Electronic Thesis and Dissertation Repository

Thesis Format



Doctor of Philosophy


Health and Rehabilitation Sciences


Moodie, Sheila


Adolescence is a time when adult behaviours become established and adolescents are more able to manage aspects of their healthcare. Research has examined adolescent transitions to self-manage their personal healthcare needs associated with chronic diseases. Providing children and adolescents with information about their health is an ongoing process and, as they mature, they should be allowed to take on more responsibility for their healthcare management. The purpose of this study was to explore the transition for adolescents who are deaf and hard of hearing toward the self-management of their hearing healthcare. A constructivist grounded theory approach was used to develop a model for the transition process. Participants included adolescents with congenital or early-identified hearing loss who communicate via the aural/oral modality, parent(s)/guardian(s) with the role of primary caregiver for a child with hearing loss, hearing resource teachers working within a school board to support students with hearing loss, and audiologists working clinically with adolescents. All participants took part in one-on-one interviews and adolescent participants were asked to complete a take-home journal. Findings from this study informed the development of the constructivist grounded theory model “I am the expert” that describes the transition for adolescents in the self-management of hearing healthcare. This model identifies the key themes of developing ownership, managing identity, developing advocacy, and doing it myself. Results from this study highlight the support role of parents, audiologists, and itinerant teachers in the transition to self-manage hearing healthcare. Implications for audiology practice and education are provided.

Summary for Lay Audience

As young people get older, it is important for them to begin to take on more responsibilities. This is also true for young people with disabilities, including those with hearing loss. It is important for young people with hearing loss to learn how to self-manage their hearing healthcare needs. This can include being able to ask questions about their hearing loss, understand their listening needs, advocate for themselves, and manage any hearing devices they may require. Currently, there is not a significant body of evidence that explores how young people learn to take on more responsibility for their hearing needs. Therefore, in this study a constructivist grounded theory methodology was used to explore how adolescents transition to self-manage their hearing healthcare. A constructivist theory is concerned with how and why an individual constructs meaning and actions from their own experiences. It can help us to discover the experiences of participants and how their social context and individuals they interact with can indirectly and directly impact them. Interviews with Adolescents, parents of children with hearing loss, audiologists, and hearing resource teachers were analyzed and the grounded theory model “I am the expert” was developed. Four major themes were identified that are important to this transition: developing ownership, managing identity, developing advocacy, and doing it myself. Results from this study can help professionals, parents, and educators to better work together to support young people with hearing loss.