Moderne Ansätze evidenzbasierter familienzentrierter Frühintervention bei Kindern mit Schwerhörigkeit oder Gehörlosigkeit

 

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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.

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