Ben-Itzhak Drorit, Greenstein Tally, Kishon-Rabin Liat
1Department of Communication Sciences and Disorders, Faculty of Health Professions, Ono Academic College, Kiryat Ono, Israel*; 2MICHA Multidisciplinary Center for Children with Hearing Loss, Tel Aviv, Israel; and 3Department of Communication Disorders, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Ear Hear. 2014 Nov-Dec;35(6):e262-71. doi: 10.1097/AUD.0000000000000059.
This study investigated the use of the Infant-Toddler Meaningful Auditory Integration Scale (IT-MAIS) as a measure of early auditory skill development in aided infants and toddlers with varying degrees of hearing loss. Specific goals were (1) to rate the change in IT-MAIS score as a function of change in hearing thresholds achieved through amplification; (2) to establish the hierarchy of early auditory skill development for infants who use hearing aids (HAs) relative to what is known in infants with normal hearing; and (3) to analyze background information variables that may account for differences in IT-MAIS performance, as age and duration of HAs use.
The study included 106 infants and toddlers (47 girls and 59 boys) aged 7 to 36 months (mean = 19.02, SD = 7.7) with various degrees of sensorineural hearing loss (mean = 86.42 dB, SD = 22.52). Infants used bilateral digital HAs with a mean experience of 8 months. All participants attended the same early intervention program. After at least 2 months of HA use, parents were interviewed with the IT-MAIS questionnaire regarding the auditory behavior of their infants in everyday situations.
The results of the present study support the following outcomes: (1) on average, every 10 dB gain in pure-tone average scores (PTA4) threshold improved the IT-MAIS score by 10%; (2) infants who were part of the same unaided hearing categories appeared to have derived different benefits from amplification; (3) when reaching the same aided category, those infants who were originally in a better unaided hearing category achieved higher IT-MAIS scores than those who belonged to a worse unaided hearing category; (4) the hierarchy of auditory development in young aided infants with hearing loss followed that of normal hearing peers; and (5) 62.9% of the variance of IT-MAIS performance was explained by aided hearing level (50.3%), unaided hearing level (6.4%), and duration of HA use (6.2)%.
The present study provides important information to assist clinicians and parents in setting realistic expectations regarding the auditory behavior of infants as a function of aided and unaided thresholds. It emphasizes the need for assessing functional hearing in young infants and not relying on hearing thresholds alone. Such data can also contribute to the decision-making process when selecting a sensory device (e.g., HA versus cochlear implant) for infants with hearing loss.
本研究调查了婴幼儿有意义听觉整合量表(IT - MAIS)作为评估不同程度听力损失的佩戴助听器的婴幼儿早期听觉技能发展的一项指标。具体目标为:(1)将IT - MAIS分数的变化评定为通过放大作用实现的听力阈值变化的函数;(2)相对于听力正常的婴幼儿,确定使用助听器(HA)的婴幼儿早期听觉技能发展的层次;(3)分析可能导致IT - MAIS表现差异的背景信息变量,如年龄和使用HA的时长。
该研究纳入了106名年龄在7至36个月(平均 = 19.02,标准差 = 7.7)的婴幼儿(47名女孩和59名男孩),他们患有不同程度的感音神经性听力损失(平均 = 86.42 dB,标准差 = 22.52)。婴幼儿使用双侧数字助听器,平均佩戴时长为8个月。所有参与者都参加了同一个早期干预项目。在使用助听器至少2个月后,就其婴幼儿在日常情境中的听觉行为,对家长进行了IT - MAIS问卷访谈。
本研究结果支持以下结论:(1)平均而言,纯音平均得分(PTA4)阈值每提高10 dB,IT - MAIS分数提高10%;(2)属于相同未佩戴助听器听力类别的婴幼儿从放大作用中获得的益处似乎有所不同;(3)达到相同佩戴助听器类别时,那些原本未佩戴助听器听力类别较好的婴幼儿的IT - MAIS分数高于未佩戴助听器听力类别较差的婴幼儿;(4)听力损失的佩戴助听器的年幼婴幼儿的听觉发展层次与听力正常的同龄人相同;(5)IT - MAIS表现的62.9%的方差可由佩戴助听器后的听力水平(50.3%)、未佩戴助听器时的听力水平(6.4%)和使用HA的时长(6.2%)来解释。
本研究提供了重要信息,以帮助临床医生和家长根据佩戴和未佩戴助听器时的阈值,对婴幼儿的听觉行为设定现实的期望。它强调了评估年幼儿童功能性听力的必要性,而不仅仅依赖于听力阈值。这些数据也有助于为听力损失婴幼儿选择感觉装置(如HA与人工耳蜗)时的决策过程。