The needs of hearing impaired children's parents who attend to auditory verbal therapy-counseling program.

OBJECTIVE: Exploring the information and support needs of parents with hearing impairment in habilitation process. The effects of variables such as duration of hearing aid use and habilitation (duration of intervention) and the number of hearing impaired individuals in family are also considered during the evaluation. METHODS: Sixty-five parents of children between 24 and 348 months of age (median: 80) participated in this study by returning the completed in The Family Needs Survey. Age at diagnosis of deafness varied from 1 to 84 months of age (median: 16). The duration of hearing aid use was 8-252 months (median: 24) and the duration of intervention was 2-176 months (median: 36). In view of the fact that the family dynamics might have effects on the type and amount of the needs of parents, the number of siblings (none, two or more siblings) and the presence of hearing impaired individuals apart from their child was also explored. RESULTS: The parental needs with regard to different topics such as general information, hearing loss, communication-services and educational resources, family and social support, childcare and community services, financial were evaluated separately. The needs of parents participating in a multi-dimensional Auditory-Verbal intervention program differed by their preferential demands. The duration of intervention was found significantly correlated with the amount of information needs related with other conditions their children may have, explaining their children's hearing problem to others, locating good baby-sitters and day-care programs for their children and transportation (p< or =0.05). It was also found that the long-termed continuing intervention generates additional psychotherapeutic, social and financial needs for the parents. No significant correlation was found between hearing impaired individuals existence with the type and amount of family needs (p>0.05). CONCLUSION: These findings support the positive effect of persistent and long-term Auditory-Verbal therapy and Counseling approach which incorporates parents as inalienable members in all rehabilitation process. Creating an adequate and appropriate educational environment by considering individualized needs and family dynamics in a long term and persistent Auditory-Verbal therapy and Counseling approach are all equally important. In addition to a team approach to management, with parents taking a major role in the habilitation process, and all these will lead to a much better outcome.

The effect of implantation age on visual attention skills.

OBJECTIVE: The aim of this study is to evaluate the visual attention skills of deaf children with cochlear implants and to determine whether age at implantation had any impact on visual attention skills. SUBJECT AND METHODS: Thirty children with cochlear implants aged 6 and 11 years were evaluated and were compared with age matched 36 normal hearing children. The children with cochlear implants were analyzed in to two groups according to their age at implantation; under and at/over 4 years old. The Gordon Diagnostic System (GDS) was used in order to evaluate visual attention skills of cochlear implanted (Group 1 and Group 2) and children with normal hearing. The number of correct responses, extraneous button presses (commission errors) and the number of omission errors or the failure to respond to target stimuli which were recorded by GDS was used to evaluate the visual attention skills of the subjects. Also six different types of commission errors (19X, XX9, XX1, X1X, X9X, XXX) were analyzed and compared both for normal and cochlear implant user children. RESULTS: Concerning the total number of correct response, omission and commission errors no statistical difference was found between two implanted groups. Besides, both groups with cochlear implantation differed from normal hearing peers on the total number of correct responses, omission errors (p<0.017). According to these findings cochlear implanted children had less correct responses and had more omission errors compared with control group. These findings clearly show that children with cochlear implants performed poorly on visual attention task which requires constant attention together with the ability to exert impulse control despite they hear enhanced sensory information by cochlear implants. Concerning the types of commission errors Group 1 and 2 performed similarly in all types of errors (p>0.017). Besides, Group 1 and 2 made more errors in types 19X, XX9 and XXX, XX9 compared with the control group (p<0.017). Group 2 who had their implants after age of 4 years old had more commission errors than the control group (p<0.017) and positive correlation was found between the total commission errors and XX9 error type with age at implantation. These findings show that children who had their implants at older ages made more commission errors and XX9 type of commission error. The children who were implanted after 4 years old were less mature; unsuccessful in controlling their impulsive behaviors and more careless where they can not get enough benefit from social and environmental motives compared with their normal hearing peers. CONCLUSION: This present research points out the positive effect of early implantation on visual attention and the possible adversities such as impulsivity, over-impatience and attention deficits which have been previously suggested as preventive or slowing down factors for the pace of auditory-verbal therapy for cochlear implantees. Assuming that the results of this study support the theory of insufficiency which suggested that the deprivation in auditory system would also adversely affect cognitive structures involved in intermodal processing the importance of early implantation is underlined. If early cochlear implantation will be carried out especially at the very critical period of language development (before age of four), this will help the child, in his/her future life, not only with his/her hearing skills and communication but for his/her attention skills and behavior.