1
|
Kabiş B, Yıldırım Gökay N, Tutar H, Karamert R, Gündüz B. The Challenges Encountered by Conventional Hearing Aid and/or Cochlear Implant Users During the COVID-19 Pandemic. Am J Audiol 2023; 32:81-89. [PMID: 36455137 DOI: 10.1044/2022_aja-22-00055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
PURPOSE The purpose of this study was to evaluate the stress, quality of life, and access to hearing health services experienced by adults and children who use hearing aid and/or cochlear implant and their families during the COVID-19 pandemic. METHOD Perceived Stress Scale, Personal Wellbeing Index, and World Health Organization Quality of Life questionnaires were applied online to 30 adults with hearing loss and parents of 61 children with hearing loss. Also, a survey was conducted to acquire more about the demographics of people who use cochlear implants and conventional hearing aids, as well as the difficulties they encountered during the COVID-19 period. RESULTS Although child user families experienced more problems than adults during the COVID-19 period, the stress levels of child user families were higher than that of adult user families (p = .05). Even though there was no statistically significant difference, the families of pediatric users had lower quality of life than adult users. CONCLUSIONS The stress/anxiety problems that arise as a result of this are coming to the forefront of both patients and their relatives. The findings indicate that creative strategies should be developed to give individuals with hearing loss efficient access to hearing health services.
Collapse
Affiliation(s)
- Burak Kabiş
- Department of Audiology, Faculty of Health Science, Gazi University, Ankara, Turkey
| | | | - Hakan Tutar
- Department of Otorhinolaryngology/Head and Neck Surgery, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Recep Karamert
- Department of Otorhinolaryngology/Head and Neck Surgery, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Bülent Gündüz
- Department of Audiology, Faculty of Health Science, Gazi University, Ankara, Turkey
| |
Collapse
|
2
|
Ayas M, Ali Al Amadi AMH, Khaled D, Alwaa AM. Impact of COVID-19 on the access to hearing health care services for children with cochlear implants: a survey of parents. F1000Res 2020; 9:690. [PMID: 32760579 PMCID: PMC7376500 DOI: 10.12688/f1000research.24915.1] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/06/2020] [Indexed: 01/09/2023] Open
Abstract
Background: The COVID-19 pandemic has affected the world in an unprecedented manner. It has aggravated psychological distress in parents of children with cochlear implants. Continuous use of a speech sound processor is critical for auditory stimulation in children with cochlear implants. However, movement restrictions imposed have affected access to hearing healthcare services. The current study explores the impact of the COVID-19 pandemic on hearing healthcare access for children with cochlear implants. Methods: An online questionnaire survey was conducted among parents of children with cochlear implants. Results: A total of 24 parents responded to the questionnaire. All the respondents reported that COVID-19 has a significant impact on access to hearing health services for their children. Speech processor breakdown and disconnection from the auditory mode of communication had a critical influence on behavioral changes in children. Conclusions: The current study highlights the hurdles faced by the parents in order to access hearing health services for their children. The use of innovative methods such as remote tele-audiology will be the way forward to tackle challenges faced by the parents.
Collapse
Affiliation(s)
- Mohammed Ayas
- University Hospital Sharjah, Sharjah, 72772, United Arab Emirates
- College of Medicine, University of Sharjah, Sharjah, 72772, United Arab Emirates
| | - Ahmad Mohd Haider Ali Al Amadi
- University Hospital Sharjah, Sharjah, 72772, United Arab Emirates
- College of Medicine, University of Sharjah, Sharjah, 72772, United Arab Emirates
| | - Duaa Khaled
- University Hospital Sharjah, Sharjah, 72772, United Arab Emirates
| | - Ahmad Munzer Alwaa
- University Hospital Sharjah, Sharjah, 72772, United Arab Emirates
- College of Medicine, University of Sharjah, Sharjah, 72772, United Arab Emirates
| |
Collapse
|
3
|
Terlektsi E, Kreppner J, Mahon M, Worsfold S, Kennedy CR. Peer Relationship Experiences Of Deaf And Hard-Of-Hearing Adolescents. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2020; 25:153-166. [PMID: 32048717 PMCID: PMC7167539 DOI: 10.1093/deafed/enz048] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 11/15/2019] [Accepted: 11/18/2019] [Indexed: 06/10/2023]
Abstract
Deaf and hard-of-hearing adolescents (DHH) experience more peer problems and lower levels of friendships than their hearing peers. This study used a qualitative approach to identify their experiences of peer problems and factors influencing them. A sample of 30, 13-19 year-old DHH adolescents with a moderate to profound hearing loss, drawn from a population-based cohort study in which their receptive language and social-emotional skills had been assessed, underwent semi-structured interviews. Interviews were analyzed using thematic analysis. Participants reported that, overall, they had developed positive and rewarding relationships with their peers, notwithstanding their earlier experience of being bullied. Conflicts and infrequency of interaction in their friendships were mainly reported by girls. Adolescents with moderate hearing loss were identified as facing the same or even more barriers than adolescents with severe to profound hearing loss in making new friends. Implications for educational practice are discussed.
