Development and evaluation of a theory-based intervention to increase infant hearing aid use:steps towards improving deaf children's language outcomes

大约每1000个婴儿中就有一个患有永久性听力损失，这意味着它是儿童中最常见的慢性疾病之一。这些儿童中大约95%的父母听力正常，几乎没有耳聋的经历，这些父母通常选择让他们的孩子使用口语（甚至那些选择使用手语的父母）。能够听到说话的声音对实现这一目标至关重要。任何程度的听力损失都会使婴儿的语言学习之旅变得更加困难，因为接触声音在一定程度上受到影响，这意味着他们在语言发展方面有很大的延迟风险。这些延迟会对入学准备、以后的学业成就、社会和情感发展、就业和心理健康产生长期影响。对于失聪儿童（这里使用的标签用于描述任何程度的听力损失的儿童），助听器是他们获得支持的关键部分。这是因为它们帮助婴儿接触语音，这对口语的发展和大脑听觉部分的发展至关重要，尤其是在生命的第一年。通过从小获得助听器并持续使用，婴儿更有可能在语言方面取得更好的成绩。然而，研究表明：1)早期使用助听器的情况不一致；2)婴儿佩戴助听器的次数没有达到最佳效果所需的次数；护理人员面临着许多阻碍助听器持续使用的因素。减少助听器的使用，即使只是部分减少，也会限制声音体验和口语的使用，这可能导致口语效果变差。尽管有明确的需求，但很少有支持方案可以帮助父母与孩子一起增加助听器的使用，而那些现有的方案也没有使用关于如何增加助听器使用的最新证据。这意味着这些支助方案可能没有达到应有的效果。因此，我们的目标是制定一项支持计划，针对家庭面临的婴儿持续使用助听器的障碍。我们将在被称为“行为改变理论”的科学理论中做到这一点，这是关于理解影响我们做什么（我们的行为）的事情，然后提供支持，帮助调整行为以实现目标；在这种情况下，目标一致的助听器使用。这项支持计划将与家长、听力学家、聋人教师和教育听力学家共同制定，以英国各地家庭已经完成的工作为基础。

There are around one in 1000 babies born with permanent hearing loss, which means it is one of the most common chronic conditions in children. Around 95% of these children are born to hearing parents who have little to no experience of deafness, and these parents usually choose for their child to use spoken language (even those that choose to use sign language). Being able to hear speech sounds is critical to this goal. Any level of hearing loss can make a baby's language learning journey harder because access to sound is effected to some degree, meaning they are at significant risk of delays in language development. These delays can have long-term effects on school readiness, later academic achievement, social and emotional development, employment, and mental health. For deaf children (label used here to describe children with any degree of hearing loss), hearing aids are a key part of the support they receive. This is because they help babies access speech sounds, which are critical for spoken language development and to develop the auditory parts of the brain, especially in the first year of life. By getting hearing aids from an early age and using them consistently, babies are more likely to have better language outcomes. However, research has shown that: 1) hearing aid use in the early years is inconsistent; 2) babies are not wearing their hearing aids as often as they need to for optimal benefits; and 3) caregivers face a number of things that can get in the way of achieving consistent hearing aid use. Any reduction in hearing aid use - even if it's only partial - limits experience with sound and access to spoken language, which can lead to poorer spoken language outcomes. Even though there is a clear need, there are very few programmes of support that could help parents increase hearing aid use with their child, and those that exist do not use the most up to date evidence on how to increase hearing aid use. This means that these programmes of support might not be as effective as they could be. We therefore aim to develop a programme of support that targets the barriers to consistent hearing aid use with babies faced by families. We will do this within the scientific theory known as 'behaviour change theory', which is about understanding the things that influence what we do (our behaviours), and then providing support to help adapt behaviours to meet goals; in this case, the goal of consistent hearing aid use. The programme of support will be co-developed with parents, Audiologists, Teachers of the Deaf, and Educational Audiologists, building on work already being done with families across the UK.