Hearing Aids Helping Parents Understand the Good the

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 Ph. D 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

Q 1 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 I With fluid and hearing fluctuation Progression of hearing loss I II Accessories Potential Complications

Q 1 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".

Q 2 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 II Teasing at school Learning to talk II II Keeping them on Losing or breaking them Swallowing battery Keeping clean and dry IIII II I I Social Concerns Physical Concerns

Q 2 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

Q 3 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 IIIII II I Wear all the time Make sure working properly Give hearing aid a ‘home’ IIIII II II Care and use

Q 3 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