The Ohio State University Wexner Medical Center, Columbus, Ohio, U.S.A.
Otol Neurotol. 2013 Dec;34(9):1648-55. doi: 10.1097/MAO.0b013e3182a0036c.
Undesirable behaviors in young children with cochlear implants suggest device soft failure.
Cochlear implant soft failure refers to nonoptimal performance not detectable with routine hardware checks. Pediatric failures may delay language development, but failure detection is difficult. A 2005 soft failure consensus statement recommended a checklist for suspected device malfunctions. That checklist included the appearance of "bad" behaviors and aggression (externalizing behaviors) or self-injury and inattentiveness (internalizing behaviors) as indicators of soft failure. Accordingly, these behaviors should predict slowed language growth, and the analyses reported here sought evidence of that predictive power.
Data from a longitudinal study of 80 children with cochlear implants collected at 6 times between 18 and 48 months were reexamined. Language measures included auditory comprehension, expressive vocabulary, and unstructured language. A parent questionnaire, the Child Behavior Checklist, examined externalizing and internalizing behaviors. Behavior measures were correlated with language measures in a series of analyses.
Externalizing and internalizing behaviors did not consistently correlate with language at the ages tested. Additionally, early behaviors did not predict later language abilities. Individual language measures correlated best with overall language development 12 months later.
This study fails to support the hypothesis that externalizing and internalizing behaviors in pediatric cochlear implant users correlate with slowed language advance. These behaviors should not be seen as evidence of declining language performance as may be seen with device soft failure. Instead clinical assessments of language abilities are necessary.
患有耳蜗植入物的幼儿出现不良行为表明设备出现软性故障。
耳蜗植入物软性故障是指无法通过常规硬件检查检测到的非最佳性能。儿科故障可能会延迟语言发展，但故障检测困难。2005 年软性故障共识声明建议对疑似设备故障进行检查表。该检查表包括“不良”行为和攻击行为（外部行为）或自伤和注意力不集中（内部行为），作为软性故障的指标。因此，这些行为应该预测语言发展缓慢，这里报告的分析旨在寻找这种预测能力的证据。
对 80 名接受耳蜗植入物的儿童进行的纵向研究的数据进行了重新检查，这些儿童在 18 至 48 个月之间接受了 6 次检查。语言测量包括听觉理解、表达词汇和非结构化语言。家长问卷《儿童行为检查表》检查了外部行为和内部行为。在一系列分析中，行为测量与语言测量相关。
外部行为和内部行为与测试时的语言并不始终相关。此外，早期行为并不能预测后期的语言能力。个体语言测量与 12 个月后整体语言发展相关性最佳。
本研究未能支持这样的假设，即儿科耳蜗植入物使用者的外部和内部行为与语言发展缓慢有关。这些行为不应被视为语言表现下降的证据，而可能与设备软性故障有关。相反，有必要对语言能力进行临床评估。
