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

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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: ana.caballero@usu.edu