Kiese-Himmel C, Reeh M
Abt. Phoniatrie/Pädaudiologie, Universitätsklinikum, Georg-August-Universität, Göttingen, Germany.
Gesundheitswesen. 2007 Apr;69(4):249-55. doi: 10.1055/s-2007-976515.
The aim of this study was to assess the oral language development of children with permanent bilateral hearing loss without additional disabilities longitudinally (5 time points t1-t5).
The present follow-up study evaluated both receptive and expressive language developmental quotients (DQ; desired value 1.0) with standardised developmental scales and receptive and expressive vocabulary size with standardised tests (results in T-scores; m=50, SD=10). Mean follow-up duration was 38.1 (SD 4.8) months.
A cohort of n=18 sensorineural hearing-impaired children was recruited from the German Göttinger Hör-Sprachregister. Mean diagnosis age was 21.4 (SD 16.6) months and mean age of amplification with hearing aids was 21.7 (SD 16.5) months.
The mean DQs slowly increased from t1 to t4 (DQ receptive 0.37/0.48/0.55/0.56; DQ expressive: 0.51/0.51/0.55/0.55) and remained norm deviant. The diagnosis age of hearing loss and both the developmental quotients for receptive (-0.41/-0.42/-0.53; p<0.05/-0.80; p<0.01) and expressive language (-0.77; p<0.01/-0.55; p<0.05/-0.66; p<0.01/-0.79; p<0.01) were significantly correlated. The mean receptive vocabulary size apparently increased and came up to the lower norm range (29.6-34.2-43.8), however the mean expressive vocabulary remained far below the norm (26.8-29.8). Children with a hearing loss from 71-90 dB scored on average mostly higher than children with a loss > 90 dB who all had received a cochlear-implant up to t3. Children who were identified as hearing-impaired before the age of 18 months exhibited on average generally greater DQs.
The individual best available amplification of hearing loss did not compulsively cause an age-adequate spoken language development, at least not in case of a hearing loss > 40 dB. So a newborn hearing screening must be the first step in identification, intervention and habilitation of an infant with hearing loss. Use of a cochlear implant seemed to have a great impact on the oral language development of children with a bilateral loss > 90 dB.
本研究旨在纵向评估永久性双侧听力损失且无其他残疾儿童的口语发展情况(共5个时间点t1 - t5)。
本随访研究使用标准化发育量表评估接受性和表达性语言发育商数(DQ;理想值为1.0),并通过标准化测试评估接受性和表达性词汇量(结果以T分数表示;均值m = 50,标准差SD = 10)。平均随访时长为38.1(标准差4.8)个月。
从德国哥廷根听力 - 语言登记处招募了n = 18名感音神经性听力受损儿童。平均诊断年龄为21.4(标准差16.6)个月,平均佩戴助听器的年龄为21.7(标准差16.5)个月。
从t1到t4,平均发育商数缓慢上升(接受性发育商数分别为0.37/0.48/0.55/0.56;表达性发育商数分别为0.51/0.51/0.55/0.55),仍低于正常范围。听力损失的诊断年龄与接受性语言发育商数(-0.41/-0.42/-0.53;p < 0.05 / -0.80;p < 0.01)和表达性语言发育商数(-0.77;p < 0.01 / -0.55;p < 0.05 / -0.66;p < 0.01 / -0.79;p < 0.01)均显著相关。平均接受性词汇量明显增加,达到较低的正常范围(29.6 - 34.2 - 43.8),然而平均表达性词汇量仍远低于正常水平(26.8 - 29.8)。听力损失在71 - 90分贝的儿童平均得分大多高于听力损失> 90分贝的儿童,后者在t3之前均接受了人工耳蜗植入。18个月前被确诊为听力受损的儿童平均发育商数总体上更高。
听力损失的个体最佳可用放大设备不一定能必然促成与年龄相符的口语发展,至少对于听力损失> 40分贝的情况并非如此。因此,新生儿听力筛查必须成为识别、干预和 habilitation(此处可能是“ habilitation”拼写有误,推测可能是“康复训练”之类的意思)听力损失婴儿的第一步。人工耳蜗植入似乎对双侧听力损失> 90分贝儿童的口语发展有很大影响。