Communication in infant diagnostic audiology

Effective communication is an essential skill for healthcare professionals and necessary for the provision of family-centred service delivery. Within Audiology, it has become increasingly important for Universal Newborn Hearing Screening (UNHS), where babies are diagnosed with permanent hearing loss within a few weeks of life - before any visible signs exist. However, few published qualitative studies looking at communication in infant diagnostic audiology exist. These could target areas to improve or provide exemplar models of practice. Therefore, this thesis aims to investigate communicative interactions and competence using recorded audiological appointments, where infants are being tested for hearing loss, following referral from UNHS. Four in-depth qualitative linguistic analyses of the communication between parents and experienced audiologists were conducted with nine audio-recorded and transcribed infant diagnostic appointments. Analyses focussed on; the type of communication that takes place in these appointments and levels of communicative engagement (Chapter 4), how relationships are built within these appointments (rapport building; Chapter 5), the ways that relationships are threatened (through the delivery of the diagnosis; Chapter 6) and, the way that emotional reactions to the diagnosis are expressed and responded to (Chapter 7). Results show that mothers and audiologists have equal communicative engagement throughout the appointment, whereas fathers have significantly less. However, separate analysis of the audiometric testing phase and the results dissemination phase shows that the mothers’ level of communicative engagement decreases significantly after a diagnosis. Further, audiologists employ numerous rapport building strategies and continue to use these throughout the appointment, employing them when the relationship is threatened as a result of the diagnosis. They also attempt to frame the diagnosis of hearing loss in neutral or positive terms, whilst attending to the emotional needs of parents. These studies highlight the importance of good communication skills within this sensitive area of audiology.