Dallas Cochlear Implant Program, Callier Advanced Hearing Research Center, The University of Texas at Dallas, Dallas, Texas 75235, USA.
Ear Hear. 2011 Feb;32(1 Suppl):27S-38S. doi: 10.1097/AUD.0b013e3181fa41bb.
The objectives of this study were to (a) evaluate changes in speech intelligibility in a group of 110 adolescent users of cochlear implants who were first assessed in elementary school (CI-E) and later in high school (CI-HS) and (b) examine factors influencing speech intelligibility performance at the CI-E and CI-HS sessions.
Participants were 110 adolescents who participated in an earlier study examining 181 young elementary school-aged children. Primary outcome measures included speech intelligibility under quiet and multispeaker background conditions and consonants correct produced in the sentences. Multiple linear regressions were used to evaluate how participant, family, and performance measures influenced their speech production during adolescence. Performance measures included estimates of speech perception, working memory, sign enhancement, and duration of seven-syllable sentences. Participant and family measures included duration of deafness, performance intelligence quotients, gender, family size, and socioeconomic status. Principal component analyses were used to construct common variables across highly intercorrelated measures. Three sets of multiple linear regressions evaluated the contributions of the variables to the variance associated with adolescent speech intelligibility.
Speech intelligibility and consonants correct significantly increased nearly 22% between the two test sessions. Speech intelligibility significantly decreased by approximately 20% in the multispeaker babble condition relative to the quiet condition. Duration of seven-syllable sentences significantly decreased during the two test sessions. Data revealed that 65.8% of the variance in adolescent speech intelligibility was predicted from participant, family, and performance measures observed in elementary school. Forty-nine percent of the variance at adolescence was accounted for by the participant, family, and performance measures observed during the high school test session. Evaluation of variance including participant and family measures at both time periods, in conjunction with the adolescent performance measures, accounted for 49% of the variance in adolescence performance. After contributions from participant and family variables at the elementary and adolescent test sessions were removed, 21% of the variance in adolescent speech intelligibility was due to the performance measures at adolescence. Independent predictors of performance at adolescence included negative effects of sign enhancement and duration of seven-syllable sentences.
Substantial improvements were made in consonant accuracy, sentence duration, and speech intelligibility between elementary and high school test sessions. Reductions in speech intelligibility performance suggest that allophonic variations, distortions, or use of speech sounds in a nonambient language may contribute to the reductions observed in multispeaker background conditions. Although a significant amount of variance in adolescent performance is accounted for by participant and family characteristics, elementary school speech production and an early reliance on speaking and listening independently account for variance in adolescence speech intelligibility. Over and beyond all the contributions made by participant, family and performance measures, greater reliance on oral communication, and shorter sentence durations independently account for variance at adolescence.
本研究的目的是(a)评估一组 110 名在小学（CI-E）和高中（CI-HS）接受初次评估的人工耳蜗植入术青少年使用者的言语可懂度变化，以及(b)检查影响 CI-E 和 CI-HS 会话中言语可懂度表现的因素。
参与者为 110 名青少年，他们参加了一项早期研究，该研究调查了 181 名小学生。主要结局测量包括在安静和多说话者背景条件下的言语可懂度以及句子中的正确辅音。多元线性回归用于评估参与者、家庭和表现测量如何影响他们在青春期的言语产生。表现测量包括言语感知、工作记忆、标志增强和七个音节句子持续时间的估计。参与者和家庭的测量包括耳聋时间、表现智商、性别、家庭规模和社会经济地位。主成分分析用于构建高度相关测量之间的通用变量。三组多元线性回归评估了变量对与青少年言语可懂度相关的方差的贡献。
言语可懂度和正确辅音在两次测试中分别增加了近 22%。与安静条件相比，在多说话者背景噪声条件下，言语可懂度显著下降约 20%。在两个测试期间，七个音节句子的持续时间显著下降。数据显示，65.8%的青少年言语可懂度方差可以从小学期间观察到的参与者、家庭和表现测量中预测。49%的青少年方差可以由高中测试期间观察到的参与者、家庭和表现测量来解释。结合青少年表现测量，同时评估参与者和家庭在两个时期的测量值，可解释青少年表现的 49%方差。在从小学和青少年测试期间去除参与者和家庭变量的贡献后，青少年言语可懂度的 21%方差归因于青少年时期的表现测量。青少年时期表现的独立预测因子包括标志增强的负面影响和七个音节句子的持续时间。
在小学和高中测试期间，辅音准确性、句子持续时间和言语可懂度都有了显著提高。言语可懂度表现的下降表明，所有语音变化、扭曲或在非环境语言中使用语音可能会导致在多说话者背景条件下观察到的下降。尽管青少年表现的很大一部分方差可以由参与者和家庭特征来解释，但在小学期间的言语产生和早期对口语和听力的独立依赖可以解释青春期言语可懂度的差异。除了参与者、家庭和表现测量的所有贡献外，更依赖口语交流和更短的句子持续时间也可以独立解释青春期的差异。
