Hearing Instrument Orientation for Children

and Their FamiliesChapter 29 by Tharpe & Ryan

Family Counseling and Education

Family Education

Often 2 to 3 week delay between Dx and HA fitting but may be delayed greater than 4 weeks

Sjoblad et al., 2001

Family Counseling and Education

During this delay, parental experiences may be either positive or negative Negative -- self-doubt, anxiety Positive -- gaining knowledge Robbins (2002) -- recommendations for audiologists to give to parents (re: parent-child interaction) for time period following Dx prior to enrollment in intervention program

Family Counseling and EducationPhase I -- From time of diagnosis to hearing aid fitting

● Continue to talk to your child -- Play gesture games, sing songs, be animated

● Begin a journal of your experience

● Contact the John Tracy Clinic -- they provide correspondence for families in more than 20 languages

Phase II-- Early weeks just following the hearing aid fitting

● Keep a weekly hearing aid calendar

● Refer to your child by name -- always have a purpose for calling your child

● Use a hand-to-ear response when a sound is heard

● Tell your interventionists of changes in vocalizations as well as auditory responses

Phase III -- After the initial adjustment to hearing aids until formal intervention

● Imitate your child's vocalizations, using intonation, patterns and sound

● Encourage an anticipatory response to sound--make clear to your child that you expect a response and wait for that response

● Select three common sounds in your home for your child to learn

Family Counseling and Education

Hearing Aid OrientationMany parents will not remember all the

information to you present to them (Eiser et al., 1994; Reese et al., 2005) What to do?printed handoutsreiterate the same information at follow-upinvite client's extended family to orientation

Family Counseling and EducationFundamental Points for Parents

PLAY VIDEO

Family Counseling and Education

Care and Maintenance cleaning - no alcohol, mold in warm water storage - case with desiccant or drying unit listening check by parent

Family Counseling and Education

Safety Features and Issues Overamplification - verification, deactivate VC Battery Ingestion Ear Placement - left vs right

Family Counseling and Education

Realistic Expectations

Effects of Background Noise Acoustic Feedback Communication Strategies Environmental Awareness

The Physical Fit

Earmolds - retain aids in the ear and house the acoustic pathway from receiver to sound outlet Style Material Venting Tubing

Retention

Behavioral Retention: Establishing the Routine

Physical Retention and Protection

Family Counseling and EducationPhase I -- From time of diagnosis to hearing aid fitting

● Continue to talk to your child -- Play gesture games, sing songs, be animated

● Begin a journal of your experience

● Contact the John Tracy Clinic -- they provide correspondence for families in more than 20 languages

Phase II-- Early weeks just following the hearing aid fitting

● Keep a weekly hearing aid calendar

● Refer to your child by name -- always have a purpose for calling your child

● Use a hand-to-ear response when a sound is heard

● Tell your interventionists of changes in vocalizations as well as auditory responses

Phase III -- After the initial adjustment to hearing aids until formal intervention

● Imitate your child's vocalizations, using intonation, patterns and sound

● Encourage an anticipatory response to sound--make clear to your child that you expect a response and wait for that response

● Select three common sounds in your home for your child to learn

Follow-Up and Monitoring

How Often for Follow-UpEvery 3 mos. for first through age 2 yearsEvery 4 to 6 mos. for children 3 years and older Hearing aid check - listening check and electroacoustic analysis

Follow-Up and MonitoringNew Moldsnew molds ~ 2 to 4xyear depending on acoustic fit

Real-ear verification following the fitting of new molds

Hearing evaluations - annually

Child Education

As the child gets older, interaction with aids increases Insertion/removal of aids and batteries Cleaning/storing aids Use of volume control and/or program button Increasing knowledge of hearing loss/ aids

References

����Eiser, C., Parkyn, T., Havermans, T., and McNinch, A. (1994). “Parents’ recall on the diagnosis of

cancer in their child,” Psycho-Oncology 3, 197-203. Ingrao, B. (1999). “MORE THAN MEETS THE EAR : UNDERSTANDING AND OPTIMIZING YOUR

CHILD’S EARMOLDS,” Volta Voices 26-29. Reese, J. L., and Hnath-Chisolm, T. (2005). “Recognition of hearing aid orientation content by first-

time users,” American journal of audiology 14, 94-104. Robbins, A. M. (2002). Empowering parents to help their newly diagnosed child gain communication

skills. The Hearing Journal, 55(11), 55-56, 59. Retrieved from http://journals.lww.com/thehearingjournal/Abstract/2002/11000/Empowering_parents_to_help_their_newly_diagnosed.10.aspx

Sjoblad, S., Harrison, M., Roush, J., and McWilliam, R. A. (2001). “Parents’ reactions and

recommendations after diagnosis and hearing aid fitting,” American journal of audiology 10, 24-31.