Auswirkungen der COVID-19-Pandemie auf die logopädische Therapie von Kindern mit einer Sprachentwicklungsstörung

Zusammenfassung

Hintergrund Im Dezember 2019 begann sich die COVID-19-Pandemie weltweit auszubreiten und sorgte für massive Einschränkungen im täglichen Leben. Viele Bildungseinrichtungen und logopädische Praxen wurden vorübergehend geschlossen (sog. Lockdown). Kinder mit einer Sprachentwicklungsstörung waren gezwungen, ihre Therapie zu pausieren. Ziel dieser Studie war es zu beschreiben, ob und wie die logopädische Therapie während des Lockdowns durchgeführt wurde und welche psychische Belastung für die betroffenen Eltern damit verbunden war.

Material und Methoden Eltern von Kindern mit einer Sprachentwicklungsstörung wurden über die Therapie ihres Kindes während des Lockdowns und über ihre damit verbundenen Ängste und Sorgen befragt.

Ergebnisse Bei 17 Patienten wurde die Sprachtherapie während des Lockdowns pausiert, während 20 Patienten ihre Therapie fortsetzen konnten. Kinder, die eine andere Sprache als Deutsch sprachen, hatten ein höheres Risiko, dass ihre Therapie pausiert wurde (Odds Ratio (OR) 5,11; 95 %-Konfidenzintervall (KI) 1,09–32,54). Eltern, deren Kinder während des Lockdowns keine Sprachtherapie erhielten, machten sich mehr Sorgen um die Entwicklung ihres Kindes.

Schlussfolgerungen Es gibt kein generelles Konzept, wie Logopädie während eines Lockdowns sicher durchgeführt werden kann. Mögliche Barrieren für die Gesundheitsversorgung könnten während der Pandemie stärker ausgeprägt sein. Die betroffenen Eltern erleben eine höhere psychosoziale Belastung.

Abstract

Objective In December 2019, the COVID-19 pandemic began to spread around the world and caused massive restrictions in our daily life. Many educational facilities and practices delivering speech therapy were temporally closed (so-called lockdown). Children with a speech and language disorder were forced to pause their therapy. The aim of this study was to describe if and how speech therapy was delivered during lockdown and what psychological burden was associated to affected parents.

Material and Methods Parents of children with a speech and language disorder were asked about their child’s therapy during lockdown and about their fears and worries associated with it.

Results For 17 patients speech therapy was paused during lockdown while 20 patients could continue their therapy. Children speaking a language other than German had a higher risk for having their therapy paused during lockdown (Odds ratio = 5.11, with 95 % confidence interval = 1.09–32.54). Parents whose children did not receive speech therapy during lockdown were more worried about their child’s development.

Conclusions There is no common concept on how speech therapy can be delivered safely during lockdown. Possible barriers to healthcare might be more pronounced during the pandemic and parents experience a high psychosocial burden.

Schlüsselwörter

Sprachentwicklungsstörung - COVID-19-Pandemie - Logopädie - Eltern - Therapieunterbrechung

