Development and Adaptive Behavior of Young Children with Hearing Loss

描述（由申请人提供）：随着新生儿听力筛查现在确定婴儿期听力损失的儿童，需要更好地了解导致这些婴儿成熟后最佳发展的特定儿童，家庭和服务因素。在现实世界环境中，对于促进这些幼儿的最佳社会情感和适应功能的变量，人们所知相对较少。我们提出的研究目标和设计采用儿童发展的交易/生态理论方法，该理论认为幼儿的发展受到许多相互关联的因素的影响，包括生物、社会和文化因素。基于这一理论框架，我们建议在复杂的背景下最好地理解轻度至重度听力损失幼儿的发展轨迹，包括儿童变量、家庭/父母特征以及儿童和家庭可获得的干预服务。该项目的具体目标是：1)确定轻度至重度听力损失幼儿在社会情感和适应功能方面的发展轨迹，并将这些发展模式与典型听力儿童的发展模式进行比较；2)探讨轻、重度听力损失儿童语言技能与社会情绪和适应性发展的关系；3)探讨父母教养和干预因素对轻、重度听力损失幼儿语言发展、社会情感和适应功能的影响。为了实现这些目标，我们提出了一项纵向多中心研究，对210名诊断为轻度至重度感音神经性听力损失的儿童和100名正常听力的儿童进行比较。这些儿童将从12个月到48个月被跟踪，并在听力、言语感知、语言、认知、社会情感问题和能力以及适应功能的结果领域进行评估。家长的参与程度、自我效能、情感可用性和语言输入将被评估。最后，具体的干预服务被认为是重要的变量，并将在整个调查中描述。多层次建模将作为分析计划的一部分实施，允许描述社会情感和适应功能的轨迹，以及测试与相关儿童，家庭和干预服务特征相关的特定假设。该项目汇集了来自多个学科的发展观点，包括听力学、言语语言病理学、发展和临床心理学、早期干预、儿科、耳鼻喉科和生物统计学。从这项纵向调查中获得的知识将为发展理论提供信息，并应促进对患有轻度至重度听力损失的幼儿进行有效和响应性的儿童和家长支持干预。

DESCRIPTION (provided by applicant): With newborn hearing screening now identifying children with hearing loss in infancy, a better understanding is needed about specific child, family, and service factors that lead to optimal development of these infants as they mature. Relatively little is known about the variables that facilitate optimal social-emotional and adaptive functioning for these young children in real-world environments. The objectives and design of our proposed study take transactional/ecological theoretic approach of child development, which purports that development in young children is influenced by many interrelated factors, including biological, social, and cultural. Based on this theoretical framework, we propose that the developmental trajectories for young children with mild to severe hearing loss are best understood within a complex context that includes child variables, family/parent characteristics, and intervention services available to the child and family. The specific aims of this project are: 1) to determine the developmental trajectories of young children with mild to severe hearing loss with respect to social-emotional and adaptive functioning and to compare these developmental patterns to those of young children with typical hearing; 2) to examine the relations between language skills and social-emotional and adaptive development in young children with mild to severe hearing loss; and, 3) to examine the influence of parenting and intervention factors on language development and social-emotional and adaptive functioning in young children with mild to severe hearing loss. To accomplish these aims, we propose a longitudinal multicenter study of 210 children diagnosed with mild to severe sensorineural hearing loss, and a group of 100 typical hearing children for comparison purposes. The children will be followed from 12 to 48 months of age and assessed under the outcome domains of audition, speech perception, language, cognition, social- emotional problems and competencies, and adaptive functioning. Parents will be assessed in terms of their involvement and self-efficacy, emotional availability, and language input. Lastly, specifics of intervention services are considered to be important variables and will be delineated throughout the investigation. Multi-Level Modeling will be implemented as part of the analytic plan, permitting descriptions of trajectories for social-emotional and adaptive functioning, as well as testing specific hypotheses regarding associations with related child, family, and intervention service characteristics. This project brings together developmental perspectives from multiple disciplines, including audiology, speech-language pathology, developmental and clinical psychology, early intervention, pediatrics, otolaryngology, and biostatistics. The knowledge gained from this longitudinal investigation will inform developmental theory and should promote effective and responsive child and parent support interventions for young children with mild-to-severe hearing loss.