Spoken language development in children following cochlear implantation.
Spoken language development in children following cochlear implantation.
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DOI：
10.1001/jama.2010.451
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发表时间：
2010-04-21
影响因子：
120.7
通讯作者：
Fink, Nancy E.
中科院分区：
文献类型：
--
作者：
Niparko, John K.;Tobey, Emily A.;Thal, Donna J.;Eisenberg, Laurie S.;Wang, Nae-Yuh;Quittner, Alexandra L.;Fink, Nancy E.
耳蜗植入术（CI）是传统放大（助听器）的手术替代方案，可促进重度至极重度感音神经性听力损失（SNHL）幼儿的口语发展。通过调整协变量，前瞻性评估幼儿CI后的口语习得。CI后3年内口语增长的前瞻性、纵向和多维评估。对2002年11月至2004年12月期间招募的来自美国6个中心的5岁之前接受CI的儿童（n=188）和来自2所学龄前学校的相似年龄的听力儿童（n=97）进行前瞻性队列研究。2005年11月至2008年5月完成随访。口语理解和表达能力测试。接受CI治疗的儿童的口语表现（10.4;[95%置信区间：9.6-11.2]分/年，理解; 8.4;[7.8-9.0]分/年，表达）比CI前基线评分（5.4;[4.1-6.7]理解; 5.8;[4.6-7.0]表达）预测的增长更大。虽然平均分数在3年后没有恢复到与年龄相适应的水平，但在CI时年龄较小的儿童中观察到明显更高的语言习得年速率（理解力1.1;[0.5-1.7]分;表达力1.0;[0.6-1.5]分），以及听力障碍史较短的儿童（理解力每年降低0.8;[0.2，1.2]分;表达力每年降低0.6;[0.2-1.0]分）。在多变量分析中，CI前更大的残余听力、更高的亲子互动评分和更高的SES与理解和表达的增长率相关。在幼儿中使用人工耳蜗植入物与更好的口语学习相关，而不是从植入前的分数预测。然而，参与者的时间和语言年龄之间的差异持续CI后，强调早期CI在适当选择的候选人的重要性。
Cochlear implantation (CI) is a surgical alternative to traditional amplification (hearing aids) that can facilitate spoken language development in young children with severe-to-profound sensorineural hearing loss (SNHL). To prospectively assess spoken language acquisition following CI in young children with adjustment of co-variates. Prospective, longitudinal, and multidimensional assessment of spoken language growth over a 3-year period following CI. Prospective cohort study of children who underwent CI before 5 years of age (n=188) from 6 US centers and hearing children of similar ages (n=97) from 2 preschools recruited between November, 2002 and December, 2004. Follow-up completed between November, 2005 and May, 2008. Performance on measures of spoken language comprehension and expression. Children undergoing CI showed greater growth in spoken language performance (10.4;[95% confidence interval: 9.6–11.2] points/year in comprehension; 8.4;[7.8–9.0] in expression) than would be predicted by their pre-CI baseline scores (5.4;[4.1–6.7] comprehension; 5.8;[4.6–7.0] expression). Although mean scores were not restored to age-appropriate levels after 3 years, significantly greater annual rates of language acquisition were observed in children who were younger at CI (1.1;[0.5–1.7] points in comprehension per year younger; 1.0;[0.6–1.5] in expression), and in children with shorter histories of hearing deficit (0.8;[0.2,1.2] points in comprehension per year shorter; 0.6;[0.2–1.0] for expression). In multivariable analyses, greater residual hearing prior to CI, higher ratings of parent-child interactions, and higher SES associated with greater rates of growth in comprehension and expression. The use of cochlear implants in young children was associated with better spoken language learning than would be predicted from their pre-implantation scores. However, discrepancies between participants’ chronologic and language age persisted after CI, underscoring the importance of early CI in appropriately selected candidates.
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作者：
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通讯作者：
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作者：
Fink, Nancy E;Wang, Nae-Yuh;Tobey, Emily A
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