Unilateral Hearing Loss Is Associated With Worse Speech-Language Scores in Children
Unilateral Hearing Loss Is Associated With Worse Speech-Language Scores in Children
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DOI：
10.1542/peds.2009-2448
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发表时间：
2010-06-01
期刊：
影响因子：
8
通讯作者：
Piccirillo, Jay F.
中科院分区：
文献类型：
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作者：
Lieu, Judith E. C.;Tye-Murray, Nancy;Piccirillo, Jay F.
目的：确定单侧听力损失（UHL）儿童是否比听力正常的兄弟姐妹语言能力更差，以及UHL儿童在学校是否更有可能接受额外帮助。
患者和方法：我们对6 - 12岁的UHL儿童与兄弟姐妹对照组（74对，n = 148）进行了一项病例对照研究。口语和书面语言量表（OWLS）的口语部分得分是主要的结果衡量指标。在控制潜在混杂变量后，使用多变量分析来确定UHL是否独立预测OWLS得分。
结果：UHL儿童在语言理解（91分对98分；P = 0.003）、口语表达（94分对101分；P = 0.007）和口语综合（90分对99分；P < 0.001）方面的得分比其兄弟姐妹差。当使用多变量回归分析时，UHL独立预测这些OWLS得分，效应量适中，为0.3 - 0.7。家庭收入和母亲教育程度也是口语表达和口语综合得分的独立预测因素。右耳或左耳UHL儿童之间以及不同听力损失严重程度的儿童之间未发现差异。UHL儿童更有可能有个别化教育计划（比值比：4.4 [95%置信区间：2.0 - 9.5]），并且更有可能接受过言语 - 语言治疗（比值比：2.6 [95%置信区间：1.3 - 5.4]）。
结论：学龄期UHL儿童的口语得分比听力正常的兄弟姐妹差。这些发现表明，应重新考虑和研究对UHL儿童不提供听力相关便利措施的常见做法，并且应告知家长和教育工作者UHL对口语技能的有害影响。《儿科学》2010年；125卷：e1348 - e1355
OBJECTIVE: To determine whether children with unilateral hearing loss (UHL) demonstrate worse language skills than their siblings with normal hearing, and whether children with UHL are more likely to receive extra assistance at school.PATIENTS AND METHODS: We conducted a case-control study of 6- to 12-year-old children with UHL compared with sibling controls (74 pairs, n = 148). Scores on the oral portion of the Oral and Written Language Scales (OWLS) were the primary outcome measure. Multivariable analysis was used to determine whether UHL independently predicted OWLS scores after we controlled for potential confounding variables.RESULTS: Children with UHL had worse scores than their siblings on language comprehension (91 vs 98; P = .003), oral expression (94 vs 101; P = .007), and oral composite (90 vs 99; P < .001). UHL independently predicted these OWLS scores when multivariable regression was used with moderate effect sizes of 0.3 to 0.7. Family income and maternal education were also independent predictors of oral expression and oral composite scores. No differences were found between children with right-or left-ear UHL or with varying severity of hearing loss. Children with UHL were more likely to have an individualized education plan (odds ratio: 4.4 [95% confidence interval: 2.0-9.5]) and to have received speech-language therapy (odds ratio: 2.6 [95% confidence interval: 1.3-5.4]).CONCLUSIONS: School-aged children with UHL demonstrated worse oral language scores than did their siblings with normal hearing. These findings suggest that the common practice of withholding hearing-related accommodations from children with UHL should be reconsidered and studied, and that parents and educators should be informed about the deleterious effects of UHL on oral language skills. Pediatrics 2010; 125: e1348-e1355