What we are doing
About CHerUB's research
Project Background
Hearing aids are an important part of the support babies with any level of hearing loss receive because they help babies access speech sounds, which are critical for spoken language development and to develop the auditory parts of the brain. By getting hearing aids from an early age and importantly using them consistently every day when they are awake, babies are more likely to have better spoken language outcomes.
However, recent research by CHerUB team members Dr Anisa Visram and Professor Kevin Munro has shown that babies are not wearing their hearing aids as often as they need to for optimal benefits, and that achieving consistent hearing aid use can be a challenge for families.
As a result of this work, we were awarded funding from the National Deaf Children’s Society (NDCS) and UKRI's Medical Research Council (MRC) to develop a programme of support for families of babies and toddlers under 3 years of age to help overcome the challenges of incorporating hearing aid use into daily life and ultimately achieve consistent hearing aid use from the very start.
We are doing this in 3 phases:
Phase 1: Understanding the challenges
Phase one has now been completed
To help us develop a programme of support for families, we needed to develop a deeper understanding of the challenges or ‘barriers’ to consistent hearing aid use that families face, how these barriers might influence one another and change over time, and the situations or circumstances they tend to happen in.
We did this in 3 steps:
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A systematic review of all the existing evidence to find the barriers to consistent hearing aid use (and any factors that help families achieve consistent hearing aid use) reported by parents and professionals working with families.
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Interviews with parents, teachers of the deaf, audiologists, and educational audiologists about their experiences and perspectives around the challenges using hearing aids, and the factors that help make it easier.
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An anonymous online parent questionnaire about thoughts and experiences using hearing aids with babies and toddlers to help quantify the challenges (e.g., which are most common).
The science behind why achieving consistent hearing aid use is no easy task
For many parents, managing hearing aid use with their baby is something that is new to their likely already hectic routine, and means having to change or adapt what they do day-to-day to achieve consistent hearing aid use. In other words, it means forming new habits. For us to be able to adopt good habits and put plans into action we need 3 things:
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Capability – whether we have the knowledge and/or skills needed to carry out the actions. For example, a good understanding of the role of hearing aids in later speech development can help parents along their journey using hearing aids.
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Opportunity – whether our social, interpersonal, and/or physical environment makes it possible to carry out the actions. For example, support from other families who have been through similar experiences can help.
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Motivation – whether we have the motivation to carry out the actions. For example, managing difficult emotions such as feelings of worry and sadness might get in the way of working towards consistent hearing aid use.
Having the capability, opportunity, and/or motivation is not always easy as there are things can get in the way, and some of these can change over time and depend on the situation and context parents find themselves in. For example, a day of temper tantrums might lead to little or no hearing aid use that day. With this in mind, it is important that we developed a better understanding of the barriers parents face, how they influence one another and change over time, and the situations or circumstances they tend to happen in. Equipped with this information, we can now work with parents and professionals to map practical solutions to these barriers in phase 2 of the project.
Phase 2: Developing a programme of support
Phase two is our current focus
Based on findings from the research in phase 1, we are building on work already being done with families across the UK to create a programme of support working closely with parents, audiologists, teachers of the deaf, and educational audiologists. We are also developing the programme of support within the scientific theory known as ‘behaviour change theory’, which is about understanding the things that influence what we do (our behaviours), and then providing support to help adapt behaviours to meet goals; in this case, the goal of consistent hearing aid use. This approach has already been successful in supporting adult hearing aid use.
Phase 3: Trying out the programme of support
Phase 3 is our next and final stage
We will invite Teachers of the Deaf and families to try using the programme of support and then chat with us about what worked, what was helpful, what they liked and didn't like, and what needs to be improved. We can then use these findings to develop and improve the programme of support. Think of this phase like a beta-test. Our plan is to then apply for further funding to continue development, which will include feedback from audiologists.