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1Running head: RESEARCH PROPOSAL
A Mixed-Methods Investigation of Parent Coaching in an Early Intervention Model:
Differences in Service Delivery for Children with Cochlear Implants
Alison King
Virginia Commonwealth University
EDUS 651: Mixed-Methods Research
Fall 2015
2RESEARCH PROPOSAL
A Mixed-Methods Investigation of Parent Coaching in an Early Intervention Model:
Differences in Service Delivery for Children with Cochlear Implants
The diagnosis of a hearing loss for parents of their newborn can be devastating and
debilitating (Luterman, 2004). Many liken it to being sent into a dark forest with no clear path.
Availability of having a guide through what is perceived as a black landscape can be the
difference between finding the light and being lost in the dark. This is the essence of parent
coaching in an early intervention (EI) program. EI providers for children with hearing loss are
typically Teachers for the Deaf/Hard-of-Hearing (TDHH) or Speech-Language Pathologists
(SLPs) that guide parents through the beginning stages of coping with their child’s disability,
assisting them in learning how to help their child in the natural environment, and helping
families in reaching community resources. However, these two distinct groups of professionals
have vastly different educational backgrounds and professional training. The American Speech-
Language Association (ASHA), the Alexander Graham Bell Association of the Deaf (AG Bell),
and the Council for Exceptional Children (CEC) each have professional standards to meet in
order to obtain professional certifications to serve children with hearing loss (ASHA, 2014; AG
Bell, 2012; CEC, 2013). Additionally, professionals in Virginia are required to be certified as
Early Intervention Professionals by meeting those discipline specific requirements (ASHA,
2014; CEC, 2013), pass online modules offered through the Infant & Toddler Connection of
Virginia, and complete an online application (Infant & Toddler Connection of Virginia, n.d.).
For over 30 years, research studies have documented the difficulty of children who are
deaf or hard-of-hearing in obtaining academic skills comparable to their hearing peers due to low
language levels (Conrad, 1979; Traxler, 2000). The effect of hearing loss on social, academic
and language development theoretically can be mitigated through research-based early
3RESEARCH PROPOSAL
intervention programs focused on parent coaching (Scheetz, 2112; White, 2006; Yoshinago-
Itano, 2003). However, there is a lack of research regarding what skills EI providers currently
possess, how they differ based on their educational backgrounds or obtained certifications, and
how they are providing parent coaching to families of children with hearing loss. Yoshinago-
Itano (2014) advocated for the development of appropriate professional development guidelines
that support evidence-based practices despite the varied professional backgrounds of those who
provide services in the EDHI and EI programs. To that end, the JCIH (2007) suggested that
guidelines be adopted and implemented that address professional qualifications for providing
family-centered intervention for children in EI programs who have an identified hearing loss.
This proposal will add to the existing body of literature by examining the differences in parent
coaching of EI professionals with varied educational backgrounds. This information can then be
utilized to create meaningful professional development opportunities linking research to practice.
Purpose of the Study
The purpose of this study is to examine the relationship between the EI provider’s
background, characteristics of parent coaching, and reported use of auditory skill development in
order to develop professional development programs for providers that work with children who
have cochlear implants. This study will utilize an explanatory sequential mixed-methods research
design with two distinct phases: quantitative followed by qualitative (Creswell & Plano-Clark,
2011). The quantitative phase will consist of data collection with the use of a survey partially
based on a previous questionnaire developed by Compton, Flynn, and Tucker (2009) as a needs
assessment for speech-language pathologists in North Carolina. The results from the quantitative
phase will inform the purposeful sample selection, data collection, and analysis used during the
qualitative phase. The rationale for this approach includes the use of quantitative data to inform
4RESEARCH PROPOSAL
the qualitative design which will provide a richer understanding of the participants’ experiences
and identify how to strengthen professional development programs for EI providers. In this
exploratory follow-up, the tentative plan is to explore the educational and training experiences of
Teachers for the Deaf and Hard-of-Hearing and Speech-Language Pathologists and explore the
impact of their training on clinical practice within the early intervention system.
Research Questions
Three specific research questions will be explored in two distinct phases with analysis of
the findings from each phase brought together to address the mixed research question.
Quantitative Research Question
What correlation exists between EI provider backgrounds and research-identified target
areas regarding areas of parent coaching and auditory skill development of children with hearing
loss that have cochlear implants?
Qualitative Research Question
What are EI provider perceptions regarding their educational background and
professional experiences with parent coaching regarding auditory skill development and other
areas identified through surveys?
Mixed-Method Research Question
In what ways do the experiences and knowledge of EI providers explain their parent
coaching practices regarding auditory skill development? Do the ASHA, CEC, and AG Bell
standards influence any differences between knowledge and parent coaching of TDHH/SLPs?
Philosophical and Theoretical Foundations
This study utilizes a pragmatic approach to investigating the differences in early
intervention practices of parent coaching utilizing both a post-positivist perspective and a
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constructivist approach with underlying care theory and analysis using systems change theory.
The initial quantitative phase utilizes a post-positivist foundation consistent with research studies
regarding the outcome measures of children who are deaf with regards to developing
communication skills and progress in the educational setting. For students with or without
disabilities, educational and functional communication outcomes have traditionally been
measured in quantifiable terms as reported by state and national databases clearly situated in a
post-positivist framework (Individuals with Disabilities Improvement Act [IDEIA] P.L. 108-446,
2004; No Child Left Behind [NCLB] P.L. 107-110, 2001; Virginia Department of Education,
2012).
Building on this information, the second phase of qualitative research expands to provide
in-depth rich information regarding the parent coaching differences that occur in early
intervention sessions with the family. The EI provider serves as a coach, or guide, to the family
refining parent-child interactions. From a constructivist approach, care theory regards
relationships as the way in which people learn and grow as opposed to merely an individual act
(Noddings, 2012). Using care theory to study the development of auditory skills in children with
hearing loss, the parent would be the ‘carer’ and the child would be the ‘cared-for’. Additionally,
the EI provider would be the ‘carer’ and the parent would be the ‘cared-for’. Noddings observed
that in the parent-young child relationship:
“only one person can really serve as carer. Reciprocity is then almost entirely defined by
the cared-for’s response of recognition. When, for whatever reason (severe illness or
handicap, for example), the cared-for is unable to respond in a way that completes the
relation, the work of the carer becomes more and more difficult. Carers in this position
need the support of a caring community to sustain them.” (Noddings, 2012, p. 54)
6RESEARCH PROPOSAL
Therefore, the parent requires support from the EI provider to guide their interactions with their
child. These interactions are based on the knowledge and experiences of the early intervention
provider. The response of the EI provider to the parent theoretically impacts the child’s speech-
language and auditory skill development.
