Health-related quality of life among mothers of children with cochlear implants with and without developmental disabilities

BACKGROUND

Cochlear implants (CIs) are widely used among children with severe to profound hearing loss. Raising a child with a CI presents unique challenges to the family, especially when the child has a developmental disability (CI-DD).

AIMS

This study aimed to elucidate the relations between the functioning of children with CIs, their mothers' coping resources (i.e., social support and family-centered care), and maternal health-related quality of life (HRQoL). Also, it examined whether the presence of a DD in addition to the child's deafness moderated these relations.

METHODS AND PROCEDURES

A sample of 100 mothers of children with CIs (54 in the CI-DD group) completed questionnaires regarding perceived social support, family-centered care, and HRQoL.

OUTCOMES AND RESULTS

Mothers of deaf children with CIs and DD experienced lower levels of family functioning and HRQoL across all dimensions compared to mothers of deaf children with CIs without DD. In addition, social support was positively related to HRQoL only among mothers of children in the CI-DD group, indicating the protective role of social support.

CONCLUSIONS AND IMPLICATIONS

Social support is an important coping resource, and psychosocial support is needed for mothers of children with CIs, especially for mothers whose children also have a DD.

O processo de adaptação e desempenho ocupacional de mães de crianças no transtorno do espectro autista

Resumo Introdução A adaptação a um filho no Transtorno do Espectro do Autismo (TEA) pode impactar o desempenho ocupacional das mães em razão dos cuidados demandados, que podem dificultar a realização das suas ocupações. Objetivo Investigar a adaptação e o desempenho ocupacional das mães de filhos com TEA. Método Estudo descritivo transversal de abordagem quantiqualitativa com 11 mães de filhos no TEA com idade entre 2 e 9 anos. Os dados foram coletados por meio da Escala Parental de Adaptação à Deficiência (EPAD) e da Medida Canadense de Desempenho Ocupacional (COPM). Os dados da EPAD foram analisados pela soma dos escores de cada participante e cálculo da média geral e os da COPM a partir dos valores atribuídos para o desempenho e satisfação. Resultados As mães estavam em adaptadas a seus filhos; entretanto, avaliaram a presença de problemas funcionais para o desempenho ocupacional após o nascimento deles. Problemas na categoria produtividade, especificamente para trabalhar, por conta das demandas de cuidados com o filho, foram referidos pela maioria das mães. Na categoria autocuidado, algumas mães referiram problemas para ir ao salão de beleza e tomar banho. Na categoria lazer, algumas mães indicaram problemas para realizar leitura, atividade física, viajar e/ou visitar amigos. Conclusão As mães deste estudo demostraram que a adaptação a seus filhos envolve fatores como transmissão do diagnóstico, informação, características dos filhos, condições socioeconômicas, resiliência, crenças e expectativas pessoais. Conclui-se que as mães de filhos no TEA investigadas apresentaram problemas funcionais para o desempenho ocupacional após o nascimento desses filhos.

Adaptation process and occupational performance of mothers of children with autism spectrum disorders

Abstract Introduction Adapting to a child with Autism Spectrum Disorder (ASD) can impact the occupational performance of mothers because of the care they demand, which can lead to difficulties in carrying out their occupations. Objective To investigate the occupational performance and adaptation of mothers to their children with ASD. Method Cross-sectional, descriptive, quantitative and qualitative study conducted with 11 mothers of children with ASD aged 2-9 years. Data were collected using the Parental Disability Adaptation Scale (EPAD) and the Canadian Occupational Performance Measure (COPM). EPAD data were analyzed by adding the scores of each participant and calculating the general average, whereas COPM data were analyzed from the values assigned to performance and satisfaction. Results The mothers were well adapted to their children; however, they evaluated the presence of functional problems for occupational performance after their birth. Functional problems in the productivity category, specifically in work performance due to the demands of caring for the children, were mentioned by most mothers. In the self-care category, some mothers reported problems related to going to the salon and taking a shower. In the leisure category, some mothers indicated problems with reading, physical activity, traveling and/or visiting friends. Conclusion The mothers in this study reported that adapting to their children with ASD involves factors such as transmission of the diagnosis, information, children characteristics, socioeconomic conditions, resilience, and personal beliefs and expectations. In conclusion, the mothers of children with ASD investigated presented functional problems regarding their occupational performance after the birth of these children.

Cochlear Implantation in Children with Autism Spectrum Disorder: A Systematic Review and Pooled Analysis

OBJECTIVE

To determine outcomes following cochlear implantation (CI) in children with autism spectrum disorder (ASD).

DATABASES REVIEWED

MEDLINE, Embase, Web of science, Cochrane Library, and Clinicaltrial.gov.

METHODS

The review was performed according to the PRISMA statement. Primary outcomes measures were changes in speech perception and speech production scores. Secondary outcome measures included communication mode, device use, parental recommendation of implant, postoperative hyperacusis, and quality of life measures. Pooled analysis of outcomes was performed if possible.

RESULTS

Twenty-four studies reported on 159 children with ASD. There were improvements in speech perception in 78% of cases and in speech expression in 63% of cases, though the extent of this improvement was variable. Seventy-four percent of children with ASD and CI are nonoral communicators. Intermittent/nonuse rate was 31%. Hearing outcomes are worse compared to children with other disabilities. The vast majority of parents would recommend CI based on their experiences.

CONCLUSION

Outcome in children with ASD and CI are highly variable and significantly poorer compared to non-ASD children. Despite this, most parents report positive experiences and the evidence supports the use of CI in children with ASD.

Cochlear implant in patients with autistic spectrum disorder-a systematic review

Introduction

In cases of autism spectrum disorders with severe to profound hearing loss, cochlear implant is a therapeutic option.

Objective

To identify evidence in the scientific literature that the cochlear implant brings benefits to people with autism spectrum disorders with associated hearing loss.

Methods

Systematic review of the literature based on the criteria recommended by PRISMA. The population, intervention, comparison, outcomes, study design, PICOS strategy, was used to define the eligibility criteria. The studies that met the inclusion criteria for this second stage were included in a qualitative synthesis. Each type of study was analyzed according to the Joanna Briggs Institute's risk of bias assessment through the critical checklist for cohort studies, prevalence studies and critical criteria and case reports.

Results

Four hundred and eighty-four articles were found in eight databases and 100 in the gray literature, mentioning the relationship between cochlear implants in patients with autism spectrum disorder and hearing loss. Twelve articles were read in full and 7 were selected for qualitative analysis in this systematic review. All seven articles were analyzed on the critical evaluation checklist. Four articles had a low risk of bias and three articles had a moderate risk of bias. In this study, were included 66 patients with autism spectrum disorder and hearing loss who received cochlear implant.

Conclusion

This systematic review indicates that a cochlear implant can bring benefits to autism spectrum disorder patients with associated deafness.

Parental Conceptualizations of Autism and Deafness in British Deaf Children

The co-occurrence of childhood deafness and autism raises complex challenges for diagnosis and family support. In this article, we explore with hearing and Deaf parents their observations of the interaction between deafness and autism and identify how the intersections of deafness and autism are conceptualized in everyday life. Eight parents participated (two of whom were Deaf BSL users) in semi-structured interviews in either BSL or spoken English. Data analysis was underpinned by a phenomenological approach in the hermeneutic tradition. Findings are discussed in terms of parents' perceptions of the relevance of deafness to their understanding of autism for their particular child, the effects of autism on sign and spoken language development and the relationship between deafness and autism in terms of their own and others' attributions of their children's characteristics. The significance of the findings for parental contributions' to diagnostic assessment and the tailoring of family support are considered.