Comparison of telepractice and in-person models of family-centred early intervention for children who are deaf or hard of hearing

- McCarthy, Melissa

Title
Comparison of telepractice and in-person models of family-centred early intervention for children who are deaf or hard of hearing
Creator
McCarthy, Melissa
Relation
University of Newcastle Research Higher Degree Thesis
Resource Type
thesis
Date
2020
Description
Research Doctorate - Doctor of Philosophy (PhD)
Description
Young children who are deaf or hard of hearing (DHH) require specialised early intervention support to achieve communication, language and developmental outcomes comparable to their same-age hearing peers. The use of family-centred early intervention (FCEI) is an internationally accepted standard for providing this support. FCEI involves families as equal partners in all aspects of early intervention including planning, implementation, and evaluation. Practitioners using FCEI aim to work collaboratively with families, build on family strengths, and expand existing family capacity. For many families with children who are DHH, access to timely and consistent FCEI is limited by a lack of appropriate services, geographical barriers, and workforce shortages. Practitioners have attempted to address these disparities by introducing a model of telepractice—the use of synchronous audio and video technology to connect practitioners and families in real-time, regardless of their individual locations. However, there is limited research examining the efficacy of telepractice in achieving the principles of FCEI. There are two aspects to this challenge. The first relates to practitioners’ ability to use family-centred practices in a telepractice setting, and the second relates to caregivers’ level of engagement and participation when FCEI is delivered through telepractice. The series of studies reported in this thesis compared the self-reported and observed behaviours of practitioners and caregivers who were engaged in FCEI in-person with those of similar practitioners and caregivers who were engaged in FCEI through telepractice. The participants were all involved in programs provided by one organisation that operated two separate FCEI programs for children who are DHH: one in-person and the other through telepractice. Participants included 141 caregivers (100 in-person and 41 telepractice) and 38 practitioners (23 in-person and 15 telepractice). In the first of two stages, practitioners completed a self-assessment of their use of family-centred practices (the Measures of Processes of Care for Service Providers), and caregivers completed a self-assessment of their own self-efficacy and involvement in their child’s early intervention (the Scale of Parental Involvement and Self-Efficacy). A subset of this group participated in the second stage of the study, which used an observational instrument (the Triadic Intervention and Evaluation Scale) to evaluate practitioners’ use of family-centred behaviours and caregivers’ level of participation and also to categorise the roles enacted by practitioners and caregivers and the relationships formed during the intervention session. Results of the self-assessments showed that there were no differences between the in-person and telepractice groups for both practitioners’ use of family-centred practices and caregivers’ levels of self-efficacy and involvement. Results from the observational analysis showed significant differences between in-person and telepractice groups for both practitioners’ use of specific FCEI behaviours and caregivers’ level of participation. In addition, there were significant differences between the two groups regarding practitioner and caregiver roles and the relationships formed between practitioners, caregivers, and children. These findings support the conclusions that (a) FCEI can be delivered through telepractice in a manner that is comparable to in-person delivery; and (b) in some circumstances, telepractice may enable practitioners to adhere more consistently to the principles of FCEI than practitioners in-person, which, in turn, provides children and families the opportunity to more fully realise the intended outcomes of FCEI. Overall, the evidence presented supports the viability of telepractice for delivering FCEI, and suggests that telepractice can provide an acceptable alternative to in-person delivery of FCEI.
Subject
telepractice; deaf/hard of hearing; family-centred; early intervention; early childhood; thesis by publication
Identifier
http://hdl.handle.net/1959.13/1423045
Identifier
uon:37896
Rights
Copyright 2020 Melissa McCarthy
Language
eng
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