Early Communication Intervention for Toddlers with Hearing Loss

项目摘要 虽然听力（HL）儿童在口语方面比以往任何时候都有更大的进步， 存在相当大的变异性，许多HL儿童的语言技能仍然比他们的语言技能差。 听力同伴。减少这种差异的关键是确定：（a）有效的早期沟通 HL儿童的干预措施和（B）影响干预结果的儿童和父母特征 （主持人和调解人）。然而，迄今为止，只有这项拟议研究的试点研究直接 研究了在一个儿童健康教育的背景下， 随机临床试验。拟议研究的总体目标是： 教导父母使用沟通支持策略对儿童沟通的结果和（B）检查 父母和孩子的特点，温和和调解干预的结果。核心假设是 系统的父母培训将导致父母更多地使用沟通支持策略， 儿童前语言行为，以及更大的儿童口语结果。具体目标包括： 比较父母使用的沟通支持策略和儿童的语言前的结果之间 在干预期间和干预后立即干预组和对照组，（B）检查父母 （交际洞察力）和儿童（对社会偶然性的敏感性;注意口语） 干预结果的调节因素;（c）比较父母使用沟通支持策略和儿童 干预后（18个月和36个月）干预组和对照组之间的口语结果 （d）检查父母（使用沟通支持策略）和儿童（语言前技能） 干预结果的中介者。这项拟议的研究将招募96名患有轻度至重度双侧 听力损失儿童将在12个月大左右参加这项研究，并将被随机分配到其中一个 父母实施的沟通干预（PICT）或对照组。两组的孩子都将 评估：（a）在12个月大时（干预前即刻），（B）在18个月大时（干预后即刻 干预结束后18个月）。干预中的儿童 小组将接受每周一次的1小时干预会议，为期6个月，其中：（a）在重要的 语言发展的前语言时期，（B）结合视觉，互动，反应，和语言 刺激沟通支持策略，与儿童更强的语言技能相关， （c）包括有系统的家长培训，有效教导家长使用沟通方法 语言发育迟缓儿童的支持技能。这项研究意义重大，因为早期有效 沟通干预可能会减少HL儿童的持续性语言延迟， 推进儿童听力损失领域的发展，在这个领域，严格的沟通非常缺乏。 干预研究

PROJECT SUMMARY While children with hearing (HL) are experiencing greater gains in spoken language than ever before, considerable variability exists and many children with HL continue to have poorer language skills than their hearing peers. Critical to reducing this variability is the identification of: (a) effective early communication interventions for children with HL and (b) child and parent characteristics that influence intervention outcomes (moderators and mediators). However, to date, only the pilot study for this proposed study has directly examined the effects of an early communication intervention for children with HL within the context of a randomized clinical trial. The overarching goals of the proposed study are to: (a) evaluate the effects of teaching parents to use communication support strategies on child communication outcomes and (b) examine parent and child characteristics that moderate and mediate intervention outcomes. The central hypothesis is that systematic parent training will result in greater parental use of communication support strategies, greater child prelinguistic behaviors, and greater child spoken language outcomes. The specific aims include: (a) comparing parent use of communication support strategies and child prelinguistic outcomes between intervention and control groups during and immediately following intervention, (b) examining parent (communicative insightfulness) and child (sensitivity to social contingency; attention to spoken language) moderators of intervention outcomes; (c) comparing parent use of communication support strategies and child spoken language outcomes between intervention and control groups after intervention (from 18 and 36 months of age); and (d) examining parent (use of communication support strategies) and child (prelinguistic skills) mediators of intervention outcomes. The proposed study will enroll 96 children with mild to profound bilateral hearing loss. Children will enroll in the study around 12 months of age and will be randomly assigned to either a parent-implemented communication intervention (PICT) or a control group. Children in both groups will be assessed: (a) at 12 months of age (immediately before intervention), (b) at 18 months of age (immediately after intervention), and (c) at 36 months of age (18 months after the end of intervention). Children in the intervention group will receive weekly, 1-hour intervention sessions for 6-months that: (a) are delivered during an important prelinguistic period of language development, (b) incorporate visual, interactive, responsive, and linguistically stimulating communication support strategies that are associated with stronger language skills in children with HL, and (c) include systematic parent training found to be effective in teaching parents to use communication support skills in children with language delays. The proposed research is significant because effective early communication intervention is likely to reduce persistent language delays in children with HL, thereby advancing the field of childhood hearing loss, where there is a striking paucity of rigorous communication intervention research.