Zhang Feng-hua, Jin Xing-ming, Shen Xiao-ming, Wu Hao
Department of Child Health Care, Xinhua Hospital, Medical College, Shanghai Jiaotong University, Shanghai 200092, China.
Zhonghua Yi Xue Za Zhi. 2006 Oct 31;86(40):2836-40.
To investigate the efficacy of early intervention on language, pronunciation and cognitive developments of infants and toddlers with hearing loss and to build up an early intervention model.
Fifty-six children with moderate to profound sensorineural hearing loss aged 10 months to 2 years were divided into two groups. 20 children, aged 10 months to 2 years, received early intervention services after wearing hearing aids for 6 - 18 months, and 36 children, aged 11 months to 2 years, didn't receive any intervention. The type and degree of hearing loss were measured by a series of auditory tests. Language and cognitive developments of the children with hearing loss and 28 age, and sex-matched children with normal hearing, aged 10 to 23 months, were evaluated by the Gesell developmental schedules. The results were expressed as developmental quotient (DQ). Pronunciation test in mandarin Chinese was adopted to evaluate the speech development of the 56 children with hearing loss.
(1) The language DQ according the Gesell developmental schedules of the children with hearing loss who received early intervention was (92.25 +/- 17.32), significantly higher than those children with hearing loss who didn't receive intervention (70.44 +/- 29.99, P = 0.00), whish was significantly lower than that of the normal hearing children (P = 0.00). However, there was no significant difference in language DQ between the children who received early intervention and the normal hearing children. There was no significant correlation between the degree of hearing loss and language DQ in the children who received early intervention (P = 0.27). (2) The personal-social developmental quotient (DQ) of the children who received intervention was (101.40 +/- 7.66), significantly higher than that of the children who didn't receive intervention (83.94 +/- 22.09, P = 0.00), that were significantly lower than that of the children with normal hearing (P = 0.00). However, there were no significant difference in the personal-social DQ between the children who received early intervention and the children with normal hearing. No significant differences in the gross motor ability, fine motor ability and adaptive ability were observed between the two groups of children with hearing loss and normal hearing children. (3) The consonant pronunciation of the children with moderate to severe hearing loss who received early intervention was normal. Among those children only one case with profound hearing loss had/d/error. The consonant pronunciation of the children with moderate hearing loss who didn't receive early intervention of those was normal. One case with moderate-severe hearing loss and one case with severe hearing loss had/d/errors. Six cases with profound hearing loss had/d, m/errors. The tone of the children with moderate to severe hearing loss who received early intervention was normal. Three cases with profound hearing loss exhibited tone errors. Among the children who didn't receive early intervention, tone errors were found in two cases with moderate hearing loss, one case with moderate-severe hearing loss, one case with severe hearing loss, and twelve cases with profound hearing loss showed.
The language, pronunciation and cognitive developments of the children who don't receive early intervention are significantly lower than those of the children with normal hearing. Early intervention can significantly improve the language, speech and cognitive abilities of children with hearing loss.
探讨早期干预对听力损失婴幼儿语言、发音及认知发育的效果，并建立早期干预模式。
将56例年龄在10个月至2岁的中重度感音神经性听力损失儿童分为两组。20例年龄在10个月至2岁的儿童在佩戴助听器6 - 18个月后接受早期干预服务，36例年龄在11个月至2岁的儿童未接受任何干预。通过一系列听力测试测量听力损失的类型和程度。采用盖塞尔发育量表对听力损失儿童以及28例年龄、性别匹配的10至23个月听力正常儿童的语言和认知发育进行评估。结果以发育商（DQ）表示。采用汉语普通话发音测试评估56例听力损失儿童的言语发育情况。
（1）接受早期干预的听力损失儿童根据盖塞尔发育量表得出的语言DQ为（92.25±17.32），显著高于未接受干预的听力损失儿童（70.44±29.99，P = 0.00），后者显著低于听力正常儿童（P = 0.00）。然而，接受早期干预的儿童与听力正常儿童之间的语言DQ无显著差异。接受早期干预的儿童中，听力损失程度与语言DQ之间无显著相关性（P = 0.27）。（2）接受干预的儿童的个人 - 社会发育商（DQ）为（101.40±7.66），显著高于未接受干预的儿童（83.94±22.09，P = 0.00），后者显著低于听力正常儿童（P = 0.00）。然而，接受早期干预的儿童与听力正常儿童之间的个人 - 社会DQ无显著差异。两组听力损失儿童与听力正常儿童在大运动能力、精细运动能力和适应能力方面未观察到显著差异。（3）接受早期干预的中重度听力损失儿童的辅音发音正常。在这些儿童中，仅1例极重度听力损失儿童存在/d/音错误。未接受早期干预的中度听力损失儿童的辅音发音正常。1例中重度听力损失儿童和1例重度听力损失儿童存在/d/音错误。6例极重度听力损失儿童存在/d、m/音错误。接受早期干预的中重度听力损失儿童的声调正常。3例极重度听力损失儿童出现声调错误。在未接受早期干预的儿童中，2例中度听力损失儿童、1例中重度听力损失儿童、1例重度听力损失儿童出现声调错误，12例极重度听力损失儿童出现声调错误。
未接受早期干预的儿童的语言、发音及认知发育显著低于听力正常儿童。早期干预可显著提高听力损失儿童的语言、言语及认知能力。