Systems change theory as defined by Ambrose (1987) encompassed not merely transition
as part of an organizational process, but as a structure of the system itself that can be altered.
Transition occurs as part of a voluntary choice involving human perception, cognition, and
feelings and their interaction with organizational variables (Amado & Ambrose, 2001). Ambrose
(1987) identified five parts essential for change including a shared vision, skills, incentives,
resources, and an action plan. When one piece of the five essential parts is missing, Ambrose
identified the resulting condition (1987). For example, when skills are missing the result is
anxiety. When resources are missing, the result is frustration. When the action plan is missing, it
results in false starts (Ambrose, 1987). In determining the differences between TDHH and SLPs
who work directly with children who have cochlear implants in the EI system, it allows the
researcher to pinpoint where the differences in training is occurring and consequently allows for
development of meaningful professional development based on the direct needs of the providers
themselves. The information provided will serve as the beginning of a statewide needs
assessment for these professionals.
Literature Review
A comprehensive literature review across the medical and education fields of inquiry was
conducted using Google Scholar, Web of Science, and Eric ProQuest. Keyword searches were
conducted using the multiple combinations including the words: hearing loss, deafness, children,
early intervention, cochlear implants, early hearing detection and intervention, professional
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training, professional development, oral deaf education, and TDHH training programs.
Additional studies were located using author searches and the reference lists from the initial
studies located through Google Scholar, Web of Science, and Eric ProQuest.
Many researchers and practitioners that work with children who are deaf/hard-of-hearing
would agree that medical advancements have pushed the field of early intervention beyond any
conceptualized vision of developing listening and spoken language that were afforded to this
population from a mere 15 years ago. In turn, early intervention practices and professional
preparation programs are struggling to “catch-up” to the opportunities that cochlear implants
have afforded children with hearing loss. However, in order for the gap between medical and
educational systems to diminish, researchers must examine where we are, where we are going,
and develop a plan for how to get there by examining the current infrastructure of professional
training conducting in-depth needs assessments.
Early Intervention
In 2013, 87.4% of the infants diagnosed with a hearing loss were referred to Part C for EI
services (Centers for Disease Control and Prevention, 2015). Yoshinago-Itano (2003; 1998)
documented that early identification of hearing loss, early amplification, by either the use of
hearing aids or cochlear implants, and appropriate early intervention each have positive effects
on the language, speech, and social-emotional development of children. The Joint Commission
on Infant Hearing (2000) stated that all infants should be screened for hearing loss by one month
of age, receive appropriate amplification by three months of age, and begin receiving EI services
by six months of age in order to optimize language outcomes. This plan is referred to as the 1-3-
6 model and is endorsed by the American Academy of Pediatrics (2006), the American Speech-
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Language Hearing Association (n.d.), and the AG Bell Academy for Listening and Spoken
Language (2007).
In 2007, the Joint Committee on Infant Hearing (JCIH) provided guidelines for
appropriate early intervention (JCIH, 2007). The position statement serves as a gold standard of
medical and education intervention for children with hearing loss. Yoshinago-Itano (2014)
published a best practices document with updated recommendations to improve existing Early
Detection Hearing Intervention (EDHI) and Early Intervention (EI) programs based on the JCIH
guidelines (2007). These recommendations included that EI services should be delivered to meet
the individual needs of the family and also be consistent with goal 3B (JCIH, 2007) stating EI
providers must have a background in Listening and Spoken Language when providing those
services. Children with cochlear implants are given access to sound and have the potential to
develop spoken language when the 1-3-6 model and JCIH (2007) guidelines are in place.
The field of early intervention has been shaped by public policy. The Individuals with
Disabilities Education Act of 1990 (IDEA; P.L. 101-476) coupled with state EHDI laws created
an intersection of advancements in education and medicine that greatly effect families of
children with hearing loss. EI services are provided in the natural environment consistent with
the IDEA using a parent coaching model. According to the IDEA Infant and Toddlers
Coordinators Association (2000), services are provided within natural contexts defined as where
a child “lives, learns, and plays” with the goal of transfer of skills into family and community
contexts. Furthermore, settings which are excluded within this definition are clinics, hospitals,
therapy rooms, or rehabilitation centers (ITCA, 2000).
EI services are provided by a range of professionals including various Educators,
Teachers for the Deaf/Hard-of-Hearing, and Speech-Language Pathologists. EI professionals
9RESEARCH PROPOSAL
must have knowledge in cognitive, speech, language, and auditory skill development when
working with children who have a hearing loss (Houston & Perigoe, 2010). They then must
apply that knowledge to parent coaching in order for caregivers to make decisions regarding
communication methodologies for their child who is deaf (Hanft, Rush, & Shelden, 2003;
Lenihan & Rice, 2005; Estabrooks, 2012; Scheetz, 2012).
Graduate level training for EI professionals vary in required coursework and do not
include specific coursework in parent coaching, but rather use an integrated approach (CEC,
2013; ASHA, 2014; Dolman, 1998; 2008) despite the federal requirements of professionals to
provide parent coaching in EI service delivery (IDEA; P.L. 101-476). Barton et al. (2014)
compiled nine evidenced based family coaching practices including: (a) providing the family
with individualized strategies to meet the needs of the family, (b) focusing on the family
routines, (c) facilitation of language through increasing awareness of primary caregivers on their
influence over development, (d) direct modeling of strategies by the professional followed by
guided practice with the caregiver, (e) focus on parent-child interactions, and (f) opportunities
for caregivers to practice target strategies throughout the day. These strategies showed a
significant increase in parental use of language-enhancing strategies resulting in an increase in
the semantic and morphologic skills of children. Barton et al. (2014) completed their research
with a small group of parents and their children who presented with a Specific Expressive
Language Delay. The results of this study align with desirable outcomes of children who have a
hearing loss and utilize spoken language options as stated in the position statement of the JCIH
(2007). A quantitative study such as the one conducted by Barton et al. (2014) focusing on
individual families during parent coaching sessions has not been completed with parents of
10RESEARCH PROPOSAL
children with a hearing loss using specific strategies to address auditory skill development,
spoken language option, or guiding parents regarding communication modalities.
Professional Preparation
Compton et al. (2009) explored the training and preparedness of Speech-Language
Pathologists (SLPs) in North Carolina to provide school-age services to children with cochlear
implants. The researchers used a quantitative approach and found that most SLPs in the school
system felt that were not prepared to provide services to this population of children regarding
therapy or knowledge of equipment. Compton et al. (2009) called for more research regarding
the preparedness of Teachers for the Deaf/Hard-of-Hearing and SLPs on a national level.
