Fitzpatrick Elizabeth M, Stevens Adrienne, Garritty Chantelle, Moher David
Audiology and Speech-Language Pathology Program, Faculty of Health Sciences, University of Ottawa, 451 Smyth Road, Ottawa, ON K1H 8M5, Canada.
Syst Rev. 2013 Dec 6;2:108. doi: 10.1186/2046-4053-2-108.
Permanent childhood hearing loss affects 1 to 3 per 1000 children and frequently disrupts typical spoken language acquisition. Early identification of hearing loss through universal newborn hearing screening and the use of new hearing technologies including cochlear implants make spoken language an option for most children. However, there is no consensus on what constitutes optimal interventions for children when spoken language is the desired outcome. Intervention and educational approaches ranging from oral language only to oral language combined with various forms of sign language have evolved. Parents are therefore faced with important decisions in the first months of their child's life.
METHODS/DESIGN: This article presents the protocol for a systematic review of the effects of using sign language in combination with oral language intervention on spoken language acquisition. Studies addressing early intervention will be selected in which therapy involving oral language intervention and any form of sign language or sign support is used. Comparison groups will include children in early oral language intervention programs without sign support. The primary outcomes of interest to be examined include all measures of auditory, vocabulary, language, speech production, and speech intelligibility skills. We will include randomized controlled trials, controlled clinical trials, and other quasi-experimental designs that include comparator groups as well as prospective and retrospective cohort studies. Case-control, cross-sectional, case series, and case studies will be excluded. Several electronic databases will be searched (for example, MEDLINE, EMBASE, CINAHL, PsycINFO) as well as grey literature and key websites. We anticipate that a narrative synthesis of the evidence will be required. We will carry out meta-analysis for outcomes if clinical similarity, quantity and quality permit quantitative pooling of data. We will conduct subgroup analyses if possible according to severity/type of hearing disorder, age of identification, and type of hearing technology.
This review will provide evidence on the effectiveness of using sign language in combination with oral language therapies for developing spoken language in children with hearing loss who are identified at a young age. The information from this review can provide guidance to parents and intervention specialists, inform policy decisions and provide directions for future research.
CRD42013005426.
永久性儿童听力损失影响着每1000名儿童中的1至3名，常常干扰典型的口语习得。通过普遍的新生儿听力筛查以及使用包括人工耳蜗在内的新听力技术来早期识别听力损失，使得大多数儿童有了习得口语的可能。然而，对于以口语为预期结果的儿童而言，什么构成最佳干预措施尚无共识。从仅使用口语到将口语与各种形式的手语相结合的干预和教育方法不断发展。因此，家长在孩子生命的最初几个月面临着重要决策。
方法/设计：本文介绍了一项系统评价的方案，该评价旨在探讨手语与口语干预相结合对口语习得的影响。将选择涉及早期干预的研究，其中使用了涉及口语干预和任何形式的手语或手语支持的疗法。对照组将包括未接受手语支持的早期口语干预项目中的儿童。要检查的主要感兴趣结果包括听觉、词汇、语言、言语产生和言语可懂度技能的所有测量指标。我们将纳入随机对照试验、对照临床试验以及其他包括比较组的准实验设计，以及前瞻性和回顾性队列研究。病例对照研究、横断面研究、病例系列研究和病例报告将被排除。将检索几个电子数据库（例如，MEDLINE、EMBASE、CINAHL、PsycINFO）以及灰色文献和关键网站。我们预计需要对证据进行叙述性综合。如果临床相似性、数据数量和质量允许进行数据的定量合并，我们将对结果进行荟萃分析。如果可能，我们将根据听力障碍的严重程度/类型以及听力技术类型进行亚组分析。
本综述将为在幼儿期被确诊的听力损失儿童中，使用手语与口语疗法相结合来发展口语的有效性提供证据。本综述的信息可为家长和干预专家提供指导，为政策决策提供依据，并为未来研究指明方向。
PROSPERO注册号：CRD42013005426。
