Building Effective Parent–Professional Partnerships

January 2017

Joni Alberg, PhD

How many times have you said one of the following things? 

"If only this parent cared enough to follow through with what I said, everything would be so much better."

"If only this parent cared enough to keep the hearing aids on, the child's listening skills would be much farther along."

"If only this parent cared enough to follow through with what I said, language development would be progressing much faster."

"If only this parent cared."

I admit, I have said this—more than once. I put all the responsibility for progress on the parent and ignored my responsibility. I forgot that it was up to me to ensure that the parent understood what I said. I forgot that the parent had a life that encompassed much more than the child on whom I was focused and on whom I placed most of my attention. I forgot that the parent was a person—a mother, a father, a partner, a parent, a caregiver, a member of an extended family, and a member of a larger community. I forgot that the most important person in the child's life was this parent, who I saw for maybe 30 minutes at each appointment.

Throughout my career of nearly 40 years, parents and families have been at the forefront. They have taught me much about their needs and desires. Most important, they have taught me how much they care for and love their children—how much they want their children to become successful individuals who are able to pursue their dreams. And I learned three very important lessons that changed the way I interact with parents.

Listening Builds Trust

Are you a good listener? Do you pay as much attention to listening as you do to talking? If you answer "no" to this question, you are in the majority. Studies show that 75% of oral communication is ignored, misunderstood, or quickly forgotten by the listener (Bolton, 1986). Is it possible that lack of follow-through on the part of parents is because they didn't understand what you wanted them to do?

How much time do you spend listening to the parents? If you are like me, I typically have an agenda to cover in a prescribed amount of time when I am with a parent. "Small talk" is not a part of this agenda—or, at least, it wasn't until I learned how important it was for me to take the time to talk with parents about their feelings, their lives, and the challenges they're facing. One simple question was all it took: "How are you doing today?" Not "Were you able to keep the hearing aids on during waking hours this week?" Not "How is Jason doing?" These questions were important, and I did want to know the answers, but I learned that I needed to understand how the parent was doing first. Because if the parent wasn't doing well, then it was highly likely that the child wasn't doing well, either.

Why does this question matter so much? It is the only way for us, as professionals, to learn about the myriad challenges a parent may be facing each day in addition to their child's loss of hearing. Is this parent all alone in addressing the child's language development and learning? Does the parent have the support of a partner or spouse? Is there an extended family that is supportive or in denial? Does the family have enough money and a roof over their heads? Is the home environment stable? Is the parent continually blaming himself or herself and feeling guilty for their child's hearing loss? Is someone else blaming the parent? Does the parent truly understand what you expect them to do?

Rarely will you meet a parent who doesn't care about their child's outcomes. If you think you have, I urge you to ask them, "How are YOU doing?" and then take the time to listen—really listen—to what they have to say. "Time?" you ask??? But I don't have time! I guarantee that if you take the time to get to know what is going on in the life of the parent, you will learn more than you ever thought possible—and this will ultimately improve your approach to interacting with the parent and improving outcomes for the child.

Knowledge of Learning Styles Improves Interactions

Do you know your preferred learning style? If not, you can easily find out by using the Index of Learning Styles Questionnaire (Solomon & Felder, n.d.) to determine it. You will answer a series of questions in response to a scenario that is presented. For example, suppose the scenario is that you purchase a new computer. Are you more likely to

  • read the user manual from cover to cover before you begin using the computer;
  • scan the user manual looking for diagrams that show how to use the computer, and only then start using the computer;
  • ignore the user manual and "get started" by relying on your past experiences with other computers, the knowledge that you probably can't break it, and the assurance that you can refer to the user manual if you get stuck; or
  • call someone who has a computer just like yours and ask them to come over to show you how to use it?

The answer that you select reveals your preferred learning style. And your preferred learning style is most likely reflected in the way you teach others. But what happens if the person you are "teaching" has a different learning style from you? Do you take the time to find out the preferred learning style of the parents with whom you are working, and then figure out how to present information to them in their preferred style, rather than your own? You can use a simple strategy like the one above to quickly find out about individual learning styles. This will give you the information you need to ensure success for the parent as you adapt your teaching style to meet their learning style.

