Ruffin Chad V, Kronenberger William G, Colson Bethany G, Henning Shirley C, Pisoni David B
DeVault Otologic Research Laboratory, Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, Indianapolis, Ind., USA.
Audiol Neurootol. 2013;18(5):289-96. doi: 10.1159/000353405. Epub 2013 Aug 23.
This study investigated long-term speech and language outcomes in 51 prelingually deaf children, adolescents and young adults who received cochlear implants (CIs) prior to 7 years of age and had used their implants for at least 7 years. Average speech perception scores were similar to those found in prior research with other samples of experienced CI users. Mean language test scores were lower than norm-referenced scores from nationally representative normal-hearing, typically developing samples, although a majority of the CI users scored within 1 standard deviation of the normative mean or higher on the Peabody Picture Vocabulary Test, Fourth Edition (63%), and the Clinical Evaluation of Language Fundamentals, Fourth Edition (69%). Speech perception scores were negatively associated with a meningitic etiology of hearing loss, older age at implantation, poorer preimplant unaided pure-tone average thresholds, lower family income and the use of 'total communication'. Subjects who had used CIs for 15 years or more were more likely to have these characteristics and were more likely to score lower on measures of speech perception compared to those who had used CIs for 14 years or less. The aggregation of these risk factors in the >15 years of CI use subgroup accounts for their lower speech perception scores and may stem from more conservative CI candidacy criteria in use at the beginning of pediatric cochlear implantation.
本研究调查了51名语前聋儿童、青少年和年轻成人的长期言语和语言结果，这些患者在7岁之前接受了人工耳蜗植入（CI），且使用人工耳蜗至少7年。平均言语感知分数与之前对其他有经验的人工耳蜗使用者样本的研究结果相似。平均语言测试分数低于来自全国代表性的听力正常、发育正常样本的常模参照分数，不过在《皮博迪图片词汇测验（第4版）》（63%）和《语言基本能力临床评估（第4版）》（69%）中，大多数人工耳蜗使用者的分数在常模均值的1个标准差范围内或更高。言语感知分数与脑膜炎性听力损失病因、植入时年龄较大、植入前无助听纯音平均阈值较差、家庭收入较低以及使用“全面交流法”呈负相关。与使用人工耳蜗14年或更短时间的受试者相比，使用人工耳蜗15年或更长时间的受试者更有可能具有这些特征，并且在言语感知测量中的得分更低。在人工耳蜗使用超过15年的亚组中，这些风险因素的聚集导致了他们较低的言语感知分数，这可能源于小儿人工耳蜗植入开始时使用的更保守的人工耳蜗植入标准。
