Chen Yuan, Wong Lena L N, Chen Fei, Xi Xin
Clinical Hearing Sciences (CHearS) Laboratory, Division of Speech and Hearing Sciences, The University of Hong Kong, Hong Kong, China.
Clinical Hearing Sciences (CHearS) Laboratory, Division of Speech and Hearing Sciences, The University of Hong Kong, Hong Kong, China.
Int J Pediatr Otorhinolaryngol. 2014 Nov;78(11):1923-30. doi: 10.1016/j.ijporl.2014.08.025. Epub 2014 Aug 25.
The purpose of this study was to examine the outcomes of cochlear implantation in young children in terms of (1) perception of lexical tones in quiet, (2) perception of sentences in quiet and in noise, (3) the effects of five demographic variables (i.e., preoperative hearing level, age at implantation, duration of cochlear implants use, maternal educational level, and whether a child underwent a hearing aid trial before implantation) on lexical tone perception and sentence perception, and (4) the relationship between lexical tone perception and sentence perception.
96 participants, aged from 2.41 years to 7.09 years, were recruited in mainland China. The children exhibited normal cognitive abilities and received unilateral implants at an average age of 2.72 years, with ages ranging from 0.69 to 5 years of age.
The mean score for tone identification was 77% (SD=13%; chance level=50%). Tone 2/tone 3 was the most difficult tone contrast to identify. Children with a longer duration of CI use and whose mothers had more years of education tended to perform better in sentence perception in quiet and in noise. Having undergone a hearing aid trial before implantation and more residual hearing were additional factors contributing to better sentence perception in noise. The only demographical variable that related to tone perception in quiet was duration of CI. In addition, while there was a modest correlation between tone perception and sentence perception in quiet (rs=0.47, p<0.001), the correlation between tone perception in quiet and sentence perception in noise was much weaker (rs=-0.28, p<0.05).
The findings suggested that most young children who had been implanted before 5 years of age and had 1-3 years of implant use did not catch up with their aged peers with normal hearing in tone perception and sentence perception. The weak to moderate correlation between tone perception in quiet and sentence perception might imply that the improvement of tone perception in quiet may not necessarily contribute to sentence perception, especially in noise condition.
本研究旨在探讨幼儿人工耳蜗植入的效果，具体包括：（1）安静环境下对声调的感知；（2）安静和噪声环境下对句子的感知；（3）五个人口统计学变量（即术前听力水平、植入年龄、人工耳蜗使用时长、母亲教育水平以及孩子在植入前是否进行过助听器试用）对声调感知和句子感知的影响；（4）声调感知与句子感知之间的关系。
在中国内地招募了96名年龄在2.41岁至7.09岁之间的参与者。这些儿童认知能力正常，平均在2.72岁时接受单侧植入，年龄范围为0.69至5岁。
声调识别的平均得分为77%（标准差=13%；机遇水平=50%）。第二声/第三声是最难识别的声调对比。人工耳蜗使用时长较长且母亲受教育年限较多的儿童在安静和噪声环境下的句子感知方面往往表现更好。植入前进行过助听器试用以及残余听力较多是有助于在噪声环境下更好地感知句子的其他因素。唯一与安静环境下声调感知相关的人口统计学变量是人工耳蜗使用时长。此外，虽然安静环境下声调感知与句子感知之间存在适度相关性（rs=0.47，p<0.001），但安静环境下声调感知与噪声环境下句子感知之间的相关性要弱得多（rs=-0.28，p<0.05）。
研究结果表明，大多数在5岁前植入且使用人工耳蜗1至3年的幼儿在声调感知和句子感知方面未能赶上同龄听力正常的儿童。安静环境下声调感知与句子感知之间弱至中度的相关性可能意味着安静环境下声调感知的改善不一定有助于句子感知，尤其是在噪声环境中。
