This study aimed to identify the effect of family factors on hearing-impaired children’s rehabilitation in Physical and psychological. It is widely accepted that the rehabilitation of hearing-impaired children is greatly influenced by family factors. However, Current situation of family rehabilitation is unclear and literature in this area is scarce. The present study complements the findings of previous research and provides a deeper understanding of Comprehensive rehabilitation by exploring the experiences of 48 adults who parent a child with hearing impairment.
Lizet Ketelaar have demonstrated that cochlear implantation does not ensure good rehabilitation and optimal oral development. Although cochlear implants enable speech perception to a certain extent in children with severe hearing impairment, they do not restore normal hearing, and the effectiveness of speech training is limited3.
The Language rehabilitation training of hearing-impaired children including Oral and written form. In the process of learning, hearing impaired children often have problems such as poor vocabulary, difficulty in making sentences, inaccurate pronunciation, difficulty in understanding, and inability to actively communicate with teachers due to their own functional impairment and developmental disorder, and they need to be very attentive listening and observation. Distraction and lose interest, initiative, and even disgusted, leading to poor recovery effect, poor speech function.
In the last decade or so, auditory-verbal therapy(AVT) has been widely promoted. AVT is a listening and spoken language (LSL) instructional approach. The AG Bell Academy for Listening and Spoken Language provides certification to specialists who deal with HL children10.Therefore, for caregivers who would like their HL children to develop speech, AVT can be seen as a reliable solution11. This method requires hearing impaired children to use their hearing to learn oral communication, and attaches great importance to the close cooperation between visual and hearing teachers, hearing and speaking teachers and parents of hearing impaired children, especially emphasizing the deep involvement of parents, and guiding and training parents to become the primary promoters of hearing impaired children's oral development. However, its problems are also prominent, mainly reflected in the small number of practical research topics on auditory oral method and narrow scope. For example, the problems involved in the research on the application of auditory oral method are still focused on the one-way teaching and guidance of professionals for hearing-impaired children and families. AVT can be seen as a tool for CI children to catch up with their NH peers, but future studies need to clarify many weaknesses in the process of evidence and validity12.
There are still few studies on how to take family as the center, based on family cultural differences, advantages of community resources and other issues to discuss how to help families improve rehabilitation effectiveness. At the same time, research results on the effectiveness of auditory and spoken language are mainly based on theoretical and empirical description, and there is a lack of well-designed, objective and credible research projects and research topics to track the effectiveness of children's comprehensive rehabilitation.
Rehabilitation of hearing impaired children, in a narrow sense, is to make full use of various means and methods to treat hearing and language problems of hearing impaired children in targeted ways, so that they can perceive the outside world and regain the ability to communicate. In a broad sense, the rehabilitation of hearing-impaired children represents a comprehensive rehabilitation, which contains both physiological and psychological.
In the past, the society paid more attention to the speech and hearing recovery of the hearing-impaired children. Lizet Ketelaar wrote in her article,“Currently, most children with a severe to profound hearing loss (HL) in the Western world receive a cochlear implant (CI). This device electrically stimulates the auditory nerve, bypassing the damaged part of the ear. The positive effects of this technology are undisputable. Numerous studies have shown that cochlear implantation improves auditory and language skills in the majority of children with a severe to profound HL. In comparison, few studies have been dedicated to examining children’s social-emotional development after cochlear implantation3.”
A person's psychological state is also crucial to his personal development. Generally, the mental health level of hearing-impaired children is significantly lower than that of ordinary children, and some hearing-impaired children may even have inferiority and autism psychology. Lizet Ketelaar’s research implies that children with a CI are at higher risk for experiencing social-emotional difficulties. A recent review of studies conducted among children with hearing impairment convincingly showed that there was a link between hearing disability and Psychological status. Emotional behavior disorder may be associated with poor Presentation ability.
The physical rehabilitation of hearing impaired children is poor, and the level of hearing recovery and speech acquisition is low. This will affect the mental rehabilitation of hearing-impaired children. Similarly, psychological problems limit optimal physical recovery.
