Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora.
Department of Otolaryngology - Head and Neck Surgery, University of Kentucky, Lexington.
J Speech Lang Hear Res. 2022 Oct 17;65(10):3646-3660. doi: 10.1044/2022_JSLHR-22-00055. Epub 2022 Aug 19.
It is well established that individuals with a communication disability, including being deaf or hard of hearing (DHH), experience inequities in health services and outcomes. These inequities extend to DHH children's access to psychosocial evidence-based interventions (EBIs). Behavioral parent training is an EBI that can be used to improve caregiver and child outcomes. Despite being supported by decades of effectiveness research, this EBI is rarely accessed by, or studied with, caregivers of DHH children. The purpose of this article is to describe a program of stakeholder-engaged research adapting and assessing behavioral parent training with caregivers of young DHH children followed in hearing health care, aimed at reducing inequities in access to this EBI.
The first section briefly summarizes the literature on disruptive behavior problems in young children, with a focus on preschool-age DHH children. The evidence base for behavioral parent training is described. Next, the gaps in knowledge and practice regarding disruptive behaviors among DHH children are highlighted, and the potential integration of behavioral parent training into the standard of care for this population is proposed.
Young DHH children who use hearing aids and/or cochlear implants experience disruptive behavior problems at rates at least as high as typically hearing children, but their access to EBIs is limited, and behavioral parent training programs tailored to this population have not been rigorously tested. Caregivers and hearing health care service providers affirm the potential benefits of behavioral parent training and were partners in adapting this EBI. This research highlights several principles and approaches essential for reducing inequities and improving the quality of life not only for DHH children and their families but also for individuals with communication disabilities more broadly: engagement of key stakeholders in research, collaboration across disciplines, and using implementation science methods and models to design for implementation, dissemination, and sustainment. Presentation Video: https://doi.org/10.23641/asha.21215900.
众所周知，存在沟通障碍的个体，包括聋人或重听人士（DHH），在获得卫生服务和结果方面存在不平等现象。这些不平等现象也延伸到 DHH 儿童获得心理社会循证干预（EBI）的机会。行为家长培训是一种 EBI，可以用于改善照顾者和儿童的结果。尽管该 EBI 得到了几十年有效性研究的支持，但聋人或重听儿童的照顾者很少使用或研究该 EBI。本文的目的是描述一个利益相关者参与的研究计划，该计划通过适应并评估在听力保健中接受随访的年轻 DHH 儿童的照顾者的行为家长培训，旨在减少该 EBI 获得机会的不平等。
第一部分简要总结了关于幼儿期行为问题的文献，重点是学龄前 DHH 儿童。描述了行为家长培训的证据基础。接下来，突出了关于 DHH 儿童行为问题的知识和实践差距，并提出将行为家长培训纳入该人群的标准护理的可能性。
使用助听器和/或人工耳蜗的年轻 DHH 儿童经历行为问题的比率至少与正常听力儿童一样高，但他们获得 EBI 的机会有限，针对该人群量身定制的行为家长培训计划尚未经过严格测试。照顾者和听力保健服务提供者肯定了行为家长培训的潜在好处，他们是适应这种 EBI 的合作伙伴。这项研究强调了几个原则和方法，这些原则和方法对于减少不平等现象和提高生活质量至关重要，不仅对 DHH 儿童及其家庭，而且对更广泛的沟通障碍个体也是如此：关键利益相关者参与研究、跨学科合作，以及使用实施科学方法和模型来进行实施、传播和维持。演示视频：https://doi.org/10.23641/asha.21215900.
