Moderne Ansätze evidenzbasierter familienzentrierter Frühintervention bei Kindern mit Schwerhörigkeit oder Gehörlosigkeit

Zusammenfassung

Die Kombination einer sehr frühen Diagnostik einer Hörstörung und frühen Aufnahme einer Familie in ein Interventionsprogramm, das auf Befähigung der Eltern zu effektiver Interaktion mit ihrem Kind abzielt, kann zur Entwicklung weitgehend altersangemessener sprachlicher und sozio-emotionaler Fertigkeiten der betroffenen Kinder führen. Neben der hörtechnischen Versorgung und einem umfangreichen Informationsangebot ist es ein zentrales Anliegen, die Familie emotional und sozial zu unterstützen. So werden negative Auswirkungen von Familienstress auf die Eltern-Kind-Interaktion und somit letztlich auf die kindliche Entwicklung vermieden. Darüber hinaus gilt es, Eltern im kommunikativ-sprachlichen Umgang mit ihrem Kind zu befähigen und durch hohe Umsetzbarkeit im Familienalltag das Gefühl der Selbstwirksamkeit zu stärken. Merkmale der Eltern-Kind-Interaktion mit Auswirkungen auf die kindliche Sprachentwicklung werden erläutert. Effiziente familienorientierte Programme werden beschrieben. Evidenz für die spezifische Wirksamkeit spezieller Aspekte der Intervention für Familien und Kinder mit spezifischen Bedürfnissen (Mehrfachbeeinträchtigung, Mehrsprachigkeit, minimale Hörstörung, Familien mit eingeschränkten Ressourcen) liegt nur eingeschränkt vor.

Abstract

The combination of very early detection of hearing loss and entry to a family-centred intervention programme has been shown to be highly effective for child language and socio-emotional development by international best-practice models. Services are provided to parents, and not directly to infants. There is evidence that families who feel self-efficient, who are competent and confident with regard to their child-rearing practices and are emotionally well, have a more responsive style of interaction with their children. Furthermore, they use higher level language strategies that promote linguistic and social development. Therefore, family-centred early intervention provides assistance for the parent-child interaction as well as social and emotional support, information and technical help for families. Essential elements of an effective interaction of parents with their child with hearing impairment are described. Due to a high national and regional variability in the detection of hearing loss, and the provision of high quality interventions, much remains to be done. International collaboration on research on efficiency of intervention, particularly for special populations of children (multiply handicapped, multilingual, minimal hearing loss) and families with restricted resources, is obligatory.

Schlüsselwörter

Hörstörung - Frühförderung - familienzentriert - Eltern-Kind-Interaktion - Evidenz

Key words

hearing loss - early intervention - family-centred programme - parent-child interaction - evidence

