Higgins Maureen B, McCleary Elizabeth A, Ide-Helvie Dana L, Carney Arlene Earley
Boys Town National Research Hospital, Omaha, Nebraska, USA.
Ear Hear. 2005 Dec;26(6):546-58. doi: 10.1097/01.aud.0000188151.99086.a3.
The purpose of this investigation was to examine the nature and frequency of deviant speech and voice physiology in children who are hard of hearing (HH).
Ten HH children (age, 5 to 15 yrs) participated. Their hearing losses ranged in severity from moderate to severe. The following speech/voice physiological measures were examined: frequency of occurrence of negative intraoral air pressure (-Po), magnitude of Po, phonatory air flow, nasal air flow, voice onset time (VOT), and fundamental frequency (F0). Findings were compared with data previously collected from 56 children with normal hearing and 7 children with cochlear implants (Higgins, McCleary, Carney, & Schulte, 2003).
Five of the 10 HH children exhibited deviant speech/voice behaviors. Only one showed deviancy on more than one measure. In addition, 8 HH children had some borderline-deviant speech behavior. The frequency and degree of speech/voice deviancy for the children in the present study was far less than what we previously had observed for children who underwent cochlear implantation after 5 yrs of age (Higgins et al., 2003). This was the case even for a child with a cochlear implant from our earlier study who eventually achieved speech perception scores that were as good as or better than some of the HH children in the present investigation.
Deviant speech/voice physiology occurs to a limited extent for some HH children. Of the measures that we examined, those related to vocal fold tension and vocal fold articulation appeared to be most sensitive to the effects of diminished auditory input and feedback that occurs for HH children. Data from this and other studies suggest that abnormally high F0 occurs for about 20% of HH children and may be associated with poor speech perception skills. Future studies should examine whether earlier implantation can help deaf children to produce speech that is at least as normal as that of HH children.
本研究旨在调查重听儿童（HH）异常言语和嗓音生理特征的性质及出现频率。
10名重听儿童（年龄5至15岁）参与研究。他们的听力损失程度从中度到重度不等。研究检测了以下言语/嗓音生理指标：口腔内负压（-Po）出现频率、Po大小、发声气流量、鼻腔气流量、嗓音起始时间（VOT）和基频（F0）。研究结果与之前从56名听力正常儿童和7名接受人工耳蜗植入的儿童中收集的数据进行了比较（希金斯、麦克利里、卡尼和舒尔特，2003年）。
10名重听儿童中有5名表现出异常言语/嗓音行为。只有1名儿童在不止一项指标上表现异常。此外，8名重听儿童有一些临界异常的言语行为。本研究中儿童言语/嗓音异常的频率和程度远低于我们之前对5岁后接受人工耳蜗植入的儿童所观察到的情况（希金斯等人，2003年）。即便对于我们早期研究中一名接受人工耳蜗植入的儿童也是如此，该儿童最终获得的言语感知分数与本研究中的一些重听儿童相当甚至更好。
部分重听儿童存在一定程度的异常言语/嗓音生理特征。在我们检测的指标中，与声带张力和声带清晰度相关的指标似乎对重听儿童听觉输入和反馈减少的影响最为敏感。本研究及其他研究的数据表明，约20%的重听儿童会出现异常高的F0，这可能与言语感知能力差有关。未来研究应探讨早期植入人工耳蜗是否能帮助聋童发出至少与重听儿童一样正常的言语。