Collapse
Affiliation(s)
- E Terlektsi
- Faculty of Medicine, University of Southampton
- School of Education, University of Birmingham
| | - J Kreppner
- School of Psychology, University of Southampton
| | - M Mahon
- Division of Psychology and Language Sciences, UCL
| | - S Worsfold
- Faculty of Medicine, University of Southampton
| | | |
Collapse
|
4
|
Bhamjee A, Roux TL, Schlemmer K, Perold J, Cass N, Schroeder K, Schlesinger D, Ceronio D, Vinck B. Parent-perceived challenges related to the pediatric cochlear implantation process and support services received in South Africa. Int J Pediatr Otorhinolaryngol 2019; 126:109635. [PMID: 31421357 DOI: 10.1016/j.ijporl.2019.109635] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 07/31/2019] [Accepted: 08/07/2019] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To determine and describe parent-perceived challenges related to the pediatric cochlear implantation process and support services received. METHOD A multicenter survey study across six cochlear implant (CI) programs in South Africa (SA) was conducted. The study sample included 82 parents of pediatric (≤18 years) CI recipients with at least 12 months CI experience. A self-administered questionnaire was developed for the purpose of this study, exploring parental challenges regarding the CI process, education of their implanted children and the support services received. RESULTS The financial implications of cochlear implantation, including CI device maintenance, were identified by parents as the most prominent challenge. Financing issues were the highest scoring reason that attributed to the delay between diagnosis of hearing loss and cochlear implantation, as well as the greatest barrier to bilateral implantation. Parent-perceived educational challenges included finding adequate educational settings specific to the individual needs of their child and a shortage of trained teachers equipped to support children with CIs. The presence of one/more additional developmental conditions and grade repetition were associated with more pronounced parent-perceived educational challenges. Parents considered speech-language therapy as the most critical support service for their implanted children to achieve optimal outcomes, while parent guidance was indicated to be the most critical support service required for parents of pediatric CI recipients. CONCLUSION A greater understanding of parent-perceived challenges will guide CI professionals to promote optimal outcomes, evidence-based service delivery and on-going support to pediatric CI recipients and their families. Study results imply a call for action regarding financial and educational support for pediatric CI recipients in SA.
Collapse
Affiliation(s)
- Aaqilah Bhamjee
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
| | - Talita le Roux
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa.
| | - Kurt Schlemmer
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Kwazulu Natal, Durban, South Africa; Durban Cochlear Implant Program, Durban, South Africa
| | - Jenny Perold
- Tygerberg Hospital-Stellenbosch University Cochlear Implant Unit, Cape Town, South Africa
| | - Nicolize Cass
- Pretoria Cochlear Implant Unit, Pretoria, South Africa
| | - Kelly Schroeder
- Port Elizabeth Cochlear Implant Unit, Port Elizabeth, South Africa
| | - Dani Schlesinger
- Chris Hani Baragwanath Academic Hospital Cochlear Implant Program, Soweto, South Africa
| | - Deon Ceronio
- Bloemfontein Cochlear Implant Program, Bloemfontein, South Africa
| | - Bart Vinck
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa; Speech-Language Audiology Department, Ghent University, Gent, Belgium
| |
Collapse
|
5
|
Porter A, Creed P, Hood M, Ching TYC. Parental Decision-Making and Deaf Children: A Systematic Literature Review. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2018; 23:295-306. [PMID: 29947773 PMCID: PMC6455895 DOI: 10.1093/deafed/eny019] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 05/23/2018] [Accepted: 05/27/2018] [Indexed: 06/08/2023]
Abstract
Parents or caregivers of children who are deaf or hard of hearing are required to make complex and rational decisions soon after the confirmation of hearing loss. Ways of facilitating decision-making have been a focus within the healthcare sector for two decades and shared decision-making is now widely viewed as the standard for good clinical care. A systematic literature review was undertaken to identify the extent to which the principles of shared decision-making and informed choice have been implemented for parents when they make decisions related to their children with permanent hearing loss. Five databases were searched for peer-reviewed papers describing the results of original research published from 2000 to 2017, yielding 37 relevant papers. Studies were reviewed using the three phases of decision-making-information exchange, deliberation, and implementation. Two decisions dominated these studies-implantable devices and communication modality. Most papers dealt with decision-making in the context of bilateral hearing loss, with only one study focusing on unilateral hearing loss. The review identified gaps where further research is needed to ensure the lessons learnt in the broader decision-making literature are implemented when parents make decisions regarding their child who is deaf or hard of hearing.
