Parent-Implemented Communication Treatment for Infants and Toddlers With Hearing Loss: A Randomized Pilot Trial
Parent-Implemented Communication Treatment for Infants and Toddlers With Hearing Loss: A Randomized Pilot Trial
复制标题
DOI：
10.1044/2018_jslhr-l-18-0079
复制
发表时间：
2019-01-01
影响因子：
2.6
通讯作者：
Roberts, Megan Y.
中科院分区：
文献类型：
--
作者：
Roberts, Megan Y.
目的：尽管人工耳蜗和助听器技术取得了进步，但许多听力损失的儿童仍然表现出比听力同龄人差的语言技能。这项随机试点试验测试了父母实施的针对语言前沟通技能的沟通治疗对听力损失婴儿和幼儿的效果。方法：参与者包括19名6至24个月大的中度至重度双侧听力损失儿童。孩子们被随机分配到父母实施的沟通治疗组或“常规护理”控制组。父母和孩子参加了长达26个小时的家庭会议，在这些会议中，父母被教导使用沟通支持策略。主要测量结果是沟通和象征性行为量表(Wetherby&Prizant，2003)，这是一种测量儿童语言前技能的工具，以及父母在自然游戏期间对沟通支持策略的使用。结果：治疗组的父母对沟通支持策略的使用增加了17%。与对照组相比，治疗组儿童在言语前语言技能方面的进步有统计学意义(d=1.09，p=0.03)。在社交和符号语言前技能上没有统计学上的显著差异，但效应大小很大(d=0.78，p=.08；d=0.91，p=.10)。结论：本研究为父母实施的沟通治疗听力损失儿童的短期效果提供了适度的初步支持。父母学习了沟通支持策略，这些策略随后影响了孩子的语言前技能。尽管这些结果看起来很有希望，但样本量很小。未来的研究应该包括更大规模的临床试验和儿童水平的治疗反应预测指标。
Purpose: Despite advances in cochlear implant and hearing aid technology, many children with hearing loss continue to exhibit poorer language skills than their hearing peers. This randomized pilot trial tested the effects of a parent-implemented communication treatment targeting prelinguistic communication skills in infants and toddlers with hearing loss.Method: Participants included 19 children between 6 and 24 months of age with moderate to profound, bilateral hearing loss. Children were randomly assigned to the parent-implemented communication treatment group or a "usual care" control group. Parents and children participated in 26, hour-long home sessions in which parents were taught to use communication support strategies. The primary outcome measures were the Communication and Symbolic Behavior Scales (Wetherby & Prizant, 2003), a measure of child prelinguistic skills, and parental use of communication support strategies during a naturalistic play session.Results: Parents in the treatment group increased their use of communication support strategies by 17%. Children in the treatment group made statistically significant more gains in speech prelinguistic skills (d = 1.09, p = .03) as compared with the control group. There were no statistically significant differences in social and symbolic prelinguistic skills; however, the effect sizes were large (d = 0.78, p = .08; d = 0.91, p = .10).Conclusions: This study provides modest preliminary support for the short-term effects of a parent-implemented communication treatment for children with hearing loss. Parents learned communication support strategies that subsequently impacted child prelinguistic skills. Although these results appear promising, the sample size is very small. Future research should include a larger clinical trial and child-level predictors of response to treatment.