Dissertation
Audibility-based counseling for parents of children with hearing loss
University of Iowa
Doctor of Philosophy (PhD), University of Iowa
Spring 2021
DOI: 10.17077/etd.005821
Abstract
The effectiveness of early detection and intervention programs for child hearing loss (HL) is hampered when an early diagnosis does not result in the early adoption of intervention. The purpose of this study was to examine informational counseling for parents as a malleable factor that can be leveraged to improve parent understanding about HL and motivate action. If parents have poor comprehension of the functional implications of childhood HL, this may lead to adverse downstream effects. Researchers have shown that parents underestimate the impact of HL when it is described using degree/configuration terms; however, no research has translated these findings into clinical counseling applications. Longitudinal research with children who use hearing aids has identified that audibility (the amount of auditory information that a listener can access, measured with the SII) is a critical factor in language and academic success. Our research examined the role of audibility-based counseling (ABC) across three stakeholder groups in a mixed-methods research design. Aim 1a examined the role of audibility in current clinical practice among audiologists using a retrospective chart review. Aim 1b used semi-structured interviews with parents of children with HL to explore their counseling experiences and the role of audibility in how they conceptualize HL. In Aim 2 we compared audibility-based descriptions to traditional descriptions with classifications of HL and HL simulations using an online survey with random group allocation.
Our findings revealed that ABC strategies elicited significantly higher levels of parent concerns about HL than classification-based strategies, but that HL simulation elicited higher levels of concern than ABC or classification-based strategies. In our parent interviews, participants reacted positively to the construct of audibility and identified applications in which audibility might support informational sharing at diagnosis and during habilitation (based on shortcomings in their own counseling experiences). Few parents revealed previous exposure to audibility-based descriptions of their child’s HL. Our retrospective chart review revealed that audiologists rarely deviate from classification-based descriptions in written communications. The use of ABC strategies may be most beneficial in cases of mild HL.
This project expands our knowledge base about counseling factors that impact parent buy-in after diagnosis and uptake of intervention for children with HL. It also provides a foundation for developing and testing clinical applications of ABC strategies in clinical populations.
Details
- Title: Subtitle
- Audibility-based counseling for parents of children with hearing loss
- Creators
- Caitlin Elizabeth Sapp
- Contributors
- Elizabeth Walker (Advisor)Carolyn Brown (Committee Member)Mary Charlton (Committee Member)Lenore Holte (Committee Member)Ryan McCreery (Committee Member)Kristi Hendrickson (Committee Member)
- Resource Type
- Dissertation
- Degree Awarded
- Doctor of Philosophy (PhD), University of Iowa
- Degree in
- Speech and Hearing Science
- Date degree season
- Spring 2021
- DOI
- 10.17077/etd.005821
- Publisher
- University of Iowa
- Number of pages
- xiv, 239 pages
- Copyright
- Copyright 2021 Caitlin Sapp
- Language
- English
- Description illustrations
- illustrations (some color), forms
- Description bibliographic
- Includes bibliographical references (pages 106-124)
- Public Abstract (ETD)
The purpose of this study was to examine how different descriptions of childhood hearing loss (HL) impact parents who are going through the evaluation process. We proposed that using descriptions based on audibility (or the amount of sound a child has access to, measured on a percentage scale) will lead to more parent concern than our current descriptions (based on level of HL, using words like slight, mild, and moderate). We also wanted to evaluate how often audiologists report information regarding audibility or functional implications of HL compared to descriptions of HL level. Finally, we examined the different counseling experiences of parents whose children currently wear hearing aids and gather their feedback on the use of audibility during parent counseling.
Our results show that descriptions using audibility resulted in higher levels of concern about HL than words like slight, mild, and moderate; however, hearing loss simulation (hearing an audio recording of what HL sounds like) produced the highest amount of parent concern about HL. In general, our results showed that audiologists do not often use any descriptions beyond level of HL in their written reports. Parents of children with HL reacted positively to audibility-based descriptions. Many parents shared that it was difficult to understand exactly what their child’s HL diagnosis meant for their development. Our work reveals that audibility is a promising tool to describe HL in a way that is relevant to our primary audience (parents of children with HL) in order to motivate appropriate action.
- Academic Unit
- Communication Sciences and Disorders
- Record Identifier
- 9984097075602771
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