Integrating Psychology Into Pediatric Audiology/Otolaryngology Clinics: Gaps and a Model of Care

Objective: This manuscript reviews what is known about psychopathology and neurodevelopmental outcomes in deaf/hard of hearing (DHH) children, identifies current research and clinical gaps, and presents a model of care for integrating psychology into pediatric otolaryngology/audiology clinics that serve DHH patients and their families. Methods: This manuscript uses a literature review and clinical reflection/peer collaboration to develop a model of integrated psychological services for pediatric psychologists in otolaryngology/audiology clinics. Results: DHH children and their families often require support beyond the traditional focus on speech/language delays. Additional concerns include increased rates of co-occurring psychological conditions (e.g., anxiety, depression), early and potentially persistent changes in neurological/neurobehavioral functioning with or without atypical language development, high levels of caregiver-reported distress, and additional medical complexities. Conclusions: Traditionally, models of multidisciplinary care for DHH children have centered on a triad of otolaryngologists, audiologists, and speech/language pathologists. However, the reviewed data clearly show these models leave numerous unmet needs that psychologists can help address. Incorporating psychologists into pediatric otolaryngology/audiology clinic settings that serve DHH patients is an essential ingredient in high-quality care that helps meet the needs of the “whole child.” Implications for Impact Statement DHH children and families are an at-risk and underserved group that frequently interacts with the pediatric health care system. This paper presents the first model of care for integrating psychologists into the medical/audiological settings that serve these patients.