform the design of a multimedia training package.

DESIGN

Quantitative and qualitative methodologies were used. A pre-post feasibility design assessed the questionnaire data from residential care support workers to measure knowledge and confidence at three stages during the training. Semi-structured interviews explored the support workers' experiences and adherence to cascading the training packages.

STUDY SAMPLE

Fourteen support workers employed by Sense (charity for deafblind people) were trained to become "Hearing Champions" and cascaded their learning to 117 support colleagues.

RESULTS

Hearing Champions gained knowledge, skills and confidence, which were subsequently enhanced by sharing their learning with others. Despite individual and organisational barriers, they reported examples of improved practice and feelings of empowerment.

CONCLUSIONS

It is feasible to deliver training to support workers in residential homes using the face-to-face "Hearing Champions" and multimedia C2Hear training methods by cascading training to their colleagues. Support workers expressed a preference for training that is portable, adaptable and interactive.

Global Data on Ear and Hearing Screening in an Intellectual Disability Population

Intellectual disability (ID) and hearing loss are frequent comorbid conditions, although otological problems often go unnoticed until picked up by screening. In the hearing program of Special Olympics (SO), athletes with ID are screened for otological problems. By retrospective analysis of all SO meetings between 2007 and 2017, more than 100,000 screenings could be included. Cerumen impaction was found in 40.7%, middle ear problems in 29.5% of those who failed hearing screening, and hearing loss confirmation in 26.9%. Prevalences for different world regions and country income groups are provided. The results emphasize the high prevalence of hearing loss in this ID population. Awareness among health care workers and active screening are required to reduce health disparities among this disadvantaged population.

Sensory impairment and intellectual disability

Sensory (visual and hearing) impairment has significant detrimental impact on sociocognitive and language development. Despite this, it is very much underrecognised and underdiagnosed in people with intellectual disability. Raising awareness of sensory impairment among professionals and carers is extremely important for early management to prevent further social handicap in people with intellectual disability. This article reviews sensory impairment in intellectual disability and its association with autism-spectrum disorder and mental illness.

Paid Support Workers for Adults with Intellectual Disabilities; Their Current Knowledge of Hearing Loss and Future Training Needs

BACKGROUND

People with intellectual disabilities are more likely to have hearing loss than the general population. For those unable to self-advocate, the responsibility of detection and management falls to their caregivers.

METHODS

This is the first cycle of a project using action research methodology to improve services. Twenty care workers were interviewed to understand their knowledge of hearing loss and hearing aids. Themes were generated using thematic analysis.

FINDINGS

This group was better qualified than their peers but received minimal training in hearing loss. They were unable to accurately estimate expected prevalence and had a negative perception of hearing aids. Only 7% of service users were known to have hearing loss.

CONCLUSIONS

Current training is not sufficient to provide the skills for detection and management of hearing problems. This group had clear ideas on methods of learning. Working in collaboration is necessary to achieve long-term change to practice.

Eliciting perceptions of satisfaction with services and supports from persons with intellectual disability and developmental disabilities: a review of the literature

BACKGROUND

Assessing the perceptions of individuals with intellectual disability (ID) and developmental disabilities (DD) is an essential part of evaluating and planning services and an important component of respect for self-direction and autonomy. It can be difficult, however, to assess satisfaction in such a way that individuals with disabilities' actual perceptions of satisfaction are accurately represented because of intellectual and communication difficulties they may have, the restricted range and nature of service systems, and the limitations of strategies used by some researchers.

METHOD

The purpose of this literature review was to systematically examine research studies designed to solicit personal satisfaction information from individuals with ID and DD. We reviewed 29 studies that met inclusion criteria to determine (1) who were participants in the studies, (2) what processes researchers used to obtain opinions and perspectives of persons with ID and DD, and (3) how researchers ensured the credibility, accuracy and voluntariness of participants' responses.

RESULTS

Findings revealed that most of the research participants had ID with higher IQs and limited needs for supports. Researchers utilised a variety of processes to elicit perceptions of satisfaction. Most studies employed individual interviews; researchers addressed comprehensibility of questions in a number of ways (e.g. use of visuals, adjusting wording of questions, providing clear examples). Few studies reported training interviewers or taking into account participants' primary language or cultural background. No studies reported educating participants about how to understand the satisfaction information data or how to use it in advocating for more appropriate supports.

CONCLUSIONS

Assessing the satisfaction with supports and services of individuals with ID and DD is complex particularly for persons with extensive support needs. Continued research using varied conceptual frameworks and new technologies is needed. Also helpful will be teaching persons with disabilities about the assessment process and how to use its results.

Exploring experiences and understandings of pain in adults with intellectual disabilities

BACKGROUND

People with intellectual disabilities (ID) are at risk that their health problems, many of which cause pain, go unrecognised and untreated. Their understanding and personal experiences of pain have received little research attention.

METHOD

Information was collected from 15 adults with ID using semi-structured interviews about their experiences and understanding of pain. Transcripts were analysed using content analysis.

RESULTS

Participants described pain using negative meanings and strong imagery, with various causes of pain suggested, but said little about how they coped with pain. Participants varied in whether they reported pains to carers, some choosing to hide the experience. There seemed a general belief that others can tell when someone is in pain.

CONCLUSIONS

Conversations regarding pain with adults with ID are a real challenge; health-care staff need to think carefully about the questions they ask. Possessing verbal skills cannot be taken as an indication that pain will be communicated.