Caregivers' communication choices for children with hearing loss

18 DECEMBER 2013

Research by a Charles Sturt University (CSU) PhD graduate provides insight into how parents make a range of decisions, and what those decisions are, when their baby is born with hearing loss.

Kate CroweResearch by a Charles Sturt University (CSU) PhD graduate provides insight into how parents make a range of decisions, and what those decisions are, when their baby is born with hearing loss.
 
Dr Kate Crowe will graduate at the Faculty of Education ceremony at CSU in Bathurst at 9.30am Thursday 19 December, and will receive her PhD for her thesis titled, Multilingual children with hearing loss: communication and choice.
 
This research has expanded current understanding of how children with hearing loss and their caregivers communicate, and what factors influence caregivers' decision-making about how their children will communicate. It will assist educators, therapists, organisations, policy-makers, and researchers to support families of children with hearing loss to make informed decisions about accessing audiological, educational, and habilitation services (to help learn and improve functional skills).
 
"Because hearing loss can affect young children's speech and language acquisition, the importance of early decisions about communication cannot be ignored," Dr Crowe said. "These decisions have long-term implications for children's linguistic, behavioural, cognitive, social, emotional, and vocational futures, as well as the immediate and long-term functioning of the child, their caregivers, and their family."
 
The findings of Dr Crowe's research highlight the breadth of influences that caregivers consider when deciding how their children with hearing loss will communicate. Caregivers placed importance on factors that were immediately relevant, such as the severity of their child's hearing loss, as well as planning for children's futures, such as maximising their children's chances of experiencing educational and vocational success and engaging in the hearing and/or deaf communities. The advice that caregivers received from professionals, such as speech pathologists, educators, and audiologists, was also an important source of influence on their decision-making.
 
Dr Crowe explained that newborn hearing screening has led to many children being identified with hearing loss very early in their lives. Early identification and intervention for hearing loss has been associated with improved auditory, speech, and language outcomes in many studies, with early access to effective communication being one of the key factors. With earlier identification, caregivers now make decisions about their children's hearing and communication management earlier than at any time in the past.
 
"Caregiver decision-making about communication with their children with hearing loss encompasses two key areas - communication mode and language choice," Dr Crowe said. "Communication mode describes decisions about the development of language through spoken language (English, Arabic), sign language (Australian Sign Language: Auslan), or a combination of speech and sign. Language choice describes decisions made by families who are multilingual; that is, whether the children will speak one or more languages. Although there is research into the outcomes of children who use different communication modes, limited information is available that describes the outcomes of multilingual children with hearing loss, the decisions made by their caregivers, or the influences on caregivers' decision-making.
 
"Determining how to support children with hearing loss in accessing effective communication may be challenging and confronting for caregivers. Most caregivers of children with hearing loss have no prior family history of hearing loss, and have limited knowledge or experience of hearing loss. Therefore, caregivers need to quickly comprehend large amounts of information in order to make informed decisions about how they and their family will communicate with their child at a time when the impact of the hearing loss on their child's speech and language acquisition is unknown."
 
Dr Crowe's research considered the issue of communication choices for children with hearing loss in four ways. Firstly, what outcomes are expected for children with hearing loss, especially those which impact on the outcomes of children who use languages other than English? Secondly, which communication modes and spoken languages are used by a population sample of young Australian children with hearing loss and their caregivers? Thirdly, what relationships exist between children and caregivers' characteristics and the communication modes and languages that they use? Finally, what influences caregivers' decision-making about communication mode and language use for their children with hearing loss? To investigate these issues, a series of reviews and research studies were conducted that have been published in or submitted to national and international journals.

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