Abstract
At least two per thousand newborns are affected by hearing loss, with up to 40% with an additional disability. Early identification by universal newborn hearing screening and early intervention services are available in many countries around the world, with limited data on their effectiveness and a lack of knowledge about specific intervention-related determinants of child and family outcomes. This concept paper aimed to better understand the mechanisms by which multi-dimensional family-centred early intervention influences child outcomes, through parent behaviour, targeted by intervention by a review of the literature, primarily in the field of childhood hearing loss, supplemented by research findings on physiological and atypical child development. We present a conceptual model of influences of multi-disciplinary family-centred early intervention on family coping/functioning and parent–child interaction, with effects on child psycho-social and cognitive outcomes. Social communication and language skills are postulated as mediators between parent–child interaction and non-verbal child outcomes. Multi-disciplinary networks of professionals trained in family-centred practice and the evaluation of existing services, with respect to best practice guidelines for family-centred early intervention, are recommended. There is a need for longitudinal epidemiological studies, including specific intervention measures, family behaviours and multidimensional child outcomes.
Highlights
In contrast to risk for academic underachievement later in life, a recent study on 385 pre-schoolers with hearing loss (HL) showed that those who started receiving early intervention by the age of 6 months had similar rates of kindergarten readiness to the total population of kindergarteners [22]
In this paper we aim to develop a comprehensive conceptual model of influences of non-medical and medical early intervention on children with HL and their families
Early intervention needs to take the specific stressors resulting from having a child with HL into account (3b), so that parents regain the energy, motivation and emotional availability required for joyful and effective parent–child interaction
Summary
Disabling hearing loss (HL), defined by a hearing threshold above 30 decibels in the better hearing ear, globally affects around 34 million children below the age of 15 [1]. Other studies on children with hearing aids or cochlear implants confirm an average language gap of 1–2 standard deviations as compared to children with typical hearing [12–14]. A more recent study on social development in children with early cochlear implants and typical cognitive functioning did not find significant differences in terms of psychosocial development, as compared to their peers with typical hearing, except with regard to prosocial behaviour [19]. In contrast to risk for academic underachievement later in life, a recent study on 385 pre-schoolers with HL showed that those who started receiving early intervention by the age of 6 months had similar rates of kindergarten readiness to the total population of kindergarteners [22]. A substantial number of studies report cognitive delays in children with HL, elevated risks for delays in social cognition [23,24] and executive functioning [25–27]
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