Geers Ann E, Nicholas Johanna, Tobey Emily, Davidson Lisa
J Speech Lang Hear Res. 2016 Feb;59(1):155-70. doi: 10.1044/2015_JSLHR-H-14-0173.
The purpose of the present investigation is to differentiate children using cochlear implants (CIs) who did or did not achieve age-appropriate language scores by midelementary grades and to identify risk factors for persistent language delay following early cochlear implantation.
Children receiving unilateral CIs at young ages (12-38 months) were tested longitudinally and classified with normal language emergence (n = 19), late language emergence (n = 22), or persistent language delay (n = 19) on the basis of their test scores at 4.5 and 10.5 years of age. Relative effects of demographic, audiological, linguistic, and academic characteristics on language emergence were determined.
Age at CI was associated with normal language emergence but did not differentiate late emergence from persistent delay. Children with persistent delay were more likely to use left-ear implants and older speech processor technology. They experienced higher aided thresholds and lower speech perception scores. Persistent delay was foreshadowed by low morphosyntactic and phonological diversity in preschool. Logistic regression analysis predicted normal language emergence with 84% accuracy and persistent language delay with 74% accuracy.
CI characteristics had a strong effect on persistent versus resolving language delay, suggesting that right-ear (or bilateral) devices, technology upgrades, and improved audibility may positively influence long-term language outcomes.
本研究的目的是区分在小学中期达到或未达到适龄语言分数的接受人工耳蜗植入（CI）的儿童，并确定早期人工耳蜗植入后持续性语言延迟的风险因素。
对幼年（12 - 38个月）接受单侧人工耳蜗植入的儿童进行纵向测试，并根据他们在4.5岁和10.5岁时的测试成绩分为正常语言发育（n = 19）、语言发育迟缓（n = 22）或持续性语言延迟（n = 19）。确定了人口统计学、听力学、语言学和学业特征对语言发育的相对影响。
人工耳蜗植入时的年龄与正常语言发育相关，但不能区分语言发育迟缓和持续性延迟。持续性延迟的儿童更有可能使用左耳植入物和较旧的言语处理器技术。他们的助听阈值更高，言语感知分数更低。学龄前形态句法和语音多样性低预示着持续性延迟。逻辑回归分析预测正常语言发育的准确率为84%，持续性语言延迟的准确率为74%。
人工耳蜗植入特征对持续性与缓解性语言延迟有强烈影响，表明右耳（或双耳）设备、技术升级和改善可听度可能对长期语言结果产生积极影响。
