Dallas Cochlear Implant Program, Callier Advanced Hearing Research Center, University of Texas at Dallas, Dallas, TX 75235, USA.
Ear Hear. 2011 Feb;32(1 Suppl):2S-12S. doi: 10.1097/AUD.0b013e3182014c53.
This article describes participants in a follow-up study of a nationwide sample of children who had used a cochlear implant (CI) since preschool. The children were originally tested when they were in early elementary grades, and results were published in a monograph supplement of Ear and Hearing. Recently, many of these children returned for follow-up testing when they were in high school with >10 yrs experience with a CI. This introductory article will (1) discuss the extent to which the sample tested is representative of typical populations and (2) describe how sample characteristics changed over time for the 112 students tested in both elementary grades and high school.
Over a 4-yr period, 112 teenagers from across North America, accompanied by a parent, attended a research camp that was similar to one in which they had participated 8 yrs earlier. A battery of auditory, speech, language, and reading tests was administered, and responses to questionnaires and written language samples were obtained and are described in the following articles in this issue. This article summarizes child, family, and educational characteristics that were quantified so that their role in outcome levels achieved could be examined statistically. For example, metrics were devised to reflect the extent to which a student's language improved when sign language was added to spoken language (i.e., sign enhancement) based on test results obtained in elementary grades and in high school.
Comparisons of early characteristics of the 112 students who returned for follow-up testing with the 72 who did not return indicated comparable Performance Intelligence Quotients, communication mode ratings, family education/income, and age at implant. However, follow-up participants had better speech perception, speech intelligibility, and language skills at 8 or 9 yrs of age. Seventy-five percent of returning teenagers were fully mainstreamed in high school (compared with 63% in elementary grades). Only 5% of adolescents were in full-time special education. Grade placement of the teenagers was appropriate to their chronologic age. Estimates of sign enhancement, family characteristics, and Performance Intelligence Quotient were consistent over the two test sessions.
A large proportion of the original sample returned for follow-up testing in adolescence, but they were a more selective group than nonreturning subjects, and their scores may overestimate long-term CI outcomes for the general population. On the other hand, CI-HS students who participated in this study received their device >10 yrs ago and did not have some of the advantages available to more recently implanted children, so their results may underestimate those outcomes.
本文介绍了一项全国范围内使用过人工耳蜗的儿童随访研究的参与者。这些儿童在学龄前就接受了人工耳蜗，最初的测试是在他们上小学早期进行的，研究结果发表在《耳与听力》杂志的增刊上。最近，这些儿童中有许多人在高中阶段返回接受了随访测试，他们已经使用人工耳蜗超过 10 年。本文将（1）讨论接受测试的样本在多大程度上代表了典型人群，（2）描述在整个小学和高中阶段接受测试的 112 名学生的样本特征随时间的变化情况。
在 4 年的时间里，来自北美的 112 名青少年在家长的陪同下参加了一个研究营，该研究营与他们 8 年前参加过的一个研究营类似。研究人员对他们进行了一系列听觉、言语、语言和阅读测试，并获得了他们对问卷和书面语言样本的回答，这些内容在本期杂志的后续文章中进行了描述。本文总结了量化的儿童、家庭和教育特征，以便能够从统计学上检验它们在获得的结果水平中的作用。例如，根据在小学和高中阶段获得的测试结果，设计了衡量学生语言能力提高程度的指标，这些指标反映了在使用口语的同时增加手语（即手语增强）对语言的促进作用。
对参加后续测试的 112 名学生和未参加测试的 72 名学生的早期特征进行比较后发现，两组学生的表现智商、沟通模式评分、家庭教育/收入和植入年龄相当。然而，参加后续测试的青少年在 8 或 9 岁时的言语感知、言语可理解度和语言技能更好。75%的参加高中阶段测试的青少年在高中阶段完全融入主流（而在小学阶段这一比例为 63%）。只有 5%的青少年接受全日制特殊教育。青少年的年级安排与他们的实际年龄相符。手语增强、家庭特征和表现智商的估计值在两个测试阶段都是一致的。
很大一部分原始样本在青少年时期返回参加了后续测试，但他们是一个比未返回的参与者更具选择性的群体，他们的分数可能高估了普通人群使用人工耳蜗的长期结果。另一方面，参加这项研究的 CI-HS 学生在 10 多年前就接受了人工耳蜗，并且没有最近接受植入的儿童所具有的一些优势，因此他们的结果可能低估了这些结果。
