Relationships among speech perception, production, language, hearing loss, and age in children with impaired hearing
Relationships among speech perception, production, language, hearing loss, and age in children with impaired hearing
复制标题
DOI：
10.1044/1092-4388(2001/022
复制
发表时间：
2001-04-01
影响因子：
2.6
通讯作者：
Tooher, R
中科院分区：
文献类型：
--
作者：
Blamey, PJ;Sarant, JZ;Tooher, R
87名听力受损的小学儿童进行了为期3年的言语知觉，生产和语言的措施进行了评估。47名平均独立纯音听力损失为106 dB HL的儿童使用了22电极人工耳蜗植入体，40名平均独立纯音听力损失为78 dB HL的儿童安装了助听器。所有儿童都参加了口/耳听力障碍方案，大多数儿童在学校的一部分时间参加了听力正常儿童的综合班。多元线性回归被用来描述之间的关系的言语感知，生产和语言的措施，并随着时间的推移的趋势。两组儿童的表现水平和趋势几乎没有差异，因此植入物的感知效果平均相当于听力阈值提高约28 dB。皮博迪图片词汇测试（PPVT）和语言基础的临床评估的分数呈上升趋势，约为听力正常儿童的60%。个别儿童的改善率与听力损失程度无显著相关性。儿童在自发对话中正确产生40%的单词的平均言语产生分数表现出很大的分散性，随着年龄的增长没有明显的上升趋势。分数的开集辅音-核-辅音（CNC）单音节词测试和Bench-Kowal-Bamford（BKB）句子测试的语言水平（作为衡量的PPVT上的等效年龄）和语音生产分数的语音视觉和听觉测试条件。在考虑语言差异后，听觉测试条件下的言语感知分数显示出轻微的下降趋势，这与听力损失对听觉外周和脑干的已知生物学影响一致。听力条件下的言语感知得分也显著下降约5%，每10代轴承损失的助听器组的回归分析模型允许分离的语言，言语生产，和听力水平的影响言语感知得分预测。该模型表明，大多数儿童在视觉-听觉条件下，当他们的语言达到与正常听力的7岁儿童相当时，句子识别率将达到90%以上，但如果他们不接受集中有效的语言训练，他们将在12岁进入中学，平均语言延迟约4至5年。
Eighty-seven primary-school children with impaired hearing were evaluated using speech perception, production, and language measures over a 3-year period. Forty-seven children with a mean unaided pyre-tone-overage hearing loss of 106 dB HL used a 22-electrode cochlear implant, and 40 with a mean unaided puretone-average hearing loss of 78 dB HL were fitted with hearing aids. All children were enrolled in oral/aural habilitation programs, and most attended integrated classes with normally hearing children for part of the time at school. Multiple linear regression was used to describe the relationships among the speech perception, production, and language measures, and the trends over time. little difference in the level of performance and trends was found for the two groups of children, so the perceptual effect of the implant is equivalent, on average, to an improvement of about 28 dB in hearing thresholds. Scores on the Peabody Picture Vocabulary Test (PPVT) and the Clinical Evaluation of language Fundamentals showed an upward trend at about 60% of the rate for normally hearing children. Rates of improvement for individual children were not correlated significantly with degree of hearing loss. The children showed a wide scatter about the average speech production score of 40% of words correctly produced in spontaneous conversations, with no significant upward trend with age. Scores on the open-set Consonant-Nucleus-Consonant (CNC) monosyllabic word test and the Bench-Kowal-Bamford (BKB) sentence test were strongly related to language level (as measured by an equivalent age on the PPVT) and speech production scores for both auditory-visual and auditory test conditions. After allowing for differences in language, speech perception scores in the auditory test condition showed a slight downward trend over rime, which is consistent with the known biological effects of hearing loss on the auditory periphery and brainstem. Speech perception scores in the auditory condition also decreased significantly by about 5% for every 10 de of bearing loss in the hearing aid group The regression analysis model allows separation of the effects of language, speech production, and hearing levels on speech perception scores so predicted. The model suggests that most of the children in the study will reach a level of over 90% sentence recognition in the auditory-visual condition when their language becomes equivalent to that of a normally hearing 7-year-old, but they will enter secondary school at age 12 with an average language delay of about 4 or 5 years unless they receive concentrated and effective language training.