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 = −0.45, p < 0.01, Parental Involvement r = −0.32, 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 (−4.43 [95% confidence interval: −6.97; −1.89]). After controlling for maternal education and activation age, parental self-efficacy mediated the negative effect between family stress and spoken language (indirect effect = −1.91 [3.45; −0.69]; proportion mediated = 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.