Department of Otolaryngology, Affiliated Sixth People's Hospital to Shanghai Jiao Tong University, Shanghai, China.
PLoS One. 2013;8(1):e53852. doi: 10.1371/journal.pone.0053852. Epub 2013 Jan 21.
To assess whether speech therapy can lead to better results for early cochlear implantation (CI) children.
A cohort of thirty-four congenitally profoundly deaf children who underwent CI before the age of 18 months at the Sixth Hospital affiliated with Shanghai Jiaotong University from January 2005 to July 2008 were included. Nineteen children received speech therapy in rehabilitation centers (ST), whereas the remaining fifteen cases did not (NST), but were exposed to the real world, as are normal hearing children.
All children were assessed before surgery and at 6, 12, and 24 months after surgery with the Categories of Auditory Performance test (CAP) and the Speech Intelligibility Rating (SIR). Each assessment was given by the same therapist who was blind to the situation of the child at each observation interval. CAP and SIR scores of the groups were compared at each time point.
Our study showed that the auditory performance and speech intelligibility of trained children were almost the same as to those of untrained children with early implantation. The CAP and SIR scores of both groups increased with increased time of implant use during the follow-up period, and at each time point, the median scores of the two groups were about equal.
These results indicate that great communication benefits are achieved by early implantation (<18 months) without routine speech therapy. The results exemplify the importance of enhanced social environments provided by everyday life experience for human brain development and reassure parents considering cochlear implants where speech training is unavailable.
评估言语治疗是否能使早期植入人工耳蜗的儿童获得更好的效果。
本研究纳入了 2005 年 1 月至 2008 年 7 月期间在上海交通大学附属第六人民医院接受人工耳蜗植入术的 34 名先天性极重度聋的儿童。19 名儿童在康复中心接受言语治疗（ST），其余 15 名儿童未接受言语治疗（NST），但他们像正常听力儿童一样置身于现实世界中。
所有儿童均在术前以及术后 6、12 和 24 个月接受了听觉绩效测试（CAP）和言语可懂度分级（SIR）评估。每次评估均由同一位治疗师进行，治疗师在每次观察间隔时对儿童的情况均不知情。比较了两组在每个时间点的 CAP 和 SIR 评分。
我们的研究表明，经过训练的儿童的听觉表现和言语可懂度几乎与早期植入且未经训练的儿童相同。两组的 CAP 和 SIR 评分均随植入后使用时间的增加而增加，在随访期间的每个时间点，两组的中位数评分基本相等。
这些结果表明，早期植入（<18 个月）而不进行常规言语治疗可获得良好的交流效果。结果证明了日常生活经验提供的增强的社会环境对人类大脑发育的重要性，并使考虑人工耳蜗植入但无法进行言语训练的父母感到放心。