Collapse
Affiliation(s)
- Ann Porter
- School of Applied Psychology, Griffith University
| | - Peter Creed
- School of Applied Psychology, Griffith University
| | | | | |
Collapse
|
6
|
Scarinci NA, Gehrke MJ, Ching TYC, Marnane V, Button L. Factors Influencing Caregiver Decision Making to Change the Communication Method of their Child with Hearing Loss. DEAFNESS & EDUCATION INTERNATIONAL : THE JOURNAL OF THE BRITISH ASSOCIATION OF TEACHERS OF THE DEAF 2018; 20:123-153. [PMID: 30872974 PMCID: PMC6411091 DOI: 10.1080/14643154.2018.1511239] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The communication journey of a child with hearing loss is often a complex, interwoven process in which the child's use of language or method of communication may change numerous times. As there has been limited research exploring the caregiver decision making process behind making such changes, this qualitative descriptive study aimed to explore the factors which influence the caregiver decision making process to change the communication method of their child with hearing loss. Individual semi-structured in-depth interviews were conducted with seven caregivers of children with hearing loss in Australia. Thematic analysis revealed five key themes which influenced caregiver decisions regarding changes to their child's method of communication, including: (1) family characteristics; (2) family access to information; (3) family strengths; (4) family beliefs; and (5) family-centered practice. The overall finding that the family unit is at the core of decision-making has important clinical implications regarding early intervention professionals' provision of family-centered services when working with the families of children with hearing loss.
Collapse
Affiliation(s)
- Nerina A Scarinci
- School of Health & Rehabilitation Sciences, The University of Queensland, St Lucia, Australia
- The HEARing Cooperative Research Centre, Melbourne, Australia
| | - Monica J Gehrke
- School of Health & Rehabilitation Sciences, The University of Queensland, St Lucia, Australia
| | - Teresa Y C Ching
- The HEARing Cooperative Research Centre, Melbourne, Australia
- National Acoustic Laboratories, Australia
| | - Vivienne Marnane
- The HEARing Cooperative Research Centre, Melbourne, Australia
- National Acoustic Laboratories, Australia
| | - Laura Button
- The HEARing Cooperative Research Centre, Melbourne, Australia
- National Acoustic Laboratories, Australia
| |
Collapse
|
7
|
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.
Collapse
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
| | | |
Collapse
|
8
|
Dev AN, Lohith U, Pascal B, Dutt CS, Dutt SN. A questionnaire-based analysis of parental perspectives on pediatric cochlear implant (CI) re/habilitation services: a pilot study from a developing CI service in India. Cochlear Implants Int 2018; 19:338-349. [DOI: 10.1080/14670100.2018.1489937] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
9
|
Matthijs L, Hardonk S, Sermijn J, Van Puyvelde M, Leigh G, Van Herreweghe M, Loots G. Mothers of Deaf Children in the 21st Century. Dynamic Positioning Between the Medical and Cultural-Linguistic Discourses. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2017; 22:365-377. [PMID: 28586425 DOI: 10.1093/deafed/enx021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Accepted: 05/17/2017] [Indexed: 06/07/2023]
Abstract
Traditional research examining the communicational choices made by families with deaf children tends to emanate from the premise that families engage with either of the two grand discourses on deafness (i.e., the medical or cultural-linguistic perspective). This study investigated hearing mother's engagement with the educational options for their child from a dynamic, poststructural perspective. Three Flemish mothers were interviewed in-depth at the child's ages of 6, 9, 12, 18, and 24 months. The data were analyzed within a theoretical model that describes the positioning process of the mothers. This method yielded alternative explanations for former findings concerning mothers' decision-making processes, especially the difficulty of learning sign language as a second language in an effort to provide a bilingual-bicultural education, and highlighted the importance of having rich experiences. It further showed that a bilingual-bicultural position was scarcely available and poorly supported for these mothers. These findings are discussed in relation to recent international consensus statements on best practices in early intervention.
