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聋儿父母早期干预的系统范围综述。

A systematic scoping review of early interventions for parents of deaf infants.

机构信息

Leeds and York Partnership NHS Foundation Trust, COMIC Research, IT Centre, Science Park, University of York, Innovation Way, Heslington, York, YO10 5NP, UK.

The University College London Ear Institute, 332 Grays Inn Rd, London, WC1X 8EE, UK.

出版信息

BMC Pediatr. 2021 Oct 22;21(1):467. doi: 10.1186/s12887-021-02893-9.

Abstract

BACKGROUND

Over 90% of the 50,000 deaf children in the UK have hearing parents, many of whom were not expecting a deaf child and may require specialist support. Deaf children can experience poorer long-term outcomes than hearing children across a range of domains. After early detection by the Universal Newborn Hearing Screening Programme, parents in the UK receive support from Qualified Teachers of the Deaf and audiologists but resources are tight and intervention support can vary by locality. There are challenges faced due to a lack of clarity around what specific parenting support interventions are most helpful.

METHODS

The aim of this research was to complete a systematic scoping review of the evidence to identify early support interventions for parents of deaf infants. From 5577 identified records, 54 met inclusion criteria. Two reviewers screened papers through three rounds before completing data extraction and quality assessment.

RESULTS

Identified parent support interventions included both group and individual sessions in various settings (including online). They were led by a range of professionals and targeted various outcomes. Internationally there were only five randomised controlled trials. Other designs included non-randomised comparison groups, pre / post and other designs e.g. longitudinal, qualitative and case studies. Quality assessment showed few high quality studies with most having some concerns over risk of bias.

CONCLUSION

Interventions commonly focused on infant language and communication followed by parental knowledge and skills; parent wellbeing and empowerment; and parent/child relationship. There were no interventions that focused specifically on parent support to understand or nurture child socio-emotional development despite this being a well-established area of poor outcome for deaf children. There were few UK studies and research generally was not of high quality. Many studies were not recent and so not in the context of recent healthcare advances. Further research in this area is urgently needed to help develop evidence based early interventions.

摘要

背景

在英国,超过 90%的 5 万名听障儿童的父母都是听力正常的,他们中的许多人并没有期望自己的孩子是听障儿童,因此可能需要专业的支持。听障儿童在许多领域的长期预后都不如听力正常的儿童。在英国,通过全民新生儿听力筛查计划(Universal Newborn Hearing Screening Programme)早期发现听障问题后,家长们可以得到聋儿教育专家和听力学家的支持,但资源有限,干预支持可能因地区而异。由于缺乏明确的指导,家长们不知道哪种特定的育儿支持干预措施最有帮助,因此面临着许多挑战。

方法

本研究旨在通过系统的范围综述,对聋儿父母的早期支持干预措施进行证据评估。在 5577 份已识别的记录中,有 54 份符合纳入标准。两位评审员通过三轮筛选,完成了数据提取和质量评估。

结果

确定的父母支持干预措施包括各种环境中的小组和个别课程(包括在线课程)。这些课程由不同专业的人员带领,针对各种不同的结果。国际上仅有五项随机对照试验。其他设计包括非随机对照比较组、前后对照和其他设计,如纵向、定性和案例研究。质量评估显示,高质量研究很少,大多数研究都存在一定的偏倚风险。

结论

干预措施通常侧重于婴儿的语言和沟通,其次是父母的知识和技能、父母的幸福感和赋权感,以及父母与孩子的关系。尽管这是聋儿不良预后的一个成熟领域,但没有专门针对父母支持以理解或培养孩子社会情感发展的干预措施。英国的研究较少,而且总体研究质量不高。许多研究都不是最近的,因此无法与最近的医疗保健进步相适应。因此,迫切需要在这一领域开展进一步的研究,以帮助开发基于证据的早期干预措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/21c3/8532316/1e705d79a699/12887_2021_2893_Fig1_HTML.jpg

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