Wang Nan Mai, Huang Tsun Sheng, Wu Che-Ming, Kirk Karen Iler
Department of Speech Language Pathology & Audiology, Chung Shan Medical University, No. 110 Chien Kuo North Road, Section 1, Taichung 402, Taiwan.
Int J Pediatr Otorhinolaryngol. 2007 Nov;71(11):1775-82. doi: 10.1016/j.ijporl.2007.08.004. Epub 2007 Sep 14.
OBJECTIVES/HYPOTHESIS: Cochlear implantation is an established method of auditory rehabilitation for severely and profoundly hearing impaired individuals. Although numerous studies have examined communication outcomes in pediatric cochlear implant (CI) recipients, data concerning the benefits of cochlear implantation in children who speak Mandarin Chinese are lacking. This study examined communication outcomes in 29 Mandarin-speaking children implanted at Chung Gung Memorial Hospital.
A prospective between-groups design was used to compare communication outcomes as a function of age at time of implantation.
Children in the Younger group were implanted before 3 years of age, whereas children in the Older group were implanted after 3 years of age. Outcome measures assessed auditory thresholds, speech perception, speech intelligibility, receptive and expressive language skills, communication barriers, and communication mode. Correlation analysis was used to examine the relationship between communication outcome and age at implantation.
Children in the Younger group demonstrated a significant level of difference on Mandarin vowels, consonants, tones, and open-set speech perception compared with the children in the Older group. Between-group differences were also shown on receptive and expressive language skills. But, no significant differences were noted on speech intelligibility or in self-ratings of communication barriers. A larger proportion of children in the Younger group used oral communication and were educated in mainstream classrooms. Communication mode change of the Younger group reached a significant level after cochlear implant. Speech perception performance was negatively correlated with age at implantation as well as chronological age. Mandarin-speaking children can obtain substantial communication benefits from cochlear implantation, with earlier implantation yielding superior results.
目的/假设：人工耳蜗植入是重度和极重度听力受损者公认的听觉康复方法。尽管众多研究已对小儿人工耳蜗植入（CI）受者的交流结果进行了考察，但关于人工耳蜗植入对说汉语普通话儿童益处的数据仍很缺乏。本研究考察了在中坜荣民总医院接受植入的29名说汉语普通话儿童的交流结果。
采用前瞻性组间设计，以比较植入时年龄对交流结果的影响。
较年幼组儿童在3岁前接受植入，而较年长组儿童在3岁后接受植入。结果测量评估了听觉阈值、言语感知、言语可懂度、接受性和表达性语言技能、交流障碍及交流方式。采用相关分析来检验交流结果与植入时年龄之间的关系。
与较年长组儿童相比，较年幼组儿童在汉语元音、辅音、声调及开放式言语感知方面表现出显著差异。两组在接受性和表达性语言技能方面也存在差异。但是，在言语可懂度或交流障碍自评方面未发现显著差异。较年幼组中有较大比例的儿童采用口语交流并在主流课堂接受教育。人工耳蜗植入后，较年幼组的交流方式变化达到显著水平。言语感知表现与植入时年龄以及实际年龄呈负相关。说汉语普通话的儿童可从人工耳蜗植入中获得显著的交流益处，早期植入效果更佳。