Current Food and Drug Administration (FDA) requirements allow for children to receive
cochlear implants at 12 months of age (ASHA, n.d.). However, many cochlear implant centers
are successfully lobbying insurance companies for earlier implantation by not adhering strictly to
FDA guidelines and using professional judgment on what is best for the child medically (Levine
& Smith, 2001). Teachers need to be prepared for the classroom. However, are EI professionals
providing quality services prior to this population of children entering school that theoretically
mitigate intensive special education services later?
Parents have choices regarding the mode of communication they want their child to
utilize including listening and spoken language options (auditory-verbal and auditory oral), total
communication (spoken language and a sign-based system), signed exact English, or American
Sign Language (Sheetz, 2012). There are specific course requirements that must be met in order
to become certified to practice Speech-Language Pathology by the ASHA during completion of a
master’s level program (ASHA, 2014). Due to the unique overlap of medical advancements and
deaf education, Speech-Language Pathology programs may also offer training in oral
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methodologies or auditory skill development, but it is not required for national certification by
ASHA (ASHA, n.d.). Course requirements do not include knowledge in the development of
auditory skills that are the foundation for auditory-verbal and auditory-oral methodologies
(Sheetz, 2012; AG Bell, n.d.). The requirements of each state vary widely for Teachers of the
Deaf/Hard-of-Hearing to obtain educational licensure (Dolman, 2008). In Virginia, candidates
must have graduated from an approved college bachelor’s level program or have a major in
special education with an additional 27 hours of coursework that do not include knowledge in
signed exact English, American Sign Language, or the development of auditory skills (Virginia
Department of Education, 2013). There are no Speech-Language Pathology programs in Virginia
that offer additional coursework in auditory skill development (Dolman, 2008; oral deaf
Education, 2008).
Project ASPIRE (Leffel et al, 2014) attempted to bridge the gap in educational
backgrounds of EI service providers by developing a parent education model that is based solely
on increasing the linguistic feedback of parents by calculating adult word count, conversational
turn-taking, and child vocalization counts combined with parent education regardless of the
varied backgrounds of providers. However, research has not addressed if professionals have
obtained training to deliver information to parents such as those contained in the Project ASPIRE
educational modules, evidenced based family coaching practices, or the guidelines set forth by
the JCIH (2007). Project ASPIRE lays a solid foundation for parent education, but professionals
need to have the skills to adapt these programs to meet the individual needs of families.
Furthermore, given that EI services are provided by a range of professionals with varied
backgrounds, research has not addressed how these professionals differ in their professional
training and professional development, how this knowledge translates to parent coaching
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provided to families, and ultimately how the parent coaching relates to parental decision making.
Research has not examined if a families chosen mode of communication is best served by one
professional over another.
Professional Perspectives
Lenihan and Rice (2005) interviewed 13 in-service professionals providing EI services to
families of children with hearing loss using Auditory-Oral or Auditory-Verbal methodologies.
Focused interviews were based on seven professional competencies essential to providing EI
services for families of children with hearing loss as suggested by the JCIH (2007), the Joint
Committee of the American Speech-Language Hearing Association (n.d.), and the Council of the
Education of the Deaf Regarding Service Provision to Children who are Deaf and Hard of
Hearing Ages Birth to 36 months (1994). The seven competencies utilized in the interviews
include: understanding development of infants and toddlers including audiological management
and communication options, collaboration and trans-disciplinary approaches to providing
services, assessment, implementation of family-centered intervention strategies, development of
effective therapy and intervention plans, understanding program administration, and advocating
for the provision of high-quality services in the least restrictive environment for all children with
hearing loss and their families (Lenihan & Rice, 2005). The researchers discovered that many
professionals felt their graduate programs did not adequately prepare them for the challenges in
providing EI services and that they gained this knowledge in working with families. EI providers
indicated that their knowledge of child development and family-centered intervention was gained
through mentoring experiences and trans-disciplinary teams rather than coursework while
obtaining their respective degrees. Therefore, the field has no way to determine what information
is being given to families if parent coaching has not been a targeted area of training in teacher
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preparation or Speech-Language Pathology preparation programs. The results of the interviews
by Lenihan and Rice (2005) were not explored with the professionals as to: (a) what aspects of
service delivery they were not prepared for with regards to the identified seven competencies, (b)
how they provide services currently, (c) how their service delivery changed as a result of
professional development, (d) what professional development they received since receiving their
various professional degrees, and (e) how their post-graduate professional development guided
their parent coaching. Knowledge and experience in each of these areas has a direct impact on
Parent Coaching that has yet to be examined in-depth from the view of the professional
providing these services and has not been addressed in the mixed-methods research.
Professional Certifications
Early intervention services can be provided for children with a hearing loss by a range of
professionals including Teachers for the Deaf/Hard-of-Hearing and Speech-Language
Pathologists. These professionals must meet minimum requirements in each of their respective
fields in order to obtain and maintain their professional certifications. However, there is also an
advance certification available from the Alexander Graham Bell Association for the Deaf and
Hard-of-Hearing (AG Bell).
Council for Exceptional Children (CEC). The Council for Exceptional Children (2013)
requires that professionals obtaining an initial licensure in Special Education: Deaf/ Hard-of-
Hearing develop competencies in the areas of learning differences, learning environments, and
instructional planning and strategies. Preparation standard 1 (learning differences) specifically
addresses family systems, cultural perspectives, the effects and relationship of onset of hearing
loss, age of identification of hearing loss, and development. Additionally, preparation standard 2
(learning environments) addresses the influence of family communication and culture on
14RESEARCH PROPOSAL
development while preparation standard 5 (instructional planning and strategies) highlights
strategies and support to enhance communication skills, application of strategies to facilitate
communication development, and implementation of strategies for developing spoken language
in orally communicating individuals. Professional standard 6 requires the continuum of lifelong
professional development and methods to remain current regarding research-validated practice
(CEC, 2013).
American Speech-Language Hearing Association (ASHA). Professionals seeking to
obtain and maintain a Certificate in Clinical Competence in Speech-Language Pathology from
ASHA (2014) must have knowledge as well as skill outcomes that align with early intervention
practices when working with children who have a hearing loss. The knowledge outcomes include
Standard IV-A competency of anatomy/physiology, psychology, and sociology. Standard IV-B
addresses speech acoustics. Standard IV-C focuses on hearing and the impact of hearing loss on
speech-language development, etiology of hearing loss, characteristics of those with hearing loss,
and overall development. Standard IV-D is concentrated on prevention comprised of assessment
and intervention for people with hearing loss including consideration of anatomy and
development. The skills outcomes for children with hearing loss are addressed in Standard V-B.
Professionals must be able to provide appropriate evaluation and intervention for these children
and their families.
Alexander Graham Bell Association for the Deaf and Hard-of-Hearing (AG Bell).
