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名婴儿中就有一名出生时患有永久性听力损失，这意味着这是儿童最常见的慢性疾病之一。这些孩子中约95%出生在听力较差的父母那里，他们几乎没有耳聋经验，这些父母通常会选择让他们的孩子使用口语(即使是那些选择使用手语的人)。能够听到语音是实现这一目标的关键。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，因为获得声音的途径在一定程度上会受到影响，这意味着他们面临着语言发育延迟的巨大风险。这些延迟可能会对入学准备、以后的学业成就、社交和情感发展、就业和心理健康产生长期影响。对于失聪儿童(这里使用的标签是指患有任何程度听力损失的儿童)，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获得语音，这对口语发育和大脑听觉部分的发育至关重要，特别是在婴儿出生的第一年。通过从小获得助听器并持续使用，婴儿更有可能获得更好的语言结果。然而，研究表明：1)早年助听器的使用不一致；2)婴儿没有像他们需要的那样频繁地佩戴助听器以获得最佳效果；3)照顾者面临许多事情，可能会阻碍助听器的持续使用。任何助听器使用的减少--即使只是部分减少--都会限制人们对声音和口语的体验，这可能会导致较差的口语效果。尽管有明显的需求，但能够帮助父母增加孩子助听器使用的支持方案很少，而且现有的方案也没有使用最新的证据来说明如何增加助听器的使用。这意味着，这些支持计划可能不会像应有的那样有效。因此，我们的目标是制定一项支持方案，以解决家庭对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，该理论是关于理解影响我们所做的事情(我们的行为)的事情，然后提供支持，帮助调整行为以达到目标；在这种情况下，目标是持续使用助听器。该支持计划将与家长、听力学家、聋人教师和教育听力学家共同开发，建立在英国各地家庭已经完成的工作的基础上。

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.