Applying Real-World Strategies Is Key

Once you have learned about the world in which a parent lives, understand the challenges they face each day, and know their preferred learning style, you can provide them with effective strategies that they can use with their child. It is one thing to tell a parent, "You need to make sure the batteries in the hearing aids are changed whenever they stop working." It is even better to tell the parent, "You need to make sure to change the batteries in the hearing aids whenever they stop working. Where do you keep your batteries? Show me how you change them. What will you do if you run out of batteries?" I worked with an audiologist who was repeatedly frustrated when the child showed up to appointments with hearing aids that didn't work because the batteries were dead. Although the mother indicated that she understood what was expected of her, in reality, she did not. Things improved only after someone went to her house, talked her through the process of what to do when the hearing aid battery stops working, asked her to practice changing the batteries, and created a reminder to place on the refrigerator about what to do when she ran out of batteries.

In a recent study by Moeller & Tomblin and the OCHL Collaboration (2015), the authors showed that speech and language delays in children with hearing loss can be greatly minimized by the consistent use of well-fitted and well-maintained hearing aids. Learning about technology or simply keeping devices on and functioning can be a struggle for many families. They need strategies for every possible situation that they may face. One parent I know heard this message loud and clear from her child's audiologist—and interpreted/adhered to the audiologist's instructions a bit too literally: The child's hearing aids did not properly fit and kept falling off his ears. Because his mother knew it was so important that she follow through with what the audiologist had told her, she duct-taped the hearing aids to the child's head. Here was a mother who listened and followed through on what she was told to do. But she didn't have any strategies for what this actually meant, and she didn't know what to do when something went wrong. Learning about the challenges parents face each day will help us provide better support and direction.

Audiologists and other service providers can help parents improve hearing aid use by providing regular, hands-on training with the hearing aids and individualized problem-based strategies to address the challenges that families experience while attempting to attain a high level of use. Families may also benefit from practical demonstrations of the advantages of consistent hearing aid use, such as hearing loss simulations, examples of listening in noise with and without hearing aids, or listening with malfunctioning hearing aids.

As clinic-based professionals, audiologists are not typically able to provide services in the home. Taking the time in a busy audiology clinic environment to establish a trusting relationship may be more difficult than doing so in a client's home, but it is no less important. Understanding the parent's learning style will help you provide information and support in a way that better taps into the parent's strengths. Some parents may need to receive written materials and resources, whereas others will benefit from meeting other families of children with hearing loss. Be sure you include extended family members, such as grandparents, in follow-up visits. A close relationship with the family's speech-language pathologist is also critical. Perhaps you can attend periodic Individual Family Service Plan meetings through remote access or, better yet, make an exception and visit the family's home in person. 

Parents are the most important teachers of their children. They know their children better than anyone else. But parents are people, too. Their lives encompass so much more than the particular situation for which we, as professionals, typically see them. It is our responsibility to learn as much as we can about each parent so we can maximize their success. Make time to ask parents every time you see them, "How are you doing?" Then, sit back and listen—really listen—to what they tell you. I guarantee that you will be a better therapist—and your patients will have better outcomes—as a result.

About the Author

Joni Alberg, PhD, is a consultant in education and human services focused on children who are deaf or hard of hearing, their parents, and the professionals who work with them. Currently, Alberg is working with the Alexander Graham Bell Association for the Deaf and Hard of Hearing in two capacities. First, she is directing a grant to develop a program for early adolescents who are deaf or hard of hearing emphasizing self-identity, self-determination, and self-advocacy. Second, she is providing technical assistance to states regarding legislation addressing the language development of children who are deaf or hard of hearing. Previously, Joni was the executive director of BEGINNINGS for Parents of Children Who Are Deaf or Hard of Hearing in Raleigh, North Carolina.

References

Bolton, R. (1986). People skills: How to assert yourself, listen to others, and resolve conflicts. New York, NY: Simon & Schuster.

Moeller, M. P. & Tomblin, J. B. (2015). An introduction to the Outcomes of Children With Hearing Loss study. Ear and Hearing, 36(1, Pt. 1), 4S–13S. doi:10.1097/AUD.0000000000000210

Solomon, B. A., & Felder, R. M. (1996). Index of Learning Styles Questionnaire. Raleigh, NC: NC State University. Retrieved from https://www.engr.ncsu.edu/learningstyles/ilsweb.html.

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