Transcript Helping Parents Understand the Good, the Bad, and the Ugly

Hearing Aids: Helping Parents Understand
the Good, the Bad, and the Ugly
Patti Martin MS CCC-A
Jan Stroud MS CCC-A
Arkansas Children’s Hospital
Nannette Nicholson PhD CCC-A
University of Arkansas for Medical Sciences
Arkansas Children’s Hospital
What you’re supposed to do . .
.
Pre-fitting
Determine candidacy
Consider pre-selection issues
Complete pre-selection procedures
Select appropriate hearing instrument
Consider fitting issues
Fitting
Fit hearing aid
Verify benefit
Hearing instrument orientation and training
Post-fitting
Validate benefit
Follow-up and referral
American Academy of Audiology, 2003
What we did . . .
Hearing Aid Fitting
Fit earmold
RECD
Program hearing aid
Make sure it works
Counseling
Care
Use
Maintenance
Good Luck
Return appointment
What we worried about . . .
Families
How they were getting used to it
Questions they would ask
What they thought we said
What they told their therapist that they didn’t
know how to do
How we felt
Rushed
Preachy
Frustrated
Inadequate
What we did about it . . .
Quality Improvement Initiative
Parent Survey
12 modified Likert scale (1 – 4)
3 open ended questions
Sample of convenience
28 experienced parents
Parent Hearing Aid Survey
4.0
Insert/Remove
HA Controls
Comfort Level
3.5
HA/Earmold
Clean
Troubleshooting
3.0
Care Kit
2.5
Use When
Playing
2.0
Technical Issues
Parent Hearing Aid Survey
4.0
Comfort Level
Child Acceptance
Full Time HA Use
3.5
HA Looks
3.0
Friend/Family
Reactions
Response
Comments
2.5
Explain/Teach
2.0
Social Emotional Concerns
Q1
What information could your audiologist
have given you that would have made the
first few weeks/months of hearing aid use
better?
Emotional Support
Parent support contact or group
Patience with process
II
II
Loss and damage prevention
Retention
Moisture, dri-aid kit, cleaning
Danger of HA batteries
I
II
III
I
With fluid and hearing fluctuation
Progression of hearing loss
I
II
Accessories
Potential Complications
Q1
What information could your audiologist
have given you that would have made the
first few weeks/months of hearing aid use
better?
I would have had a more positive attitude concerning
deafness if I could have had someone to consult with
about deafness in general. I felt as if I were on a dark
fearful road with no hope in the future. I was told all
of the general information about aids and deafness, but
lacked the crucial information that all parents need to
hear and be mentored on and that is "what the future
holds". "We as parents" need support groups and
people who can be contacted to help during the "scary
hours".
Q2
What was your biggest worry when your
child got hearing aids?
Emotional Concerns
Improvement in listening
Acceptance of hearing aids by child
Comfort/discomfort
IIII I
IIII I
II
Teasing at school
Learning to talk
II
II
Keeping them on
Losing or breaking them
Swallowing battery
Keeping clean and dry
III
IIII II
I
I
Social Concerns
Physical Concerns
Q2
What was your biggest worry when your
child got hearing aids?
Would she want to wear them? And it took me a
few months actually to make her wear them. And
when I actually took control of the situation and
started making her wear them all waking hours, she
got so comfortable with them and used to wearing
them she had to be asleep, then I would take them
out. You really have to be somewhat determined to
make your child wear the hearing aids frequently so
they get used to them and what to wear them.
Q3
What advice would you give ‘new’ parents
about hearing aid use?
Emotional Support
Find someone you can talk to
Patience with process
Learn to accept hearing loss
Perseverance
Don’t worry about what other people say
Don’t be nervous/afraid of them
I
II
I
IIIII
II
I
Wear all the time
Make sure working properly
Give hearing aid a ‘home’
IIIII III
II
II
Care and use
Q3
What advice would you give ‘new’ parents
about hearing aid use?
Be more stubborn than your child. If they take out the
hearing aids - put them back in. When your child is
small get brightly colored ear molds. It makes the
hearing aids easier to find if lost and it also lets
strangers know that your child is wearing hearing aids.
It also makes wearing hearing aids more fun for your
child.
What we do now . . .
Pre-appointment
Pre-fitting/pre-programming
Estimated RECD
What we do now . . .
Appointment
Establishing rapport
Questions about last session
What has happened since then
How are they getting along
Decide on goals for session with parents
What we are going to do
How we will do it
Do it
Practice it
Family centered approach
Explain and demonstrate everything as we go
Ask parents to demonstrate skills learned
Provide written instructions
What we do now . . .
• Post-appointment
– Call 2 days later
– Send packet of resources
– Return 2 – 4 weeks
What Have We Learned?
Parents of younger children are different than later
identified children
Less confident
Diagnosis
Benefit of amplification
Less convinced
Impact of early listening on language development
Need to intervene prior to delay
More contact
• Reassurance
– Other parents
– Audiologist
– Primary care physician
• Information
– Advance technology
– How to evaluate quality
What Have We Learned?
Parents of younger children are
different than later identified children
More contact
Reassurance
Other parents
Audiologist
Primary care physician
Information
Advance technology
How to evaluate quality
Next Steps
Connections
Other parents
Parent mentors
Deaf/hard hearing adults
Continue to increase redundancy of message
Give information in multiple formats
Spoken in native language
Written
Audio/Video
Outcomes
Evidence based
Age appropriate
Family friendly
Measured in natural environment