Listening and Spoken Language Specialists (LSLS) are Teachers for the Deaf/Hard-of-Hearing,
Audiologists, or Speech-Language Pathologists who are certified by the AG Bell. These
professionals specialize in developing spoken language outcomes in children by demonstrating a
high level of competency and adhering to the Principles and Practices of Auditory-Verbal
15RESEARCH PROPOSAL
Therapy (AG Bell Academy for Listening and Spoken Language, 2007). Oral methodologies
such as Auditory-Verbal, Auditory-Oral, and Cued Speech have grown in popularity and are now
considered a viable option for the education of children who are deaf (Dornan et al., 2010).
According to the AG Bell Academy for Listening and Spoken Language (n.d.), the
backgrounds of the LSLS Certified Professionals are varied. Of those who have obtained a
certification as either LSLS Certified Auditory-Verbal Therapist (Cert. AVT) or Certified
Auditory-Verbal Educator (Cert. AVEd), 43.2% are Educators of the Deaf, 38.8% are Speech-
Language Pathologists, 11.8% are Audiologists, and 6.3% are School Administrators. LSLS
professionals abide by 10 Principles based on either their designation as a Cert. AVT or Cert.
AVEd. Regardless, each set of principles includes the concept of guiding and coaching parents.
For the Cert. AVT, 6 of the 10 principles address coaching parents. These include:
Guide and coach parents to help their child use hearing as the primary sensory modality
in developing listening and spoken language.
Guide and coach parents to become the primary facilitators of their child's listening and
spoken language development through active consistent participation in individualized
Auditory-Verbal therapy.
Guide and coach parents to create environments that support listening for the acquisition
of spoken language throughout the child's daily activities.
Guide and coach parents to help their child integrate listening and spoken language into
all aspects of the child's life.
Guide and coach parents to use natural developmental patterns of audition, speech,
language, cognition, and communication.
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Guide and coach parents to help their child self-monitor spoken language through
listening (AG Bell Academy of Listening and Spoken Language, 2007).
Parent coaching presumably leads to greater maternal sensitivity resulting in higher levels of
spoken language outcomes of children with hearing loss. The parent coaching model is the core
of Auditory-Verbal Therapy (AG Bell Academy of Listening and Spoken Language, 2007).
Research Design
Creswell and Plano-Clark (2011) defined mixed-methods research by not only the
combined methods of quantitative and qualitative research, but also by how they are integrated,
which one is given priority, the timing of the phases, how they are framed philosophically, and
what specific mixed-method design is then utilized to answer the research questions. This study
will utilize an explanatory sequential design where the quantitative data from the first phase will
be utilized to develop the qualitative data collection measures. The notation of this study is
QUAN + qual = explain results. The quantitative data is given priority as the qualitative data will
be used to explain the quantitative results. Integration of data after both the quantitative and
qualitative phases are completed will allow the researcher to answer the mixed-methods research
question and address how the standards from each professional designation influence their
service delivery. Challenges of the sequential explanatory design include the length of time to
complete the in-depth qualitative portion and participant selection for the qualitative phase.
Participants will be selected based on extreme cases for the qualitative portion and interviews
will be completed to the point of saturation of data. Extreme cases will be defined as
representatives from each set of professionals responding to the survey varying greatly in their
respective responses. For example, cases chosen will be those that indicate that they have
extensive educational background in auditory skill development or parent coaching as well as
17RESEARCH PROPOSAL
those with no educational experience in these areas. Interviews will be scheduled quickly after
the completion and analysis of the quantitative phase of the study. Interviews will be completed
at the convenience of the participants in their home or community setting in order to have them
completed in a timely manner. Information sheets regarding the purpose of the study will be
given to all participants and informed consent obtained prior to any data collection procedures.
Figure 1 is a diagram of the procedures for implementation of this study. The procedures
and products at each phase are listed. The first phase is quantitative data collection followed by
quantitative data analysis that informs the qualitative sample selection and development of
measures utilized. The second phase is qualitative collection and analysis. Finally, the results
from the quantitative and qualitative phases will be integrated to answer the mixed-methods
research question and jointly display the data from both phases.
18RESEARCH PROPOSAL
19RESEARCH PROPOSAL
Data Collection and Analysis
The Early Intervention and Parent Coaching study will involve two iterative stages with
the first stage informing the development of the second. First, the researcher will conduct an
online survey administered to Teachers for the Deaf/Hard-of-Hearing and Speech-Language
Pathologists in Virginia. Second, semi-structured interviews will be completed. Integration of
results will be done to answer the third research question.
Quantitative Phase
The quantitative research question asks ‘Is there a correlation between EI provider
backgrounds and research-identified target areas regarding areas of parent coaching and auditory
skill development of children with hearing loss that use oral communication methodologies?’ In
order to answer the first research question for the proposed study, the sample, materials and
procedures, data management and analysis are described below.
Participants and setting. Participants will be recruited by contacting the Partnership for
People with Disabilities, the Virginia Infant Toddler Connection Specialist Network, and the
Speech-Language Hearing Association of Virginia with information regarding the study. EI
service coordinators will be contacted to disseminate information regarding the study and to
recruit participants. Links to the survey will be sent to Ann Hughes, at the Partnership for People
with Disabilities, and Deana Buck with the Virginia Infant Toddler Connection Specialist
Network so that EI providers who provide services to children with a hearing loss in the state
have an opportunity to participate in the study. Participants will be selected if they meet the
following criteria: (a) individuals currently work with families and children who have a hearing
loss, (b) have EI certification through Virginia, and (c) self-identify as using a parent coaching
model in their service delivery. The contact personnel from these organizations have agreed to
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disseminate information to the professionals in their databases by email once Institutional
Review Board approval has been obtained.
Probabilistic sampling will be utilized. A random sampling of professionals of Teachers
for the Deaf/Hard-of-Hearing and Speech-Language Pathologists will be sampled. There are
approximately 500 professionals in Virginia serving children with hearing loss in Virginia.
Power analysis reveals a sample size of 218 would be needed to obtain a confidence interval of
95% with a margin of error of +/-5 for the final study. Central Limit Theorem requires a
minimum sample of 32 in order establish reliability of the survey instrument and to obtain 10%
of the sample size estimated (Jolley & Mitchell, 2013). Therefore, the survey will be piloted in
order to establish reliability. Information regarding the study and informed consent will be
obtained from all participants. Standard procedures have been established for securing data and
they are explained in further detail in the data management section.
Measures. Constructs, or characteristics, to be measured through the survey include: (a)
professional background and demographic data, (b) self-assessment of expertise in auditory skill
development and (c) parent coaching practices with regards to auditory skill development. The
measures are described below. The participant survey is adapted from the survey used by
Compton (2009). The original survey by Compton et al. (2009) was specific to North Carolina,
addressed only Speech-Language Pathologists, and was not directed to professionals in EI.
