The idea of parents making informed decisions about their Deaf or hard of hearing (DHH) child’s language acquisition is a laudable one— if parents were actually given all the information. However, it is well-documented anecdotally that when educating parents of DHH children, professionals tend to omit, dismiss, and twist information. As Kecman (2019) states, “though stakeholders widely acknowledge the benefits of informed choice…it appears that the way information is provided is not always consistent with these recommendations” (p. 8). This may be a conscious or unconscious process, but it is one that professionals must work to ameliorate because it results in information that misleads or biases parents.
In a qualitative study by Eleweke & Rodda (2000), data showed that parents were most strongly persuaded by the information they received in the period immediately after their child was diagnosed. This relates to the cognitive bias of anchoring. Anchoring bias is the tendency to rely too heavily on an initial piece of presented information to make a decision (Allen et al., 2020). This can then affect all ensuing decisions on the topic. “Anchoring bias is a common cognitive bias and can lead to narrow-minded thinking” (Sharma et al., 2021, p. 4). Therefore, if professionals present parents with misinformation that they anchor to, it may negatively influence all the subsequent decisions they make about their DHH child. The authors note that during this initial period, information is often presented in an unbalanced way. For example, the parents in the study who chose an auditory-oral approach appeared to be misinformed about how a signed language might have benefitted their children, as evidenced by some of their comments about British Sign Language (Eleweke & Rodda, 2000). Thus, it is vital that professionals present all language options equally so as to lessen misconceptions and misperceptions.
The authors also found that parents’ perception of the functions of assistive listening devices (i.e., hearing aids and cochlear implants) also influenced their choice of a communication approach. The information provided by specialists may have led the parents to have unrealistic expectations about the devices (Eleweke & Rodda, 2000). Because of the information they were given, the parents who chose the auditory-oral approach appeared to have very high expectations of the utility of the hearing aids and “seemed disappointed that their hopes were not realized” (Eleweke & Rodda, 2000, p. 379). If professionals inform parents about listening devices in a way that implies that they “fix” hearing or make a DHH child like a hearing child, they may believe this. It is critical that professionals explain to parents that hearing devices are simply technological tools. “Their use does not guarantee any specific outcome” (Szarkowski, 2019, p. 244), and they certainly do not allow DHH children to hear normally. Professionals should not lead parents to believe that the devices are capable of more than they actually are. They must be accurate and truthful in their explanation of how they work and what should be expected from them. Perhaps if parents understood the limitations of hearing devices, they would have more realistic expectations for their child’s use of them.
Lastly, the attitudes of services professionals and educational authorities could influence the parents’ decisions regarding communication approach and school choice for their child. The parents who chose a British Sign Language expressed that the professionals appeared to follow their own philosophies and would rather “make the child adapt to their system [even if] the system is not adaptable to the child’s needs” (Eleweke & Rodda, 2000, p. 380). Kecman (2019) notes that there are human elements involved in the process of informed choice such as the— often emotional— decision-making process that parents of DHH children go through, as well as professionals’ attitudes towards deafness and its management. All of this can influence the way that potential options are communicated to parents.
Importantly, the way that information is presented is just as influential as whether it is presented at all. This is related to a cognitive bias called the framing effect. This means that the presentation of information, whether in positive or negative semantics, affects people’s decision-making (Kte’pi, 2020). If professionals present information about signed language to parents in a negative or dismissive way (e.g., “It may hinder him from speaking” or “You probably won’t need it”), parents may be less likely to use a signed language with their DHH child. If information is presented in a positive or neutral light (e.g., “It’s very beneficial for all children” or “It’s equally as important as spoken language”) then perhaps parents will be more likely to explore that opportunity.
It is professionals’ duty to accurately and completely explain all language opportunities for DHH children to parents in a balanced way. Only then can parents make a truly informed decision.
References
Allen, J., Miller, B. R., Vido, M. A., Makar, G. A., & Roth, K. R. (2020). Point-of-care ultrasound, anchoring bias, and acute pulmonary embolism: A cautionary tale and report. Radiology Case Reports, 15, 2617-2620.
Eleweke, C. J., & Rodda, M. (2000). Factors contributing to parents' selection of a communication mode to use with their deaf children. American Annals of the Deaf, 145(4), 375-383.
Kecman, E. (2019). Old challenges, changing contexts: Reviewing and reflecting on information provision for parents of children who are deaf or hard-of-hearing. Deafness & Education International, 21(1), 3-24.
Kte’pi, B. (2020). Framing effect (psychology). Salem Press Encyclopedia.
Sharma, R. K., McManus, C., & Kuo, J. H. (2021). Idiopathic thyroid abscess in a healthy 22-year-old female: A case of anchoring bias. Journal of Clinical and Translational Endocrinology: Case Reports, 19.
Szarkoswki, A. (2019). Language development in children with cochlear implants: Possibilities and challenges. In N. S. Glickman & W. C. Hall (Eds.), Language deprivation and deaf mental health (pp. 235-262). Routledge.