Fulcher Anne, Purcell Alison A, Baker Elise, Munro Natalie
The Shepherd Centre, Sydney, Australia.
Int J Pediatr Otorhinolaryngol. 2012 Dec;76(12):1785-94. doi: 10.1016/j.ijporl.2012.09.001. Epub 2012 Oct 17.
OBJECTIVES: Age-appropriate speech/language outcomes for children with early identified hearing loss are a possibility but not a certainty. Identification of children most likely to achieve optimal outcomes is complicated by the heterogeneity of the children involved in outcome research, who present with a range of malleable (e.g. age of identification and cochlear implantation, type of intervention, communication mode) and non-malleable (e.g. degree of hearing loss) factors. This study considered whether a homogenous cohort of early identified children (≤ 12 months), with all severities of hearing loss and no other concomitant diagnoses could not only significantly outperform a similarly homogenous cohort of children who were later identified (>12 months to <5 years), but also achieve and maintain age-appropriate speech/language outcomes by 3, 4 and 5 years of age. METHODS: A mixed prospective/retrospective comparative study of a homogenous cohort of 45 early identified (≤ 12 months) and 49 late identified (> 12 months to < 5 years) children with hearing loss was conducted. The children all attended the same oral auditory-verbal early intervention programme. Speech/language assessments standardized on typically developing hearing children were conducted at 3, 4 and 5 years of age. RESULTS: The early identified children significantly outperformed the late identified at all ages and for all severities of HL. By 3 years of age, 93% of all early identified participants scored within normal limits (WNL) for speech; 90% were WNL for understanding vocabulary; and 95% were WNL for receptive and expressive language. Progress was maintained and improved so that by 5 years of age, 96% were WNL for speech, with 100% WNL for language. CONCLUSIONS: This study found that most children with all severities of hearing loss and no other concomitant diagnosed condition, who were early diagnosed; received amplification by 3 months; enrolled into AV intervention by 6 months and received a cochlear implant by 18 months if required, were able to "keep up with" rather than "catch up to" their typically hearing peers by 3 years of age on measures of speech and language, including children with profound hearing loss. By 5 years, all children achieved typical language development and 96% typical speech.
目标：对于早期确诊听力损失的儿童而言，实现符合其年龄阶段的言语/语言发育结果是有可能的，但并非必然。由于参与结果研究的儿童具有异质性，其表现出一系列可变因素（如确诊年龄和人工耳蜗植入年龄、干预类型、沟通方式）和不可变因素（如听力损失程度），因此确定最有可能实现最佳结果的儿童变得复杂。本研究探讨了一个由早期确诊（≤12个月）、患有各种程度听力损失且无其他伴随诊断的儿童组成的同质队列，是否不仅能显著优于另一组同样同质的、较晚确诊（>12个月至<5岁）的儿童，而且在3岁、4岁和5岁时能否实现并维持符合其年龄阶段的言语/语言发育结果。 方法：对45名早期确诊（≤12个月）和49名较晚确诊（>12个月至<5岁）的听力损失儿童组成的同质队列进行了一项前瞻性/回顾性混合比较研究。所有儿童都参加了同一个口语法听觉言语早期干预项目。在3岁、4岁和5岁时，对以听力正常儿童为标准进行标准化的言语/语言评估。 结果：在所有年龄阶段以及所有听力损失程度方面，早期确诊的儿童均显著优于较晚确诊的儿童。到3岁时，所有早期确诊参与者中93%的言语得分在正常范围内（WNL）；90%的词汇理解得分在WNL；95%的接受性和表达性语言得分在WNL。进展得以维持并有所改善，以至于到5岁时，96%的言语得分在WNL，100%的语言得分在WNL。 结论：本研究发现，大多数患有各种程度听力损失且无其他伴随诊断疾病、早期确诊、3个月内佩戴助听器、6个月内参加听觉言语干预且必要时18个月内接受人工耳蜗植入 的儿童，在言语和语言指标方面到3岁时能够“跟上”而非“赶上”听力正常的同龄人，包括重度听力损失儿童。到5岁时，所有儿童均实现了典型的语言发育，96%实现了典型的言语发育。
Int J Pediatr Otorhinolaryngol. 2012-12
Int J Speech Lang Pathol. 2014-2
Int J Pediatr Otorhinolaryngol. 2012-7
Ment Retard Dev Disabil Res Rev. 2003
Arch Otolaryngol Head Neck Surg. 2004-5
Acta Otolaryngol. 2009-4
Indian J Otolaryngol Head Neck Surg. 2024-12
S Afr J Commun Disord. 2024-10-28
Zotero 插件