This study sought to determine whether participation in an early intervention program, specifically HI HOPES, was associated with levels of parenting stress, perceived social support, and the perceived socio-emotional functioning of the child. The results from the analyzes suggest that participation in HI HOPE's early intervention program appears independent of levels of parental stress, perceived social support and the child's perceived socio-emotional functioning.
Parenting a Deaf Child
Diagnosing a child as deaf
It is possible for infants with hearing loss to match the language, social-emotional, and cognitive outcomes of their hearing peers, provided their hearing loss is diagnosed early and intervened between 6 and 9 months of age (Swanepoel et al. , 2009). In an effort to provide infants with hearing loss the greatest chance of optimal outcomes, early hearing screening has become the standard of care in many places around the world (Swanepoel et al., 2009).
Parents’ reactions to their child’s diagnosis
Early Intervention
The HI HOPES Programme
HI HOPES provides support to children and families in families' homes (Stӧrbeck & Calvert-Evers, 2008). HI HOPES aims to empower and inform parents about all aspects of a child with hearing loss to ensure that parents are prepared to make decisions that are in the best interests of their child (Stӧrbeck & Moodley, 2011).
Research Objectives
To evaluate whether participation in HI HOPES is associated with less parenting stress in mothers as caregivers compared to mothers who did not participate in the HI HOPES program. To evaluate whether participation in HI HOPES is associated with maternal caregivers perceiving their child's social-emotional development differently than caregivers of mothers who did not participate in the HI HOPES program.
Research Overview
13 will also investigate whether parents feel that they have more social support by providing such support. To evaluate whether participation in HI HOPES is associated with greater perceived social support from participating maternal caregivers compared to maternal caregivers who did not participate in the program.
Conclusion
Introduction
Understanding Disability
Medical Model of Disability
It is said that the individual is the cause of disability, while society as a whole has no responsibility for creating a disabling environment (Areheart, 2008). This means that when a child is diagnosed as deaf, it is the parents' responsibility to find solutions for the child and teach him how to best fit into a (predominantly) hearing society.
Social Model of Disability
Like the social model, the linguistic minority model does not treat deafness as a disability (Skelton & Valentine, 2003). It constructs being deaf as an impairment that needs to be cured, and a choice is made on behalf of the child before they can decide to be part of the deaf community.
Defining disability for this research
The third model to be considered is the linguistic minority model, which, unlike the medical and social model, is particularly related to Deaf people. Advocates or members of the Deaf community argue that giving a child a cochlear implant before they can choose whether they want it or not goes against the child's right to choose what happens to their body.
A Proposed Model for this Research
Parenting stress
In the last two decades, considerable attention has been given to parenting stress (Åsberg, Vogel, Bowers, 2008). This study will examine the relationship between parenting stress and participation in an early intervention.
Perceived social support
In the year 2015, more than 30 million South Africans lived in poverty in the year 2015 (Statistics SA, 2017). Therefore, it is worth considering the link between poverty, disability and stress. Therefore, when considering stress in the South African context, it is important to bear in mind the role that poverty can play.
Parental perceptions of the child’s socio-emotional development
Support is considered of utmost importance when faced with a crisis or difficult situation (Iwelunmor et al., 2012).
Conclusion
Introduction
Aims of this Study
Research objectives and associated hypotheses
There is a significant difference in how maternal caregivers perceive their children in terms of their socio-emotional development between those who participated in the HI HOPES program and those who did not.
Research design
Study setting
Sample
Sampling procedure
The intervention group consisted of primary maternal caregivers of deaf children under the age of seven who had participated in the HI HOPES program. Members of the non-intervention group were maternal caregivers of deaf children under the age of seven who did not participate in the HI HOPES intervention. In the HI HOPES group, Parent Advisors sat down with the participants and explained the questionnaires and answered any questions a participant might have had.
Ethical issues in sampling
Similar meetings were held with the audiologists as with the parent advisors and all questions were addressed. Audiologists (often) sent test packets home to the mother's caregivers to complete on their own time, or with the child to hand in to the mother's caregiver. The non-intervention group had no one to administer the tests and not all tests were completed (these were excluded).
Data collection
- Test packs
- Parental Stress Index (PSI)
- Social Support Questionnaire (SSQ)
- Strengths and Difficulties Questionnaire (SDQ)
These domains take into account both factors inherent in the child and the parent (Nolte, 2011). The focus of the Parent-Child Interaction Domain is on the quality of parent-child attachment (Pipp-Siegel et al., 2002). Things that contribute to stress in the parent domain include parental characteristics that impact their parenting, such as depression and social isolation (Pipp-Siegel et al., 2002).
