Early Communication Intervention for Deaf/Hard of Hearing Toddlers: A Randomized Clinical Trial
Maranda K Jones1, Katherine Zanzinger1, Jeffrey Grauzer1
1Roxelyn and Richard Pepper Department of Communication Sciences, School of Communication, Northwestern University, Evanston, Illinois.
Insights
Parent-mediated interventions (PMIs) significantly improved communication in deaf and hard-of-hearing toddlers. These early interventions showed particular benefits for families using sign language, enhancing both parent strategies and child communication outcomes.
Area of Science:
- Pediatrics
- Speech and Hearing Sciences
- Developmental Psychology
Background:
- Early intervention is crucial for deaf and hard-of-hearing (DHH) children's development.
- Parent-mediated interventions (PMIs) offer a promising approach for early communication development in DHH toddlers.
Purpose of the Study:
- To evaluate the impact of a PMI on parent strategy use and child communication.
- To determine if communication mode (sign language exposure) moderates the intervention's effectiveness.
Main Methods:
- A 2x2 parallel stratified clinical trial involving 96 parent-child dyads.
- Participants were DHH toddlers aged 12-18 months, randomized to PMI or control group.
- Intervention delivered via telehealth over 6 months, with outcomes measured pre-, during, and post-intervention.
Main Results:
- The PMI group showed statistically and clinically significant improvements in parent strategy use (Cohen's d = 1.57) and child communication (Cohen's d = 0.59).
- Child communication gains were significantly greater for children exposed to sign language compared to those not exposed (B = 18.93, P = 0.02).
Conclusions:
- The PMI is an effective early communication intervention for DHH toddlers, enhancing parent strategy use and child communication.
- The intervention demonstrates particular benefits for parent-child dyads utilizing sign language.
Objective:
To maximize outcomes for deaf and hard-of-hearing (DHH) children, it is essential to develop effective early interventions. Parent-mediated interventions (PMIs) are a promising form of early communication interventions for DHH toddlers. The current study tests the effect of the PMI by evaluating (1) the effect of the PMI on parent strategy use and child communication and (2) the extent to which communication mode moderates these effects.
Methods:
This single-site parallel stratified clinical trial (2 × 2; hearing device, communication mode) enrolled 96 parent-child dyads. Child inclusion criteria were as follows: (1) between 12 to 18 months old, (2) diagnosed with bilateral hearing loss, (3) no additional diagnoses, (4) had at least 1 parent with typical hearing, and (5) exposed to some degree of spoken language by their parents. Communication mode (ie, how a language is conveyed) was measured as exposure or no exposure to sign. Dyads were randomized to the PMI or control group. The PMI occurred weekly via telehealth over 6 months. Outcomes were measured before, during, and immediately after intervention.
Results:
Parent strategy use (Cohen's d = 1.57) and child communication (Cohen's d = 0.59) were greater for participants in the PMI group, indicating a statistically and clinically significant intervention effect. The intervention effect on child communication was significantly greater for children exposed to signs than children not exposed to signs (Regression Coefficient (B) = 18.93, SE = 8.09, P = .02).
Conclusion:
The PMI effectively facilitates parent strategy use and child communication outcomes. Moreover, this early communication intervention seems particularly beneficial for parent-child dyads who use sign.
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