Fulcher Anne Nivelles, Purcell Alison, Baker Elise, Munro Natalie
The Shepherd Centre , Newtown, Sydney , Australia.
Int J Speech Lang Pathol. 2015 Jun;17(3):325-33. doi: 10.3109/17549507.2015.1032351. Epub 2015 May 9.
Early identification of severe/profound childhood hearing loss (HL) gives these children access to hearing devices and early intervention to facilitate improved speech and language outcomes. Predicting which infants will go on to achieve such outcomes remains difficult. This study describes clinician identified malleable and non-malleable factors that may influence speech and language outcomes for children with severe/profound HL.
Semi-structured interviews were conducted with six experienced auditory verbal clinicians. A collective case study design was implemented. The interviews were transcribed and coded into themes using constant comparative analysis.
Clinicians identified that, for children with severe/profound HL, early identification, early amplification and commencing auditory-verbal intervention under 6 months of age may facilitate child progress. Possible barriers were living in rural/remote areas, the clinicians' lack of experience and confidence in providing intervention for infants under age 6-months and belonging to a family with a culturally and linguistically diverse (CALD) background.
The results indicate that multiple factors need to be considered by clinicians working with children with HL and their families to determine how each child functions within their own environment and personal contexts, consistent with the International Classification of Functioning, Disability and Health (ICF) framework. Such an approach is likely to empower clinicians to carefully balance potential barriers to, and facilitators of, optimal speech and language outcomes for all children with HL.
尽早识别重度/极重度儿童听力损失(HL),能让这些儿童获得听力设备并接受早期干预,以促进言语和语言能力的改善。预测哪些婴儿能够取得这样的结果仍然很困难。本研究描述了临床医生确定的可能影响重度/极重度HL儿童言语和语言结果的可变因素和不可变因素。
对六位经验丰富的听觉言语临床医生进行了半结构化访谈。采用了集体案例研究设计。访谈内容被转录,并使用持续比较分析法编码成主题。
临床医生确定,对于重度/极重度HL儿童,早期识别、早期听力放大以及在6个月龄前开始听觉言语干预可能促进儿童进步。可能的障碍包括生活在农村/偏远地区、临床医生缺乏为6个月龄以下婴儿提供干预的经验和信心,以及属于文化和语言多样化(CALD)背景的家庭。
结果表明,为HL儿童及其家庭提供服务的临床医生需要考虑多个因素,以确定每个儿童在其自身环境和个人背景中的功能状况,这与《国际功能、残疾和健康分类》(ICF)框架一致。这种方法可能使临床医生能够仔细权衡所有HL儿童在实现最佳言语和语言结果方面的潜在障碍和促进因素。