Glanemann Reinhild, Reichmuth Karen, Matulat Peter, Zehnhoff-Dinnesen Antoinette Am
Clinic of Phoniatrics and Pedaudiology, University Hospital Muenster, Germany.
Int J Pediatr Otorhinolaryngol. 2013 Dec;77(12):2023-9. doi: 10.1016/j.ijporl.2013.10.001. Epub 2013 Oct 14.
With the implementation of the Universal Newborn Hearing Screening (UNHS), the age of diagnosis of children with hearing loss (HL) has been steadily declining in the past years. Consequently, there is a need for early educational intervention methods that are suitable for infants at the preverbal level. To meet this need we have developed and evaluated the Muenster Parental Programme (MPP), a responsive parenting programme for parents of children with HL aged 3-18 months. It aims at enhancing the parents' communicative skills towards their child.
The MPP is introduced following confirmation of a HL. Flanked by two individual counselling sessions, the programme comprises six group sessions and two single training sessions with video feedback. The focus of the programme lies in enhancing parents' responsive behaviour and in reducing inappropriate initiative behaviour. The present study involved 29 parents of 24 children aged 6.6 (mean, range: 3-12) months at the outset of the MPP. The children's degree of HL ranged from moderate to profound. Parents of children with unilateral HL and/or risk for an additional developmental delay were included. The prospective study compared parent communication skills of a trained (N = 15) versus a control group (N = 14) before and after the MPP. For this purpose, instances of responsive behaviour to the signals of the child and total time of initiative behaviour within a 4-min video-sample were measured before and after completion of the study in both groups.
Trained parents could enhance their responsiveness to vocal and preverbal signals of the child (Wilcoxon test, p = .002) and also their responsiveness to non-verbal signals (Wilcoxon test, p < .001). Moreover, parents reduced their inappropriate initiative behaviour (related t-test, p < .001). Pre-post comparisons in the control group were non-significant.
The increased parental responsiveness to infants with HL is of great importance as these early behaviours underlie later acquisition of speech, language, hearing and social communication skills. The MPP constitutes the first evaluated group concept for parents of infants with HL in the German-speaking countries and equally meets the needs of parents and professionals.
随着新生儿听力普遍筛查(UNHS)的实施,过去几年中听力损失(HL)儿童的诊断年龄一直在稳步下降。因此,需要适合处于语言前水平婴儿的早期教育干预方法。为满足这一需求,我们开发并评估了明斯特家长计划(MPP),这是一项针对3至18个月大HL儿童家长的响应式育儿计划。其目的是提高家长与孩子沟通的技能。
在确诊HL后引入MPP。该计划由两次个体咨询会议作为辅助,包括六次小组会议和两次带视频反馈的单独培训会议。该计划的重点在于增强家长的响应行为,并减少不适当的主动行为。本研究在MPP开始时纳入了24名年龄为6.6(平均,范围:3至12)个月儿童的29位家长。儿童的HL程度从中度到重度不等。单侧HL和/或有额外发育迟缓风险的儿童家长也被纳入。这项前瞻性研究比较了训练组(N = 15)和对照组(N = 14)在MPP前后的家长沟通技能。为此,在研究结束前后,对两组4分钟视频样本中对孩子信号的响应行为实例和主动行为总时长进行了测量。
接受培训的家长能够提高对孩子声音和语言前信号的响应能力(Wilcoxon检验,p = .002),以及对非语言信号的响应能力(Wilcoxon检验,p < .001)。此外,家长减少了不适当的主动行为(相关t检验,p < .001)。对照组的前后比较无显著差异。
家长对HL婴儿响应能力的提高非常重要,因为这些早期行为是后期获得言语、语言、听力和社会沟通技能的基础。MPP是德语国家首个经过评估的针对HL婴儿家长的团体概念,同样满足了家长和专业人员的需求。