Inter Disciplinary Approach to Vocabulary Development in Hearing Impairment

Study Overview
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Brief Summary
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The research aims to address to address the role of interdisciplinary working between professionals in the field of speech and language pathology/therapy. There is considerable evidence to state that when professionals work in collaboration with each other on particular goals that the outcomes are more favorable, functional and beneficial for the child.

Detailed Description
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The aim of the current research is to devise a joint interventional program between the speech and language pathologist and teachers in order to support their comprehension and expression of functional vocabulary. This study was devised as there is a gap in collaborative working by professionals in Pakistan. Often therapy is provided through a medical model of taking the child outside the class for one to one sessions. There is lack of lack of collaborative goal planning. This is particularly true for children who are in hearing impairment centres. In Pakistan, the prevalence of all hearing loss in rural Pakistan has been estimated to be 7.9%, in a general population setting. The high prevalence rates are a source of concern. The impact of hearing impairment manifests itself in many ways. As is evident from the studies carried out on the impact of hearing impairment on vocabulary skills and speech-language and communication difficulties in general of children and adolescents, that these difficulties if not identified in a timely manner will affect later schooling and educational attainment. Vocabulary knowledge is a key predictor of reading comprehension, which is essential for academic progress. In the field of early intervention and early childhood special education caregiver involvement has been documented as important. Speech, language and communication needs (SLCN) are prevalent among primary school-aged children. Collaboration between speech and language therapists (SLTs) and teachers is beneficial for supporting children's communication skills. Findings from an Australian study suggests that change to service delivery needs to be considered at an individual, interpersonal and organizational level to enable better outcomes for children with SLCN and increased support for their families and the professionals who work with them. Hence, timely identification and management plays a pivotal role. It is critical that therapy is provided in a manner as to generalize learnt skills. Research described speech therapy services as largely happening outside of the classroom such as removing individuals or small groups from the classroom for intervention sessions ('pull out') or that involve the speech-language pathologist indirectly affecting the child's educational program by providing modeling or coaching to relevant educators in the use of strategies to promote specific skills ('consultation'). There is no denying that collaborative working is essential. A study comparing improvement on a specific study measure designed on selected vocabulary in 12 classrooms with 3 conditions: (1) Pull-out - 50-minute group or one to one sessions for twelve weeks. (2) Classroom-based - Weekly 40-minute lessons for 12 weeks (3) Collaborative - Weekly 40-minute SLP-teacher planned and team taught lessons for 12 weeks. The results suggested evidence for the benefits of collaborative working such as the ability to discuss, design and plan between the teacher and SLP, resulting in greater outcomes and facilitating generalization of the activities in students who require it the most. The study sheds light on the need for such collaboration and provides evidence sums for further research to address similar outcomes in Pakistan.

Official Title
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The Effect Of An Inter Disciplinary Approach On Vocabulary Development in Children With Hearing Impairment; A Randomized Control Trial

Conditions
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Hearing Impaired Children

Intervention / Treatment
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* Other: Vocabulary based intervention- Non Collaborative
* Other: Vocabulary based intervention - Collaborative


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Hearing impaired children from 6 to 11 years of age who have severe unilateral or bilateral hearing loss from birth and for whom Urdu has their first language. There hearing age is at least one year. Their parents were not hearing impaired. Children used hearing aids. Unilateral & bilateral hearing impaired children were equally distributed. Exclusion Criteria: Children who did not present with HI as their main diagnosis or may have other co-morbid conditions.

Ages Eligible for Study
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Minimum Age: 6 Years
Maximum Age: 11 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Collaboration group<br>This group of children will have targets and vocabulary that has been designed collaboratively and then the therapist and teacher both reinforce the vocabulary during the week | Other: Vocabulary based intervention - Collaborative<br>* List of 10 words functional words Therapy 3 times a week for 20 minutes Duration = 9 weeks With SLP and to be reinforced by teachers in class over the week<br>* Other names: Inter-disciplinary working;|
| Active Comparator: Non-collaborative group<br>This group of children will have targets and vocabulary that has been designed collaboratively but they will only be practiced with the therapist during the week | Other: Vocabulary based intervention- Non Collaborative<br>* List of 10 words functional words Therapy 3 times a week for 20 minutes Duration = 9 weeks Only with SLP<br>* Other names: Total Communication;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Vocabulary List | There will be 10 functional words that will be designed post collaboration with the teachers. The list will accommodate 6 Ling sounds and will be implemented with both groups. The participants will be tested on the list pre-intervention and post intervention. Scoring will be based on binary responses such as correct and incorrect responses. Any further responses will be addressed qualitatively. | 9th week | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Hearing Impairment, Language Intervention, Interdisciplinary working