Collapse
Affiliation(s)
- Liesbeth Matthijs
- Department of Psychology and Educational Sciences, Research Group IDNS (Interpersonal, Discursive and Narrative Studies), Vrije Universiteit Brussel (VUB), Brussel, Belgium
| | - Stefan Hardonk
- Marie Curie Fellow, University of Iceland-Centre for Disability Studies, Sæmundargötu 2, 101 Reykjavík, Iceland
- SEIN Identity, Diversity and Inequality Research, Faculty of Business Economics, Hasselt University, Hasselt, Belgium
| | - Jasmina Sermijn
- Department of Psychology and Educational Sciences, Research Group IDNS (Interpersonal, Discursive and Narrative Studies), Vrije Universiteit Brussel (VUB), Brussel, Belgium
| | - Martine Van Puyvelde
- Department of Psychology and Educational Sciences, Research Group IDNS (Interpersonal, Discursive and Narrative Studies), Vrije Universiteit Brussel (VUB), Brussel, Belgium
- VIPER (Vital Signs and PERformance monitoring) Research Unit-LIFE Department, Royal Military Academy, Brussels, Belgium
- Department of Experimental and Applied Psychology, Vrije Universiteit Brussel, Belgium
| | - Greg Leigh
- RIDBC Renwick Centre Renwick Centre for Research and Professional Education at the Royal Institute for Deaf and Blind Children, Sydney
- Centre for Special Education and Disability Studies at the University of Newcastle, Australia
- Department of Linguistics, Macquarie University
| | - Mieke Van Herreweghe
- Faculty of Arts and Philosophy, Department of Linguistics, University of Ghent, Belgium
| | - Gerrit Loots
- Department of Psychology and Educational Sciences, Research Group IDNS (Interpersonal, Discursive and Narrative Studies), Vrije Universiteit Brussel (VUB), Brussel, Belgium
- Institutional University cooperation with Universidad Catolica Boliviana "San Pablo" (UCB)
- Department of Economy and Social Sciences, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| |
Collapse
|
10
|
Mostafavi F, Hazavehei SMM, Oryadi-Zanjani MM, Rad GS, Rezaianzadeh A, Ravanyar L. Phenomenological needs assessment of parents of children with cochlear implants. Electron Physician 2017; 9:5339-5348. [PMID: 29038719 PMCID: PMC5633235 DOI: 10.19082/5339] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2016] [Accepted: 04/26/2017] [Indexed: 11/21/2022] Open
Abstract
Background The use of cochlear implants has been a remarkable success in reducing disabilities in those with impaired hearing, which have made a significant change in the patients’ quality of life. Only by relying on cochlear implants, disabilities cannot be eliminated in the hearing impaired, and, alongside this intervention, rehabilitation practices such as through family and community support are necessary. Aim To explain the needs of parents of children with cochlear implants to increase the quality of rehabilitation services and family-based interventions. Methods A descriptive phenomenology study was performed with the participation of 16 people, including eight mothers, three fathers, and five experts involved with the rehabilitation of children aged 2–7 years with cochlear implants. The research setting was centers with speech therapy service providers for hearing-impaired children in the city of Shiraz (Iran) in 2015. Information was gathered through in-depth interviews with participants and analyzed by using Colaizzi’s nine-step analysis method and MAXQDA (Ver10) applications. Results The mean age of participants was 34 years, and the average age of diagnosis of hearing problems in children was 12 months. The obtained data from the analysis of interviews about the needs of parents of children with cochlear implants were categorized into 19 sub-contents and five contents, as follows: the need for access to health care services; psychological needs; mood-related needs of a child; educational needs and financial requirements. Conclusion Parents of children with cochlear implants have numerous needs, and they encounter problems based on their situation and experiences. The results indicate the necessity of close cooperation among different professionals such as an audiologist, pediatrician, psychologist, and speech therapist for the program’s success.
Collapse
Affiliation(s)
- Firoozeh Mostafavi
- Ph.D. of Community Health, Associate Professor, Department of Health Education and Health Promotion, Faculty of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Seyed Mohammad Mahdi Hazavehei
- Ph.D. of Health Education and Health Promotion, Professor, Department of Public Health, Faculty of Health, Hamedan University of Medical Sciences, Hamedan, Iran
| | - Mohammad Majid Oryadi-Zanjani
- Ph.D. of Speech Therapy, Assistant Professor, Department of Speech Therapy, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Gholamreza Sharifi Rad
- Ph.D. of Health Education, Professor, Department of Health Education and Health Promotion, Faculty of Health, Islamic Azad University, Qom Brunch, Qom, Iran
| | - Abbas Rezaianzadeh
- Ph.D. of Epidemiology, Associate Professor, Department of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Leila Ravanyar
- Ph.D. Candidate of Health Education and Health Promotion, Department of Health Education and Health Promotion, Faculty of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| |
Collapse
|
11
|
Professionals’ Guidance About Spoken Language Multilingualism and Spoken Language Choice for Children With Hearing Loss. ACTA ACUST UNITED AC 2016. [DOI: 10.1017/jse.2016.3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The purpose of this research was to investigate factors that influence professionals’ guidance of parents of children with hearing loss regarding spoken language multilingualism and spoken language choice. Sixteen professionals who provide services to children and young people with hearing loss completed an online survey, rating the importance of a range of potential influences on the guidance they provide to parents. These participants were invited to comment on the importance of these influences. Participants included teachers of the deaf, speech-language pathologists, special education teachers, psychologists, auditory-verbal therapists, Auslan interpreters, and curriculum coordinators. All participants had experience working with multilingual families and reported that they would sometimes or always recommend multilingualism for children with hearing loss, with fewer reporting that they would sometimes recommend monolingualism. Professionals placed greater importance on factors relating to family and community considerations (e.g., family language models, communication within the family, community engagement), and less importance on organisational policy and children's characteristics. This research provides an initial insight into the factors that professionals consider when guiding parents around spoken language and spoken language multilingualism decision-making for their children with hearing loss.
Collapse
|
12
|
Li Z, Younger K, Gartenhaus R, Joseph AM, Hu F, Baer MR, Brown P, Davila E. Inhibition of IRAK1/4 sensitizes T cell acute lymphoblastic leukemia to chemotherapies. J Clin Invest 2015; 125:1081-97. [PMID: 25642772 DOI: 10.1172/jci75821] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Accepted: 12/11/2014] [Indexed: 12/11/2022] Open
Abstract
Signaling via the MyD88/IRAK pathway in T cells is indispensable for cell survival; however, it is not known whether this pathway functions in the progression of T acute lymphoblastic leukemia (T-ALL). Here, we determined that compared with thymic and peripheral T cells, T-ALL cells from patients have elevated levels of IRAK1 and IRAK4 mRNA as well as increased total and phosphorylated protein. Targeted inhibition of IRAK1 and IRAK4, either with shRNA or with a pharmacological IRAK1/4 inhibitor, dramatically impeded proliferation of T-ALL cells isolated from patients and T-ALL cells in a murine leukemia model; however, IRAK1/4 inhibition had little effect on cell death. We screened several hundred FDA-approved compounds and identified a set of drugs that had enhanced cytotoxic activity when combined with IRAK inhibition. Administration of an IRAK1/4 inhibitor or IRAK knockdown in combination with either ABT-737 or vincristine markedly reduced leukemia burden in mice and prolonged survival. IRAK1/4 signaling activated the E3 ubiquitin ligase TRAF6, increasing K63-linked ubiquitination and enhancing stability of the antiapoptotic protein MCL1; therefore, IRAK inhibition reduced MCL1 stability and sensitized T-ALL to combination therapy. These studies demonstrate that IRAK1/4 signaling promotes T-ALL progression through stabilization of MCL1 and suggest that impeding this pathway has potential as a therapeutic strategy to enhance chemotherapeutic efficacy.
Collapse
|
13
|
Mitchiner JC. Deaf parents of cochlear-implanted children: beliefs on bimodal bilingualism. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2015; 20:51-66. [PMID: 25237151 DOI: 10.1093/deafed/enu028] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This study investigated 17 Deaf (1) families in North America with cochlear-implanted children about their attitudes, beliefs, and practices on bimodal bilingualism (defined as using both a visual/manual language and an aural/oral language) in American Sign Language (ASL) and English. A survey and follow-up interviews with 8 families were conducted. The majority of the Deaf families exhibited positive beliefs toward bimodal bilingualism, where they set high expectations for their children to become equally fluent in both languages. However, their perspectives about the purpose for each language differed; they viewed English as a "survival language" and ASL as a "cultural language" but supported the use of both languages at home as part of their children's lives.
Collapse
|
14
|
Crowe K, McLeod S, McKinnon DH, Ching TYC. Speech, Sign, or Multilingualism for Children With Hearing Loss: Quantitative Insights Into Caregivers' Decision Making. Lang Speech Hear Serv Sch 2014; 45:234-47. [DOI: 10.1044/2014_lshss-12-0106] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Purpose
The authors sought to investigate the influence of a comprehensive range of factors on the decision making of caregivers of children with hearing loss regarding the use of speech, the use of sign, spoken language multilingualism, and spoken language choice. This is a companion article to the qualitative investigation described in Crowe, Fordham, McLeod, and Ching (2014).
