Meeting Participant Needs Theoretical Foundations

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Presentation transcript:

Meeting Participant Needs Theoretical Foundations VCU Aural Rehabilitation Support Group: Connecting Adult Cochlear Implant Patients Alison King, Jennifer Garbarini, & Haley Athey VCU Health, Department of Audiology, Richmond, VA The LACE program was selected for the VCU Audiology Aural Rehabilitation group due to the statistically significant improvements for trained subjects on outcome measures (Sweetow & Palmer, 2005). LACE is a self-paced adaptive computer program designed to improve listening and communication skills. 5 Keys to Communication Success (Jessen, 2014) is a educational guide created to reduce frustrations with hearing loss and communication. This book targets the deconstruction of communication breakdowns related to hearing loss. For this reason, the LACE program and the 5 Keys to Communication Success were chosen. The LACE program is available as a CD or internet-based service and the participants complete tasks at home. The CD version was purchased for this grant-funded program. Participants reported performance and gave feedback about frustrations to the auditory therapist through emails, phone calls, and during support group sessions. Audiology team support encouraged healthy communication skills in collaboration with clinical best practice. Program Characteristics The MCV Hospitals Auxiliary provides support to the VCU Medical Center’s patients, visitors and staff through service, fundraising and other activities. Grants are awarded yearly through a competitive grant process within the health system. VCU Audiology was awarded $625.00 for materials. The group met in a VCUHS facility. Participant Outcomes A significant finding of this program was that the adult cochlear implant users extolled the value of connecting with other CI users about struggles in communication and positive hearing experiences. Discussions regarding cochlear implant sound quality and acclimation of daily life activities were held between the participants. The following qualitative themes included benefits of the program as well as common concerns. Benefits: Participants valued sharing of experiences with other CI users Increase in participant satisfaction post-cochlear implantation with the use of auditory rehabilitation Improved listening and communication skills Exploration of strategies to assist with difficult listening situations Extended time with audiological staff to address connectivity and CI troubleshooting Concerns: Initial frustration post-activation with auditory comprehension and discrimination LACE too hard for beginning listeners Preference for the iPad and iPod applications None of the participants were able to find the LACE useful for the first 5 months post CI activation Common listening concerns: listening in noise, listening to music, listening to secondary sound sources, and use of assistive listening devices Connectivity was a concern among all participants The auditory therapist and audiologists facilitated monthly discussions for participants regarding home use of LACE, online resources, and other relevant topics chosen by participants. Topics included: Introduction and overview of LACE Interfacing CI with accessories and listening to music with your new technology Listening in noisy environments; 5 Keys to Communication Success (Jessen, 2014) Connectivity: Tips and Tricks Online Resources Review Meeting Participant Needs All participants expressed frustration with the difficulty of the LACE program, regardless of prior hearing aid use. So additional resources were located to assist with developing auditory discrimination and comprehension skills. Resources were web-based programs as well as apps commercially available for the iPad or iPod. These included the apps Angel Sounds, AB Clix, Continents and Oceans, and Shazam. Web-based resources included HOPE notes and Cochlear Adult Communication Skills. Participants also needed multiple demonstrations re: connecting their devices to assistive technology for aural rehabilitation activities. Introduction Montano and Spitzer (2014) documented that patients enrolled in auditory rehabilitation post-cochlear implant activation were able to optimize their auditory comprehension and improve their overall satisfaction. Thus, VCU Audiology initiated a support group for adults (aged 60-83) who had recently received their first cochlear implant. Some participants were long-time hearing aid wearers and continued to wear an aid on the unimplanted ear. Others had not worn aids in many years. Through a grant funded by the MCVH Auxiliary, recipients had the opportunity to participate in five group sessions over a five month period. They received copies of the Listening and Communication Enhancement (LACE) computer program for home use and the 5 Keys to Communication Success (Jessen, 2014) book. The group allowed new recipients to share experiences of learning to listen with a cochlear implant as well as enhance their auditory skills through the use of provided materials. Additionally, online resources were cultivated per participant request. Theoretical Foundations Aural rehabilitation significantly improves listening outcomes for individuals with hearing loss (Sweetow & Palmer, 2005). Auditory training programs such as Listening and Communication Enhancement (LACE) are supported by research as a helpful tool to improve listening skills. Jessen, D. (2014). Frustrated by Hearing Loss? 5 Keys to Communication Success. Cut to the Chase Communication. Montano, J., Spitzer, J. (2014). Adult Audiologic Rehabilitation (2nd ed.). San Diego, California: Plural Publishing. Sweetow, R., Henderson-Sabes, J. (2004). The case for LACE, individualized listening and auditory communication enhancement training. Hearing Journal, 57 (3), 32-40. Sweetow, R., & Palmer, C. V. (2005). Efficacy of individual auditory training in adults: A systematic review of the evidence. J Am Acad Audiology, 16, 494-504.