Parental Decision Making Regarding Cochlear Implant Use In School-age Children: A Self-determination Perspective

Hearing parents of children who are deaf face many complex decisions that have life long ramifications. The first decision is whether or not to pursue cochlear implantation, which has become a physician preferred intervention recommendation for deafness. Cochlear implants can provide access to sound that improves auditory experiences. This provides optimism for the facilitation of academic, social, and communication development. The problem lies in the variability found in the consistency of the use of cochlear implants. Non-use and inconsistent use of the device is related to less than favorable speech, language, and academic outcomes. There is little understanding of what facilitates or diminishes the successful use of the device. This narrative research study included an exploration of the lived experience of seven hearing parents who are raising at least one child with a cochlear implant. Semistructured interviews were conducted. Self-Determination Theory was used as the theoretical framework and social constructivism was the interpretive paradigm. The findings indicated that in six out of seven narratives, the parents’ interactions and relationships with medical and school personnel in various contexts, did not support the parents’ basic psychological needs of autonomy, competence, and relatedness. Recommendations for practitioners include suggestions for creating an environment that is supportive of all parents’ basic psychological needs. These recommendations include providing complete, unbiased information to parents of children who are diagnosed with vi deafness, taking the perspective of the patient or parent, treating families with respect, allowing time to answer parents’ questions, and implementing basic principles of client/patient-centered care, to help children who are diagnosed with deafness reach their full developmental potential