Early intervention and language development in children who are deaf and hard of hearing
Early intervention and language development in children who are deaf and hard of hearing
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DOI：
10.1542/peds.106.3.e43
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发表时间：
2000-09-01
期刊：
影响因子：
8
通讯作者：
Moeller, MP
中科院分区：
文献类型：
--
作者：
Moeller, MP
Objective.本研究的主要目的是探讨一组聋哑和听力障碍儿童5岁时的干预年龄和语言结果之间的关系。对112名听力损失儿童进行了5岁时的词汇技能检查，这些儿童在不同年龄参加了综合干预计划。言语推理技能进行了探讨，在一个小组的80名儿童。参与者使用皮博迪图片词汇测试和标准参考措施进行评估，学前语言评估工具，由擅长评估听力损失儿童的专业人员单独管理。采用问卷调查的方法，编制了家庭参与儿童干预水平的评定量表。在5岁时，入学年龄和语言成绩之间存在统计学显著的负相关。最早入学的儿童（例如，11个月大）在5岁时表现出比后来入学的儿童更好的词汇和口头推理能力。无论听力损失的程度如何，早期入学的儿童在这些指标上的得分接近他们的听力同龄人。在试图了解性能和因素之间的关系，如入学年龄，家庭参与，听力损失的程度，和非语言智力，多元回归模型应用于数据。分析显示，只有2个这些因素解释了显着的量在5岁时获得的语言成绩的差异：家庭参与和入学年龄。令人惊讶的是，在控制了其他因素的影响后，家庭参与解释了最多的方差（r = 0.615; F变化= 58.70），强调了这个变量的重要性。在考虑回归中的其他变量后，入学年龄也对解释的方差有显著贡献（r = .452; F变化= 19.24）。重要的是，家庭参与和入学年龄的因素之间存在相互作用，影响结果。早期入学对所有家庭参与程度的儿童都有好处。然而，这项研究中最成功的儿童是那些家庭参与程度高的儿童，他们很早就参加了干预服务。那些家庭被描述为参与程度有限或一般的儿童在5岁时的得分比他们的听力同龄人低2个标准差。即使在最好的情况下（例如，早期入学与高水平的家庭参与配对），本研究中的儿童在抽象语言推理中的得分与听力同龄人相比处于较低的平均范围内，反映了这些儿童群体的语言差异。与Yoshinaga-Itano等人的研究结果一致，（1）显著更好的语言评分与早期入组干预相关。高水平的家庭参与与积极的语言成果，相反，有限的家庭参与与显着的儿童语言延迟在5岁，特别是当登记的干预是晚。结果表明，成功的实现时，早期识别与积极参与家庭的早期干预配对。
Objective. The primary purpose of this study was to examine the relationship between age of enrollment in intervention and language outcomes at 5 years of age in a group of deaf and hard-of-hearing children.Method. Vocabulary skills at 5 years of age were examined in a group of 112 children with hearing loss who were enrolled at various ages in a comprehensive intervention program. Verbal reasoning skills were explored in a subgroup of 80 of these children. Participants were evaluated using the Peabody Picture Vocabulary Test and a criterion-referenced measure, the Preschool Language Assessment Instrument, administered individually by professionals skilled in assessing children with hearing loss. A rating scale was developed to characterize the level of family involvement in the intervention program for children in the study.Results. A statistically significant negative correlation was found between age of enrollment and language outcomes at 5 years of age. Children who were enrolled earliest (eg, by 11 months of age) demonstrated significantly better vocabulary and verbal reasoning skills at 5 years of age than did later-enrolled children. Regardless of degree of hearing loss, early-enrolled children achieved scores on these measures that approximated those of their hearing peers. In an attempt to understand the relationships among performance and factors, such as age of enrollment, family involvement, degree of hearing loss, and nonverbal intelligence, multiple regression models were applied to the data. The analyses revealed that only 2 of these factors explained a significant amount of the variance in language scores obtained at 5 years of age: family involvement and age of enrollment. Surprisingly, family involvement explained the most variance after controlling for the influence of the other factors (r = .615; F change = 58.70), underscoring the importance of this variable. Age of enrollment also contributed significantly to explained variance after accounting for the other variables in the regression (r = .452; F change = 19.24). Importantly, there were interactions between the factors of family involvement and age of enrollment that influenced outcomes. Early enrollment was of benefit to children across all levels of family involvement. However, the most successful children in this study were those with high levels of family involvement who were enrolled early in intervention services. Late-identified children whose families were described as limited or average in involvement scored >2 standard deviations below their hearing peers at 5 years of age. Even in the best of circumstances (eg, early enrollment paired with high levels of family involvement), the children in this study scored within the low average range in abstract verbal reasoning compared with hearing peers, reflecting qualitative language differences in these groups of children.Conclusions. Consistent with the findings of Yoshinaga-Itano et al,(1) significantly better language scores were associated with early enrollment in intervention. High levels of family involvement correlated with positive language outcomes, and, conversely, limited family involvement was associated with significant child language delays at 5 years of age, especially when enrollment in intervention was late. The results suggest that success is achieved when early identification is paired with early interventions that actively involve families.