Hooper Stephen R, Ashley Timothy A, Roberts Joanne E, Zeisel Susan A, Poe Michele D
Department of Psychiatry and The Clinical Center for the Study of Development and Learning, University of North Carolina School of Medicine, Chapel Hill, NC 27599-7255, USA.
J Dev Behav Pediatr. 2006 Aug;27(4):281-9. doi: 10.1097/00004703-200608000-00001.
This study examined the impact of otitis media with effusion (OME) and associated hearing loss between 6 and 48 months of age on attention dimensions (i.e., selective/focus, sustained) during the elementary school years. A prospective cohort design in which 74 African American infants were recruited between ages 6 and 12 months. Ear examinations were done repeatedly using both otoscopy and tympanometry, and hearing was assessed using standard audiometric procedures between 6 and 48 months. Multiple measures of attention (i.e., direct assessment, behavioral observations, parent/teacher ratings) were administered from kindergarten through second grade to assess two theoretical dimensions of attention: selective/focused and sustained. The home environment was assessed annually. Results indicated that neither early childhood OME nor hearing loss showed significant correlations with any of the longitudinal or cross-sectional measures of selective/focused attention and sustained attention. In contrast, children with mothers who had fewer years of education and who lived in less responsive and supportive home environments scored higher on both parent and teacher ratings of sustained attention (i.e., hyperactivity) through the second grade of elementary school. For NEPSY Auditory Attention in second grade, a significant interaction between the Home Observation for Measurement of the Environment and hearing loss was uncovered. This interaction showed that children with hearing loss from poor home environments experienced greater difficulties on the NEPSY Auditory Attention task than those with hearing loss from good home environments. These findings do not support a direct linkage of a history of OME and associated hearing loss to difficulties in selective/focused attention or sustained attention in early elementary school children. Relationships between sociodemographic variables and attention-related functions appear stronger and should be considered as mediators in any examination of the linkages between early OME and subsequent attention functions.
本研究考察了6至48个月大时患有中耳积液（OME）及相关听力损失对小学阶段注意力维度（即选择性/集中性、持续性）的影响。采用前瞻性队列设计，在6至12个月大的婴儿中招募了74名非裔美国婴儿。在6至48个月期间，使用耳镜检查和鼓室图反复进行耳部检查，并采用标准听力测试程序评估听力。从幼儿园到二年级进行了多项注意力测量（即直接评估、行为观察、家长/教师评分），以评估注意力的两个理论维度：选择性/集中性和持续性。每年评估家庭环境。结果表明，幼儿期的OME和听力损失与选择性/集中性注意力和持续性注意力的任何纵向或横向测量均无显著相关性。相比之下，母亲受教育年限较少且生活在反应性较低和支持性较差的家庭环境中的儿童，在小学二年级时，家长和教师对其持续性注意力（即多动）的评分较高。对于二年级的NEPSY听觉注意力，发现了家庭环境观察量表和听力损失之间的显著交互作用。这种交互作用表明，来自不良家庭环境的听力损失儿童在NEPSY听觉注意力任务上比来自良好家庭环境的听力损失儿童遇到更大的困难。这些发现不支持OME病史及相关听力损失与小学早期儿童选择性/集中性注意力或持续性注意力困难之间存在直接联系。社会人口统计学变量与注意力相关功能之间的关系似乎更强，在任何对早期OME与后续注意力功能之间联系的考察中，都应将其视为中介因素。
