Parenting Stress, Self-Efficacy, and Involvement: Effects on Spoken Language Ability Three Years After Cochlear Implantation

Abstract

Objective: This study evaluated associations among parenting stress, self-efficacy, and involvement in relation to spoken language outcomes in young children 3 years following cochlear implantation. Study Design: Cross-sectional. Setting: Six university tertiary medical centers. Patients: One hundred sixty-four young children with bilateral, severe-to-profound sensorineural hearing loss who had 3 years of experience with a CI; children with substantial cognitive impairments were excluded from the study. Main Outcome Measures(s): Family Stress Scale (FSS), Scale of Parental Involvement and Self-Efficacy (SPISE), Oral and Written Language Scales (OWLS). Results: Correlations were of moderate strength between FSS scores and SPISE scores (Parental Self-Efficacy, r ¼ À0.45, p < 0.01, Parental Involvement r ¼ À0.32, p < 0.01). As hypothesized, parents reporting higher levels of stress reported lower perceptions of self-efficacy and involvement. In addition, results showed that family stress had a direct, negative effect on spoken language (À4.43 [95% confidence interval: À6.97; À1.89]). After controlling for maternal education and activation age, parental selfefficacy mediated the negative effect between family stress and spoken language (indirect effect ¼ À1.91 [3.45; À0.69]; proportion mediated ¼ 0.43). No mediating effects were found for parental involvement. Conclusions: These findings highlight the need for parenting interventions that focus on reducing stressors and increasing parents' perceptions of self-efficacy in families of children using cochlear implants. Integration of mental health screening and tailored parenting interventions in CI clinics may increase parental self-efficacy and involvement, with measurable benefits in the child's use of spoken language.

Caregiver stress and social determinants of health in key populations: immigrant parents, parents of children with medical complexity, and adolescent parents

“…These correlations were stronger among Black participants, who reported higher levels of food insecurity and difficulties with family finances during the pandemic [15 ▪ –17 ▪ ]. For parents of children with newly-placed cochlear implants, stress correlated with less use of spoken language in the home, which can, in turn, affect child language outcomes [18 ▪ ]. This SDOH is discussed at length in the upcoming section on parents of children with medical complexity.…”

Family-Centered Early Intervention (FCEI) Involving Fathers and Mothers of Children Who Are Deaf or Hard of Hearing: Parental Involvement and Self-Efficacy

“…Overall, both mothers and fathers report relatively high levels of self-efficacy related to caring for and supporting the audiologic needs and language development of children who are DHH [26,28]. Family stress does seem to negatively impact both PSE related to audiological care and parent involvement, at least among children who utilize spoken language [29]. The exploration of PSE of parents/caregivers of children who are DHH outside of the focus of audiologic understanding and management is an area that is, to date, understudied.…”

Multidimensional Family-Centred Early Intervention in Children with Hearing Loss: A Conceptual Model

“…However, in contrast to families with children with typical hearing, greater parenting stress in families with children with HL was associated with poorer spoken language skills in their children, which, in turn, mediated the association with poorer inhibitory control skills [ 82 ]. A recent multicentre study, on 164 young children with normal intelligence, with a duration of cochlear implant use of at least three years, focused on possible mechanisms through which parenting stress affects spoken language outcomes and found parental self-efficacy as a mediator to account for 43% of this relationship [ 83 ].…”