Data analysis
Scoring the measures used (PSI, SSQ, SDQ)
32 The internal reliability of the SDQ appears to be generally good (Hawes & Dadds, 2004). The study found that the SDQ had satisfactory internal reliability with a Cronbach Alpha of .73 (Goodman, 2001). Although the SDQ has been translated into numerous languages, including isiZulu, the cultural appropriateness of the SDQ remains a question (Hawes & Dadds, 2004).
Descriptive statistics
Profiles were created by referring to tables in the PSI manual that convert raw scores to T-scores and percentiles based on the child's age.
Inferential Statistics
The mean profiles for the two groups, HI HOPES and non-intervention, can be found in Appendix 5 and Appendix 6, respectively.
Conclusion
Introduction
The Participant Information Sheet
Maternal caregiver demographics
Information regarding the participants' highest level of education was also requested in the participant information sheet. The question about employment status was one of the only questions in the participant information sheet that was completed by 100% of the sample. In the intervention group, the majority of participants (54.2%) reported having two to three children, while the majority of parents in the non-intervention group, 30.4%, reported having four or more children.
Participants’ children demographics
37 Only five participants from the intervention group (14.3%) and five participants from the non-intervention group (21.7%) had a job.
The Parental Stress Index (PSI) results
Results for research objective one
The first objective of this research project was to determine whether participation in HI HOPES is associated with lower parenting stress. To answer this question, an independent t-test was performed to compare the mean total stress score of the two groups. The hypothesis for this research question was directional (HI HOPE parents experience less stress than the non-intervention group).
Social Support Questionnaire (SSQ) results
Results for research objective two
The Mann-Whitney U test revealed that satisfaction with social support between the HI HOPES and non-intervention was not significant (u=389; p= .416). Therefore, we fail to reject the null hypothesis and conclude that there is no significant difference in perceived social support between the HI-HOPES group and the non-intervention group. The mother caregivers in the HI HOPES group never mentioned their PA or deaf mentor (support provided to them by the HI HOPES group) as a form of social support.
Strengths Difficulties Questionnaire (SDQ) results
Results for research objective three
As can be seen in this table, mothers' caregivers from both groups rated their children similarly on the five subscales. Maternal caregivers in the non-intervention group rated their children higher on emotional symptoms as well as prosocial behavior. To determine whether the SDQ total scores were significant, indicating that the HI HOPES and non-intervention groups perceived their children's social-emotional development differently, an independent samples t-test was conducted.
Conclusion
Therefore, we do not reject the null hypothesis and conclude that there is no significant difference in how caregiver mothers perceive their child's socio-emotional development, as measured by the SDQ, between HI HOPES and the non-intervention group (t= 0.542; df=56; p=0.590; 95 %Cl).
Introduction
Non-significant Findings
Research Objective One: Decreasing Parenting Stress
In the HI HOPES group, 85.7% of maternal caregivers were unemployed and in the no intervention group 78.3% of maternal caregivers were unemployed. This finding suggests that the maternal caregivers in this study may not be financially secure, and this is interesting for two reasons. Second, this finding supports the idea that people living with disabilities are among the poorest and most vulnerable groups (Groce, 2011) and more needs to be done in terms of researching the nuances of this relationship (Groce, 2011).
Research Objective Two: Increasing Perceived Social Support
First, living with less money than one needs is known to cause stress and even psychological distress (Santiago, Wadsworth & Stump, 2011). However, they may be considered less important, or perhaps not considered social support, in the South African context, where family networks provide an important resource for resilience. Therefore, the maternal caregivers in the HI HOPES groups and in the non-intervention group have similar networks of social support available to them.
Research Objective Three: The Perceived Socio-Emotional Development of the Child
Limitations
Therefore, the HI HOPES cohort would not have been much larger, even if every eligible maternal caregiver had participated. For this reason, it may have been prudent to approach this study from a different methodological paradigm. Furthermore, all three questionnaires used in this study (PSI, SSQ, SDQ) have been standardized and used in other research (Abidin, 1995; Sarason et al., 1983; Goodman, 2001).
Future Research
The same can be done for perceived social support and the child's perceived socio-emotional functioning. For this study, maternal caregivers of deaf children were compared in terms of their parenting stress, perceived social support, and perceived socio-emotional functioning of the child. When Disability Isn't "Just Right": Deepening the Medical Model of Disability and the Goldilocks Dilemma.
Permission email from HI HOPES
Informed consent (English)
I understand that I am participating of my own free will and may choose not to complete the test at any time if I wish to do so. I also understand that this is a research project, the purpose of which is not necessarily to benefit me personally. I understand that this consent form will not be linked in any way to my responses and that my responses will remain confidential.
Letter of instruction to Parental Advisors included in test pack
Participant information sheet
HI-HOPES (Intervention) Group PSI Profile form
