Schramm Bianka, Bohnert Andrea, Keilmann Annerose
University Medical Center of the Johannes Gutenberg University, Department for ENT and Communication Disorders, Mainz, Germany.
Int J Pediatr Otorhinolaryngol. 2010 Jul;74(7):812-9. doi: 10.1016/j.ijporl.2010.04.008. Epub 2010 May 8.
This study had two aims: (1) to document the auditory and lexical development of children who are deaf and received the first cochlear implant (CI) by the age of 16 months and the second CI by the age of 31 months and (2) to compare these children's results with those of children with normal hearing (NH).
This longitudinal study included five children with NH and five with sensorineural deafness. All children of the second group were observed for 36 months after the first fitting of the device (cochlear implant). The auditory development of the CI group was documented every 3 months up to the age of two years in hearing age and chronological age and for the NH group in chronological age. The language development of each NH child was assessed at 12, 18, 24 and 36 months of chronological age. Children with CIs were examined at the same age intervals at chronological and hearing age.
In both groups, children showed individual patterns of auditory and language development. The children with CIs developed differently in the amount of receptive and expressive vocabulary compared with the NH control group. Three children in the CI group needed almost 6 months to make gains in speech development that were consistent with what would be expected for their chronological age. Overall, the receptive and expressive development in all children of the implanted group increased with their hearing age.
These results indicate that early identification and early implantation is advisable to give children with sensorineural hearing loss a realistic chance to develop satisfactory expressive and receptive vocabulary and also to develop stable phonological, morphological and syntactical skills for school life. On the basis of these longitudinal data, we will be able to develop new diagnostic tools that enable clinicians to assess child's progress in hearing and speech development.
本研究有两个目的：（1）记录16个月前接受首次人工耳蜗植入（CI）且31个月前接受第二次CI的失聪儿童的听觉和词汇发展情况；（2）将这些儿童的结果与听力正常（NH）儿童的结果进行比较。
这项纵向研究包括5名听力正常儿童和5名感音神经性耳聋儿童。第二组的所有儿童在首次佩戴设备（人工耳蜗）后观察36个月。人工耳蜗组的听觉发展情况在听力年龄和实际年龄达到两岁之前每3个月记录一次，听力正常组则按实际年龄记录。每名听力正常儿童的语言发展情况在实际年龄12、18、24和36个月时进行评估。人工耳蜗植入儿童在实际年龄和听力年龄的相同时间间隔接受检查。
两组儿童均呈现出个体的听觉和语言发展模式。与听力正常对照组相比，人工耳蜗植入儿童在接受性和表达性词汇量方面的发展有所不同。人工耳蜗组中有3名儿童在言语发展方面需要近6个月的时间才能取得与其实际年龄相符的进步。总体而言，植入组所有儿童的接受性和表达性发展随着听力年龄的增长而提高。
这些结果表明，对于感音神经性听力损失儿童，早期识别和早期植入是可取的，这能让他们有切实的机会发展出令人满意的表达性和接受性词汇量，还能为学校生活发展稳定的语音、形态和句法技能。基于这些纵向数据，我们将能够开发新的诊断工具，使临床医生能够评估儿童在听力和言语发展方面的进展。
