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台北地區0~3歲聽損嬰幼兒於醫學中心接受整合性早期療育之語言治療成效初探

A Preliminary Study of the Effectiveness of Speech Therapy for the 0 to 3-Year-Old Infants and Toddlers With Hearing Loss Receiving Integrated Early Intervention in the Medical Center in Taipei

摘要


台灣新生兒先天性聽力損失(簡稱聽損)發生率約為(千分之3~4),根據《2014台灣新生兒聽力篩檢與確診指引手冊》之建議,若新生兒出生時聽力篩檢未通過,應於出生1個月內進行複篩,4個月內確診,6個月前配戴聽能輔具並接受早期療育,使聽損孩子有較好的語言、認知及社會技能發展。回顧過去國內文獻,研究對象多於醫療院所確診並接受輔具介入後,再至基金會接受聽力語言訓練之聽損嬰幼兒,因此本研究探討0~3歲聽損嬰幼兒於同一醫療院所,接受整合性早期療育服務之語言治療成效。本研究以11位於台大醫院接受整合性早期療育之0~3歲聽損嬰幼兒及其家長為研究對象,於本院耳鼻喉部確診並配戴輔具後開始語言治療,於介入前後使用《零歲至三歲華語嬰幼兒溝通及語言篩檢測驗》評估個案的語言能力,並參考Zineldin在2006年提出之5Qs模型自編「聽損兒童早期療育服務調查表」調查家長的滿意度。結果顯示經過語言治療介入後,個案語言能力皆有顯著進步,家長對整合性早期療育整體滿意度在「同意」程度之上,此結果顯示聽損嬰幼兒於同一醫療院所接受整合性早期療育服務之語言治療有初步的成效,此服務流程與療育課程更可推廣至相關單位及日後研究者參考。

關鍵字

聽損 早期療育 語言治療 滿意度

並列摘要


The incidence of congenital hearing loss for newborns in Taiwan is about (3 to 4 per mille). According to the guidelines for newborn hearing screening and diagnosis suggested by Health Promotion Administration, Ministry of Health and Welfare in 2014, newborns who failed hearing screening at birth should be referred for re-screening before 1 month of age, determine the diagnosis of hearing loss before 4 months of age, and fit hearing aids and begin early intervention before 6 month of age. This can enhance their language development, cognition and social skills. Reviewing the past research in Taiwan, almost hearing-loss infants received the intervention in the foundations that specialize in aural training after be diagnosed and fit hearing aids. This study explores the effect of speech therapy for the 0 to 3-year-old infants and toddlers with hearing loss receiving integrated early intervention services at the National Taiwan University Children's Hospital (NTUCH). Participants included 11 infants and toddlers with hearing loss and their parents. The infants and toddlers with hearing-loss were diagnosed in Department of Otolaryngology, NTUCH, and began speech therapy after fitting hearing aids or receiving cochlear implantation. The Communication and Language Screening Test for Birth to Three Chinese-Speaking Infant-Toddlers was used to assess their language ability before and after receiving speech therapy, and author used self-edited "Early Intervention for Hearing-Loss Children Questionnaire" based on the 5Qs model proposed by Zineldin (2006) to investigated parental satisfaction. There was significant improvement in language ability after speech therapy, and overall parental satisfaction with the integrated early intervention at NTUCH was above the level of "agreed." This study reveals that the speech therapy for infants and toddlers with hearing loss receiving integrated early intervention at NTUCH has preliminary effectiveness. This service process and treatment course can be promoted by medical units and future research.

參考文獻


賴思吟、陳怡慧(2011)。學前聽覺障礙兒童家長對療育服務現況與滿意度之研究。特殊教育與復健學報,25,73-93。doi:10.6457/BSER.201112.0075。
陳瑞玲、王紀勳、吳俊良、范君揚、周昱甫、林鴻清(2015)。台灣實施公費新生兒聽力篩檢之過去、現況與未來。台灣耳鼻喉頭頸外科雜誌,50,67-73。doi:10.6286/2015.50.2.67
Joint Committee on Infant Hearing. (2000). Year 2000 position statement: Principles and guidelines for early hearing detection and intervention programs. American Journal of Audiology, 9, 9-29. doi:10.1044/1059-0889(2000/005)
Kaipa, R., & Danser, M. L. (2016). Efficacy of auditory-verbal therapy in children with hearing impairment: A systematic review from 1993 to 2015. Internatioal Journal of Pediatric Otorhinolaryngology, 86, 124-134. doi:10.1016/j.ijporl.2016.04.033
Moeller, M. P. (2000). Early intervention and language development in children who are deaf and hard of hearing. Pediatrics, 106, e43. doi:10.1542/peds.106.3.e43

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