Key words

speech and language disorder - COVID-19 - psychological burden

Publication History

Received: 21 April 2021

Accepted: 25 August 2021

Article published online:
10 September 2021

• Literatur

• 1 Centers for Disease Control and Prevention. 2020 Im Internet (Stand: 04.02.2021): https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html
• 2 Interdisziplinäre S2k-Leitlinie, Erstellungsdatum: 16.12.2011. Im Internet (Stand: 01.02.2021): https://www.awmf.org/uploads/tx_szleitlinien/049-006l_S2k_Sprachentwicklungsstoerungen_Diagnostik_2013-06-abgelaufen_01.pdf
• 3 Donald KA, Wedderburn CJ, Barnett W. et al Risk and protective factors for child development: An observational South African birth cohort. PLoS Med 2019; 16: e1002920 DOI: 10.1371/journal.pmed.1002920.
• 4 Feldmann HM. How young children learn language and speech: implications of theory and evidence for clinical pediatric practice, Pediatr. Rev 2019; 40: 398-411 DOI: 10.1542/pir.2017-0325.
• 5 Schleswig-Holstein, Ministerium für Soziales, Gesundheit, Wissenschaft und Gleichstellung, Bericht: Untersuchungen der Kinder- und Jugendärztlichen Dienste und der Zahnärztlichen Dienste in Schleswig-Holstein, Schuljahr 2014/2015. Im Internet (Stand: 04.02.2021): https://www.schleswig-holstein.de/DE/Landesregierung/VIII/Service/Broschueren/Broschueren_VIII/Gesundheit/schuleinguntber2015.pdf;jsessionid=DF4C59FF787A345EB777FF11B091B6C4.delivery1-replication?__blob=publicationFile&v=1
• 6 May-Mederake B. Early intervention and assessment of speech and language development in young children with cochlear implants, Int. J Pediatr Otorhinolaryngol 2012; 76: 939-946 DOI: 10.1016/j.ijporl.2012.02.051. . Epub 2012 Apr 17
• 7 Nicholas JG, Geers AE. Effects of early auditory experience on the spoken language of deaf children at 3 years of age. Ear Hear 2006; 27: 286-298 DOI: 10.1097/01.aud.0000215973.76912.c6.
• 8 Bishop DV, Adams C. A prospective study of the relationship between specific language impairment, phonological disorders and reading retardation, J. Child Psychol Psychiatry 1990; 31: 1027-1050 DOI: 10.1111/j.1469-7610.1990.tb00844.x.
• 9 Weir E, Bianchet S. Developmental dysfluency: early intervention is key. CMAJ 2004; 170: 1790-1791 DOI: 10.1503/cmaj.1040733.
• 10 Tohidast SA, Mansuri B, Bagheri R. et al Provision of speech-language pathology services for the treatment of speech and language disorders in children during the COVID-19 pandemic: Problems, concerns, and solutions. Int J Pediatr Otorhinolaryngol 2020; 138: 110262 DOI: 10.1016/j.ijporl.2020.110262. . Epub 2020 Jul 15
• 11 Williams PCM, Howard-Jones AR, Hsu P. et al SARS-CoV-2 in children: spectrum of disease, transmission and immunopathological underpinnings. Pathology 2020; 52 (07) 801-808 DOI: 10.1016/j.pathol.2020.08.001. . Epub 2020 Aug 19
• 12 Corona-Arbeitsschutzstandard. Im Internet (Stand: 09.06.2021): https://www.bgw-online.de/DE/Home/Branchen/News/Logo-Physio-Ergo-Corona-Arbeitsschutzstandard.html
• 13 Ärzteschaft. Corona: Videobehandlung für Logopäden Mittel der Wahl. Im Internet (Stand: 24.02.2021): https://www.aerzteblatt.de/nachrichten/117390/Corona-Videobehandlung-fuer-Logopaeden-Mittel-der-Wahl
• 14 Keine Richtlinien für Ergotherapeuten. Im Internet (Stand: 24.02.2021): https://www.rbb24.de/panorama/thema/2020/coronavirus/beitraege/berlin-ergotherapie-mach-friedenau-krise.html
• 15 Castillo-Allendes A, Contreras-Ruston F, Cantor-Cutiva LC. et al Voice Therapy in the Context of the COVID-19 Pandemic: Guidelines for Clinical Practice. J Voice 2020; DOI: 10.1016/j.jvoice.2020.08.001. . Epub ahead of print