• Literatur

• 1 Fortnum HM, Summerfield AQ, Marshall DH et al. Prevalence of permanent childhood hearing impairment in the United Kingdom and implications for universal neonatal hearing screening: questionnaire based ascertainment study. BMJ 2001; 40: 323-536
• 2 Gallaudet Research Institute. Regional and national summary report of data from the 2007–08 annual survey of the deaf and hard of hearing children and youth. Washington DC: GRI, Gallaudet University; 2008
• 3 Van Naarden K, Decouflé P, Caldwell K. Prevalence and characteristics of children with serious hearing impairment in metropolitan Atlanta, 1991–1993. Pediatrics 1999; 103: 570-575
• 4 Mitchell RE, Karchmer MA. Chasing the mythical ten percent: Parental hearing status of deaf and hard of hearing students in the United States. Sign Language Studies. 2002
• 5 Shelton TL, Jeppson ES, Johnson B. Family-centered care for children with special health care needs. Washington DC: Association for the Care of Children’s Health; 1987
• 6 Sarimski K, Hintermair M, Lang M. Zufriedenheit mit familienorientierter Frühförderung. Frühförderung Interdisziplinär 2012; 2: 56-70
• 7 Trivette CM, Dunst CJ, Hamby DW. Influences of family-systems intervention practices on parent-child interactions and child development. Topics in Early Childhood Special Education 2010; 30: 5-19
• 8 Bandura A. Self-efficacy: The exercise of control. New York: Freeman; 1997
• 9 DesJardin JL. Family empowerment: Supporting language development in young children who are deaf or hard of hearing. The Volta Review 2007; 106: 275-298
• 10 Fellinger J, Holzinger D, Mally B. Aspekte der familiären Verarbeitung von hochgradiger Hörschädigung bei Kindern – Eine empirische Studie. Sprache-Stimme-Gehör 1997; 21: 60-63
• 11 Hintermair M. Parental resources, parental stress, and socioemotional development of deaf and hard of hearing children. Journal of Deaf Studies and Deaf Education 2006; 11: 493-513
• 12 Moeller MP. Early intervention and language development in children who are deaf and hard of hearing. Pediatrics. 2000 106
• 13 DesJardin JL. Maternal contributions: Supporting language development in young children with hearing loss. Paper präsentiert anlässlich der Tagung Universal Hearing Screening: Beyond Newborn Screening. Lake Como, Italien; 2006;
• 14 Calderon R. Parental involvement in deaf children’s education program as a predictor of child’s language, early reading, and social emotional development. Journal of Deaf Studies and Deaf Education 2000; 5: 140-155
• 15 Calderon R, Naidu S. Further support of benefits of early identification and intervention with children with hearing loss. The Volta Review 2000; 100: 53-84
• 16 Yoshinaga-Itano C. Successful outcomes for deaf and hard of hearing children. Seminars in Hearing 2000; 21: 309-325
• 17 Calderon R, Bargones J, Sidman S. Characteristics of hearing families and their young deaf and hard of hearing children: Early intervention follow-up. American Annals of the Deaf. 1998. 143. 347-362
• 18 Roberts MY, Kaiser P. The effectiveness of parents-implemented language interventions: A meta-analysis. American Journal of Speech-Language Pathology 2011; 20: 180-199
• 19 Hart B, Risley T. Meaningful differences in the everyday experience of young American children. Baltimore: Brookes; 1995
• 20 Walker D, Greenwood C, Hart B et al. Prediction of school outcomes based on early language production and socioeconomic factors. Child Development 1994; 65: 606-621
• 21 Campbell FA, Ramey CT. Effects of early intervention on intellectual and academic achievement: A follow-up study of children from low income families. Child Development 1994; 65: 684-698
• 22 Campbell FA, Ramey CT. Cognitive and school outcomes for high risk African American students at middle adolescence: Positive effects of early intervention. American Educational Research Journal 1995; 32: 743-772
• 23 Alstan St. E, James-Robert I. Home environments of 10-month-old infants selected by the WILSTAAR screen for pre-language difficulties. International Journal of Language & Communication Disorders 2005; 38: 397-415
• 24 Hammer C, Tomblin B, Zhang X et al. Relationships between parenting behaviors and specific language impairment in children. International Journal of Language & Communication Disorders 2001; 36: 185-205
• 25 Gilkerson J, Richards JA. Impact of Adult Talk, Conversational Turns, and TV During the Critical 0–4 Years of Child Development. LENA research foundation: The power of talk 2009; 2
• 26 Pressman L, Pipp-Siegel S, Yoshinaga-Itano C et al. The relation of sensitivity to child expressive language gain in deaf and hard-of-hearing children whose caregivers are hearing. Journal of Deaf Studies and Deaf Education 1999; 4: 294-304
• 27 Sandal S, McLean M, Smith B. DEC recommended practices in early intervention/early childhood special education. Longmont, CO: Sopris West; 2000
• 28 Wulbert M, Inglis S, Kriegsmann E et al. Language delay and associated mother-child interactions. Developmental Psychology 1975; 11: 61-67
• 29 Papoušek H, Papoušek M.. Fragile aspects of early social integration. In: Murray L, Cooper PJ. Hrsg. Postpartum depression and child development. New York: The Guilford Press; 1997: 35-52
• 30 Meadow-Orlans PK, Steinberg A. Effects of infant hearing loss and maternal support on mother-infant interactions at 18 months. Journal of Applied Developmental Psychology 1993; 14: 407-426
• 31 Pipp-Siegel S, Biringen Z. Assessing the quality of relationships between parents and children: The emotional availability scales. TheVolta Review 1998; 100: 237-249
• 32 Koester LS, Traci MA, Brooks LR et al. Mother-infant behaviors at 6 and 9 months: A microanalytic view. In: Meadow-Orlans KP, Spencer PE, Koester LS. Hrsg. The world of deaf infants: A longitudinal study. New York: Oxford University Press; 2004: 40-56
• 33 Giezen M. Speech and sign perception in deaf children with cochlear implants. Universiteit van Amsterdam, Academisch Proefschrift. 2011
• 34 Peterson CC. Theory-of mind development in oral deaf children with cochlear implants or conventional hearing aids. Journal of Child Psychology, Psychiatry, and Allied Disciplines 2004; 45: 1096-1106
• 35 Moeller MP. Intervention and language development in children who are deaf and hard of hearing. Pediatrics 2000; 106
• 36 Watkins S, Taylor D, Pittman P. SKI-HI Curriculum: Family-centered programming for infants and young children with hearing loss. Logan: Utah State University, SKI-HI Institute, Department of Communicative Disorders/Deaf Education; 2004
• 37 Yoshinaga-Itano C, Sedey AL, Coulter BA et al. Language of early and later identified children with hearing loss. Pediatrics 1998; 102: 1168-1171
• 38 Moeller MP. Early intervention and language development in children who are deaf and hard of hearing. Pediatrics. 2000 106
• 39 Holzinger D, Fellinger J, Beitel C. Early onset of family-centred intervention predicts language outcomes in children with hearing loss. International Journal of Pediatric Otorhinolaryngology 2011; 75: 256-260
• 40 Stredler Brown A, Yoshinaga-Itano C. F.A.M.I.L.Y. assessment: A multidisciplinary evaluation tool. In: Roush J, Matkin N. Hrsg Infants and toddlers with hearing loss: Family-centered assessment and intervention. Baltimore: York Press; 1994: 133-161
• 41 Hintermair M. Hearing impairment, social networks and coping. The need for families with hearing-impaired children to relate to other parents and to hearing impaired adults. American Annals of the Deaf 2000; 145: 41-53
• 42 Watkins S, Pittman P, Walden B. The deaf mentor experimental project for young children who are deaf and their families. American Annals of the Deaf 1998; 143: 29-34