Divisions of Biostatistics and Epidemiology and
Developmental and Behavioral Pediatrics, Department of Pediatrics, Cincinnati Children's Hospital Medical Center and College of Medicine, University of Cincinnati, Cincinnati, Ohio.
Pediatrics. 2020 Oct;146(4). doi: 10.1542/peds.2020-0557.
Children who are deaf or hard of hearing (D/HH) have improved language outcomes when enrolled in early intervention (EI) before the age of 6 months. Little is understood about the long-term impact of EI on outcomes of kindergarten readiness (K-readiness). The study objective was to evaluate the impact of EI before the age of 6 months (early) versus after 6 months (later) on K-readiness in children who are D/HH.
In this study, we leveraged data from the Ohio Early Hearing Detection and Intervention Data Linkage Project, which linked records of 1746 infants identified with permanent hearing loss born from 2008 to 2014 across 3 Ohio state agencies; 417 had kindergarten records. The Kindergarten Readiness Assessment was used to identify children as ready for kindergarten; 385 had Kindergarten Readiness Assessment scores available. Multiple logistic regression was used to investigate the relationship between K-readiness and early EI entry while controlling for confounders (eg, hearing loss severity and disability status).
Children who were D/HH and entered EI early ( = 222; 57.7% of the cohort) were more likely to demonstrate K-readiness compared with children who entered EI later (33.8% vs 20.9%; = .005). Children who entered early had similar levels of K-readiness as all Ohio students (39.9%). After controlling for confounders, children who entered EI early were more likely to be ready for kindergarten compared with children who entered later (odds ratio: 2.02; 95% confidence interval 1.18-3.45).
These findings support the sustained effects of early EI services on early educational outcomes among children who are D/HH. EI entry before the age of 6 months may establish healthy trajectories of early childhood development, reducing the risk for later academic struggles.
在 6 个月之前接受早期干预（EI）的聋或重听（D/HH）儿童的语言发展结果得到了改善。对于 EI 对幼儿园准备（K-准备）结果的长期影响知之甚少。本研究的目的是评估在 6 个月之前（早期）与之后（晚期）接受 EI 对 D/HH 儿童 K-准备的影响。
在这项研究中，我们利用了俄亥俄州早期听力检测和干预数据链接项目的数据，该项目链接了 2008 年至 2014 年在俄亥俄州 3 个机构中发现的 1746 名患有永久性听力损失的婴儿的记录；其中 417 名有幼儿园记录。使用幼儿园准备评估来确定儿童是否准备好上幼儿园；其中 385 名儿童有幼儿园准备评估分数。使用多变量逻辑回归来研究 K-准备与早期 EI 入学之间的关系，同时控制混杂因素（例如，听力损失严重程度和残疾状况）。
与晚期进入 EI 的儿童（33.8%比 20.9%；P =.005）相比，早期进入 EI 的 D/HH 儿童更有可能表现出 K-准备。早期进入 EI 的儿童的 K-准备水平与俄亥俄州所有学生相似（39.9%）。在控制混杂因素后，与晚期进入 EI 的儿童相比，早期进入 EI 的儿童更有可能为上幼儿园做好准备（优势比：2.02；95%置信区间：1.18-3.45）。
这些发现支持早期 EI 服务对 D/HH 儿童早期教育结果的持续影响。6 个月之前的 EI 入学可能会建立儿童早期发展的健康轨迹，降低以后学业困难的风险。