• 16 Doll EJ, Braden MN, Thibeault SL. COVID-19 and Speech-Language Pathology Clinical Practice of Voice and Upper Airway Disorders, Am. J Speech Lang Pathol 2021; 30: 63-74 DOI: 10.1044/2020_AJSLP-20-00228. . Epub 2020 Dec 17
• 17 Sarti D, De Salvatore M, Gazzola S. et al So far so close: an insight into smart working and telehealth reorganization of a Language and Learning Disorders Service in Milan during COVID-19 pandemic, Neurol. Sci 2020; 41: 1659-1662 DOI: 10.1007/s10072-020-04481-8. . Epub 2020 May 29
• 18 Coker TR, Rodriguez MA, Flores G. Family-centered care for US children with special health care needs: who gets it and why?. Pediatrics 2010; 125: 1159-1167 DOI: 10.1542/peds.2009-1994. . Epub 2010 May 3
• 19 Maul CA. Working with culturally and linguistically diverse students and their families: perceptions and practices of school speech-language therapists in the United States, Int. J Lang Commun Disord 2015; 50: 750-762 DOI: 10.1111/1460-6984.12176. . Epub 2015 Jul 27
• 20 Morgan PL, Hammer CS, Farkas G. et al Who Receives Speech/Language Services by 5 Years of Age in the United States?. Am J Speech Lang Pathol 2016; 25: 183-199 DOI: 10.1044/2015_AJSLP-14-0201.
• 21 Rosen-Reynoso M, Porche MV, Kwan N. et al Disparities in Access to Easy-to-Use Services for Children with Special Health Care Needs, Matern. Child Health J 2016; 20: 1041-1053 DOI: 10.1007/s10995-015-1890-z.
• 22 McManus BM, Robert S, Albanese A. et al Predictors of receiving therapy among very low birth weight 2-year olds eligible for Part C early intervention in Wisconsin. BMC Pediatr 2013; 13: 106-2431 DOI: 10.1186/1471-2431-13-106.
• 23 McManus B, McCormick MC, Acevedo-Garcia D. et al The effect of state early intervention eligibility policy on participation among a cohort of young CSHCN. Pediatrics 2009; 124 (Suppl. 04) S368-S374 DOI: 10.1542/peds.2009-1255G.
• 24 Newacheck P, Hughes D, Hung Y. et al Health needs and consumer views – the unmet health need of America's children. Pediatrics 2000; 105: 989-997 . Im Internet: https://pediatrics.aappublications.org/content/pediatrics/105/Supplement_3/989.full.pdf
• 25 Ekeland AG, Bowes A, Flottorp S. Effectiveness of telemedicine: a systematic review of reviews, Int. J Med Inform 2010; 79: 736-771 DOI: 10.1016/j.ijmedinf.2010.08.006.
• 26 Roine R, Ohinmaa A, Hailey D. Assessing telemedicine: a systematic review of the literature. CMAJ 2001; 165: 765-771
• 27 Wales D, Skinner L, Hayman M. The Efficacy of Telehealth-Delivered Speech and Language Intervention for Primary School-Age Children: A Systematic Review, Int. J Telerehabil 2017; 9: 55-70 DOI: 10.5195/ijt.2017.6219.
• 28 Bradford NK, Caffery LJ, Smith AC. Telehealth services in rural and remote Australia: a systematic review of models of care and factors influencing success and sustainability. RRH 2016; 16: 4268
• 29 Ciccia AH, Whitford B, Krumm M. et al Improving the access of young urban children to speech, language and hearing screening via telehealth, J Telemed. Telecare 2011; 17: 240-244 DOI: 10.1258/jtt.2011.100810. . Epub 2011 Jun 2
• 30 Tenforde AS, Borgstrom H, Polich G. et al Outpatient Physical, Occupational, and Speech Therapy Synchronous Telemedicine: A Survey Study of Patient Satisfaction with Virtual Visits During the COVID-19 Pandemic, Am. J Phys Med Rehabil 2020; 99: 977-981 DOI: 10.1097/PHM.0000000000001571.
