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Audibility-Based Informational Counseling in Pediatric Audiology Using the Speech Intelligibility Index: A Qualitative Study
Journal article   Peer reviewed

Audibility-Based Informational Counseling in Pediatric Audiology Using the Speech Intelligibility Index: A Qualitative Study

Caitlin Sapp, Mary Charlton, Ryan McCreery and Elizabeth A Walker
Ear and hearing
04/27/2026
DOI: 10.1097/AUD.0000000000001808
PMID: 42043787

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Abstract

To fully engage caregivers of children who are deaf or hard of hearing, audiologists need counseling tools that adequately convey the impact of permanent childhood hearing loss (HL) on development and the benefits of interventions like hearing technology. The present study examines the parent experience of receiving informational counseling during the diagnostic and intervention process with early amplification. We used qualitative methods to gather feedback on caregiver experiences with informational counseling. Based on themes identified from caregiver experiences, we sought to identify potential patterns that could inform counseling during early diagnosis and intervention appointments. We used a semistructured interview design to collect perspectives from a group of parents with experience in the early HL diagnostic and intervention process. Fifteen mothers and 4 fathers took part. We developed an interview guide focused on parent perceptions of their early HL counseling experiences related to the diagnosis and recommendations for intervention such as hearing aids. We also described and discussed the use of audibility-based counseling strategies as a novel tool with parent stakeholders. Several important themes emerged from our analysis of parent utterances, including difficulty explaining the diagnosis to others, challenges in understanding the implications of HL, and the broad acceptability of audibility-based counseling with some caveats. Parents in our sample tended to overestimate their child's unaided audibility. Parents may struggle to take the information learned from audiologists and communicate information about HL to friends and family. Audibility-based counseling strategies are potentially more straightforward to understand than terms like "mild" and "moderate" when describing HL and the need for hearing technology to both parents and their extended network. While parents readily provided information about their child's pure-tone average-based-based degree of HL, they tended to overestimate how much unaided audibility their child may experience. This mismatch may have clinical implications for adequately perceiving the need for intervention with hearing technology.
 EHDI Parent counseling Newborn hearing screening Qualitative Pediatric audiology

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