Hearing Aids: Helping Parents Understand the Good, the Bad, and the Ugly Patti Martin MS CCC-A Jan Stroud MS CCC-A Arkansas Childrens Hospital Nannette.

Hearing Aids: Helping Parents Understand the Good, the Bad, and

the Ugly

Patti Martin MS CCC-AJan Stroud MS CCC-A

Arkansas Children’s HospitalNannette Nicholson PhD CCC-A

University of Arkansas for Medical SciencesArkansas Children’s Hospital

Pre-fittingDetermine candidacyConsider pre-selection issues Complete pre-selection proceduresSelect appropriate hearing instrumentConsider fitting issues

FittingFit hearing aidVerify benefitHearing instrument orientation and training

Post-fittingValidate benefitFollow-up and referral

American Academy of Audiology, 2003

What you’re supposed to do . . .

What we did . . .Hearing Aid Fitting

Fit earmoldRECDProgram hearing aidMake sure it works

CounselingCareUseMaintenance

Good LuckReturn appointment

What we worried about . . .

FamiliesHow they were getting used to itQuestions they would askWhat they thought we saidWhat they told their therapist that they didn’t know how to do

How we feltRushedPreachy FrustratedInadequate

What we did about it . . .

Quality Improvement InitiativeParent Survey

12 modified Likert scale (1 – 4)3 open ended questions

Sample of convenience28 experienced parents

Parent Hearing Aid Survey

2.0

2.5

3.0

3.5

4.0

Technical Issues

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rt L

evel

Insert/Remove

HA Controls

HA/EarmoldClean

Troubleshooting

Care Kit

Use WhenPlaying

Parent Hearing Aid Survey

2.0

2.5

3.0

3.5

4.0

Social Emotional Concerns

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Child Acceptance

Full Time HA Use

HA Looks

Friend/FamilyReactions

ResponseComments

Explain/Teach

What information could your audiologist have given you that would have made the first few weeks/months of hearing aid use better?

Emotional SupportParent support contact or group IIPatience with process II

AccessoriesLoss and damage prevention IRetention IIMoisture, dri-aid kit, cleaning IIIDanger of HA batteries I

Potential ComplicationsWith fluid and hearing fluctuation IProgression of hearing loss II

Q1

What information could your audiologist have given you that would have made the first few weeks/months of hearing aid use better?

Q1

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".

What was your biggest worry when your child got hearing aids?

Emotional ConcernsImprovement in listening IIII IAcceptance of hearing aids by child IIII IComfort/discomfort II

Social ConcernsTeasing at school IILearning to talk II

Physical ConcernsKeeping them on IIILosing or breaking them IIII IISwallowing battery IKeeping clean and dry I

Q2

What was your biggest worry when your child got hearing aids?

Q2

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.

What advice would you give ‘new’ parents about hearing aid use?

Emotional SupportFind someone you can talk to IPatience with process IILearn to accept hearing loss IPerseverance IIIIIDon’t worry about what other people say IIDon’t be nervous/afraid of them I

Care and useWear all the time IIIII IIIMake sure working properly IIGive hearing aid a ‘home’ II

Q3

Q3

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 advice would you give ‘new’ parents about hearing aid use?

What we do now . . .

Pre-appointment Pre-fitting/pre-programming Estimated RECD

What we do now . . .

AppointmentEstablishing rapport

Questions about last sessionWhat has happened since thenHow are they getting along

Decide on goals for session with parentsWhat we are going to doHow we will do itDo itPractice it

Family centered approachExplain and demonstrate everything as we goAsk parents to demonstrate skills learnedProvide 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 DiagnosisBenefit of amplification

Less convincedImpact of early listening on language developmentNeed 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 StepsConnections

Other parentsParent mentorsDeaf/hard hearing adults

Continue to increase redundancy of message

Give information in multiple formatsSpoken in native languageWrittenAudio/Video

OutcomesEvidence basedAge appropriateFamily friendlyMeasured in natural environment