Speech, language, and reading skills after early cochlear implantation
Speech, language, and reading skills after early cochlear implantation
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DOI：
10.1001/archotol.130.5.634
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发表时间：
2004-05-01
影响因子：
--
通讯作者：
Geers, AE
中科院分区：
文献类型：
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作者：
Geers, AE
目的：研究5岁前植入人工耳蜗术的儿童在8至9岁时表现出的言语、语言和阅读技能是否与植入人工耳蜗的年龄或使用时间有关。设计：考察儿童首次接受人工耳蜗植入的年龄(2、3或4岁)、接受更新的(Spectra)处理器的年龄、言语感知、言语产生、语言和阅读方面的表现结果。以及植入物和更新处理器的使用时间。设置：在连续4年举办的夏季研究夏令营进行数据收集，以最大限度地增加特定年龄(8-9岁)的儿童数量。由有经验的检查员对儿童进行个别测试，他们的父母和治疗师提供背景和教育历史信息。参与者：来自33个不同州和加拿大5个省的181名儿童接受了5岁前接受人工耳蜗植入的测试。对133名表现智商在80分或以上、出生时就有耳聋症状的儿童进行了植入年龄分析。结果：对每个儿童进行了一系列的言语知觉、言语产生、语言和阅读测试，并将每项技能的得分降为一个因素。结果：植入时的年龄与使用时间之间的相关系数对所测量的任何结果技能都没有达到显著意义。安装更新的语音处理器(Spectra)的年龄与语音产生结果显著相关(更早使用更新的处理器与更高的语音清晰度相关)，但与任何其他技能领域无关。然而，在2岁接受植入手术的儿童中(43%)比在4岁接受植入手术的儿童(16%)获得了与听力正常的同龄人相称的综合言语和语言技能。此外，80%的出生后听力丧失且在耳聋发病一年内接受人工耳蜗术的儿童有正常的言语和语言技能。结论：对于2~4岁接受人工耳蜗术的儿童，早期人工耳蜗术并不能确保更好的言语感知、言语产出、语言或阅读技能。然而，如果孩子出生后听力正常，并在听力丧失后不久就接受了人工耳蜗植入，那么他们可能会有更好的言语和语言熟练程度。进一步研究在2岁前植入人工耳蜗术的益处将有助于家庭和临床医生更好地理解进行人工耳蜗术的决定的时间敏感性。
Objective: To examine whether age at cochlear implantation or duration of implant use is associated with speech, language, and reading skills exhibited at age 8 to 9 years in children who underwent implantation by age 5 years.Design: Performance outcomes in speech perception, speech production, language, and reading were examined in terms of the age at which children first received a cochlear implant (2, 3, or 4 years), the age they received an updated (Spectra) processor, and the duration of use of an implant and an updated processor.Setting: Data collection was conducted at summer research camps held over 4 consecutive years to maximize the number of children available at a specific age (8-9 years). Children were tested individually by experienced examiners, and their parents and therapists provided background and educational history information.Participants: A total of 181 children from 33 different states and 5 Canadian provinces who received a cochlear implant by age 5 years were tested. A subsample of 133 children with performance IQ scores of 80 or greater and onset of deafness at birth were selected for the age-at-implantation analysis. Another subsample of 39 children with deafness acquired by age 3 years was also examined.Outcome Measures: A battery of tests of speech perception, speech production, language, and reading was administered to each child and reduced to a single factor score for each skill.Results: Correlation coefficients between age at implantation and duration of use did not reach significance for any of the outcome skills measured. Age at which the updated speech processor (Spectra) was fitted was significantly related to speech production outcome (earlier use of an updated processor was associated with greater speech intelligibility) but not to any other skill area. However, more of the children who underwent implantation at age 2 years (43%) achieved combined speech and language skills commensurate with their age-matched peers with normal hearing than did children who underwent implantation at age 4 years (16%). Furthermore, normal speech and language skills were documented in 80% of children who lost hearing after birth and who underwent implantation within a year of onset of deafness.Conclusions: For children who receive a cochlear implant between the ages of 2 and 4 years, early cochlear implantation does not ensure better speech perception, speech production, language, or reading skills. However, greater speech and language proficiency may be expected from children who exhibit normal hearing for even a brief period after birth and receive a cochlear implant shortly after losing their hearing. Further research examining the benefits of cochlear implantation before age 2 years will help families and clinicians better understand the time-sensitive nature of the decision to conduct cochlear implant surgery.