Communication development in children who receive the cochlear implant younger than 12 months: Risks versus benefits
Communication development in children who receive the cochlear implant younger than 12 months: Risks versus benefits
复制标题
12 个月以下接受人工耳蜗植入的儿童的沟通发展： 风险与益处
DOI：
10.1097/aud.0b013e31803153f8
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发表时间：
2007-04-01
期刊：
影响因子：
3.7
通讯作者：
Leigh, Jaime R.
中科院分区：
文献类型：
--
作者：
Dettman, Shani J.;Pinder, Darren;Leigh, Jaime R.
背景。一些国家普遍新生儿听力筛查的出现以及其他国家针对高危婴儿的筛查计划的实施，促进了听力损失婴儿的早期转诊、诊断和干预。设备技术的进步、二十年的儿科临床经验、人们对人工耳蜗植入对幼儿的功效的日益认识，以及美国食品和药物管理局最近改变年龄标准以包括 12 个月大的儿童，导致越来越多的幼儿接受人工耳蜗植入。支持为 12 个月以下婴儿提供服务的证据是从生理学研究、使用助听器的儿童研究以及使用植入物的 12 个月以上儿童研究中推断出来的。然而，迄今为止，关于 6 至 12 个月接受植入物的儿童的沟通发展的研究成果还很少发表。目前的研究假设，由于儿童仍处于发育的关键时期，早期植入会导致语言习得率增加。方法。对在澳大利亚墨尔本接受多通道植入的 19 名婴儿（平均植入年龄，0.88 岁；范围，0.61-1.07，SD 0.15）和 87 名幼儿（平均植入年龄，1.60 岁；范围，1.13-2.00，SD 0.24）完成了回顾性审查。这些儿童的植入前听力学评估包括辅助和非辅助听力图、听觉脑干反应、听觉稳态反应（ASSR）和耳声发射，并表明所有病例均存在严重的双侧听力损失。沟通评估包括罗塞蒂婴幼儿语言量表的完成以及教育心理学家的认知和运动评估。对所有病例的计算机断层扫描、磁共振成像和手术记录进行了审查。植入后语言评估根据罗塞蒂婴幼儿语言量表的语言理解和语言表达量表随时间的增长速度进行报告。结果：结果表明，人工耳蜗植入可以在非常年幼的儿童中安全地进行，并具有良好的语言效果。 12 个月前接受植入的儿童的接受性 (1.12) 和表达性 (1.01) 语言生长的平均速率显着高于 12 至 24 个月之间接受植入的儿童所达到的速度，并且与听力正常的同龄人所达到的生长速度相匹配。这些初步结果支持在经验丰富的儿科植入中心为 12 个月以下的儿童提供人工耳蜗。
Background. The advent of universal neonatal hearing screening in some countries and the availability of screening programs for at-risk infants in other countries has facilitated earlier referral, diagnosis, and intervention for infants with hearing loss. Improvements in device technology, two decades of pediatric clinical experience, a growing recognition of the efficacy of cochlear implants for young children, and the recent change in the U.S. Food and Drug Administration's age criteria to include children as young as 12 mo has led to increasing numbers of young children receiving cochlear implants. Evidence to support provision for infants younger than 12 mo is extrapolated from physiological studies, studies of children using hearing aids, and studies of children older than 12 mo of age with implants. To date, however, there are few published research findings regarding communication development in children between 6 and 12 mo of age who receive implants. The current study hypothesized that earlier implantation would lead to increased rates of language acquisition as the children were still in the critical period for their development.Method. A retrospective review was completed for 19 infants (mean age at implantation, 0.88 yr; range, 0.61-1.07, SD 0.15) and 87 toddlers (mean age at implantation, 1.60 yr; range, 1.13-2.00, SD 0.24) who received the multichannel implant in Melbourne, Australia. Preimplantation audiological assessments for these children included aided and unaided audiograms, auditory brain stem response, auditory steady state response (ASSR), and otoacoustic emission and indicated profound to total bilateral hearing loss in all cases. Communication assessment included completion of the Rossetti Infant-Toddler Language Scale and educational psychologists' cognitive and motor assessment. Computed tomography scan, magnetic resonance imaging, and surgical records for all cases were reviewed. Postimplantation language assessments were reported in terms of the rate of growth over time on the language comprehension and language expression subscales of the Rossetti Infant-Toddler Language Scale.Results: Results demonstrated that cochlear implantation may be performed safely in very young children with excellent language outcomes. The mean rates of receptive (1.12) and expressive (1.01) language growth for children receiving implants before the age of 12 mo were significantly greater than the rates achieved by children receiving implants between 12 and 24 mo, and matched growth rates achieved by normally hearing peers. These preliminary results support the provision of cochlear implants for children younger than 12 mo, of age within experienced pediatric implantation centers.