The Ida Institute’s My World pediatric counseling tool is part of a broader movement to integrate psychosocial development theories and infused counseling into pediatric audiology practice. We recently had the opportunity to discuss these emerging trends in the field of pediatric audiology with four leading researchers and clinicians:
- Eileen Rall (Ida Fellow, Senior Audiologist, The Children’s Hospital of Philadelphia)
- Leischa Eiten (Clinical Coordinator, Boys Town National Research Hospital)
- Sheila Moodie (Research Audiologist, National Centre for Audiology, the University of Western Ontario)
- Lisa Davidson (Assistant Professor, Program in Audiology and Communication Sciences, Washington University School of Medicine)
(From left to right in the picture above)
Ida Fellow Eileen Rall has had positive experiences using the My World tool with patients at the Children’s Hospital of Philadelphia. Rall found that the tool provided her with a unique opportunity to peek into the communication situations children may experience in their everyday life at school and at home. Using the tool, she was able to get a more holistic view of the child and how they are dealing with their hearing loss from both an emotional and audiological perspective.
“The children became engaged in play and make-believe while using the tool, so one can tell that they are really exploring their world. You can see the child moving into a classroom and interacting with her peers,” states Rall. “For example, I was able to discover that one of my patients had difficulty with one of her classmates at school, leaving her emotionally distraught.”
The My World tool is part of a larger effort to support the child in their psychosocial development and ensure they develop a healthy relationship with their hearing loss. Recently, Sheila Moodie conducted a series of interviews with young adults who had an identified hearing loss at younger ages. Moodie found that children who grew up learning to be autonomous and competent about managing their hearing loss felt more positive about their hearing loss later in life than children who did not receive such interaction and training from their audiologist and parent. Children who grew up shielded from information about their hearing loss harbored negative feelings about their hearing loss later in life.
To address such concerns, Eileen Rall and the Children’s Hospital of Philadelphia have developed counseling guidelines and discussion points to help pediatric audiologists foster independence, autonomy, and self-advocacy among children with hearing loss. The guidelines are flexible, allowing the practitioner to incorporate discussion topics and questions offered by patients. By following the guidelines, pediatric audiologists can ensure that they are addressing key aspects of the child’s psychosocial development.
“The first stage of psychosocial development is whether the child develops trust or mistrust with their environment, whether their needs are being taken care, and whether they are bonding with their parents and their caregivers,” states Rall. “Once they trust their environment, children begin to start exploring and wanting to control their own bodies. For example, a two year old may take out their ear mold at inopportune times. If you are constantly critical of that behavior, the child can develop self-doubt...[Instead] we can redirect children when they do something the wrong way, and teach them how to do it the right way. All of these actions helps the child develop a sense of autonomy and move up on the psychosocial development ladder.”
Counseling skills and patient-centered care principles go hand-in-hand when implementing the guidelines at the Children’s Hospital of Philadelphia. When seeing patients, Eileen Rall reinforces key discussion points by conducting “infused counseling.” She does not view the counseling guidelines as a checklist that are reviewed before the consultation session and then placed in a drawer. Counseling is a part of everything that she does throughout the day.
“It is not as if one minute I am a counselor and the next minute I am an audiologist. When I greet my patients, I model effective communication strategies from the waiting room back,” states Eileen Rall. “I call out positive behaviors when I see them. If for example, the child takes out their hearing aid properly, I reinforce and applaud such behavior. “Counseling” becomes what I do. I use the guidelines on a daily basis and I do not use any more time with my patients than other audiologists.”
We look forward to checking in with Eileen Rall, Leischa Eiten, Lisa Davidson, and Sheila Moodie at a later point to learn more about the changing field of pediatric audiology.