‘Part of Our World’: Influences on Caregiver Decisions about Communication Choices for Children with Hearing Loss

Abstract

Caregivers of young children with hearing loss make decisions about which communication mode/s and spoken language/s their children and family will use. Influences on decision-making about communication were examined for 177 caregivers of Australian children with hearing loss through a questionnaire. The majority of the 157 children used speech as part or all of their communication system (n = 138, 87.9%), and approximately one-third of the children (n = 52, 33.1%) currently or had previously used sign as part or all of their communication system. Twenty-two (14.0%) children and 35 (19.8%) caregivers used a spoken language other than English. Four themes emerged from the qualitative analysis of caregiver responses about the most important influences on their decision-making. Theme one identified caregivers’ sources of information, including advice from professionals, family, and friends, as well as caregivers’ own research and preferences. Theme two related to practicalities of communication within the family and the community, as well as the need for one language or communication mode to be acquired before another was introduced. Theme three described the influence of children’s individual characteristics on caregivers’ decision-making, including children’s ability to access speech through audition, communication skills, additional disabilities, and children’s own preferences about communication. Finally, in theme four caregivers expressed their hopes for their children’s future lives, specifically fostering a sense of belonging, creating future opportunities and successes, and giving children the opportunity to choose their own method of communication. The findings can assist families and professionals to make informed decisions about children’s communication.

Speech, Sign, or Multilingualism for Children With Hearing Loss: Quantitative Insights Into Caregivers' Decision Making

“…In the current investigation, these gaps were taken into account to provide an exploratory description of influences on caregiver decision making about communication mode and language use for Australian children with hearing loss. Two methodologies were used to examine this topic: a qualitative investigation, reported in Crowe, Fordham, McLeod, and Ching (2014), and the quantitative investigation described in this article. Both of these articles are based on the responses of the same caregivers to different parts of a questionnaire.…”

“…This is a companion article to the qualitative investigation described in Crowe, Fordham, McLeod, and Ching (2014). Method: Through a questionnaire, 177 caregivers of 157 Australian children with hearing loss (ages 3;5 to 9;4 [years;months], M age = 6;6) rated the importance of a range of potential influences on their decision making regarding their children's communication.…”

Exploring how parents of children with unilateral hearing loss make habilitation decisions: a qualitative study

“…Following identification of UHL, treatment options available include hearing aid provision (Contralateral Routeing Of Signal (CROS) aid, behind the ear hearing aids, Bone Anchored Hearing Aids (BAHA) on softband) (Rohlfs et al 2017) and other types of audiological intervention such as cochlear implants and bone-anchored hearings aids (Lieu 2013;Doshi et al 2013;Hassepass et al 2013), although cochlear implants and bone-anchored hearing aids are not routine intervention options in England. Modes of communication are also an important factor to consider and the subsequent need for Speech and Language Therapy is also available to help support children with hearing losses (Ching et al 2018;Crowe, Fordham, et al 2014).…”

“…This suggests that decision making is a linear, static process; however the needs of a child with hearing loss will change as they grow, such as school attendance, forming friendships and use of changing technologies. Crowe, Fordham, et al (2014) surveyed parental decision making with regard to children with bilateral hearing loss and noted that information sources (friends, families and clinicians), the child's characteristics and the practicalities of communication strategies all influenced decision making. Similarly communication choices were examined in an American population (Decker and Vallotton 2016).…”

Factors influencing caregiver decision making to change the communication method of their child with hearing loss

“…In recognition of the importance of understanding the process behind caregiver decision-making for children with hearing loss, there is a body of literature which has explored factors that influence caregiver decision-making in the period following the initial diagnosis of hearing loss (Chang, 2017; Crowe, Fordham, McLeod, & Ching, 2014; Crowe, McLeod, McKinnon, & Ching, 2014; Decker et al, 2012; Eleweke & Rodda, 2000; Li, Bain, & Steinberg, 2003; Li, Bain, & Steinberg, 2004; Scarinci, Erbasi, Moore, Ching, & Marnane, 2017). To understand the reasoning behind caregiver decisions to change a child’s method of communication, it is important to first understand the initial decision-making process.…”