Therefore, changes to the original survey were made to reflect the program in Virginia and
specifically target EI professionals. For example, the demographics were expanded to include
TDHH, developmental specialists, and SLPs. The Preparation and Training section was
expanded to include parent coaching, but eliminates communication methodology approaches.
Additionally, two sections were added to include the use of Parent Coaching as defined by
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Carton et al. (2014) and self-assessment of auditory skill development based on the Auditory
Learning Guide (Walker, 2009) and auditory-verbal intervention (Simser, 1993). The three
sections of the survey are grouped. The first section consists of five questions, the second section
consists of 18 questions, and the third section is comprised of two checklists for both parent
coaching and auditory skill development.
Components of the Participant Survey (Appendix B):
Professional background. Demographic information will be collected regarding
each participant including: a) educational background, (b) work environments, (c)
undergraduate and graduate experience in various areas preparing them to work
with children who have cochlear implants, d) years of experience, (e) years of
experience in EI, and (f) perceived preparedness in working with this population.
Parent coaching. Participants will answer survey questions to determine what
parent coaching practices they believe they currently use as defined by Carton et
al. (2014) with regards to working with families of children with hearing loss.
These responses to questions will inform the questions developed for the second
section of the study.
Professional skills self-assessment. Participants will complete a brief self-
assessment of their level of expertise with auditory skill development rating their
level of expertise using a 1-5 scale with 1 being “novice”, 3 being “comfortable”,
and 5 being expert. The items on the assessment were derived from the Auditory
Learning Guide (Walker, 2009) and Simser’s guide to auditory development of
infants and toddlers (1993).
22RESEARCH PROPOSAL
Data Collection Procedures. Survey data will be completed via an on-line response
system managed by the researcher. Estimated time of completion for the online survey is 20
minutes and must be completed in one session. The surveys will be completed using a secure on-
line system, Limesurvey. Limesurvey is a web-based application used to administer surveys
specifically for research projects and it is compliant with the Health Insurance Portability and
Accountability Act (HIPPA). Data will be prepared for analysis by proceeding through a series
of steps (e.g. identification of outliers, descriptive statistics, and tests of homogeneity). If
participants do not want to complete the survey online, LimeSurvey has a function that allows
for paper copies of the survey to be made available that are identical to the online version.
Copies will be made available for those who want to participate, but not complete the survey
online. Additionally, data reduction procedures will be used to prepare data for analyses by
grouping of test items for constructs including (a) auditory skill development and (b) parent
coaching behaviors identified in the Barton (2014) study to establish reliability and validity.
SPSS will be used to analyze all results using both descriptive and inferential statistical analysis.
Data analysis procedures. Analysis will be completed using Pearson Product-Moment
Correlation Coefficients, reported in a correlational matrix, and Multiple Linear Regression will
be completed assuming the data is parametric and all assumptions are met (Howell, 2003). The
proportion of the variance will be explained by squaring the correlational coefficient as to
explain each of the correlations within a greater context. Pearson’s Product-Moment Coefficients
will allow the researcher to examine the correlation between individual variables (ex.
background and knowledge of auditory skill development).
Effect sizes will be calculated by the use of r2. Multiple linear regressions will be
completed to analyze each of the independent variables (i.e. self-assessment of skills – novice to
23RESEARCH PROPOSAL
expert) with each of the dependent variables. For example, the researcher would then be able to
use the professional designation to predict levels of participation in the parent coaching model
(Barton, 2014).
Validity and Reliability. Questions on the survey will be asked in several different
wordings without changing meaning to ensure reliability. Construct validity will be completed
by two doctoral students in the VCU School of Education to ensure that the survey is addressing
the target constructs without superfluous information. The r value will be calculated for
reliability between test items and if r > 0.70, it is considered acceptable. Internal consistency
reliability will be completed to assess items within the same construct using Cronbach’s alpha
(>0.70 is acceptable). If internal consistency is low between items within the same construct,
existing items will be examined for wording and/or more items will be added for that specific
construct.
Qualitative Phase
The qualitative research question asks ‘What are EI provider perceptions regarding their
educational background and professional experiences with parent coaching regarding auditory
skill development and other areas identified through surveys?’ In order to answer the second
research question for the proposed study, the sample, data collection procedures, and data
analysis are described below.
Participants and Setting. Participants will be selected from respondents to the survey
based on their professional designation, years of experience, varying levels of expertise, and
answers to open-ended questions contained within the survey to allow for maximum variation
sampling. Extreme cases will be identified from the quantitative data using NVivo matrix
function in order to select participants for the qualitative phase. Extreme cases will be defined as
24RESEARCH PROPOSAL
representatives from each set of professionals responding to the survey varying greatly in their
respective responses. Interviews will be scheduled quickly after the completion and analysis of
the quantitative phase of the study. Information sheets regarding the purpose of the study will be
given to all participants and consent forms will be obtained.
Data collection procedures and instruments. Data collection will consist of participant
interviews (Appendix C) as well as secondary document analysis of the standards for
professional credentialing agencies. Instruments include a semi-structured interview (Appendix
C).
Participant interviews. Participant interviews will be completed until the level of
saturation is achieved and no new data or relevant information is emerging (Biklen & Bogdan,
2007). Therefore, the exact number of participants for the qualitative phase is unknown. An
initial list of questions for the semi-structured interviews is contained in Appendix C and will be
extended based on the data gathered from the quantitative phase and from the interviews
themselves. Interviews are estimated to be completed in a one hour session. Interviews will be
collected and digitally audio recorded. The researcher will use pseudonyms for participants to
maintain confidentiality and all recordings will be disposed of after transcription. All the data
will be stored on a secure server that has passcodes and only the researcher can access it.
Participants will be asked to review their transcript as a means of member-checking prior to
analysis. Field notes will be utilized during the qualitative phase of this study throughout the
interview process to ensure contextual information is documented thereby adding to the richness
of the interview process. This process will also help filter any researcher bias, as these notes will
help the researcher reflect on the interviews.
25RESEARCH PROPOSAL
Data analysis procedures. All data will be coded based on a prior codes developed from
the literature review, document analysis, and new codes added based on participant responses
(Appendix D). These emergent codes will be combined to generate a set of themes that are
participant type-specific and also common across participant groups. Interviews will be audio-
recorded. NVivo will be used to assist in identification of themes present in the interviews.
NVivo is a widely-used qualitative data analysis computer software package specially designed
to analyze large volumes of qualitative data and is commonly used by government agencies and
universities for large-scale research projects. Data from the interviews and document analysis
will then be compared to the breakdown in systems as proposed by Ambrose (1987) to generate
where training needs exist and generate future directions for practice and research.
