Early Intervention and Language Early Intervention and Language Development in Children Who AreDevelopment in Children Who Are

Deaf and Hard of Hearing Deaf and Hard of Hearing

Moeller M P 2000 Pediatrics Sep;106(3):E43.

Aswathy.A.P.II BASLP

AIMAIMThe primary purpose of this study was to examine the relationship between age of enrollment in intervention and language outcomes at 5 years of age in a group of deaf and hard-of-hearing children.

PARTICIPANTSPARTICIPANTSParticipants in this study were 112 children (58 males; 54 females)

with prelingual-onset hearing losses ranging from mild to profound (mean better ear pure tone average [PTA] = 77.8)

These children were included if they had: 1) confirmed bilateral, sensorineural hearing loss; 2) participated in the DEIP program between 1981 and 1994; 3) received formal language evaluations through 5 years of age; 4) lived in a home where English was spoken; 5) hearing parent(s); and6) no evidence of major secondary disabilities, including nonverbal intelligence scores,70.

Demography of the sampleDemography of the sample

Age of Age of Identification/EnrollmentIdentification/EnrollmentThey were identified through such procedures as high-risk registries,neonatal intensive care unit screening, child find programs, and parental self-referral.

They ranged in age of identification from the second day of life to 54 months of age.

Age at amplification and enrollment in intervention services ranged from <1 month to 54 months with a mean of 22 months.

The average time that elapsed between age of identification and initiation of services across the group of children was 3 months.

Vocabulary skillsVocabulary skills at 5 years of age were examined in a group of 112 children with hearing loss who were enrolled at various ages in a comprehensive intervention program. Verbal reasoningVerbal reasoning skills were explored

in a subgroup of 80 of these children. A rating scale was developed to characterize the level of family family involvement involvement in the intervention program for children in the study.

METHODMETHOD

RESULTSRESULTS

Children who were enrolled earliest (eg, by 11 months of age) had better vocabulary and verbal reasoning skills at 5 yrs of age than did later-enrolled children.

Regardless of degree of hearing loss, early-enrolled children achieved scores on these measures that approximated those of their hearing peers

The analyses revealed that only 2 factors explained a significant amount of the variance in language scores obtained at 5 yrs of age:

– family involvementfamily involvement and – age of enrollmentage of enrollment

Vocabulary scores plotted as a function of the two key variables, age of enrollment and family involvement ratings

The rating 4 to 5 (filled circle) represents the highest levels of family involvement;

3 (filled triangle) represents average family involvement;

1 to 2 (open square) represents below average family involvement

The figure clearly shows that:

Early enrollment was of benefit to children across all levels of family involvement. However, the most successful the most successful children in this study were those children in this study were those with high levels of family with high levels of family involvement who were enrolled early involvement who were enrolled early in intervention servicesin intervention services..

CONCLUSIONSBetter language scores were associated with early enrollment in intervention.

High levels of family involvement High levels of family involvement correlated with positive language correlated with positive language outcomes.outcomes.

Limited family involvement was associated with significant child language delays at 5 years of age, especially when enrollment in intervention was late.

The results suggest that success is success is achieved when early identification is achieved when early identification is paired with early interventions that paired with early interventions that actively involve familiesactively involve families.

CONCLUSIONS

About the author of the paper

Mary Pat MoellerMary Pat Moeller, Ph.D., Director,Center for Childhood DeafnessEducation: Purdue University B.S. 1972 Speech and Hearing Sciences

Purdue Univeristy M.S. 1973 Audiology/Aural Rehabilitation

University of Nebraska-Lincoln Ph.D. 2002 Psychological Studies: Child Language/Deafness

Professional Affiliations: Fellow of the American Speech-Language-Hearing Association (1986);

Certificates: Certificate of Clinical Competence in Audiology, Am. Speech & Hearing Assoc.; License to Practice Audiology, State of Indiana; License to Practice Audiology, State of Nebraska.