Integrating CI Sound Processor Data Logging into Auditory ......Integrating CI Sound Processor Data...
Transcript of Integrating CI Sound Processor Data Logging into Auditory ......Integrating CI Sound Processor Data...
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Integrating CI Sound Processor Data Logging into Auditory-Verbal Practice: An Examination of
its Usefulness for Practitioners and Families
Pamela Steacie, Janet Olds, Elizabeth Shaw-Pickard, Jo-Anne Whittingham, Deirdre Neuss, Erin McSweeney, Kelley Rabjohn,
Rosemary Somerville, Yves Beauregard David Schramm
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Disclaimer: I have no financial interests to disclose.
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Rationale for Study • Consistent access to sound
– is essential for spoken language development.• Consistent CI use
– after initial activation is not guaranteed.• Data logging (DL) has potential
– to improve device use.• Preliminary study
– To look at DL.
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Study Components
– Part A: Retrospective Chart Review of data logging numbers
– Part B: Focus Group Interview with
AVTs and audiologists
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Retrospective Chart Review
PURPOSE: • To investigate:
– Full time, fair and poor device use. – Did poor and fair users improve use with DL
and AVT? – Did parents accurately estimate time device
used?
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Retrospective chart review
PARTICIPANTS:
– 20 CI users post activation.
– CIs had DL enabled.
– Age at activation <6 years.
– AVT from weekly to occasionally.
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Retrospective chart review
INFORMATION COLLECTED: – Average # of hours of access to sound per day (“on air”/ “locked”).
– Parent estimate of average # of hours of use.
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0 1 2 3 4 5 6 7 8 9
10
3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22
Tim
e Lo
cked
/On
Air
(hou
rs)
Time Since Activation (months)
Child 05- Number of daily hours use
R ear L ear
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RESULTS: DEVICE USE
12
5 5
0 2 4 6 8
10 12 14
Full time from activation
Improved or improving
Chronic poor or fair
Full time from activation Improved or improving
Chronic poor or fair
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RESULTS Factors associated with sub-optimal use:
• Infection or injury. • Retention issues, • Equipment problems. • Infrequent clinic visits. • Socio-economic, family stressors. • Multiple other special needs, e.g. child with CP needing headrest.
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RESULTS:
DL versus PARENT ESTIMATE
– Obtained 7 parent estimates on same day as DL. • 2 parents estimated correctly. • 5 parents over-estimated. • NO parents under-estimated.
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Part B Focus Group:
AVTs and CI audiologists PURPOSE: – Determine:
• whether we find DL to be useful. • whether we’re using DL effectively.
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Focus Group
• METHOD: – Conducted by CI team psychologist. – One focus group and one individual interview. – 2 CI audiologists and 5 AVTs from CHEO
Audiology. – Qualitative research methodology used and
themes extracted.
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Focus Group RESULTS: • Theme 1: Counselling
• DL provides accurate information on device use.
• Prompts follow-up AVT counselling. • Parents need non-judgmental support. • Knowing exact number can motivate parent.
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Focus Group RESULTS: • Theme 2: Enhancing device use:
– DL helped clarify barriers to CI use, – Checking time “coil off/unlock’’ and # of “coil off/unlock
events” can prompt CI audiologist, AVT to probe: • Device off head but turned on during naps? • Child removing often? • Magnet too weak? • Different wearing option needed?
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Focus Group RESULTS: • Theme 3: Collaboration:
– Audiologists may enlist AVT help as AVTs see families more often.
– AVTs may request DL if suspect poor device use. – Value of collaboration around DL recognized. – Through focus group, AVTs now better informed
about potential of DL.
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Focus Group
RESULTS: • Theme 4: Changes to practice:
– Challenges were identified – Resulted in changes to our practice.
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• DL not always enabled on sound processors.
• DL to be enabled in all CIs post activation. – AB Naida Q 70’s will now be
programmed separately. – Audiologist will record NU6
average # daily hours “use”, time coil offs and # of coil offs at each programming visit.
Challenge in logging Change to practice
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• AVTs lack timely access to DL info.
• DL not done systematically,
so poor device use not always flagged immediately.
• DL info not reported
systematically.
• AVTs can access CI programming equipment to check DL.
• DL to be done at every scheduled CI visit until full time use at 3 successive visits.
• Change to CI report template to include basic DL info.
Challenge in sharing Change to practice
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Conclusion • DL a very useful tool. • Strongly suggest systematic
obtaining and sharing
of DL information. Pamela Steacie, M.Sc., LSLS Cert.AVT Audiology Service Children’s Hospital of Eastern Ontario [email protected] 613-737-7600 x2126