語前聾兒童人工耳蝸植入術後一年內的聽覺發展和言語識別

傅瑩, 陳源, 郗昕, 洪夢迪, 陳艾婷, 王倩, 黃麗娜

Research output: Contribution to journalArticle

Abstract

目的 探索語前聾兒童人工耳蝸植入術後早期的聽覺發展和言語識別,同時探討現行中文聽障兒童聽覺和言語識別測試工具的可行性。

方法 共有83例重度–極重度語前聾患兒參與本研究,按耳蝸植入手術時的年齡將患兒分為四組:A組(1~2歲)18例、B組(2~3歲)30例、C組(3~4歲)24例、D組(4~5歲)11例。使用嬰幼兒/有意義聽覺整合量表(Infant–Toddler/Meaningful Auditory Integration Scale, MAIS/IT–MAIS)問卷,普通話早期言語感知測試(MandarinEarly Speech Perception Test, MESP)、普通話兒童言語能力測試(Mandarin Pediatric SpeechIntelligibility Test, MPSI)等閉合式言語識別測試,由經過培訓的聽力學專業人員對患兒術後的聽覺發展和言語識別能力進行評估。分別在術前和開機後3、6、12個月時對各組患兒進行評估,評估人員記錄測試結果並採用SPSS19.0軟體進行統計學分析。

結果 術後早期的聽覺發育和言語識別的發展隨康復時間延長而逐步提高。各組受試患兒的MAIS/IT–MAIS得分隨著康復時間的延長,均呈現相同的增長趨勢,組間差異具有統計學意義(F=5.743,P=0.007)。植入年齡3~4歲的C組兒童術前MAIS/IT–MAIS得分即已高於其他各組,在術後各隨訪節點得分也高於另外三組。術前助聽器使用經驗多的兒童,其MAIS/IT–MAIS得分也高於未使用助聽器或使用經驗少的兒童(F=4.947,P=0.000)。MESP測試顯示,在植入後1年內,患兒的言語察覺能力始終優先於言語識別能力,但言語識別能力隨著人工耳蝸使用時間延長而有明顯提高;各亞測試項的難度呈現較明顯的漸次增大的層級。MPSI在開機12個月時才僅有約40%的受試兒童能完成安靜條件下的測試,且隨著語競比的降低,能完成該測試的兒童的比例顯著下降。

結論 人工耳蝸植入術後1年,患兒即發展出一定的聽力及言語識別能力。中文版IT–MAIS/MAIS、MESP、MPSI是評估植入後兒童早期聽覺、言語識別的可用工具。

Objective To investigate the development of early auditory capability and speech perception in the prelingual deaf children after cochlear implantation, and to study the feasibility of currently available Chinese assessment instruments for the evaluation of early auditory skill and speech perception in hearing-impaired children.

Methods A total of 83 children with severe-to-profound prelingual hearing impairment participated in this study. Participants were divided into four groups according to the age for surgery: A (1-2 years), B (2-3 years), C (3-4 years) and D (4-5years). The auditory skill and speech perception ability of CI children were evaluated by trained audiologists using the infant-toddler/ meaningful auditory integration scale (IT-MAIS/MAIS) questionnaire, the Mandarin Early Speech Perception (MESP) test and the Mandarin Pediatric Speech Intelligibility (MPSI) test. The questionnaires were used in face to face interviews with the parents or guardians. Each child was assessed before the operation and 3 months, 6 months, 12 months after switch-on.

Results After cochlear implantation, early postoperative auditory development and speech perception gradually improved. All MAIS/IT-MAIS scores showed a similar increasing trend with the rehabilitation duration(F=5.743, P=0.007). Preoperative and post operative MAIS/IT-MAIS scores of children in age group C (3-4 years) was higher than that of other groups. Children who had longer hearing aid experience before operation demonstrated higher MAIS/IT-MAIS scores than those with little or no hearing aid experience(F=4.947, P=0.000). The MESP test showed that, children were not able to perceive speech as well as detecting speech signals. However as the duration of CI use increased, speech perception ability also improved substantially. However, only about 40% of the subjects could be evaluated using the most difficult subtest on the MPSI in quiet at 12 months after switch-on. As MCR decreased, the proportion of children who could be tested using the MPSI reduced.

Conclusions Within one year after CI , children develop early auditory and speech perception capabilities with time. Chinese versions of the IT-MAIS/MAIS, MESP and MPSI are useful instruments to document early auditory and speech perception skills in children after CI implantation. Copyright © 2015 中華醫學會.
Original languageChinese
Pages (from-to)274-280
Journal中華耳鼻咽喉頭頸外科雜誌
Volume4
DOIs
Publication statusPublished - 2015

Citation

傅瑩、陳源、郗昕、洪夢迪、陳艾婷、王倩和黃麗娜(2015):語前聾兒童人工耳蝸植入術後一年內的聽覺發展和言語識別,《中華耳鼻咽喉頭頸外科雜誌》,4,頁 274-280。

Keywords

  • 耳蝸植入術
  • 聽覺喪失
  • 言語知覺
  • 兒童
  • Cochlear implantation
  • Hearing loss
  • Speech perception
  • Child
  • Alt. title: Development of early auditory and speech perception skills within one year after cochlear implantion in prelingual deaf children