PEDIATRIC HEARING AID MANAGEMENT CHALLENGES AMONG HISPANIC FAMILIES
Ana Caballero and Karen MuñozUtah State University
EHDI Meeting March 9, 2015
Factors Affecting Outcomes
Spoken Language
Early Intervention
Auditory experience
Language Experiences
Yoshinaga-Itano et al., 1998; Moeller et al., 2009; Tomblin et al., 2014; Muñoz, et al, 2014
Parent Parent Parent Parent ChallengesChallengesChallengesChallenges
Parent Challenges Impact Hearing Aid Use
Pare
nt
Ch
alle
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s He
arin
g aid u
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1/3 most waking hours based on parent report (Munoz et al., 2014)
4.5 hours per day based on data logging (Jones, 2013)
Parent report over-estimates use time (Walker et al., 2013) and - -
� Fewer hours of use for younger children milder hearing loss and lower maternal education
Such as…
� Activities
� Child behavior
� Emotions
� Recognition of benefit
� Parent confidence
� Skills of other caregivers
Munoz et al., 2013; Walker et al., 2013; Munoz et al., 2014.
Hispanic Culture: Factors to consider
Beliefs
Access to Services
Cultural Perspectives
• Language• Familism• Fatalism
• Family-centered• Culturally sensitive• Same quality &
quantity
Hispanic Parent Perspectives
Hispanic Parent Survey Findings(N=18)
EducationEducationEducationEducation IncomeIncomeIncomeIncome
High School or less 44%Less than $20,000
59%
High School Graduate/GED
39%$21,000-$40,000
29%
Some College 11%$41,000-$80,000
6%
Bachelor’s Degree 6%More than $81,000
6%
Parent DemographicsParent DemographicsParent DemographicsParent Demographics
• Primary caregiver: Mother (89%)
• Child lives with: Both parents (89%)
• Communication with Audiologist: • Needs help: 56%
Child Demographics
Degree of Hearing LossDegree of Hearing LossDegree of Hearing LossDegree of Hearing Loss
Better ear
Mild 11%
Moderate 28%
Moderately severe
17%
Severe 28%
Profound 5%
Do not know 11%
• Current Age: M = 25 months (Range: 3-64)
• Duration HA use: M = 11 months (minimum 3 months)
• HA Fitting = 27% older than 6 months
• Additional disabilities: 17%
• Spoken language: 94%
• Other family members with hearing loss: 31%
What information do Hispanic Parents need?MOST FREQUENTLY DESIRED
Most Frequently DesiredMost Frequently DesiredMost Frequently DesiredMost Frequently Desired %%%%
What child can/cannot hear without hearing aids 82%
What child can/cannot hear with hearing aids 76%
How to get loaner hearing aids 71%
How to help the child hear better in noisy places 71%
Finding financial assistance 65%
Knowing when the audiologist needs to check the hearing aids
65%
Meeting other parents with children with hearing loss 65%
How to determine if the hearing aids are helping 59%
How to prevent losing the hearing aids 59%
Knowing about hearing aid options/accessories 53%
What skills do Hispanic Parents want to learn?MOST FREQUENTLY DESIRED
Most Frequently DesiredMost Frequently DesiredMost Frequently DesiredMost Frequently Desired %%%%
How to do basic hearing aid maintenance 76%
How to keep hearing aids on when child resists 59%
How to use a listening stethoscope to check hearing aid function
59%
How to do the Ling Sound Test 53%
How to teach others to help manage the hearing aids 47%
How to know when the child needs new earmolds 41%
How to clean and re-attach the tubing to the hearing aid 41%
93% 93% 93% 93% ---- Battery tester 93% Battery tester 93% Battery tester 93% Battery tester 93% ---- Air blower 79% Air blower 79% Air blower 79% Air blower 79% ---- Listening stethoscope 67% Listening stethoscope 67% Listening stethoscope 67% Listening stethoscope 67% ---- Cleaning Cleaning Cleaning Cleaning toolstoolstoolstools
Parents have…Parents have…Parents have…Parents have…
What Hearing Aid Use Challenges Are Encountered?TOP CHALLENGES
TopTopTopTop ChallengesChallengesChallengesChallenges %%%%
Fear of losing hearing aids 78%
Frequent feedback 56%
Distractions and needs of other children at home 39%
Activities (playing outside, riding in the car) 39%
Difficulty getting a set routine 39%
Not seeing my child benefiting from hearing aids 39%
Other caregiver’s ability to manage hearing aids 35%
The hearing aids not working 29%
Support and CommunicationWhat do Hispanic parents want from their Audiologist?
Needs from their AudiologistNeeds from their AudiologistNeeds from their AudiologistNeeds from their Audiologist %%%%
Check to see if I need help or support 39%
Help me to monitor problems 33%
Give me the opportunity to talk about how I am feeling
28%
Ask for my thoughts and opinions 28%
Provide me with concrete resources 28%
Teach me in ways I can learn 28%
Talk in a way I can understand 22%
Help me gain confidence managing the hearing aids 22%
Clinical Implications
Considerations to improve services when….….working with the Hispanic population
FamilyFamilyFamilyFamily ConsiderationsConsiderationsConsiderationsConsiderations SuggestionsSuggestionsSuggestionsSuggestions
Educational level: LowTeach in a way I can learn
• Provide information at an appropriate educational level • Provide information to both parents and extended family
Family annual income: Low • Provide information about funding resources/programs
English proficiency level: LowTalk in a way I can understand
• Provide interpretation services• Provide written resources in the native language
Opportunity to talk about their feelings, thoughts and opinions
Check to see if I need help or support
• Ask parents how they are doing• Find out what is important to the parents• Include parents in decision making and problem solving
“I want my Audiologist to be patient with me” …“I want to have more time with the Audiologist”
Considerations to improve services when….….working with the Hispanic population
ConsiderationsConsiderationsConsiderationsConsiderations SuggestionsSuggestionsSuggestionsSuggestions
Child’s age when fit with hearing aids: > 6 months• Provide written resources about hearing loss/HA/CI/Follow Up.• Provide guidelines/roadmap to parents considering cultural
trends.
Meeting other parents with children with HL• Provide educational and support groups.• Provide networking opportunities.
Other caregiver’s ability to manage HAs• Provide hearing aid management education to caregivers and
extended families, not only the parents.
“Are there any other Hispanic families with children with hearing loss?. I would like to meet them”
HISPANIC PARENTS NEEDED FOR RESEARCH STUDY
Requirements:
Hispanic Families with:• Children 0-5 years old • Bilateral hearing loss • Have hearing aids • Speak Spanish
If interested, PLEASE contact me:Ana Caballero – (801) 857-1828Email: [email protected]