Social Inclusion of Children Wearing a Cochlear Implant - Dimity Dornan

Social Inclusion of Children Wearing a Cochlear Implant - Dimity Dornan

• 1.
  Social Inclusion of Children Wearing a Cochlear Implant Gabriella Constantinescu, Aleisha Davis, Rebecca Phillips and Dimity Dornan 10th Anniversary: Cochlear Implantation in Armenia
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  First Voice: Whoare we?  Established in 2010 in Australia  The National Voice for member Centres whose primary focus is the provision of listening and spoken language to children with hearing loss (HL)  5 Centres in Australia  1 Centre in New Zealand
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  First Voice: Whoare we? Aims:  To improve the speech, language, social, cognitive and academic development of children with HL  To improve the support families receive  To raise awareness of early childhood HL  To advocate for evidence-based early intervention listening and spoken language services for children with HL
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  First Voice: Whoare we? First Voice Centres  Have the largest cohort of children with HL in the world, supporting more than 1,000 children with HL  About 720 children are in early intervention  About 40% of children have a cochlear implant  Are actively involved in a wide range of research relating to HL
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  Background: Why socialinclusion?  Social inclusion is a common focus of pediatric early intervention and for First Voice  It is identified as a desired outcome in key policy documents:  The Australian National Disability Agreement  United Nations Convention on the Rights of Persons with Disabilities
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  Background: Why socialinclusion?  Social inclusion (SI) may be influenced by the child’s communication mode, speech and language skills  Percy-Smith et al. (2008); 167 children with CI  Higher level of SI = exposed to spoken language alone than spoken language & supportive signs or spoken language & sign language  Association between higher level of SI and clear speech production, good speech understanding & a large vocabulary.
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  Background: Why socialinclusion?  Hadjikakou et al. (2008); 69 children HA & CI  Oral communication skills suggested as causal factors in academic inclusion of children with HL exposed to spoken language  Further large scale studies needed to quantify these findings and look at the impact of early intervention on SI for children with HL.
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  Background: Why socialinclusion?  Barriers to measuring SI  Varying indicators of social inclusion are used across diverse fields, such as economics, education and health  There isn’t a common understanding of the conceptual underpinnings of SI and approaches to measurement  Without a common understanding it is difficult for organisations to benchmark and monitor the efficacy of their services in relation to this outcome.
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  Literature review Aims:  To develop a model for defining and evaluating social inclusion. Method:  Searched electronic databases and websites  Search terms: social inclusion, participation, children, disabilities.
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  Literature review findings New Social Inclusion Definition  SI refers to the connectedness of the individual with their social setting rather than their ‘presence’ (Phillips, Hogan & Dornan, submitted)
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  Literature review findings The 5 Faces of social inclusion:  Personal independence and self-determination  Health and access to services  Education  Interacting with society and fulfilling social roles  Economic participation of the parent Choice Wellbeing  Independence
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  Literature review findings The 5 Faces of social inclusion:  Personal independence and self-determination Health and disability Community resources Housing Social accommodation  Health and access to services  Education  Interacting with society and fulfilling social roles  Economic participation of the parent
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  Literature review findings The 5 Faces of social inclusion:  Personal independence and self-determination Education participation Education and skills  Health and access to services  Education  Interacting with society and fulfilling social roles  Economic participation of the parent
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  Literature review findings The 5 Faces of social inclusion:  Personal independence and self-determination  Health and access to services  Education  Interacting with society and fulfilling social roles  Economic participation of the parent Social networks Social participation Acceptance Role functioning and acceptance Behaviour Social resources
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  Literature review findings The 5 Faces of social inclusion:  Personal independence and self-determination  Health and access to services  Education  Interacting with society and fulfilling social roles  Economic participation of the parent Work participation  Material/ economic resources
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  Applying the 5Faces model  The 5 Faces can be used as a model to guide the selection and development of surveys to address the breadth of social inclusion Example  First Voice wanted to benchmark the social inclusion of their children to provide evidence for listening and spoken language service delivery  Focused on 2 Faces: Education; and Interacting with society and fulfilling social roles
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  Applying the 5Faces model Example  Developed an online survey for parents to complete about their child’s social inclusion  Questions addressing the 2 Faces were selected from a national survey – the Longitudinal Study of Australian Children (LSAC)  This allowed benchmarking of the findings against this national dataset
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  Preliminary findings 78parents of children aged 4-5 years completed the survey  Mean age = 4.9 years  Male (n= 43), Female (n=35)  All children had a permanent bilateral HL, were optimally aided (hearing aids and/or cochlear implants) and were enrolled in a listening and spoken language program for a minimum of 6 months.
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  Preliminary findings Education Parents of children with HL were less likely to be ‘very satisfied’ with their child’s education program, and more likely to be ‘satisfied’ (p=0.05)  It is quite likely that this is due to parents being less satisfied in communication they receive from the teacher about their child’s progress (p=0.05) Children with HL were less likely than their peers to spend 10+ hours/week in an education program (p=0.00) This may be because parents are instead spending time with their child in a language enriched environment (in keeping with the FV philosophy)
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  Preliminary findings Interactingwith Society and Fulfilling Social Roles Children with HL had a similar level of SI as their hearing peers, if not better,  e.g. children with HL were more likely to have been involved in recreation and leisure activities at home over the previous week, such as reading a book, (p=0.004), or playing with toys or games (p=0.02).  These outcomes may be seen due to guidance parents receive in early intervention and parents encouraging participation in these activities to improve speech and language
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  Take home messages  Need to consider more than just the activities the child is involved in and their friendships  The 5 Faces model can be used to guide the development of surveys to benchmark social inclusion  Findings from the First Voice Social Inclusion study will be made available in early 2014.
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  Acknowledgements  TelstraFoundation Social Inclusion Grant  All First Voice Centres and participants  This presentation uses unit record data from Growing Up in Australia, the Longitudinal Study of Australian Children (LSAC). The LSAC study is conducted in partnership between FaHCSIA, AIFS and the ABS. The findings and views reported in this paper are those of the author and should not be attributed to FaHCSIA, AIFS or the ABS.
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  References  Commonwealthof Australia. (2009a). Social inclusion: A compendium of social inclusion indicators. Canberra: Social Inclusion Unit, Department of the Prime Minister and Cabinet Retrieved from http://www.socialinclusion.gov.au/sites/www.socialinclusion.gov.au/files/publications/pdf/compen dium-of-si-indicators.pdf.  Council of Australian Governments. (2009). National Disability Agreement. Canberra: Council of Australian Governments Retrieved from http://www.dhcs.act.gov.au/__data/assets/pdf_file/0019/103942/National_Disability_Agreement. pdf.  Hadjikakou, K., Petridou, L., & Stylianou, C. (2008). The academic and social inclusion of oral deaf and hard-of-hearing children in Cyprus secondary general education: Investigating the perspectives of the stakeholders. European Journal of Special Needs Education, 23, 17-29.  Percy-Smith, L., Jensen, J., Caye-Thomasen, P., Thomsen, J., Gudman, M., & Lopez A. (2008). Factors that affect the social well-being of children with cochlear implants. Cochlear Implants International, 9(4), 199-214.  Phillips, R., Hogan, A., & Dornan, D. (submitted). The five faces of social inclusion: Concepts of social inclusion theory and its measurement in children with disabilities.  United Nations. (2006). Convention on the rights of persons with disabilities and optional protocol. New York: United Nations Retrieved from http://www.un.org/disabilities/documents/convention/convoptprot-e.pdf.