Validity. Once transcribed, participants will be asked to review their transcript as a
means of member-checking prior to analysis. Once transcripts have been verified by participants,
the researcher and one additional researcher, who is also a doctoral student at VCU, will
separately rate the interviews based on the developed coding system and audio-recordings will
be erased. Coding will be compared for consensus prior to data being analyzed. Interviews will
also be checked for disconfirming evidence. Field notes in qualitative research serve to provide
context and clarity to situations (Maxwell, 2013; Bilken & Bogdan, 2007).
Mixed Methods Data Analysis Procedures
The mixed-methods question asks ‘In what ways do the experiences and knowledge of EI
providers explain their parent coaching practices regarding auditory skill development? Do the
ASHA, CEC, CED, and AG Bell standards influence any differences between knowledge and
parent coaching of varied service providers?’ In order to answer the final research question for
the proposed study, the data analysis is described.
26RESEARCH PROPOSAL
The professional standards for each of these groups will be analyzed using qualitative
document analysis. The requirements from each organization will be compared to each other as
well as to participant responses from the surveys and interviews (Biklen & Bogdan, 2007). The
data from the document analysis will be utilized as a comparison to the lived experiences of the
participants. This information will assist in answering the mixed methods research question ‘Do
the ASHA, CEC, CED, and AG Bell standards influence any differences between knowledge and
parent coaching of varied service providers?’
Qualitative themes from participants will be displayed jointly with quantitative results.
The quantitative and qualitative results will be linked to further explain the similarities and
differences between Teachers for the Deaf/Hard-of-Hearing and Speech-Language Pathologists
educational backgrounds and their views of parent coaching regarding auditory skill
development.
Potential Ethical Issues
Safety measures to ensure the confidentiality of data are being taken at every phase of
this study. Information about the purpose of the study and consent will be obtained prior to
collecting any data. Surveys will be completed using a secure on-line system, Limesurvey.
Limesurvey is a web-based application used to administer surveys specifically for research
projects and it is compliant with the Health Insurance Portability and Accountability Act
(HIPPA). Interviews will be collected and digitally audio recorded. Recordings from the surveys
will be stored on encrypted jump drives. The researcher will use pseudonyms for participants to
maintain confidentiality and all recordings will be disposed of after transcription. In the event
that participants do not wish for the interview to be audiotaped, the researcher will take written
notes during the interview. The researcher will remove any personal information that can lead to
27RESEARCH PROPOSAL
identification of participants. After the interview is completed and transcribed, participants will
be sent a written copy the interview to verify the content. This is done so that they can be sure
their views are accurately expressed.
Participation in the study is voluntary. Participants can choose not to answer any portion
of the online survey or to discuss any particular issue during the interview. Should any problems
arise during the course of the study, participants are encouraged to contact the principal
investigator, Dr. Donna Gilles. They may also withdraw from the study at any time and/or
withdraw the data gathered for the research prior to data analysis.
Timeline for Completing the Study
This study will begin with the survey being distributed in March of 2016. The subsequent
qualitative interviews will be completed from May-July of 2016.
Researcher’s Resources and Skills
Alison King is a doctoral student in the Department of Special Education and Disability Policy at
Virginia Commonwealth University. She holds a Master’s degree in Speech-Language
Pathology. Ms. King has a Certificate of Clinical Competence in Speech-Language Pathology
and is licensed to practice Speech-Language Pathology by the state of Virginia. Ms. King is a
Listening and Spoken Language Specialist/Certified Auditory-Verbal Therapist. Her research
interests focus on early intervention, developing spoken language with children who have a
hearing loss, and professional preparation for Educators of the D/deaf and Speech-Language
Pathologists.
Resources
28RESEARCH PROPOSAL
This research will be conducted using Virginia Commonwealth University resources in
collaboration with the Partnership for People with Disabilities, the Virginia Infant Toddler
Connection Specialist Network, and Infant and Toddler Connection of Virginia.
Partnership for People with Disabilities. The Partnership for People with Disabilities is
recognized by the U.S. Department of Health and Human Services, Administration on
Developmental Disabilities (ADD), as a university center for excellence in developmental
disabilities. The Partnership is home to more than 20 federal and state programs, staffed by more
than 80 professionals, family members, people with disabilities, and university students
supporting individuals with disabilities and their families. The Partnership maintains an
interdisciplinary approach to all of its activities, which allows it to explore a wide spectrum of
professional services and community interests as it seeks to expand opportunities to individuals
with disabilities. The Partnership for People with Disabilities is recognized throughout the
Commonwealth of Virginia for its strong programs supporting families, individuals, and service
providers in the Early Intervention/Education arena. The Partnership is working to equip family
members, health care providers, preschool teachers, child care providers, and others serving who
serve infants and young children and their families with the awareness, knowledge, and skills
through technical assistance and training needed to make a difference in their lives.
Virginia Infant Toddler Connection Specialist Network. The Virginia Infant & Toddler
Specialist Network promotes excellence in early care centers and family care homes by
increasing the educational level and skills of those who work with infants and toddlers. The
ITSN works with center-based and family child care programs in enhancing the quality of care in
their infant and toddler classrooms. The Network provides services at no cost to providers and is
supported by a Virginia Department of Social Services grant.
29RESEARCH PROPOSAL
Infant and Toddler Connection of Virginia. The Infant & Toddler Connection of Virginia
provides early intervention supports and services to infants and toddlers from birth through age
two who are not developing as expected or who have a medical condition that can delay normal
development. Early intervention supports and services focus on increasing the child's
participation in family and community activities that are important to the family. In addition,
supports and services focus on helping parents and other caregivers know how to find ways to
help the child learn during everyday activities.
30RESEARCH PROPOSAL
Appendix A- Participant Information and Consent Form
RESEARCH SUBJECT INFORMATION AND CONSENT FORM
Title: A Mixed-Methods Investigation of Parent Coaching in an Early Intervention Model: Differences in Service Delivery for Children with Cochlear Implants
VCU IRB NO.:
If any information contained in this consent form is not clear, please ask the study staff to explain any information that you do not fully understand. You may take home an unsigned copy of this consent form to think about or discuss with family or friends before making your decision.
PURPOSE OF THE STUDY
The purpose of this research study is to explore the educational background and perceptions of Early Intervention providers regarding parent coaching and auditory skill development of children who are Deaf/Hard-of-Hearing. You are being asked to participate in this study because you are an Early Intervention provider in Virginia that works directly with a child who is deaf and utilizes a cochlear implant.
