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家长实施的晚说话者早期语言干预计划:父母的沟通行为变化与儿童 3 岁和 4 岁时的语言发展结果。

Parent-implemented early language intervention programme for late talkers: parental communicative behaviour change and child language outcomes at 3 and 4 years of age.

机构信息

Dutch Foundation for the Deaf and Hard of Hearing Child, Amsterdam, the Netherlands.

Developmental Psychology Leiden University, Leiden, the Netherlands.

出版信息

Int J Lang Commun Disord. 2019 May;54(3):451-464. doi: 10.1111/1460-6984.12451. Epub 2019 Jan 24.

Abstract

BACKGROUND

Late language emergence is a risk indicator for developmental language disorder. Parent-implemented early language intervention programmes (parent programmes) have been shown to have positive effects on children's receptive and expressive language skills. However, long-term effectiveness has rarely been studied. Additionally, little is known about which strategies parents learn to use after participating in parent programmes and whether this affects their child's language development.

AIMS

To evaluate medium- and long-term effectiveness (1 and 2 years after inclusion) of a low-dosage parent programme in a sample of late talkers (LTs) with an expressive language delay. Specifically, we investigated which strategies the parents learned to use in interaction with their child and which strategies were associated with child language growth over time.

METHODS & PROCEDURES: This quasi-experimental study with a longitudinal design included 24-month-old LTs. After the pre-test, parents of children in the intervention group received a parent programme (n = 30), while parents of children in the comparison group received care as usual (n = 30). Children's language development was assessed using standardized language tests at pre-test and two follow-up tests at 36 and 48 months of age. Change in parental communicative behaviour was measured by a parent-child interaction observation measure, at pre-test and follow-up at 36 months of age.

OUTCOMES & RESULTS: At 36 months old, children in the parent programme group showed a significantly higher growth in expressive vocabulary than children in the comparison group. However, differences between the groups were not seen in the long-term, at the 48-month follow-up. In contrast to parents in the comparison group, parents in the parent programme group changed their communicative behaviour positively in two domains: Interaction and Pressure on the child. However, no changes in the domains of Language Stimulation and Responsiveness were observed. Children's growth in expressive vocabulary and expressive syntax was associated with a decrease in the domain of Pressure.

CONCLUSIONS & IMPLICATIONS: At 4 years of age, the majority of children in both groups achieved expressive vocabulary scores within the normal range. However, the mean score for expressive syntax in both groups remained below that of their peers, and 29% of the children still had expressive language scores below the mean range. Ongoing monitoring of LTs' language development is necessary in order to make decisions regarding the timing and nature of intervention.

摘要

背景

语言出现较晚是发育性语言障碍的一个风险指标。已证实,家长实施的早期语言干预方案(家长方案)对儿童的接受性和表达性语言技能有积极影响。然而,很少有研究长期效果。此外,对于家长在参加家长方案后学习使用哪些策略以及这些策略是否影响其孩子的语言发展,人们知之甚少。

目的

在有表达性语言延迟的晚说话者(LT)样本中,评估低剂量家长方案的中短期(纳入后 1 年和 2 年)效果。具体而言,我们调查了家长在与孩子互动中学到了哪些策略,以及哪些策略与随时间推移孩子的语言增长有关。

方法与程序

本研究采用纵向设计的准实验设计,纳入 24 月龄的 LT。在预测试后,干预组儿童的家长接受家长方案(n = 30),而对照组儿童的家长接受常规护理(n = 30)。在预测试和 36 个月及 48 个月的两次随访测试中,使用标准化语言测试评估儿童的语言发展。在预测试和 36 个月的随访中,通过亲子互动观察测量来衡量父母沟通行为的变化。

结果

在 36 个月时,家长方案组儿童的表达词汇量增长显著高于对照组。然而,在长期随访中,即 48 个月时,两组之间没有差异。与对照组的家长相比,家长方案组的家长在两个领域积极改变了他们的沟通行为:互动和对孩子施压。然而,在语言刺激和反应性两个领域没有观察到变化。儿童表达词汇量和表达语法的增长与施压领域的减少有关。

结论与意义

在 4 岁时,两组中的大多数儿童的表达词汇量得分都在正常范围内。然而,两组的表达语法平均得分仍低于同龄儿童,29%的儿童的表达语言得分仍低于平均范围。为了做出关于干预时机和性质的决策,有必要对 LT 的语言发展进行持续监测。

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