Method
Through a questionnaire, 177 caregivers of 157 Australian children with hearing loss (ages 3;5 to 9;4 [years;months],
M
age
= 6;6) rated the importance of a range of potential influences on their decision making regarding their children's communication. The majority of children were reported to use speech (96.6%) as part or all of their communication system, with fewer children reported to use sign (20.9%). Few children used more than one spoken language (8.3%).
Results
Proportional analyses and exploratory factor analyses were conducted. Overall, caregivers' decisions were influenced by their children's audiological and intervention characteristics, communication with those around them, community participation, access to intervention and education services in English, and concerns about their children's future lives. The advice of speech-language pathologists, audiologists, and specialist teachers was more important to caregivers than advice from medical practitioners and nonprofessionals.
Conclusion
Caregivers' decision making regarding communication mode and language use is influenced by factors that are not equally weighted and that relate to child, family, community, and advice from others. Knowledge of these factors can assist professionals in supporting caregivers making choices regarding communication.
Supplemental Material
https://doi.org/10.23641/asha.6170282
Collapse
Affiliation(s)
- Kathryn Crowe
- Charles Sturt University, Bathurst and Sydney, New South Wales, Australia
- HEARing CRC, Sydney, New South Wales, Australia
- National Acoustic Laboratories, Sydney, New South Wales, Australia
| | - Sharynne McLeod
- Charles Sturt University, Bathurst and Sydney, New South Wales, Australia
| | - David H. McKinnon
- Charles Sturt University, Bathurst and Sydney, New South Wales, Australia
| | - Teresa Y. C. Ching
- HEARing CRC, Sydney, New South Wales, Australia
- National Acoustic Laboratories, Sydney, New South Wales, Australia
| |
Collapse
|
15
|
Crowe K, Fordham L, McLeod S, Ching TYC. "Part of our world": Influences on caregiver decisions about communication choices for children with hearing loss. DEAFNESS & EDUCATION INTERNATIONAL : THE JOURNAL OF THE BRITISH ASSOCIATION OF TEACHERS OF THE DEAF 2014; 16:61-85. [PMID: 25349528 PMCID: PMC4208665 DOI: 10.1179/1557069x13y.0000000026] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Caregivers of young children with hearing loss make decisions about which communication mode/s and spoken language/s their children and family will use. Influences on decision-making about communication were examined for 177 caregivers of Australian children with hearing loss through a questionnaire. The majority of the 157 children used speech as part or all of their communication system (n = 138, 87.9%), and approximately one-third of the children (n = 52, 33.1%) currently or had previously used sign as part or all of their communication system. Twenty-two (14.0%) children and 35 (19.8%) caregivers used a spoken language other than English. Four themes emerged from the qualitative analysis of caregiver responses about the most important influences on their decision-making. Theme one identified caregivers' sources of information, including advice from professionals, family, and friends, as well as caregivers' own research and preferences. Theme two related to practicalities of communication within the family and the community, as well as the need for one language or communication mode to be acquired before another was introduced. Theme three described the influence of children's individual characteristics on caregivers' decision-making, including children's ability to access speech through audition, communication skills, additional disabilities, and children's own preferences about communication. Finally, in theme four caregivers expressed their hopes for their children's future lives, specifically fostering a sense of belonging, creating future opportunities and successes, and giving children the opportunity to choose their own method of communication. The findings can assist families and professionals to make informed decisions about children's communication.
Collapse
Affiliation(s)
- Kathryn Crowe
- HEARing CRC, Australia National Acoustic Laboratories, Australia Charles Sturt University, Australia
| | | | | | - Teresa Y C Ching
- HEARing CRC, Australia National Acoustic Laboratories, Australia
| |
Collapse
|
16
|
Castellanos I, Kronenberger WG, Beer J, Henning SC, Colson BG, Pisoni DB. Preschool speech intelligibility and vocabulary skills predict long-term speech and language outcomes following cochlear implantation in early childhood. Cochlear Implants Int 2013; 15:200-10. [PMID: 23998347 DOI: 10.1179/1754762813y.0000000043] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Speech and language measures during grade school predict adolescent speech-language outcomes in children who receive cochlear implants (CIs), but no research has examined whether speech and language functioning at even younger ages is predictive of long-term outcomes in this population. The purpose of this study was to examine whether early preschool measures of speech and language performance predict speech-language functioning in long-term users of CIs. Early measures of speech intelligibility and receptive vocabulary (obtained during preschool ages of 3-6 years) in a sample of 35 prelingually deaf, early-implanted children predicted speech perception, language, and verbal working memory skills up to 18 years later. Age of onset of deafness and age at implantation added additional variance to preschool speech intelligibility in predicting some long-term outcome scores, but the relationship between preschool speech-language skills and later speech-language outcomes was not significantly attenuated by the addition of these hearing history variables. These findings suggest that speech and language development during the preschool years is predictive of long-term speech and language functioning in early-implanted, prelingually deaf children. As a result, measures of speech-language functioning at preschool ages can be used to identify and adjust interventions for very young CI users who may be at long-term risk for suboptimal speech and language outcomes.