DESCRITPION OF THE STUDY AND YOUR INVOLVEMENTIf you decide to be in this research study, you will be asked to sign this consent form. In this study you will be asked to complete an online survey lasting approximately 20 minutes. The survey will consist of demographic information such as your area of specialty (ex. Teacher for the Deaf/hard-of-hearing or Speech-Language Pathologist), gender, age, and years of experience. You will also be asked about your educational background with regards to specific coursework. You will also be asked to complete a self-assessment of your comfort level with auditory skill development and parent coaching in an Early Intervention model. Finally, you will be asked to be considered for participation in a one-on-one interview at a later date and provide your contact information. One-on-one interviews will last approximately one hour at a convenient location to you or by phone. There will be no monetary compensation for participation in the study.
If you agree to participate, you will be given the link to the online survey. If you agree to be interviewed, the interview will be audiotaped. In the event that you do not wish for the interview to be audiotaped, the researcher will take written notes during the interview. Audiotaped interviews will be transcribed and analyzed for the purposes of the research study. All interviews will be kept confidential and only pseudonyms will be used when reporting the results from the study. The researcher will remove any personal information that can lead to your identification. After the interview is completed and transcribed, you will be sent a written copy of your interview to verify the content. This is done so that you can be sure your views are accurately expressed.
RISKS AND DISCOMFORTS
31RESEARCH PROPOSAL
Sometimes talking about these subjects causes people to become upset. Several questions will asked about your educational experiences and how this applies to your practices in Early Intervention. You do not have to talk about any subjects you do not want to talk about, and you may leave the interview at any time. Participation in the study is voluntary. Participants can choose not to answer any portion of the online survey or to discuss any particular issue during the interview. Should any problems arise during the course of the study, participants are encouraged to contact the principal investigator, Dr. Donna Gilles. You may also withdraw from the study at any time and/or withdraw the data gathered for the research prior to data analysis.
BENEFITS TO YOU AND OTHERSYou may not get any direct benefit from this study, but, the information we learn from people in this study may help us design better programs for professional development in Virginia.
COSTSThere are no costs for participating in this study other than the time you will spend being interviewed and filling out the survey questions.
CONFIDENTIALITYPotentially identifiable information about you will consist of survey and interview notes and recordings. Data is being collected only for research purposes. Your data will be identified by participant numbers for the online survey. For the interviews, the researcher will use pseudonyms for participants to maintain confidentiality and all recordings will be disposed of after transcription No personal identification will be collected. Other records, will be on encrypted jump drives and kept in a locked file cabinet for two months after the study ends and will be destroyed at that time. Interview notes and survey results will be kept indefinitely. Access to all data will be limited to study personnel. A data and safety monitoring plan is established.
The researcher will not tell anyone the answers you give us; however, information from the study and information from your interview and the consent form signed by you may be looked at for research or legal purposes by the principal investigator, or by Virginia Commonwealth University. VOLUNTARY PARTICIPATION AND WITHDRAWALYou do not have to participate in this study. If you choose to participate, you may stop at any time without any penalty. You may also choose not to answer particular questions that are asked in the study.
Your participation in this study may be stopped at any time by the study staff without your consent. The reasons might include: the study staff thinks it necessary for your health or safety; you have not followed study instructions; administrative reasons require your withdrawal.
32RESEARCH PROPOSAL
QUESTIONS
If you have any questions, complaints, or concerns about your participation in this research, contact:
Alison King, Doctoral Student VCU Department of Audiology403 North 11th StreetNelson Clinic, Room 304Richmond, VA 2321950(804) [email protected] Dr. Donna Gilles, Principal Investigator VCU Partnership for People with Disabilities PO Box 843020 Richmond, VA 23284-3020 (804) 828-8244 [email protected]
The researcher/study staff named above is the best person(s) to call for questions about your participation in this study.
If you have any general questions about your rights as a participant in this or any other research, you may contact:
Office of ResearchVirginia Commonwealth University800 East Leigh Street, Suite 3000P.O. Box 980568Richmond, VA 23298Telephone: (804) 827-2157
Contact this number to ask general questions, to obtain information or offer input, and to express concerns or complaints about research. You may also call this number if you cannot reach the research team or if you wish to talk with someone else. General information about participation in research studies can also be found at http://www.research.vcu.edu/irb/volunteers.htm.
CONSENTI have been given the chance to read this consent form. I understand the information about this study. Questions that I wanted to ask about the study have been answered. My signature says that I am willing to participate in this study. I will receive a copy of the consent form once I have agreed to participate.
33RESEARCH PROPOSAL
Participant name printed Participant signature Date
________________________________________________Name of Person Conducting Informed Consent Discussion / Witness (Printed)
________________________________________________
34RESEARCH PROPOSAL
Appendix B – Survey
Title: A Mixed-Methods Investigation of Parent Coaching in an Early Intervention Model: Differences in Service Delivery for Children with Cochlear Implants
The purpose of this research study is to explore the educational background and perceptions of Early Intervention providers regarding parent coaching and auditory skill development of children who are Deaf/Hard-of-Hearing. You are being asked to participate in this study because you are an Early Intervention provider in Virginia that works directly with a child who is deaf and utilizes a cochlear implant.
The survey should take approximately 20 minutes to complete. There are four sections. The first section consists of 5 demographic questions about your work experience. In the second section you will be asked about your undergraduate and graduate training for working with children who have a hearing loss. In the third section you will provide brief information about your parent coaching practices and report on your level of expertise with auditory skill development. At the end of the survey, you will be asked if you are willing to participate in an interview regarding your own experiences.
Completing this survey is voluntary. You may skip items or exit the survey at any time. If you have additional questions, please feel free to contact Alison King at (804) 380-9650 or [email protected].
Part 1: Demographics
1. What is your area of specialty?a. Teacher for the Deaf/Hard-of-Hearingb. Speech-Language Pathologistc. Developmental Specialistd. Auditory-Verbal Therapiste. Other ______________________
2. What area of Virginia do you primarily provide services? (indicate all)a. Cityb. Suburbanc. Rural countyd. Other _______________________
3. What part of Virginia do you work in? (indicate all)a. Tidewaterb. Piedmontc. Blue Ridged. Valley and Ridgee. Appalachian Plateau
4. Your gendera. Male
35RESEARCH PROPOSAL
b. Femalec. Prefer not to answer
5. Your age:a. 22-35b. 36-45c. 46-60d. 61+
Part 2: Preparation and Training
6. Indicate the highest level of training received.a. Bachelor’sb. Master’sc. Post-graduate training (ex. Completion of VA Leadership in Neurodevelopmental
Disabilities – LEND)d. Doctoratee. If you have more than one degree in each area, please specify all areas you hold
degrees in. ________________________________________________7. Number of years of experience post-graduation.
a. 1-5b. 6-10c. 11-15d. 16-20e. 21+
8. Number of years of experience working with children who have a hearing loss.a. 1-5b. 6-10c. 11-15d. 16-20e. 21+
9. Number of years of experience working in early intervention.a. 1-5b. 6-10c. 11-15d. 16-20e. 21+
10. Number of years of experience working with children who have cochlear implants.a. 1-5b. 6-10c. 11-15d. 16-20e. 21+
11. What certifications/licenses do you hold?a. ASHA Certificate of Clinical Competenceb. Council on Education of the Deafc. Teacher licensure in Virginia. List areas: ________________
36RESEARCH PROPOSAL
d. Listening and Spoken Language Specialiste. National Teacher Certificationf. Virginia Health Professional Licenseg. Other: ___________________________
College Instruction
12. UndergraduateFor each area below, indicate the amount of undergraduate college instruction you had in each area. Also, indicate if in that area you had a workshop or practicum.
