Colombani Arianna, Saksida Amanda, Pavani Francesco, Orzan Eva
Institute for Maternal and Child Health - IRCCS "Burlo Garofolo" - Trieste, Italy.
Institute for Maternal and Child Health - IRCCS "Burlo Garofolo" - Trieste, Italy.
Int J Pediatr Otorhinolaryngol. 2023 Feb;165:111421. doi: 10.1016/j.ijporl.2022.111421. Epub 2022 Dec 28.
Language and communication outcomes in children with congenital sensorineural hearing loss (cSNHL) are highly variable, and some of this variance can be attributed to the quantity and quality of language input. In this paper, we build from the evidence that human language is inherently multimodal and positive scaffolding of children's linguistic, cognitive, and social-relational development can be supported by Parent Centered Early Interventions (PCEI), to suggest that the use of gestures in these interventions could be a beneficial approach, yet scarcely explored.
This systematic review aimed to examine the literature on PCEI focused on gestures (symbolic and deictic) used to enhance the caregiver-child relationship and infant's language development, in both typically and atypically developing populations. The systematic review was conducted following the PRISMA guidelines for systematic reviews and meta-analyses. From 246 identified studies, 8 met PICO inclusion criteria and were eligible for inclusion. Two reviewers screened papers before completing data extraction and risk of bias assessment using the RoB2 Cochrane scale.
Included studies measured the effect of implementing symbolic or deictic gestures in daily communication on the relational aspects of mother/parent-child interaction or on language skills in infants. The studies indicate that gesture-oriented PCEI may benefit deprived populations such as atypically developing children, children from low-income families, and children who, for individual reasons, lag behind their peers in communication.
Although gesture-oriented PCEI appear to be beneficial in the early intervention for atypically developing populations, this approach has been so far scarcely explored directly in the context of hearing loss. Yet, symbolic gestures being a natural part of early vocabulary acquisition that emerges spontaneously regardless of hearing status, this approach could represent a promising line of intervention in infants with cSNHL, especially those with a worse head start.
先天性感音神经性听力损失（cSNHL）儿童的语言和沟通结果差异很大，其中一些差异可归因于语言输入的数量和质量。在本文中，我们基于以下证据展开论述：人类语言本质上是多模态的，以家长为中心的早期干预（PCEI）可以支持儿童语言、认知和社会关系发展的积极支架作用，进而提出在这些干预中使用手势可能是一种有益的方法，但目前几乎未被探索。
本系统评价旨在研究关于PCEI的文献，该文献聚焦于用于加强照顾者与儿童关系以及促进正常和非典型发育人群中婴儿语言发展的手势（象征性和指示性）。该系统评价按照系统评价和荟萃分析的PRISMA指南进行。从246项已识别研究中，有8项符合PICO纳入标准并 eligible for inclusion。两名 reviewers在使用RoB2 Cochrane量表完成数据提取和偏倚风险评估之前对论文进行了筛选。
纳入研究测量了在日常沟通中实施象征性或指示性手势对母婴/亲子互动关系方面或婴儿语言技能的影响。研究表明，以手势为导向的PCEI可能使非典型发育儿童、低收入家庭儿童以及因个人原因在沟通方面落后于同龄人的儿童等弱势群体受益。
尽管以手势为导向的PCEI似乎在非典型发育人群的早期干预中有益，但到目前为止，这种方法在听力损失背景下几乎未被直接探索。然而，象征性手势是早期词汇习得的自然组成部分，无论听力状况如何都会自发出现，这种方法可能是cSNHL婴儿，尤其是那些起步较差的婴儿的一种有前景的干预途径。
