Geal-Dor M, Tranovsky Y, Boudilovsky E, Adelman C, Adler M, Levi H
Speech and Hearing Clinic, Hadassah University Medical Center, Jerusalem, Israel; Department of Communication Disorders, Hadassah Academic College, Jerusalem, Israel.
Int J Pediatr Otorhinolaryngol. 2013 Nov;77(11):1852-5. doi: 10.1016/j.ijporl.2013.08.027. Epub 2013 Sep 4.
Speech acquisition after cochlear implant is a long process. Various studies have followed the auditory milestones in the early period after implantation. The aim of the present study was to track the development of hearing skills in the early period after cochlear implantation and evaluate which factors influence the process.
195 records of children implanted in the Hadassah Medical Center were examined retrospectively. Data on etiology, age at implantation and type of implant were collected. In addition, information on the rate of progress was measured: the first time that there was detection and identification of Ling sounds, the first time it was possible to obtain SDT (speech detection threshold), SRT (speech reception threshold) and an audiogram, and the first accurate repetition of VCV (vowel consonant vowel) sounds.
Results show a consistent pattern of auditory milestone acquisition similar to that of normal development, from milestones that do not require decoding beginning with SDT, detection of Ling sounds followed by an audiogram which requires cooperation, to tasks that involve decoding starting with SRT and repetition of Ling sounds and finally VCV repetition. The children implanted before 24 months of age achieved the auditory milestones later than children implanted between 2 and 6 years, apparently since these tasks involve cognitive abilities which are not yet developed in the youngest children. Previous hearing experience improved the rate of acquisition of the auditory milestones and progress was faster in the second implanted ear compared to the first implanted ear.
More research is needed to address the relationship between acquisition of early auditory milestones and performance with the cochlear implant later on in life.
人工耳蜗植入后言语获得是一个漫长的过程。各种研究追踪了植入后早期的听觉发育里程碑。本研究的目的是追踪人工耳蜗植入后早期听力技能的发展，并评估哪些因素影响这一过程。
回顾性检查了哈达萨医疗中心195例儿童植入记录。收集了病因、植入年龄和植入类型的数据。此外，还测量了进展速度的信息：首次检测和识别林氏音的时间、首次获得言语检测阈值（SDT）、言语接受阈值（SRT）和听力图的时间，以及首次准确重复元音辅音元音（VCV）音的时间。
结果显示，听觉发育里程碑的获得模式与正常发育一致，从不需要解码的里程碑（从SDT开始），到需要合作的听力图的林氏音检测，再到涉及解码的任务（从SRT和林氏音重复开始，最后是VCV重复）。24个月前植入的儿童比2至6岁植入的儿童更晚达到听觉发育里程碑，显然是因为这些任务涉及最年幼儿童尚未发育的认知能力。既往听力经验提高了听觉发育里程碑的获得速度，与第一只植入耳相比，第二只植入耳的进展更快。
需要更多研究来探讨早期听觉发育里程碑的获得与后期人工耳蜗使用表现之间的关系。
