Pediatric Hearing Aid Management - Ear and Hearing
Jacobs EHDI Poster Final
1. Learning Project
Self-Efficacy
Questionnaire Methods Results
Discussion
In Summary
Demographics
Questions
1. What is parental self-efficacy?
2. How is parental self-efficacy related to language outcomes
of children with hearing loss?
3. Do parent perceptions of EI services align with best
practice recommendations?
4. What strategies can EIs use with parents to foster parental
self-efficacy?
Activities
1. Literature review
2. Online parent questionnaire
3. Early Interventionist interview
Important findings
1. Parental self-efficacy positively relates to expressive and
receptive language outcomes of children with hearing
loss.3,5,7
2. Current best practice recommendations for family-
centered early intervention for children with hearing loss
include increasing parental self-efficacy.12
3. Research shows that mothers of children with cochlear
implants perceive themselves as having more parental
self-efficacy than mothers of children with hearing aids.6
4. Questionnaires completed by an EI and parents of
children with hearing loss revealed they did not agree on
the importance of developing parental self-
efficacy/confidence during sessions.
• Implement a mentorship model by collaborating with
parents to provide hands-on training and practice.4,7,8,10,13
• Help parents understand how hearing loss impacts
communication development and how to monitor their
child’s hearing technology and hearing status.2
• Provide consistent, constructive, and encouraging
feedback to parents.2,7,13
• Recognize the family as the most significant resource for
the child.10
• Incorporate suggested strategies into the daily routines of
the family.8,13
• Monitor parental self-efficacy.4,7
Parent/Early Interventionist Questionnaire
Parents
(n=16)
On a scale of 1 being the most important and 8
being the least important, the Early Interventionist
should…
EI
(n=1)
1 Provide communication strategies I can use
with my child during daily routines
4
2 Work directly with my child on his/her
communication skills
8
3 Provide me with feedback during home visits on
my language interactions with my child
3
4 Teach me how my child’s hearing loss impacts
communication
2
5 Increase my confidence in managing my
child’s listening device(s) and communicating
with my child
1
6 Teach me about my child’s audiogram/hearing
loss
5
7 Teach me how to use and troubleshoot my child’s
listening devices
6
8 Provide information to me related to parent
support groups
7
6%
62%13%
19%
Listening Device
None
Hearing Aid(s)
Cochlear Implant(s)
Both
38%
31%
31%
Environment for EI Sessions
Home
School/Daycare
Both
• An online questionnaire was distributed via email
to families of children with hearing loss
participating in early intervention services
throughout the United States.
• Participants rated statements related to the role of
the EI provider with 1 being the most important
and 8 being the least important.
• The results from 16 families were compared to
feedback from an Early Interventionist currently
working in the Midwest region.
Location
Parents self-reported living in five different states in
the Midwest, South, and Northeast regions.
Age
Range: 13 – 45 months Mean: 26.5 months
2 2
0
1
6
5
0-3 months 3-6 months 6-9 months 9-12 months 1-2 years 2-3 years
Length of Time Receiving EI Services
High Parental
Self-Efficacy
Higher Level
Language
Techniques
Used by
Parents
Improved
Language
Outcomes for
Children with
Hearing Loss
People with Low
Self-Efficacy1,7
People with High
Self-Efficacy1,7
• Doubt they are capable
• Avoid difficult tasks
• Have low aspirations
• Do not commit to goals
• Give up quickly
• Do not take failure well
• Have the knowledge, but do
not persist through the task
• Take on challenging tasks
• Set and commit to
challenging goals
• See failure as a reason to
try harder
• Have the knowledge and
persist until success is
achieved
Definitions
• Self-Efficacy - the belief in one’s ability to complete a task
successfully1
• Parental Self-Efficacy – the belief in one’s ability to
perform parenting tasks and roles7
• “They never allowed us to feel we were
doing anything wrong.”
• “Encouraging us how to improve as
parents and communication partners
with our child.”
• “Lots of examples and lots of feedback
on what we are doing.”
Ask yourself, “Did I leave the
parent feeling empowered and
motivated for the upcoming
week?”
(JCIH, 2013, p. 1345)
Strategies Early Interventionists Can Use to Foster Parental Self-Efficacy to Promote
Improved Language Outcomes for Children with Hearing Loss
Lindsay Jacobs, M.Ed.
“In what ways has the early interventionist
helped you feel more confident about
using communication strategies with your
child?”
Statements in bold demonstrated the greatest disparities
when comparing parent responses to the EI’s responses.
• While early enrollment in early intervention
improves language outcomes for children with
hearing loss,11 parental self-efficacy promotes the
use of higher level language techniques, which
also leads to improved language outcomes.3,5,7
• Research shows that families can learn to use
higher level language techniques regardless of
socioeconomic status.3
• Questionnaire results from this project
demonstrate that parents may not understand the
role of the EI and the importance of developing
parental self-efficacy as it relates to their child’s
language development.
• Research shows that mothers of children with
cochlear implants have higher parental self-
efficacy compared to mothers of children with
hearing aids, which may be due to:6
• Additional support from cochlear implant
teams
• More time to gain knowledge given implant
users are typically older
• Ineffectiveness of hearing aids, which may
cause mothers to feel more efficacious with
cochlear implants
Self-Efficacy and Language Development
• To foster language development in children with hearing
loss, parents need knowledge and skills, confidence in
those skills, and daily use of the skills through interactions
with their children.7
• Mothers of children with hearing loss who have high
parental self-efficacy use higher level language techniques
including recasts and open-ended questions, which studies
have shown to be associated with better language
outcomes.3,5,7
References
Strategies for EIs
Please see the handout for a full list of references.