title: Early natural auditory-verbal education of children with profound hearing impairments in the Federal Republic of Germany: results of a 4 year study.
abstract: Early education of children with hearing impairments has been carried out in the FRG for the past ca. 40 years using a variety of different educational concepts. One of these concepts is the natural auditory-verbal approach. By supporting the development of hearing, even amongst children with profound hearing impairments, it stakes the claim of being capable of initiating the children's development of natural auditory-verbal skills, which are then comparable to those of children with normal hearing. Nevertheless, to this date, no empirical study of the approach and its measure of success had ever been undertaken. During the course of this study, the measures involved in a hearing-oriented system of early education were comprehensively examined. The analysis was performed on the advancements made in the natural auditory-verbal skills of infants suffering a loss of hearing of 90 dB or more and who were educated in such a way. The study comprised 103 children with profound hearing impairments, who were younger than 24 months old at the time the study began. Their respective developments were followed in three separate surveys between 1996 and 1998. The results were analysed using bivariate as well as statistical correlation methods. The children's development is impeded by such factors as late initial diagnosis; delayed supply of hearing aids and late commencement of early education; poorly-adjusted hearing aids and short periods of wearing them. A system of early education that is only to a very limited degree hearing-oriented, and a family environment where little is spoken and where the child's auditory disability receives only scant attention, may also play a part. On the other hand, under favourable circumstances, even children with profound hearing-impairments may attain a development level of natural auditory-verbal skills which corresponds to that of children who can hear well-perhaps with a certain time-delay, and certainly involving a greater effort on the part of the children, but basically, in the same natural way and with a very similar quality of results. The early education system must urgently be improved by the introduction of screening for new-born infants. As far as devices are concerned, the cochlear-implant (CI) will very soon be standard equipment for infants with profound hearing-impairments. Within institutional facilities, there is a broad consensus that the goal of these measures consists of the development of speech communication skills in children. In practice, however, the strategies for realising this goal are not only very different, but also, partly, have downright counterproductive effects.
authors.affiliation: University of Education Heidelberg, Keplerstrasse 87, D-69120 Heidelberg, Germany. gdiller@cic-rheinmain.de
authors.forename: G
authors.initials: G
authors.lastname: Diller
authors.forename: P
authors.initials: P
authors.lastname: Graser
authors.forename: C
authors.initials: C
authors.lastname: Schmalbrock
mesh_terms: D001309:Auditory Threshold; D016009:Chi-Square Distribution; D002675:Child, Preschool; D003054:Cochlear Implants; D003638:Deafness / Q000175:diagnosis* / Q000534:rehabilitation*; D004519:Education, Special / Q000379:methods*; D005260:Female; D005858:Germany; D006310:Hearing Aids; D006801:Humans; D007223:Infant; D007804:Language Development; D007807:Language Tests; D008137:Longitudinal Studies; D008297:Male; D011336:Probability; D012720:Severity of Illness Index; D013070:Speech Therapy / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome