儿童有无耳蜗植入物的智商比较：纵向研究结果及其与语言的关系。
Comparisons of IQ in Children With and Without Cochlear Implants: Longitudinal Findings and Associations With Language.
机构信息
Department of Otolaryngology, University of Miami, Coral Gables, FL.
School of Public Health, Johns Hopkins University, Baltimore, MD.
出版信息
Ear Hear. 2018 Nov/Dec;39(6):1187-1198. doi: 10.1097/AUD.0000000000000578.
OBJECTIVES
To make longitudinal comparisons of intelligence quotient (IQ) in children with cochlear implants (CIs) and typical hearing peers from early in development to the school-age period. Children with additional comorbidities and CIs were also evaluated. To estimate the impact of socioeconomic status and oral language on school-age cognitive performance.
DESIGN
This longitudinal study evaluated nonverbal IQ in a multicenter, national sample of 147 children with CIs and 75 typically hearing peers. IQ was evaluated at baseline, prior to cochlear implantation, using the Bayley Scales of Infant and Toddler Development and the Leiter International Performance Scale. School-age IQ was assessed using the Wechsler Intelligence Scales for Children. For the current study, only the Perceptual Reasoning and Processing Speed indices were administered. Oral language was evaluated using the Comprehensive Assessment of Spoken Language.
RESULTS
Children in the CI group scored within the normal range of intelligence at both time points. However, children with additional comorbidities scored significantly worse on the Processing Speed, but not the Perceptual Reasoning Index. Maternal education and language were significantly related to school-age IQ in both groups. Importantly, language was the strongest predictor of intellectual functioning in both children with CIs and normal hearing.
CONCLUSION
These results suggest that children using cochlear implants perform similarly to hearing peers on measures of intelligence, but those with severe comorbidities are at-risk for cognitive deficits. Despite the strong link between socioeconomic status and intelligence, this association was no longer significant once spoken language performance was accounted for. These results reveal the important contributions that early intervention programs, which emphasize language and parent training, contribute to cognitive functioning in school-age children with CIs. For families from economically disadvantaged backgrounds, who are at-risk for suboptimal outcomes, these early intervention programs are critical to improve overall functioning.
目的
从儿童早期发展到学龄期，对植入人工耳蜗（CI）的儿童与听力正常的同龄人进行智商（IQ）的纵向比较。还评估了患有其他合并症和 CI 的儿童。估计社会经济地位和口语语言对学龄期认知表现的影响。
设计
本纵向研究评估了来自多中心、全国性样本的 147 名植入 CI 的儿童和 75 名听力正常的同龄人的非言语 IQ。在植入耳蜗之前，使用贝利婴幼儿发育量表和 Leiter 国际表现量表在基线时评估 IQ。使用韦氏儿童智力量表评估学龄期 IQ。对于本研究，仅进行了感知推理和处理速度指数的评估。使用综合口语语言评估法评估口语语言。
结果
CI 组的儿童在两个时间点的智商均处于正常范围内。然而，患有其他合并症的儿童在处理速度方面的得分明显较低，但在感知推理指数方面没有。母亲的教育和语言在两组中与学龄期 IQ 显著相关。重要的是，语言是 CI 儿童和听力正常儿童智力功能的最强预测因素。
结论
这些结果表明，使用人工耳蜗的儿童在智力测量方面与听力正常的同龄人表现相似，但患有严重合并症的儿童存在认知缺陷的风险。尽管社会经济地位与智力之间存在很强的关联，但一旦考虑到口语语言表现，这种关联就不再显著。这些结果揭示了早期干预计划对 CI 儿童学龄期认知功能的重要贡献，这些计划强调语言和家长培训。对于来自经济劣势背景、存在发育结果不理想风险的家庭，这些早期干预计划对于改善整体功能至关重要。
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