Purpose: It is well established that individuals with a communication disability, including being deaf or hard of hearing (DHH), experience inequities in health services and outcomes. These inequities extend to DHH children’s access to psychosocial evidence-based interventions (EBIs). Behavioral parent training is an EBI that can be used to improve caregiver and child outcomes. Despite being supported by decades of effectiveness research, this EBI is rarely accessed by, or studied with, caregivers of DHH children. The purpose of this article is to describe a program of stakeholder-engaged research adapting and assessing behavioral parent training with caregivers of young DHH children followed in hearing health care, aimed at reducing inequities in access to this EBI. Method: The first section briefly summarizes the literature on disruptive behavior problems in young children, with a focus on preschool-age DHH children. The evidence base for behavioral parent training is described. Next, the gaps in knowledge and practice regarding disruptive behaviors among DHH children are highlighted, and the potential integration of behavioral parent training into the standard of care for this population is proposed. Conclusions: Young DHH children who use hearing aids and/or cochlear implants experience disruptive behavior problems at rates at least as high as typically hearing children, but their access to EBIs is limited, and behavioral parent training programs tailored to this population have not been rigorously tested. Caregivers and hearing health care service providers affirm the potential benefits of behavioral parent training and were partners in adapting this EBI. This research highlights several principles and approaches essential for reducing inequities and improving the quality of life not only for DHH children and their families but also for individuals with communication disabilities more broadly: engagement of key stakeholders in research, collaboration across dis-ciplines, and using implementation science methods and models to design for implementation, dissemination, and sustainment. Presentation Video: https://doi.org/10.23641/asha.21215900.
|Number of pages||15|
|Journal||Journal of Speech, Language, and Hearing Research|
|State||Published - Oct 2022|
Bibliographical noteFunding Information:
This article stems from the 2021 Research Symposium at the American Speech-Language-Hearing Association Convention, which was supported by National Institute on Deafness and Other Communication Disorders Award R13DC003383. The adaptations and hybrid trial described are supported by the National Institute of Deafness and Other Communication Disorders of the National Institutes of Health under Award R01DC016957. All project costs ($2,851,335) are financed with this federal support. The content is solely the responsibility of the author and does not necessarily represent the official views of the National Institutes of Health. The author and team of investigators (Julie Jacobs, Matthew Bush, Joneen Lowman, Philip Westgate, and Liza Creel) would like to thank the caregivers, children, service providers, and administrators who have generously participated in each phase of their research. Additionally, they would like to thank the research assistants and interventionists who contributed to preliminary and ongoing studies described herein, including Mallory Antel, Laura Bellnier, Diana Bigler, Cady Cornell, Heather Davis, Emily Goble, Anthony Mahairas, Callahan Moraska, Allison Merritt, Meagan Pilar, and Tess Smith. Special appreciation goes to Cathy Lester, Sarah Roof, and Lori Travis for their ongoing work to connect us with state partnering agencies, and to Lisa Kovacs, Hands & Voices Director of Programs, for her contributions to training and adaptation resources. They would also like to thank Yasaman Parsi, the REACH Institute, and Jessica Jaramillo for exceptional training and support in the FCU. They acknowledge the University of Kentucky Center for Clinical and Translational Science (UL1TR001998) and the University of Kentucky College of Medicine for supporting their preliminary studies. Finally, they are deeply grateful to the members of our Hearing and Behavior Community Advisory Board, who continue to inform this work each step of the way.
© 2022 The Authors.
ASJC Scopus subject areas
- Language and Linguistics
- Linguistics and Language
- Speech and Hearing