Best practices for family-centred early intervention for children who are deaf or hard of hearing

Dr Melissa McCarthy discusses best practices for family-centred early intervention for children who are deaf or hard of hearing. This presentation provides families with an understanding of what to look for when choosing and evaluating early intervention services for their child with hearing loss.

Dr McCarthy is passionate about the potential of telepractice to provide families with access to the best possible services – no matter where they live. She was instrumental in developing Australia’s first, nationwide telepractice program for children who are deaf or hard of hearing. Dr McCarthy has dedicated the last ten years to researching the effectiveness of telepractice for delivering family-centred early intervention.

Visit Dr McCarthy’s website: https://melissamccarthy.com.au/

  • McCarthy, M. (2020).Comparison of telepractice and in-person models of family-centred early intervention for children who are deaf or hard of hearing [Doctoral dissertation, University of Newcastle]. NOVA Repository. http://hdl.handle.net/1959.13/1423045
  • McCarthy, M., Leigh, G., & Arthur-Kelly, M. (2019). Telepractice delivery of family-centred early intervention for children who are deaf or hard of hearing: A scoping review. Journal of Telemedicine and Telecare. 25(4), 249-260. doi:10.1177 /1357633X18755883
  • McCarthy, M., Leigh, G., & Arthur-Kelly, M. (2020). Comparison of caregiver engagement in telepractice and in-person family-centered early intervention. The Journal of Deaf Studies and Deaf Education, 25(1), 33-42. doi.org/10.1093/deafed/enz037
    Read the article – https://academic.oup.com/jdsde/article/25/1/33/5626309
  • McCarthy, M., Leigh, G., & Arthur-Kelly, M. (2021). Practitioners’ self-assessment of family-centered practice in telepractice versus in-person early intervention. The Journal of Deaf Studies and Deaf Education, 26(1), 46-57. doi.org/10.1093/deafed/enaa028

Q: Can you talk a bit about the fact that family centred practice can be face-to-face or through telepractice.

Dr McCarthy:  Those family-centred practices I talked about, collaborating with the family, using familiar activities, and really collaborating with the family, recognising the parents as experts and respecting the family’s individual circumstances, those family-centred practices can be used in-person or through telepractice. The point I was trying to make about family-centred telepractice is, when we did research on family-centred  practices, there was a difference between in-person and telepractice. Even the when in-person sessions were family-centred, they weren’t quite as good as family-centred telepractice. In our studies, professionals used more family-centred practices more often during telepractice sessions.

Q: So any service you are accessing should be using family centred practices –  family-centred early intervention?

Dr McCarthy: McCarthy: Absolutely. Family-centred practices and family-centred early intervention are absolutely considered best practised in early intervention for all children, and including children who are deaf or hard-of-hearing. Research has consistently shown that family-centred early intervention leads to better outcomes for children and families.

Q: Families often think that more is better. Does having three sessions a week necessarily mean that you’re doing the best by your child?

Dr McCarthy: McCarthy: More isn’t necessarily better. In general, more is better if it’s you (the parent) interacting with your child in those 84 hours a week that they’re awake. But if you’re spending six of those in the car to get to three sessions with a therapist who is doing activities that don’t translate to your life,  then it’s not as effective. So for me, obviously I’m a strong proponent of family-centred practice to support language development and communication, particularly with those familiar activities. I believe it’s far more effective for families to develop the knowledge, skills, and confidence they need to support their children all day, every day rather than having more therapy sessions.

Imagine changing your child’s nappy. How many times do you do that in a day – three, five, 10, 12? If you developed language every time you changed your child’s nappy, the amount of language exposure your child would receive is phenomenal compared to one hour of therapy with a professional. So more is only better if you are interacting with your child more.

Q: How does this fit into the NDIS system?

Dr McCarthy: Family-centred telepractice is an Early Childhood Intervention Support service that is funded through NDIS, but unfortunately, you do need to do a bit of digging to find the right provider for your family. You do have to speak to other people. It’s about informed choice. You do have to ask around and gather information from different sources. Groups like Aussie Deaf Kids Facebook group is a great place to pose questions and where you can get input from other families who may have had different experiences with different providers in different locations.

Q: How does a family choose a family-centred provider like you describe?

Dr McCarthy: I really wanted families to feel like they understood the research about family-centred early intervention and family-centred telepractice so they could advocate for themselves. As a service provider, I spend a lot of time contacting NDIS planners and early childhood partners and trying to make sure they understand the needs of children who are deaf or hard-of-hearing.

And I suspect that that’s maybe the gap we need to bridge as professionals.  We need to be making sure the planners understand what the families need, so when families come to them saying “I need family-centred early intervention for my child”, the planners understand what that means for a child who is deaf or hard-of-hearing.

Children learn and develop best through everyday play and interactions with their parents, carers and families. Family-centred early intervention helps families build skills, knowledge and confidence and help to create the best environment for their child’s development and their family’s wellbeing.

Parents are experts on their children. Family-centred early intervention draws on parents’ expertise to develop the right supports and services for their child and family.

Family-centred early intervention for children who are deaf or hard of hearing recognises each family’s strengths and natural skills.  Family-centred early intervention promotes:

  • joyful, playful communication between the child and family,
  •  enjoyment in being a parent, and 
  • the health and well-being of both the child and the family.

Read more about best practices in family-centred early intervention for children who are deaf or hard of hearing.

  • Moeller, M. P., Carr, G., Seaver, L., Stredler Brown, A., & Holzinger, D. (2013). Best practices in family centered early intervention for children who are deaf or hard of hearing:  An international consensus statement. Journal of Deaf Studies and Deaf Education, 18, 429-445. doi.org/10.1093/deafed/ent034 
    Read the articlehttps://academic.oup.com/jdsde/article/18/4/429/562489