Horn D L, Davis R A O, Pisoni D B, Miyamoto R T
DeVault Otologic Research Laboratory, Department of Otolaryngology/Head and Neck Surgery, Indiana University School of Medicine, Indianapolis, Indiana 46202, USA.
Ear Hear. 2005 Aug;26(4):389-408. doi: 10.1097/00003446-200508000-00003.
To determine the effects of length of cochlear implant use and other demographic factors on the development of sustained visual attention in prelingually deaf children and to examine the relations between performance on a test of sustained visual attention and audiological outcome measures in this population.
A retrospective analysis of data collected before cochlear implantation and over several years after implantation. Two groups of prelingually deaf children, one >6 years old (N = 41) and one <6 years old (N = 47) at testing, were given an age-appropriate Continuous Performance Task (CPT). In both groups, children monitored visually presented numbers for several minutes and responded whenever a designated number appeared. Hit rate, false alarm rate, and signal detection parameters were dependent measures of sustained visual attention. We tested for effects of a number of patient variables on CPT performance. Multiple regression analyses were conducted to determine if CPT scores were related to performance on several audiological outcome measures.
In both groups of children, mean CPT performance was low compared with published norms for normal-hearing children, and performance improved as a function of length of cochlear implant use and chronological age. The improvement in performance was manifested as an increase in hit rate and perceptual sensitivity over time. In the younger age group, a greater number of active electrodes predicted better CPT performance. Results from regression analyses indicated a relationship between CPT response criterion and receptive language in the younger age group. However, we failed to uncover any other relations between CPT performance and speech and language outcome measures.
Our findings suggest that cochlear implantation in prelingually deaf children leads to improved performance on a test of sustained visual processing of numbers over 2 or more years of cochlear implant use. In preschool-age children who use cochlear implants, individuals who are more conservative responders on the CPT show higher receptive language scores than do individuals with more impulsive response patterns. Theoretical accounts of these findings are discussed, including cross-modal reorganization of visual attention and enhanced phonological encoding of visually presented numbers.
确定人工耳蜗使用时长及其他人口统计学因素对语前聋儿童持续性视觉注意力发展的影响，并研究该人群中持续性视觉注意力测试表现与听力学结果指标之间的关系。
对人工耳蜗植入术前及术后数年收集的数据进行回顾性分析。两组语前聋儿童，一组在测试时年龄大于6岁（N = 41），另一组小于6岁（N = 47），接受了适合其年龄的连续性能任务（CPT）测试。在两组中，儿童需在数分钟内视觉监测呈现的数字，并在指定数字出现时做出反应。命中率、虚报率和信号检测参数是持续性视觉注意力的相关指标。我们测试了多个患者变量对CPT表现的影响。进行多元回归分析以确定CPT分数是否与多项听力学结果指标的表现相关。
与正常听力儿童已发表的标准相比，两组儿童的平均CPT表现均较低，且表现随着人工耳蜗使用时长和实际年龄的增长而改善。表现的改善表现为随着时间推移命中率和感知敏感性的增加。在较年轻的年龄组中，更多的有源电极预示着更好的CPT表现。回归分析结果表明，较年轻年龄组中CPT反应标准与接受性语言之间存在关系。然而，我们未能发现CPT表现与言语和语言结果指标之间的任何其他关系。
我们的研究结果表明，语前聋儿童植入人工耳蜗后，在使用人工耳蜗2年或更长时间后，数字持续性视觉处理测试的表现会有所改善。在使用人工耳蜗的学龄前儿童中，在CPT测试中反应较为保守的个体比反应模式较为冲动的个体表现出更高的接受性语言分数。讨论了这些发现的理论解释，包括视觉注意力的跨模态重组以及视觉呈现数字的语音编码增强。
