PP109 - Deaf or Hard of Hearing Children’ s Language Modalities: What Information Is Provided?

Abstract:
Providers of Deaf or hard of hearing (DHH) children are one of the first to provide information to parents about their child’s hearing status. There is a lack of literature regarding professionals’ impact on language modality decisions for DHH children. This study primarily aims to answer a question: How do providers of DHH children offer guidance, information, and recommendations to parents about language modality? Results analyzed from interviews with providers suggest that the majority of providers do counsel parents of DHH children about language modality decisions, however professional and personal factors influence what they emphasize regarding counseling language modalities.

Summary:
Making early decisions regarding language modality will benefit Deaf or hard of hearing (DHH) children in supporting their language development, academic performance, and psychosocial development. The decision-making process generally involves DHH children and their families as well as a diverse team of healthcare providers, which may include primary care providers, audiologists, speech-language pathologists (SLPs), early interventionists, DHH teachers, etc. Healthcare professionals’ involvement in language modality decision-making process for DHH children should ideally be unbiased and client-centered, but the reality is often more complex. There is a sparse literature on how professionals provide information and recommendations to DHH children and their families or their impact on language modality decision-making for DHH children. Therefore, the study aims to address three research questions: 1) How do providers of DHH children offer guidance, information, and recommendations to parents about language development and modality? 2) What information, guidance, and recommendations do providers of DHH children offer to parents about language development and modality? 3) Is there a bias in healthcare counseling in support of DHH children's language selection? If so, what are the biases?

141 participants, including a group of 84 providers and a group of 57 parents, were recruited across the states to complete a questionnaire. Among all participants, 23 participants (16 providers and 7 parents) consented to participate in an interview after completing the questionnaire. This research study was approved by the Institutional Review Board (IRB) at California State University, Sacramento under protocol number Cayuse-23-24-74. Questionnaire responses were collected anonymously using Qualtrics, including demographic questions and general questions about their perceptions and experience of language modality decision-making. Semi-structured interviews were scheduled with participants who consented to the interview and conducted via Zoom. The interviews were guided by a list of open-ended probe questions such as “What is your approach in giving information about language modality?” and “What topics were specifically discussed when your providers touched on language modalities?” The interviews were audio-recorded, de-identified, and then transcribed in Otter.ai. The transcriptions were then coded using a thematic analysis approach.

Brief Summary of Clinical Takeaways:
Results suggested that providers apply a variety of approaches in language modality counseling. Some of them tend to provide all resources possible whereas others emphasize information based on factors such as children’s hearing status or family priorities. Professional and personal factors such as education may influence their approaches. SLPs and audiologists were perceived by both providers and parents to emphasize hearing and oral communication the most, while early interventionists were considered to have more of a whole-child perspective. However, most providers have been attempting to put aside their bias and use evidence-based practice. Regardless of the approach, providers encounter other challenges toward providing all possible communication options, including systematically inadequate resources, time constraint, and parents’ strong preference to a particular modality. Providers are looking for more resources on language options in a factual and neutral manner, systematic curriculum adjustments in education programs to require exposure to Deaf studies, and continuous education to enhance evidence-based practice.