Frequency of Early Intervention Sessions and Vocabulary Skills in Children with Hearing Loss

Abstract

Background: A primary goal of early intervention is to assist children in achieving age-appropriate language skills. The amount of intervention a child receives is ideally based on his or her individual needs, yet it is unclear if language ability impacts amount of intervention and/or if an increased frequency of intervention sessions results in better outcomes. The purpose of this study was to determine the relationship between the frequency of early intervention sessions and vocabulary outcomes in young children with hearing loss. Methods: This was a longitudinal study of 210 children 9 to 36 months of age with bilateral hearing loss living in 12 different states. Expressive vocabulary skills were evaluated using the MacArthur–Bates Communicative Development Inventories. Results: A higher number of intervention sessions reported at the first assessment predicted better vocabulary scores at the second assessment, and more sessions reported at the second assessment predicted better scores at the third assessment. For each increase in the number of sessions reported, there was a corresponding, positive increase in vocabulary quotient. In contrast, children’s vocabulary ability at an earlier time point did not predict intervention session frequency at a later point in time. Conclusions: A significant prospective effect was apparent with more therapy sessions resulting in improved vocabulary scores 9 months later. These findings underscore the importance of early intervention. Pediatricians and other health care professionals can help apply these findings by counseling parents regarding the value of frequent and consistent participation in early intervention.

Factors Associated with Early Intervention Intensity for Children Who Are Deaf or Hard of Hearing

“…However, children who enroll at later ages may be entering EI with more delayed developmental outcomes and therefore require more intense services (more time in service and more service types) to try and “catch up” prior to EI exit that is required at 36 months of age. Consistent with a previous work [ 12 ], we found that children with either bilateral or more significant degrees of hearing loss had levels of higher service intensity. Children with more severe levels of hearing loss may require additional services, given the potential greater impact their hearing loss may have on language development, compared to those with milder levels.…”

“…Previous literature has stated that children enrolled in EI receive a range of service intensity from approximately 2 h per week [ 18 ] to 2–3 h per month [ 19 , 20 , 21 ]. Wiggen et al [ 12 ] reported that children who were DHH received on average 3–4 intervention sessions per month ranging from 30–90 min, with the majority of sessions lasting 60 min each. Intervention sessions were not necessarily limited to Part C EI and included sessions that occurred within intervention centers.…”

“…There is also robust evidence focused on language supporting the importance of the age of enrollment into EI [ 8 , 9 , 10 , 11 ]. Few studies have assessed whether aspects of EI, including dosage or intensity, are associated with outcomes in children who are DHH [ 12 , 13 , 14 ].…”

Understanding the Impact of Child, Intervention, and Family Factors on Developmental Trajectories of Children with Hearing Loss at Preschool Age: Design of the AChild Study

“…Among intervention variables predicting language outcomes early fitting with hearing aids and/or early cochlear implantation and timely access to family-centred early intervention as well as a higher intensity of early intervention haven been shown to predict language and functional communication outcomes [ 17 , 36 , 37 , 38 ]. International consensus based best practice of family-centred early intervention has been described and is supported by growing empirical evidence [ 39 ].…”

Special Issue “Early Intervention for Hearing Loss in Children: Drafting from Theory to Clinical Practice”

“…Self-efficacy in fathers was shown to be related to higher involvement and perceived support from EI providers, emphasizing efforts to actively increase involvement of fathers. In a multicenter longitudinal North American study Wiggin et al [ 10 ] investigated effects of increased frequency of early intervention sessions in children 9 to 36 months of age. By structural equation modeling controlling for maternal education, degree of hearing loss and meeting with the Joint committee on Infant Hearing 1-3-6 guidelines (completion of screening by 1 month, diagnosis of hearing loss by 3 months and enrolment in intervention by 6 months of age) significant effects of a higher number of intervention sessions at the first assessment on expressive vocabulary outcomes 9 months later was found.…”