• 31 Pamplona MDC, Ysunza PA. Speech pathology telepractice for children with cleft palate in the times of COVID-19 pandemic, Int. J Pediatr Otorhinolaryngol 2020; 138: 110318 DOI: 10.1016/j.ijporl.2020.110318. . Epub 2020 Aug 15
• 32 Lam JHY, Lee SMK, Tong X. Parents' and Students' Perceptions of Telepractice Services for Speech-Language Therapy During the COVID-19 Pandemic: Survey Study, JMIR Pediatr. Parent 2021; 4: e25675 DOI: 10.2196/25675.
• 33 Fong R, Tsai CF, Yiu OY. The Implementation of Telepractice in Speech Language Pathology in Hong Kong During the COVID-19 Pandemic, Telemed. J E Health 2021; 27: 30-38 DOI: 10.1089/tmj.2020.0223. . Epub 2020 Jul 14
• 34 McAllister J. The impact of adolescent stuttering and other speech problems on psychological well-being in adulthood: evidence from a birth cohort study, Int. J Lang Commun Disord 2013; 48: 458-468 DOI: 10.1111/1460-6984.12021. . Epub 2013 May 3
• 35 St Clair MC, Forrest CL, Yew SGK. et al Early Risk Factors and Emotional Difficulties in Children at Risk of Developmental Language Disorder: A Population Cohort Study, J. Speech Lang Hear Res 2019; 62: 2750-2771 DOI: 10.1044/2018_JSLHR-L-18-0061. . Epub 2019 Jul 12
• 36 Anfinrud P, Stadnytskyi V, Bax A. Visualizing Speech-Generated Oral Fluid Droplets with Laser Light Scattering, N. Engl J Med 2020; 382: 2061-2063 DOI: 10.1056/NEJMc2007800. . Epub 2020 Apr 15
• 37 Asadi S, Wexler AS, Cappa CD. et al Aerosol emission and superemission during human speech increase with voice loudness. Sci Rep 2019; 9: 2348-019 DOI: 10.1038/s41598-019-38808-z.
• 38 Somsen GA, van Rijn C, Kooij S. et al Small droplet aerosols in poorly ventilated spaces and SARS-CoV-2 transmission, Lancet Respir. Med 2020; 8: 658-659 DOI: 10.1016/S2213-2600(20)30245-9. . Epub 2020 May 27
• 39 Hebbeler K, Spiker D, Bailey D. et al Early intervention for infants and toddlers with disabilities and their families: participants, services, and outcomes 2007; 11247. Im Internet: https://www.sri.com/wp-content/uploads/pdf/neils_finalreport_200702.pdf
• 40 Noblitt B, Alfonso KP, Adkins M. et al Barriers to Rehabilitation Care in Pediatric Cochlear Implant Recipients, Otol. Neurotol 2018; 39: e307-e313 DOI: 10.1097/MAO.0000000000001777.
• 41 Beitchman JH, Brownlie EB, Inglis A. et al Seven-year follow-up of speech/language impaired and control children: psychiatric outcome, J. Child Psychol Psychiatry 1996; 37: 961-970 DOI: 10.1097/00004583-199411000-00015.
• 42 Botting N, Durkin K, Toseeb U. et al Emotional health, support, and self-efficacy in young adults with a history of language impairment, Br. J Dev Psychol 2016; 34: 538-554 DOI: 10.1111/bjdp.12148. . Epub 2016 May 25
• 43 Conti-Ramsden G, Botting N. Emotional health in adolescents with and without a history of specific language impairment (SLI), J. Child Psychol Psychiatry 2008; 49: 516-525 DOI: 10.1111/j.1469-7610.2007.01858.x. . Epub 2008 Jan 21
• 44 Eiser C. Psychological effects of chronic disease. J Child Psychol Psychiatry 1990; 31: 85-98 DOI: 10.1111/j.1469-7610.1990.tb02274.x.
• 45 Wallander JL, Varni JW. Effects of pediatric chronic physical disorders on child and family adjustment. J Child Psychol Psychiatry 1998; 39: 29-46
• 46 Zhou SJ, Zhang LG, Wang LL. et al Prevalence and socio-demographic correlates of psychological health problems in Chinese adolescents during the outbreak of COVID-19, Eur. Child Adolesc Psychiatry 2020; 29: 749-758 DOI: 10.1007/s00787-020-01541-4. . Epub 2020 May 3
• 47 Blome C, Augustin M. Measuring change in quality of life: bias in prospective and retrospective evaluation. Value Health 2015; 18: 110-115 DOI: 10.1016/j.jval.2014.10.007.