Improving Pediatric Hearing Testing for Children with Developmental Delays: The Effects of Video Modeling on Child Compliance and Caregiver Stress
09 June 2020 (online)
Background For children with developmental delays (DDs) of any kind (e.g., global DDs, autism spectrum disorder, and Down syndrome), it is essential to understand if a hearing loss may be contributing to these delays. However, toddlers with DDs may have difficulty understanding directions, may be uncomfortable with a new situation, or may simply not want to complete the hearing testing tasks. Regardless of the reasons, noncompliant behaviors have a negative impact on hearing testing, which requires reliable behavioral responses from the child.
Purpose The purpose of this study was to test a video intervention to improve hearing testing compliance in toddlers with developmental disabilities.
Research Design Double-blind randomized clinical trial.
Study Sample Twenty-four children with DDs between 24 and 36 months of age.
Intervention Video model of the hearing testing procedures.
Data Collection and Analysis The primary child outcome measure was the number of hearing tests completed by the audiologist. Caregiver outcome included a parent survey of perceived stress level before and after the evaluation.
Results There was no significant difference between treatment and control groups regarding the number of hearing tests that were completed. Parents in the treatment group reported less stress following the evaluation as compared with parents of children in the control group.
Conclusions Pre-exposure to the hearing testing procedures did not significantly improve patient compliance but may reduce caregiver stress. Given the high rates of noncompliance in toddlers with DDs, audiologists may benefit from multiple strategies to help improve testing compliance.
- 1 Al-Namankany A, Petrie A, Ashley P. Video modelling for reducing anxiety related to the use of nasal masks place it for inhalation sedation: a randomised clinical trial. Eur Arch Paediatr Dent 2014; 16 (01) 13-18
- 2 American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. Arlington, VA: American Psychiatric Publishing; 2013
- 3 Baker B, Blacher J, Crnic K, Edelbrock C. Behavior problems and parenting stress in families of three-year-old children with and without developmental delays. J Amer Ment Retard 2002; 107 (06) 433-444
- 4 Baker BL, McIntyre LL, Blacher J, Crnic K, Edelbrock C, Low C. Pre-school children with and without developmental delay: behaviour problems and parenting stress over time. J Intellect Disabil Res 2003; 47 (4–5): 217-230
- 5 Bellini S, Akullian J. A meta-analysis of video modeling and video self-modeling interventions for children and adolescents with autism spectrum disorders. Exceptional Child 2007; 73 (03) 264-287
- 6 Case L, Yun J. Video modeling and Test of Gross Motor Development-3 performance among children with autism spectrum disorder. Eur J Adapt Phys Act 2019; 11 (02) 1-10
- 7 Charlop-Christy MH, Le L, Freeman KA. A comparison of video modeling with in vivo modeling for teaching children with autism. J Autism Dev Disord 2000; 30 (06) 537-552
- 8 Cuvo AJ, Godard A, Huckfeldt R, Demattei R. Training children with autism spectrum disorders to be compliant with an oral assessment. Res Autism Spectr Disord 2010; 4 (04) 681-696
- 9 Davis R, Stiegler LN. Toward more effective audiological assessment of children with autism spectrum disorders. Semin Hear 2005; 26 (04) 241-252
- 10 Demopoulos C, Lewine JD. Audiometric profiles in autism spectrum disorders: does subclinical hearing loss impact communication?. Autism Res 2016; 9 (01) 107-120
- 11 Downs D, Schmidt B, Stephens TJ. Auditory behaviors of children and adolescents with pervasive developmental disorders. Semin Hear 2005; 26 (04) 226-240
- 12 Dworzynski K, Ronald A, Bolton P, Happé F. How different are girls and boys above and below the diagnostic threshold for autism spectrum disorders?. J Am Acad Child Adolesc Psychiatry 2012; 51 (08) 788-797
- 13 Fitzpatrick EM, Lambert L, Whittingham J, Leblanc E. Examination of characteristics andmanagement of childrenwith hearing loss and autismspectrumdisorders. Int J Audiol 2014; 53 (09) 577-586
- 14 Gray C, White AL, McAndrew S. My Social Stories Book. London, UK: Jessica Kingsley Publishers; 2002
- 15 Harris P, Taylor R, Thielke R, Payne J, Gonzalez N, Conde J. Research electronic data capture (REDCap)–a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inf 2009; 42 (02) 377-381
- 16 Joint Committee on Infant Hearing. Year 2007 position statement: principles and guidelines for early hearing detection and intervention programs. Pediatrics 2007; 120 (04) 898-921
- 17 Kayfitz AD, Gragg MN, Orr RR. Positive experiences of mothers and fathers of children with autism. J Appl Res Intellect Disabil 2010; 23 (04) 337-343
- 18 Kwok S, Ho P, Chan A, Gandhi S, Urn D. Ocular defects in children and adolescents with severe mental deficiency. J intellect disabil Res 1996; 40 (04) 330-335
- 19 Lord C, Rutter M, DiLavore P, Risi S, Gotham K, Bishop S. Autism Diagnostic Observation Schedule, Second Edition. Torrance, CA: Western Psychological Services; 2012
- 20 Moeller MP. Early intervention and language development in children who are deaf and hard of hearing. Pediatrics 2000; 106 (03) e43
- 21 Padish-Clarin G, Hawkins J. Retrospective analysis of decreasing the use of anesthesia in pediatric audiology: a preliminary study. Am J Audiol 2015; 24 (04) 557-562
- 22 R Core Team. R: A Language and Environment for Statistical Computing. Vienna, Austria: R Foundation for Statistical Computing; 2017
- 23 Rosenhall U, Nordin V, Sandström M, Ahlsé G, Gillberg C. Autism and hearing loss. J Autism Dev Disord 1999; 29 (05) 349-357
- 24 Tharpe AM, Bess FH, Sladen DP, Schissel H, Couch S, Schery T. Auditory characteristics of children with autism. Ear Hear 2006; 27 (04) 430-441
- 25 Zimmerman IL, Steiner VG, Pond RE. Preschool Language Scale, Fifth Edition. San Antonio, TX: Psychological Corp; 2011