Collapse
|
17
|
Kotjan H, Purves B, Small SA. Cochlear implantation for a child with cochlear nerve deficiency: parental perspectives explored through narrative. Int J Audiol 2013; 52:776-82. [PMID: 23987238 DOI: 10.3109/14992027.2013.820000] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The objective of this study was to explore, from the parents' perspectives, decision-making regarding a cochlear implant (CI) for their child when a favourable outcome is less likely because of abnormal neurophysiology. DESIGN The primary research method of this single case study was qualitative interviewing drawing on a narrative approach to elicit the parents' perspectives about their experiences over time. Each parent was interviewed separately, but thematic analyses were undertaken both within and across interviews in order to identify overlaps and differences. STUDY SAMPLE Participants included the parents of a five-year old child with severe-profound hearing loss, cochlear nerve deficiency, and bilateral common cavities who had received a CI at the age of 18 months. RESULTS Four themes were identified across the four narrative stages that emerged from the parents' accounts of their experiences regarding their daughter's CI. Themes included hope and despair, questioning professionals' motivations, does deafness need a cure, and bringing the child into the family. Although these themes emerged from both parents' accounts, each parent expressed different perspectives and insights within them. CONCLUSIONS Findings highlight the central place of parental needs and perspectives in decision-making regarding a CI, particularly in the context of uncertain outcomes.
Collapse
|
18
|
Harris MS, Kronenberger WG, Gao S, Hoen HM, Miyamoto RT, Pisoni DB. Verbal short-term memory development and spoken language outcomes in deaf children with cochlear implants. Ear Hear 2013; 34:179-92. [PMID: 23000801 PMCID: PMC3530632 DOI: 10.1097/aud.0b013e318269ce50] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Cochlear implants (CIs) help many deaf children achieve near-normal speech and language (S/L) milestones. Nevertheless, high levels of unexplained variability in S/L outcomes are limiting factors in improving the effectiveness of CIs in deaf children. The objective of this study was to longitudinally assess the role of verbal short-term memory (STM) and working memory (WM) capacity as a progress-limiting source of variability in S/L outcomes after CI in children. DESIGN Longitudinal study of 66 children with CIs for prelingual severe-to-profound hearing loss. Outcome measures included performance on digit span forward (DSF), digit span backward (DSB), and four conventional S/L measures that examined spoken-word recognition (Phonetically Balanced Kindergarten word test), receptive vocabulary (Peabody Picture Vocabulary Test ), sentence-recognition skills (Hearing in Noise Test), and receptive and expressive language functioning (Clinical Evaluation of Language Fundamentals Fourth Edition Core Language Score; CELF). RESULTS Growth curves for DSF and DSB in the CI sample over time were comparable in slope, but consistently lagged in magnitude relative to norms for normal-hearing peers of the same age. For DSF and DSB, 50.5% and 44.0%, respectively, of the CI sample scored more than 1 SD below the normative mean for raw scores across all ages. The first (baseline) DSF score significantly predicted all endpoint scores for the four S/L measures, and DSF slope (growth) over time predicted CELF scores. DSF baseline and slope accounted for an additional 13 to 31% of variance in S/L scores after controlling for conventional predictor variables such as: chronological age at time of testing, age at time of implantation, communication mode (auditory-oral communication versus total communication), and maternal education. Only DSB baseline scores predicted endpoint language scores on Peabody Picture Vocabulary Test and CELF. DSB slopes were not significantly related to any endpoint S/L measures. DSB baseline scores and slopes taken together accounted for an additional 4 to 19% of variance in S/L endpoint measures after controlling for the conventional predictor variables. CONCLUSIONS Verbal STM/WM scores, process measures of information capacity, develop at an average rate in the years after cochlear implantation, but were found to consistently lag in absolute magnitude behind those reported for normal-hearing peers. Baseline verbal STM/WM predicted long-term endpoint S/L outcomes, but verbal STM slopes predicted only endpoint language outcomes. Verbal STM/WM processing skills reflect important underlying core elementary neurocognitive functions and represent potential intervention targets for improving endpoint S/L outcomes in pediatric CI users.
