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

B Wright,T Wakefield,R Swanwick,M Garside,R Hargate,G Carr,I Noon,P Simpson

doi:10.1186/s12887-021-02893-9

Abstract

BackgroundOver 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.MethodsThe 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.ResultsIdentified 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.ConclusionInterventions 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.

Highlights

This research seeks to add to the evidence base by providing an up to date systematic scoping review of parent support interventions for deaf infants, synthesising the targets of these interventions and highlighting any evidence gaps to inform subsequent early intervention training and research in a UK context
The first two sifts examined records based on title and abstract. 41 were excluded by reviewers as duplications, 1,262 were identified as not relevant and 3,858 were excluded as they did not meet the PICOS criteria. 13 additional records were added through reference checking. 429 papers were sought for full paper screening
We mapped the interventions with Randomised Controlled Trials (RCTs) evidence to these 10 principles: we found that none of the 5 RCTs included all 10 of the consensus principles

Summary

Introduction

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. Over 90% of deaf children in the UK are born to hearing parents, most of whom were not expecting a deaf child [3, 4] and whom may require specialist support and advice. There is a body of evidence that a significant number of deaf children experience poorer outcomes than hearing children, in terms of educational attainment [5], social. Being deaf can have a range of impacts for both the child and their family [8] including auditory, linguistic, cognitive, social, literacy, and academic functioning [9]. Some deaf children can display difficulties in executive functioning [21], abstract thinking and problem-solving skills that adversely affect academic achievement [22]

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