The Ohio State University, Columbus, USA.
J Speech Lang Hear Res. 2013 Feb;56(1):13-30. doi: 10.1044/1092-4388(2012/11-0338). Epub 2012 Jun 28.
Common wisdom suggests that listening in noise poses disproportionately greater difficulty for listeners with cochlear implants (CIs) than for peers with normal hearing (NH). The purpose of this study was to examine phonological, language, and cognitive skills that might help explain speech-in-noise abilities for children with CIs.
Three groups of kindergartners (NH, hearing aid wearers, and CI users) were tested on speech recognition in quiet and noise and on tasks thought to underlie the abilities that fit into the domains of phonological awareness, general language, and cognitive skills. These last measures were used as predictor variables in regression analyses with speech-in-noise scores as dependent variables.
Compared to children with NH, children with CIs did not perform as well on speech recognition in noise or on most other measures, including recognition in quiet. Two surprising results were that (a) noise effects were consistent across groups and (b) scores on other measures did not explain any group differences in speech recognition.
Limitations of implant processing take their primary toll on recognition in quiet and account for poor speech recognition and language/phonological deficits in children with CIs. Implications are that teachers/clinicians need to teach language/phonology directly and maximize signal-to-noise levels in the classroom.
一般认为，与正常听力（NH）的同龄人相比，患有耳蜗植入物（CI）的听力障碍者在噪声环境中聆听会遇到不成比例的更大困难。本研究旨在研究语音、语言和认知技能，这些技能可能有助于解释患有 CI 的儿童的言语在噪声中的能力。
对三组幼儿园儿童（NH、助听器使用者和 CI 用户）进行了安静和噪声环境下的语音识别测试，以及与语音感知、一般语言和认知技能领域相关的能力有关的任务测试。这些最后一项测试作为回归分析的预测变量，以言语识别测试中的得分作为因变量。
与 NH 儿童相比，CI 儿童在噪声环境下的语音识别能力以及在其他大多数测试中的表现都不如前者，包括在安静环境下的语音识别能力。有两个令人惊讶的结果：（a）噪声效应在所有组中都是一致的；（b）其他测试的分数并不能解释 CI 儿童在语音识别方面的任何组间差异。
植入物处理的局限性对安静环境下的识别能力造成了主要影响，并导致 CI 儿童的语音识别能力差和语言/语音缺陷。这意味着教师/临床医生需要直接教授语言/语音，并在课堂上最大化信号噪声比。
