Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, U.S.A.
Laryngoscope. 2014 Sep;124(9):2176-81. doi: 10.1002/lary.24746. Epub 2014 Jun 10.
OBJECTIVES/HYPOTHESIS: To evaluate the association between hearing loss and nonverbal intelligence in US children.
The Third National Health and Nutrition Examination Survey (NHANES III) is a cross-sectional survey (1988-1994) that used complex multistage sampling design to produce nationally representative demographic and examination data.
A total of 4,823 children ages 6 to 16 years completed audiometric evaluation and cognitive testing during NHANES III. Hearing loss was defined as low-frequency pure-tone average (PTA) >25 dB (0.5, 1, 2 kHz) or high-frequency PTA >25 dB (3, 4, 6, 8 kHz) and was designated as unilateral or bilateral. Nonverbal intelligence was measured using the Wechsler Intelligence Scale for Children-Revised block design subtest. Low nonverbal intelligence was defined as a standardized score <4, two standard deviations below the standardized mean of 10.
Mean nonverbal intelligence scores differed between children with normal hearing (9.59) and children with bilateral (6.87; P = .02) but not unilateral (9.12; P = .42) hearing loss. Non-Hispanic black race/ethnicity and family income <$20,000 were associated with 3.92 and 1.67 times higher odds of low nonverbal intelligence, respectively (odds ratio [OR]: 3.92; P < .001; OR: 1.67; P = .02). Bilateral hearing loss was independently associated with 5.77 times increased odds of low nonverbal intelligence compared to normal hearing children (OR: 5.77; P = .02). Unilateral hearing loss was not associated with higher odds of low nonverbal intelligence (OR: 0.73; P = .40).
Bilateral but not unilateral hearing loss is associated with decreased nonverbal intelligence in US children. Longitudinal studies are urgently needed to better understand these associations and their potential impact on future opportunities.
目的/假设：评估美国儿童听力损失与非言语智力之间的关系。
第三次国家健康和营养检查调查（NHANES III）是一项横断面调查（1988-1994 年），采用复杂的多阶段抽样设计，生成具有全国代表性的人口统计学和检查数据。
共有 4823 名 6 至 16 岁的儿童在 NHANES III 期间完成了听力评估和认知测试。听力损失定义为低频纯音平均（PTA）>25dB（0.5、1、2kHz）或高频 PTA>25dB（3、4、6、8kHz），并指定为单侧或双侧。非言语智力使用韦氏儿童智力量表修订版的积木设计分量表进行测量。非言语智力低下定义为标准化得分<4，低于标准化均值 10 的两个标准差。
正常听力儿童（9.59）和双侧听力损失儿童（6.87；P=0.02）而非单侧听力损失儿童（9.12；P=0.42）的平均非言语智力得分存在差异。非西班牙裔黑人种族/民族和家庭收入<20000 美元与低非言语智力的几率分别增加 3.92 和 1.67 倍（比值比[OR]：3.92；P<0.001；OR：1.67；P=0.02）。与正常听力儿童相比，双侧听力损失与低非言语智力的几率增加 5.77 倍独立相关（OR：5.77；P=0.02）。单侧听力损失与低非言语智力的几率增加无关（OR：0.73；P=0.40）。
双侧但非单侧听力损失与美国儿童非言语智力下降有关。迫切需要进行纵向研究，以更好地了解这些关联及其对未来机会的潜在影响。
