Nicholas Johanna G, Geers Ann E
a Department of Otolaryngology , Washington University School of Medicine , Box 8115, 660 S. Euclid Ave., St. Louis , MO 63130 , USA.
b School of Behavioral and Brain Sciences , The University of Texas at Dallas , GR41, 800 West Campbell Rd., Richardson , TX 75080 , USA.
Cochlear Implants Int. 2018 Jan;19(1):26-37. doi: 10.1080/14670100.2017.1380114. Epub 2017 Oct 10.
To determine whether relative delays among domains exist in the conversational use of vocabulary, syntax, and morphology by children with cochlear implants (CIs) and whether these were differentially affected by age of implantation (AOI) and the audibility of speech.
Participants in this short-term longitudinal study were 126 children with AOI of 6-38 months and a matched group of 30 children without hearing loss. Language samples of the same children at ages 3.5 and 4.5 were analyzed for the breadth of vocabulary and bound morphemes used, and sentence length.
At both test ages, expressive language domains were delayed equally. Higher performance across domains was independently associated with younger AOI and better pre-implant-aided thresholds. No domain was affected differently by very early implantation, but bound morpheme breadth was associated with better CI-aided thresholds. Between 63 and 78% of children with AOI of 6-11 months scored close to hearing age-mates by 4.5, a level achieved by fewer than 25% of those with AOI of 19-24 months or later ages.
Previous studies indicated greater language delays in the areas of morphology and syntax than those of vocabulary, with the earliest ages of implantation conferring the greatest benefit to those domains. The current design addressed inconsistency across studies in modes of communication used, presence/absence of other disabilities, and differences in language domains chosen as outcome measures.
Linguistic domains benefitted equally from early implantation, regardless of the duration of auditory stimulation. Better pre-CI-aided hearing often compensated for later AOI. Bound morpheme use was greater with better CI-aided thresholds.
确定人工耳蜗植入（CI）儿童在词汇、句法和形态学的对话使用中各领域之间是否存在相对延迟，以及这些延迟是否受到植入年龄（AOI）和言语可听度的不同影响。
这项短期纵向研究的参与者为126名植入年龄在6至38个月的儿童以及30名听力正常的匹配儿童。对这些儿童在3.5岁和4.5岁时的语言样本进行分析，以确定其使用的词汇广度、粘着语素以及句子长度。
在两个测试年龄，表达性语言领域的延迟程度相同。各领域表现较好与较低的植入年龄和植入前较好的助听阈值独立相关。极早期植入对各领域的影响并无差异，但粘着语素广度与较好的人工耳蜗助听阈值相关。6至11个月植入年龄的儿童中，63%至78%在4.5岁时的得分接近听力正常的同龄人，而19至24个月或更大植入年龄的儿童中，只有不到25%能达到这一水平。
先前的研究表明，形态学和句法领域的语言延迟比词汇领域更大，最早的植入年龄对这些领域的益处最大。当前的设计解决了以往研究在交流方式、是否存在其他残疾以及作为结果测量的语言领域选择方面的不一致问题。
无论听觉刺激的持续时间如何，语言领域均从早期植入中同等受益。植入前较好的听力往往可以弥补较晚植入年龄的影响。人工耳蜗助听阈值越好，粘着语素的使用就越多。