None One Lecture
Several Lectures
Entire Course
Workshop Practicum
AudiologyAural HabilitationAuditory-Verbal TherapyAuditory StrategiesAuditory Skill DevelopmentParent CoachingCochlear ImplantsFM Technology
13. GraduateFor each area below, indicate the amount of graduate college instruction you had in each area. Also, indicate if in that area you had a workshop or practicum.
None One Lecture
Several Lectures
Entire Course
Workshop Practicum
AudiologyAural HabilitationAuditory-Verbal TherapyAuditory StrategiesAuditory Skill DevelopmentParent CoachingCochlear ImplantsFM Technology
14. Did you observe or work with children who had cochlear implants in graduate/undergraduate clinics or externships?
a. Yesb. No
37RESEARCH PROPOSAL
15. Did you observe or work with children who had cochlear implants in graduate/undergraduate early intervention settings where services were provided in the home or a community setting?
a. Yesb. No
16. Please check all areas where you have attended workshops or seminars post-graduation.a. Cochlear implant technologyb. Auditory-Verbal Therapyc. Auditory Skill Developmentd. Habilitation/Rehabilitation strategies with cochlear implantse. Parent Coaching
17. Overall, how well do you feel that your college experiences have prepared you to provide services to children with cochlear implants?
a. Very confidentb. Somewhat confidentc. Neutrald. Lacking confidencee. No confidence
18. Indicate what areas you believe you want to receive professional development in order to serve families of children with cochlear implants
Yes No Maybe
AudiologyAural HabilitationAuditory-Verbal TherapyAuditory StrategiesAuditory Skill DevelopmentParent CoachingCochlear ImplantsFM Technology
Part 3: Parent Coaching and Auditory Skill Self-Assessment
Please indicate which of the following parent coaching practices you have used or currently use and to what extent with your families of children with cochlear implants.
Not at All Seldom Often FrequentlyProviding the family with individualized strategiesUse materials available in the homeFocusing on the family routinesBring in materials to use for EI sessions
38RESEARCH PROPOSAL
Planning EI sessionsLeaving materials for caregivers to use with the childDirectly working with the child and the caregiver is not presentDirectly working with the child and the caregiver is presentEI sessions provided in the homeEI sessions provided in the daycare settingFacilitation of language through increasing awareness of primary caregivers influence over developmentDirect modeling of strategies followed by guided practiceFocus on parent-child interactionsAssist families in generating ways to facilitate language throughout the dayFocus on child behaviorProviding the family with written feedback
Please complete this brief self-assessment of your level of comfort with the intervention targeting following auditory skills for children with cochlear implants. A scale of 1-5 is being used with 1 being “novice”, 3 being “comfortable”, and 5 being expert. Your answers are confidential.
Novice Comfortable
Expert
1 2 3 4 5 NASound awarenessDetection of environmental noisesDetection of speech soundsDetection of the Ling 6 SoundsLearning a conditioned response to soundLocalization of soundResponse to name being calledDevelopment of consonant discriminationHierarchy of consonant development by auditionLing step one - four consonants
39RESEARCH PROPOSAL
Hierarchy of vowel development by auditionDevelopment of auditory feedback loopAuditory feedback for suprasegmental features of speechAuditory feedback for hierarchy for consonant developmentAuditory feedback for words and sentencesAuditory discrimination of critical elementsHierarchy of auditory comprehension of question formsIdentification of objects by descriptionClosed and open set discrimination Closed and open set comprehensionAuditory sequencing of directionsAuditory memoryAuditory figure-groundStrategies for making acoustic signal salientUse of the hand cueUse of acoustic highlightingSpeech acoustics and the impact of developmentUse of wait timeUse of Learning to Listen SoundsCreating ideal listening environmentsUse of serve and return
40RESEARCH PROPOSAL
Appendix C: Beginning Interview Questions
Tell me about your educational background.
Tell me specifically about what courses or experiences helped to prepare you to work with children that have cochlear implants and their families.
Tell me about your background with Early Intervention.
How comfortable are you with assessing children with cochlear implants?
How comfortable are you with providing auditory-based intervention to children with cochlear implants?
What parent coaching practices do you currently use?
How do you feel about parent coaching in an EI model?
How did your education prepare you to provide parent coaching?
What are your thoughts about providing parent coaching regarding auditory skills in children with hearing loss?
How do you integrate parent coaching and auditory skill development?
What professional development experiences do you believe would be beneficial to you? What about to other providers in Early Intervention?
41RESEARCH PROPOSAL
Appendix D: Codes
Beginning list of A Priori Codes – Based on Literature Review
Group Code Definition TypeTDHH/SLP PC Parent Coaching Model A PrioriTDHH/SLP AS Auditory Skills (non-specific) A PrioriTDHH/SLP R Regulatory (i.e. ASHA, CEC) A PrioriTDHH/SLP P Policy (i.e. IDEA) A PriorTDHH/SLP GT Graduate Training A PrioriTDHH/SLP PC1 Individualized strategies A PrioriTDHH/SLP PC2 Family routines A PrioriTDHH/SLP PC3 Facilitation through caregivers A PrioriTDHH/SLP PC4 Direct modeling A PrioriTDHH/SLP PC5 Parent-Child Interactions A PrioriTDHH/SLP PC6 Daily practice A PrioriTDHH/SLP AST Auditory Strategy A PrioriTDHH/SLP AA Auditory Awareness A PrioriTDHH/SLP AD Auditory Discrimination A PrioriTDHH/SLP AM Auditory Memory A PrioriTDHH/SLP AC Auditory Comprehension A PrioriTDHH/SLP AI Auditory Identification A PrioriTDHH/SLP IS Increased skills A PrioriTDHH/SLP PD Professional development A PrioriTDHH/SLP Pre Prepared A PrioriTDHH/SLP AON Area of need A Priori
Emergent Codes – Initial set of codes developed from the interviews with TDHH/SLPs
Group Code Definition TypeTDHH/SLP AS - S Auditory skills - specified EmergentTDHH/SLP EmergentTDHH/SLP Emergent
Final Codes Group Code Definition
TDHH
SLPs
42RESEARCH PROPOSAL
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