Collapse
Affiliation(s)
- Michael S Harris
- DeVault Otologic Research Laboratory, Indiana University School of Medicine, Indianapolis, IN 46202, USA.
| | | | | | | | | | | |
Collapse
|
19
|
Crowe K, McKinnon DH, McLeod S, Ching TY. Multilingual children with hearing loss: Factors contributing to language use at home and in early education. CHILD LANGUAGE TEACHING AND THERAPY 2013; 29:111-129. [PMID: 23519446 PMCID: PMC3600429 DOI: 10.1177/0265659012467640] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Understanding the relationship between children's cultural and linguistic diversity and child, caregiver, and environmental characteristics is important to ensure appropriate educational expectations and provisions. As part of the Longitudinal Outcomes of Children with Hearing Impairment (LOCHI) study, children's caregivers and educators completed questionnaires on demographic characteristics, including the communication mode (oral, manual, or mixed) and languages used in home and early educational environments. This article reports an exploratory analysis to examine factors associated with language use and communication mode of children at 3 years of age. A Chi Square Automatic Interaction Detector (CHAID) analysis was performed on data from 406 children to examine factors influencing communication mode and oral language use. The factor that most influenced children's communication mode at home was the communication mode used by their female caregiver. Children's communication mode in their early education environment was most related to the communication mode they used at home, and then related to the presence of additional needs in the children, female caregivers' level of education and the male caregivers' use of languages other than English (LOTEs). A second exploratory CHAID analysis of data for children from multilingual families (n = 106) indicated that female caregivers' use of English at home significantly influenced whether children used a LOTE at home. Finally, the use of a LOTE at home was associated with the use of a LOTE in the early education environment. These findings serve as an initial description of the factors that were associated with the communication mode and language use of children with hearing loss.
Collapse
Affiliation(s)
- Kathryn Crowe
- HEARing CRC, Australia; Charles Sturt University, Australia; National Acoustic Laboratories, Australia
| | | | | | | |
Collapse
|
20
|
Peñaranda A, Suárez RM, Niño NM, Aparicio ML, García JM, Barón C. Parents' narratives on cochlear implantation: reconstructing the experience of having a child with cochlear implant. Cochlear Implants Int 2012; 12:147-56. [PMID: 21917202 DOI: 10.1179/146701010x12711475887397] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
This paper discusses parents' narratives on cochlear implantation in Bogotá, Colombia using a qualitative approach. The main research objective was to identify how parents perceived the processes of diagnosis of their child's hearing loss, making the decision for cochlear implantation and the post-surgery period. All participants were hearing couples (n = 13) with similar socio-cultural backgrounds whose children had undergone cochlear implant surgery. Results show why cochlear implants are a very highly valued technological device with great symbolic power for parents. The study also deals with how perceptions about oral/sign language and disability, as well as social expectations for their children's lifetime opportunities, determine how the parents themselves have experienced their journey through the process of their children's cochlear implantation.
Collapse
Affiliation(s)
- Augusto Peñaranda
- Grupo de Implante Coclear, Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | | | | | | | | | | |
Collapse
|
21
|
Huttunen K, Välimaa T. Parents' views on changes in their child's communication and linguistic and socioemotional development after cochlear implantation. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2010; 15:383-404. [PMID: 20601372 DOI: 10.1093/deafed/enq029] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Our aim was to obtain versatile information on the communication and socioemotional development of implanted children in their everyday environment. We studied 18 children implanted unilaterally at the mean age of 3 years 4 months. All had normal nonverbal intelligence, but 8 (44%) had concomitant problems. Their parents filled out semistructured questionnaires at 6 months and then annually 1-5 years after activation. Parents reported a change from use of signs to speech, and changes in the children's vocal behavior and spoken language development. They also reported that children had calmed down and showed an increased sense of self-confidence and safety with an expanded social life. The greatest changes started to take place 1 year after implantation. Five years after implantation, two thirds of children were judged to be as independent as their age peers. We conclude that changes in communication pave the way to benefits in psychosocial development after implantation.
Collapse
Affiliation(s)
- Kerttu Huttunen
- Department of Otorhinolaryngology, Institute of Clinical Medicine, PO Box 5000, FI-90014 Oulun Yliopisto, Finland.
| | | |
Collapse
|