Lin Frank R, Wang Nae-Yuh, Fink Nancy E, Quittner Alexander L, Eisenberg Laurie S, Tobey Emily A, Niparko John K
Department of Otolaryngology-Head and Neck Surgery, John Hopkins School of Medicine, Baltimore, Maryland , USA.
Otol Neurotol. 2008 Feb;29(2):208-13. doi: 10.1097/mao.0b013e31812f6fa6.
Clinicians and investigators use multiple outcome measures after early cochlear implantation (CI) to assess auditory skills, speech, and language effects. Are certain outcome measures better associated with optimal childhood development from the perspective of parents? We studied the association between several commonly used outcome instruments and a measure of parental perceptions of development to gain insight into how our clinical tests reflect parental perceptions of a child's developmental status.
Cross-sectional analysis.
Six academic centers.
One hundred eighty-eight deaf children (<6 yr) 1 year after CI activation enrolled in the longitudinal Childhood Development after CI study.
Measures of auditory skills, speech, and language. Parental perceptions of development quantified with a visual analogue scale (visual analogue scale-development).
Nonparametric and parametric regression methods were used to model the relationship between outcome measures and visual analogue scale-development scores.
All outcome measures were positively associated with parental perceptions of development, but more robust associations were observed with language measures and a parent-report scale of auditory skills than with a selected measure of closed-set speech. For speech and language data, differences were observed in the trajectories of associations among younger (2-3 yr) versus older (4-5 yr) children.
Our results demonstrate the importance of measuring multiple outcome measures after early pediatric CI. The degree to which an outcome measure reflects childhood development as perceived by parents may be affected by the child's age. Measures that are based on parental report and broader outcome measures focused on verbal language offer the potential for a fuller understanding of the true effectiveness of early implantation.
临床医生和研究人员在早期人工耳蜗植入（CI）后使用多种结局指标来评估听觉技能、言语和语言效果。从家长的角度来看，某些结局指标是否与儿童的最佳发育更相关？我们研究了几种常用结局工具与家长对发育的认知指标之间的关联，以深入了解我们的临床测试如何反映家长对孩子发育状况的认知。
横断面分析。
六个学术中心。
188名人工耳蜗植入激活后1年的失聪儿童（<6岁），他们参与了人工耳蜗植入后的儿童纵向发育研究。
听觉技能、言语和语言指标。用视觉模拟量表（视觉模拟量表-发育）量化家长对发育的认知。
使用非参数和参数回归方法对结局指标与视觉模拟量表-发育得分之间的关系进行建模。
所有结局指标均与家长对发育的认知呈正相关，但与语言指标和家长报告的听觉技能量表相比，与选定的封闭式言语指标的相关性更强。对于言语和语言数据，在年龄较小（2 - 3岁）与年龄较大（4 - 5岁）儿童之间的关联轨迹上观察到差异。
我们的结果表明了在小儿早期人工耳蜗植入后测量多种结局指标的重要性。结局指标反映家长所感知的儿童发育的程度可能受孩子年龄的影响。基于家长报告的指标以及侧重于言语语言的更广泛结局指标，有可能更全面地了解早期植入的真正效果。
