Nittrouer Susan, Lowenstein Joanna H, Holloman Christopher
Otolaryngology, Ohio State University, United States.
Otolaryngology, Ohio State University, United States.
Res Dev Disabil. 2016 Aug;55:143-60. doi: 10.1016/j.ridd.2016.03.020. Epub 2016 Apr 12.
Newborn hearing screening has made it possible to provide early treatment of hearing loss to more children than ever before, raising expectations these children will be able to attend regular schools. But continuing deficits in spoken language skills have led to challenges in meeting those expectations. This study was conducted to (1) examine two kinds of language skills (phonological and morphosyntactic) at school age (second grade) for children with cochlear implants (CIs); (2) see which measures from earlier in life best predicted performance at second grade; (3) explore how well these skills supported other cognitive and language functions; and (4) examine how treatment factors affected measured outcomes.
Data were analyzed from 100 second-grade, monolingual English-speaking children: 51 with CIs and 49 with normal hearing (NH). Ten measures of spoken language and related functions were collected: three each of phonological and morphosyntactic skills; and four of other cognitive and language functions. Six measures from preschool and seven from kindergarten served as predictor variables. The effects of treatment variables were examined.
Children with CIs were more delayed acquiring phonological than morphosyntactic skills. Mean length of utterance at earlier ages was the most consistent predictor of both phonological and morphosyntactic skills at second grade. Early bimodal stimulation had a weak, but positive effect on phonological skills at second grade; sign language experience during preschool had a negative effect on morphosyntactic structures in spoken language.
Children with CIs are delayed in language acquisition, and especially so in phonological skills. Appropriate testing and treatments can help ameliorate these delays.
新生儿听力筛查使比以往更多的儿童能够获得听力损失的早期治疗，这提高了人们对这些儿童能够进入正规学校的期望。但口语技能持续存在的缺陷给实现这些期望带来了挑战。本研究旨在：（1）检查学龄期（二年级）人工耳蜗植入（CI）儿童的两种语言技能（语音和形态句法）；（2）确定生命早期的哪些指标最能预测二年级时的表现；（3）探究这些技能对其他认知和语言功能的支持程度；（4）研究治疗因素如何影响测量结果。
对100名二年级单语说英语的儿童的数据进行分析：51名人工耳蜗植入儿童和49名听力正常（NH）儿童。收集了10项口语及相关功能的指标：语音和形态句法技能各3项；其他认知和语言功能4项。来自学前班的6项指标和来自幼儿园的7项指标作为预测变量。研究了治疗变量的影响。
人工耳蜗植入儿童在语音技能的获得上比形态句法技能更滞后。早期年龄的平均语句长度是二年级语音和形态句法技能最一致的预测指标。早期双模式刺激对二年级的语音技能有微弱但积极的影响；学前班期间的手语经验对口语中的形态句法结构有负面影响。
人工耳蜗植入儿童在语言习得方面存在延迟，尤其是在语音技能方面。适当的测试和治疗有助于改善这些延迟。
