Bilateral versus unilateral cochlear implantation in young children

Introduction This pilot study compared tele-intervention to conventional intervention for children with hearing loss in terms of communication performance, parental perceptions and clinician perceptions. Methods A within-subject design was employed, including 10 children with hearing loss and their parents who each received a structurally similar tele-intervention and conventional intervention session in a counterbalanced manner. Quality of communication performance was analysed using a modified Tait video analysis method. Parent and clinician perceptions were collected through rating-scale surveys and thematic analysis of qualitative responses. Results No significant difference ( p > 0.05) was found between tele-intervention and conventional intervention in terms of communication performance of children. Parent perceptions were not significantly different ( p > 0.05) between conventional and tele-intervention in terms of facilitating meaningful communication interaction. Significant differences were evident for parents' comfort level during the session, whether they found it to be a beneficial experience and whether they would like to continue receiving intervention through this method.  Clinician perceptions of conventional and tele-intervention were not significantly different ( p > 0.05) and tele-intervention was deemed a valuable method of service delivery for clients. Discussion This study provides preliminary evidence that tele-intervention is effective for communication intervention and can be a valuable solution to typical barriers such as distance and the shortage of trained interventionists.

/pdf/tele-intervention-for-children-with-hearing-loss-a-6aw9uw6esj.pdf

Tele-intervention for children with hearing loss: A comparative pilot study:

This article presents an initial evaluation of a technique known as the Diary of Early Language (Di-EL), designed to obtain data about early lexical development in young children with profound hearing loss using cochlear implants, hearing aids, or both. The validity of the Di-EL, a parent report technique, was examined through comparisons with other measures of language development. Lexical data reported by parents using the Di-EL was found to agree with that reported by the same parents for the same children using the MacArthur Communicative Development Inventories (CDI), although some differences in the lexical items were noted. Rate of lexical acquisition on the Di-EL was found to correlate highly with that measured by the CDI and with expressive language skills as measured by the Rossetti Infant Toddler Language Scale, suggesting that the Di-EL is a valid measure of early lexical progress. These results are discussed with reference to other diary studies, along with research and clinical applications of the Di-EL.

Assessment of Language Skills in Young Children with Profound Hearing Loss under Two Years of Age

Background: 
Recent research shows that parental sensitivity can explain a significant and unique amount of growth in speech and language outcomes in children with cochlear implants. In this intervention study we explored the impact of an intervention designed to support parental sensitivity on children's communication development.

Aims: 
This study tests the effect of a complex intervention in the context of childhood hearing impairment using a case study design of three families. Propositions for each case were made using parental report of the child's development in an attempt to identify change in outcome measurements that were not likely to be due to general development in the child or a halo effect from the intervention.


Methods and Results: 
Multiple pre- and post-intervention measures were taken. Outcome measures were mother–child contingencies to vocal utterances, emotional availability and an assessment of early communication in the child. Results for each case showed that improvements in some outcome measurements were found after the intervention and were maintained at follow-up.

Conclusions & Implications: 
Taking account of developmental change in intervention studies with children is challenging. Single-subject intervention studies can be designed to allow research interventions to be tailored to meet families’ specific needs. Video interaction guidance may support pre-linguistic communicative development in children with hearing impairment.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/1460-6984.12039

Video Feedback Intervention: A Case Series in the Context of Childhood Hearing Impairment.

Background and Aim: Evidence on the efficacy of parenting interventions to support communication development in deaf and hard-of-hearing children is emerging. In previous research, we showed that parental participation in a video feedback-based intervention enhanced parental self-esteem, and emotional availability to their deaf and hard-of-hearing children. This paper investigates the impact of the intervention on development of the children’s prelingual communication skills and autonomy. Evidence on the efficacy of parenting interventions to support communication development is warranted. Methods: Sixteen hearing parents with a prelingual deaf and hard-of-hearing child (Mage= 2.05 years, SD= 1.77) were recruited by self-selection from paediatric audiological services, and randomly stratified into Intervention First, and Waiting-List Groups. Families completed three sessions of Video Interaction Guidance in their homes. Designed for maximal inclusion, the sample comprised of children with complex developmental and social needs. Primary inclusion criterion was child’s prelingual status (<50 signed/spoken words), which was established using speech and language therapy reports. Child communicative autonomy was assessed from a 20-minute free play video-recording using a gold standard measure for deaf and hard-of-hearing children (Tait) before and after the intervention. Results: Mann-Whitney U test indicated no significant difference between the two groups. The groups were collated and Wilcoxon Signed Rank test with Time (Pre/Post intervention) as a repeating variable was run. A significant increase was shown child’s communicative autonomy (Z -3.517, p< .0001, d=0.62), and decrease in child’s no-responses (Z -3.111, p< .005, d=0.55) were seen. There was no significant difference in the overall number of turn-taking between the parent and child. Indicating differences in the quality of the parent-child interactions, not the quantity. Conclusion: This study adds to the emerging evidence for parenting interventions with deaf and hard-of-hearing children. We hypothesise that the video feedback intervention with its focus on emotional availability, created space for the child to show increased communicative autonomy during parent-child interactions. Communicative autonomy is a long-term predictor of communication and linguistic development in deaf and hard-of-hearing children, and its conceptual underpinning makes it a good early measure of relational agency. Results can inform wider interventions that focus on quantity of the parent-child communication.

/pdf/communication-skills-and-communicative-autonomy-of-1fzgb2l58p.pdf

Communication Skills and Communicative Autonomy of Prelinguistic Deaf and Hard-of-Hearing Children: Application of a Video Feedback Intervention.

A technique for assessing pre-verbal communication behaviours in young children with hearing impairment has previously been developed, based on rigorous analysis of video recordings of the child interacting with a known adult in a controlled setting. The technique has been found to be valuable for monitoring progress of children with hearing aids, and more recently with cochlear implants. The originators have shown the resultant measures to have important predictive validity, and the technique is gaining widespread acceptance. This study examined the reliability of the method across different observers. Twelve video samples were selected to represent the range of ages and stages of auditory development encountered in the implant programme. Three observers analysed the samples independently, according to the established protocol. There was a very high level of accord amongst observers, with 498 agreements and only 12 differences in all possible comparisons between the three observers on the variou...

Video analysis of pre‐verbal communication behaviours: use and reliability

The use and reliability of Tait video analysis in assessing preverbal language skills in profoundly deaf and normally hearing children under 12 months of age.

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Video analysis of pre‐verbal communication behaviours: use and reliability

The use and reliability of Tait video analysis in assessing preverbal language skills in profoundly deaf and normally hearing children under 12 months of age.