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Pediatric Hearing Aid Use: Parent-Reported Challenges

Muñoz, Karen1,2; Olson, Whitney A.1; Twohig, Michael P.3; Preston, Elizabeth1; Blaiser, Kristina1; White, Karl R.2,3

doi: 10.1097/AUD.0000000000000111
Research Articles

Objectives: The aim of this study was to investigate parent-reported challenges related to hearing aid management and parental psychosocial characteristics during the first 3 years of the child’s life.

Design: Using a cross-sectional survey design, surveys were distributed to parents of children with hearing loss via state Early Intervention programs in Utah and Indiana. Packets contained one family demographic form and two sets of three questionnaires to obtain responses from mothers and fathers separately: the Parent Hearing Aid Management Inventory explored parent access to information, parent confidence in performing skills, expectations, communication with the audiologist, and hearing aid use challenges. The Acceptance and Action Questionnaire measured psychological flexibility, experiential avoidance, and internal thought processes that can affect problem-solving ability and decrease an individual’s ability to take value-based actions. The Patient Health Questionnaire identified symptoms of depression. Thirty-seven families completed questionnaires (35 mothers and 20 fathers).

Results: Most responses were parents of toddlers (M = 22 months) who had been wearing binaural hearing aids for an average of 15 months. Both mothers and fathers reported that even though the amount of information they received was overwhelming, most (84%) preferred to have all the information at the beginning, rather than to receive it over an extended time period. Parents reported an array of challenges related to hearing aid management, with the majority related to daily management, hearing aid use, and emotional adjustment. Sixty-six percent of parents reported an audiologist taught them how to complete a listening check using a stethoscope, however, only one-third reported doing a daily hearing aid listening check. Both mothers and fathers reported a wide range of variability in their confidence in performing activities related to hearing aid management, and most reported minimal confidence in their ability to troubleshoot hearing aid problems. More than half of the parents reported child behavior and activities, such as playing outside, as a major hearing aid use challenge. Parents reported hearing aids were worn all waking hours by 35% of children and less than 5 hr/day by 31%. Almost half of the parents (47%) did not feel that they had enough time to talk about their emotions when speaking with their audiologist(s), 69% reported the audiologist did not help them know what to expect related to emotions about their child’s hearing loss, and 22% reported symptoms of depression.

Conclusions: Parents reported an array of challenges, even after their child had been wearing hearing aids for a prolonged time, revealing critical implications for how to provide audiological care. Audiologists have an important role in partnering with parents to identify and jointly problem-solving challenges related to their child’s hearing aid use. Supporting parents includes not only addressing technical aspects of hearing testing and hearing aid function but also addressing parent thoughts, feelings, and emotions.

Newborn hearing screening provides the opportunity for early hearing loss detection and intervention. For children learning spoken language, auditory experience is an essential intervention component. Parents of young children, however, experience an array of challenges with hearing aid management that negatively influences consistent hearing aid use. Beyond technical expertise and services, audiologists have a central role in adjustment counseling to support parent learning. By better understanding parent experiences with daily hearing aid management, audiologists can more effectively partner with parents to identify barriers and explore solutions.Supplemental Digital Content is available in the text.

1Department of Communicative Disorders and Deaf Education, Utah State University, Logan, Utah, USA; 2National Center for Hearing Assessment and Management, Utah State University, Logan, Utah, USA; and 3Department of Psychology, Utah State University, Logan, Utah, USA.

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The work reported in this article was funded in part by the Maternal and Child Health Bureau under Cooperative Agreement No. U52MC04391 with the National Center for Hearing Assessment and Management at Utah State University. The opinions expressed in the article are those of the authors and do not necessarily reflect those of the Bureau.

The authors declare no other conflict of interest.

Address for correspondence: Karen Muñoz, Department of Communicative Disorders and Deaf Education, Utah State University, 2620 Old Main Hill, Logan, UT 84321, USA. E-mail:

Received December 12, 2013; accepted August 22, 2014.

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