Factors influencing parents’ decisions about communication choices during early education of their child with hearing loss: a qualitative study

ABSTRACT

To explore the factors influencing parents’ choice of communication mode during early education of their child with hearing loss. Qualitative descriptive analysis of semi-structured interviews with parents of children with hearing loss. Fourteen parents of children who participated in the Longitudinal Outcomes of Children with Hearing Impairment study. Four themes emerged from thematic analysis of the interview data: (1) parents draw on a variety of experiences and information to make decisions; (2) parents’ preferred outcomes for their children drive their choices; (3) child’s preference and proficiency drive parental choice; and (4) parents’ fears and worries influence decisions. The results reinforced the importance of parents receiving unbiased, descriptive information as well as evaluative information from professionals, so that they could consider all options in making a decision that met their needs. Parents also require continual support for implementation of their choices as they adjust to their children’s changing communication needs. Parent decisions around communication mode are rarely made in isolation, but occur within a larger decision-making matrix that include device choices, early intervention agency choices, and ‘future-proofing’ the child’s ongoing communication needs.

KEYWORDS:

• Decision making
• communication
• early education
• parents
• deaf children
• perspectives
• parents
• qualitative

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes on contributors

Dr Teresa Y. C. Ching is Head of Communication Sciences Department at the National Acoustic Laboratories, Australia. Her current research focuses on investigating efficacy of early intervention for populations of children with bilateral hearing loss or unilateral hearing loss, identifying factors affecting outcomes, determining sound discrimination ability in infants with hearing loss or auditory neuropathy spectrum disorder using cortical auditory evoked potential measurements and behavioral responses, evaluating effectiveness of amplification, devising methods for prescribing hearing aids and electric-acoustic stimulation (bimodal fitting) for children and adults, and exploring perspectives of professionals and families on management of hearing loss in young children.

Dr Nerina Scarinci is Head of Speech Pathology in the School of Health and Rehabilitation Sciences at The University of Queensland. Nerina's research focuses on the application of the World Health Organization's International Classification of Functioning, Disability, and Health (ICF) and family-centred care (FCC) principles for individuals with communication disability and their family members. Nerina has a special interest in improving communication outcomes for children with hearing loss, and children with language delay.

Vivienne Marnane is a researcher in the Communication Sciences Department at the National Acoustic Laboratories, with qualifications in speech pathology and epidemiology. She is currently involved in research investigating the efficacy of early intervention and amplification, and the factors that affect short- and long-term outcomes for pediatric populations with hearing loss, including those with unilateral hearing loss.

Jessica Sjahalam-King is a research audiologist within the Audiology department at the National Acoustic Laboratories. Jessica works with the families and children currently participating in the Longitudinal Outcomes of Children with Hearing Impairment (LOCHI) and Children with Unilateral Hearing Loss (CUHL) studies. Prior to her current role, Jessica had a background in anthropology and working with children and adolescents with cognitive disabilities.

Laura Button is a research Speech Pathologist, and Speech Pathology Manager in the Communication Sciences Department at the National Acoustic Laboratories. She is involved in the research teams investigating the outcomes of children with hearing loss, family experiences, and alternate delivery models.

Jessica Whitfield is a research speech pathologist working within the Communication Sciences Department of the National Acoustic Laboratories, Australia. She has a clinical background providing assessment and intervention to children with speech, language and literacy difficulties. Jessica joined the National Acoustic Laboratories in 2010 as a research speech pathologist to work with the families and evaluate the speech and language outcomes of children currently participating in the Longitudinal Outcomes of Children with Hearing Impairment (LOCHI) and Children with Unilateral Hearing Loss (CUHL) studies.

Additional information

Funding

The project described was partly supported by Award Number R01DC008080 from the National Institute on Deafness and Other Communication Disorders, and by the Victorian Government Department of Education and Training, through the Victorian Deaf Education Institute. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Deafness and Other Communication Disorders or the National Institutes of Health. The project was also supported by the Commonwealth of Australia through the Department of Health Office of Hearing Services, and through the establishment of the HEARing CRC and the Cooperative Research Centres Program. The funding organizations had no role in the design and conduct of the study; in the collection, analysis, and interpretation of the data; or in the decision to submit the paper for publication; or in the preparation, review, or approval of the manuscript. The authors have no financial relationships relevant to this article to disclose.