Construction of re-screen results in a universal newborn hearing screening program : the discourses of parents and a screener

Parents and a screener may formulate in different ways the meaning of screen results that are disclosed in a universal newborn hearing screening (UNHS) program. The purpose of the present qualitative study was to examine how 5 parents and 1 screener who participated in 1 provincial UNHS program in Canada constructed meanings about screen results and also ways that the screening context may have influenced the development of constructed meanings. Sources of data were 14 interactions consisting of 4 videotaped parent-screener interactions and 10 individual, follow-up interviews between the researcher and each participant. One screener was selected in order to explore in-depth the inconsistencies and variation in accounts that just 1 screener could provide in various contexts where the screen results were discussed. Four of the 5 mothers had infants who had been referred from an initial stage of screening and passed the second stage of screening, whereas 1 mother had an infant who received a refer result at the second stage of screening and was subsequently diagnosed with a hearing loss. The language of the interactions was analyzed using a discourse analytic approach. The findings of the study included the following: 1) the screener's talk was predominant in each of the screening interactions and included a preponderance of yes-no questions, requests, and declarative statements; 2) parents initiated infrequently during screening interactions and asked few questions; and 3) the parents' and the screener's accounts of the screen results differed depending upon the social context of the interaction. Two social implications of these findings included the potential for some parents not to express their concerns about the screen results with the screener and also for parents and the screener to lack correspondence in their actions, both verbal and non-verbal. The present study has implications for examining the discourse of disclosure sessions between the screener and parents as collaborative and interactive opportunities for meaning construction. The adoption of more parent-centered as opposed to instrumental-focused approaches in the UNHS program may help to create a social context that is conducive to parents' expression of concerns and questions with the UNHS screener.Education, Faculty ofEducational and Counselling Psychology, and Special Education (ECPS), Department ofGraduat