Therefore, we will pay attention to the hearing-impaired children from both physiological and psychological aspects to promote their comprehensive recovery. This is not the same as the rehabilitation of hearing-impaired children in the narrow sense, but it is of great significance and has an impact on the development of hearing-impaired children in their later life.
Parents play an important and irreplaceable role during the rehabilitation of hearing-impaired children, so it is very important for the parents to receive appropriate training. The degree of parental cooperation can affect the time of hearing impaired children's speech training, and the positive cooperative attitude of parents will improve the effect of children's speech rehabilitation. Hearing-impaired children's chances of integrating into hearing society largely depend on their parents13.
Ennur Erbasi, Nerina Scarinci, Louise Hickson, et al conducted a study about Parental involvement in the care and intervention of children with hearing loss.The results indicated that parental involvement in the intervention of children with hearing loss is multifaceted in nature and incorporates a broad range of behaviours and practices14.
Children have the most contact with parents every day, and their development is more directly dependent on the guidance and feedback of parents, and the most important growth environment is the family. Therefore, we study whether family factors are related to the formation of children's hearing and language ability, and whether they affect their overall recovery and social integration mentality and emotional cognition. Concretely analyze the factors of family details and explore the influencing path.in our study, we found that The role of families in the rehabilitation process of hearing-impaired children has not been fully played, and the rehabilitation of hearing-impaired children urgently needs to be extended from schools and rehabilitation institutions to families, so as to form a more unified and comprehensive rehabilitation system.
At present, special education and rehabilitation knowledge, as professional knowledge, is mainly concentrated by doctors, experts in rehabilitation institutions, teachers of special education and other groups. A study observed that parents struggle to communicate with their hearing impaired children hence some parents end up using gestures, facial expression, pointing, touching and other manual signs that are not recognised in trying to communicate with their children15.
Most parents of special children have sporadic and insufficient special education knowledge, leading to a serious shortage of educational effectiveness. They can not correctly understand the physical and mental development characteristics of special children, can not objectively look at the differences of children, can not systematically plan the education of children, and there are unreasonable expectations for children. Furthermore, parents' levels of education and economic status have a significant effect on their parents' needs16.
The survey data also show that parents generally have a low grasp of the rehabilitation and education knowledge of hearing-impaired children, but they have a strong willingness to understand and learn about the rehabilitation and education knowledge of hearing-impaired children. Therefore, we propose to combine online and offline classes to provide effective channels for parents to learn these knowledge.
Different hearing-impaired children have their own characteristics such as family environment and rehabilitation progress. If only relying on universal and non-systematic rehabilitation techniques, it is difficult to ensure that every child can achieve a better rehabilitation effect. In order to improve the adaptability of the hearing-impaired children with their own conditions and rehabilitation methods, we put forward the "personalized family rehabilitation guidance ", as a new focus on improving the rehabilitation effect in the family perspective. This guidance puts forward more effective solutions for hearing impaired children's hearing recovery, language development, mental health and comprehensive rehabilitation in the future by means of professional assessment, personalized intervention and dynamic tracking.
Many parents have a one-sided cognition of the psychological development rules of special children, and they still can't deal with emergencies effectively. Moreover, due to various obstacles in the society and work, online and offline large-scale lectures may not meet the learning needs of some parents. In this era of new media, a lot of high-quality short videos are booming according to the needs of the society. As a common, streamlined and efficient publicity mode, short videos are favored by many people.
Language rehabilitation teaching of hearing impaired children is much different from that of normal people, the relevant curriculum software is still in the experimental stage, and the clinical and non-clinical applications are relatively limited. For personalized family rehabilitation mode, the intervention of the assisted mode of online speech rehabilitation APP can provide a more convenient technical choice for their rehabilitation training, while the assistance of online supporting courses will also facilitate the transition from special education to general education for hearing-impaired children.