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评估双侧人工耳蜗植入的幼儿的精细言语辨别能力。

Assessing Fine-Grained Speech Discrimination in Young Children With Bilateral Cochlear Implants.

机构信息

Waisman Center, University of Wisconsin-Madison, Madison, Wisconsin.

出版信息

Otol Neurotol. 2019 Mar;40(3):e191-e197. doi: 10.1097/MAO.0000000000002115.

Abstract

HYPOTHESIS

Children of 2 to 3 years old with cochlear implants can perform consonant discriminations using fine-grained acoustic cues.

BACKGROUND

Children born with severe-to-profound deafness are provided with early cochlear implantation (<2 yr) to maximize oral communication outcomes. Little is known regarding their abilities to discriminate consonant contrasts for accurately identifying speech sounds.

METHODS

Using a Reaching for Sound paradigm to collect behavioral responses, consonant contrast discrimination was measured in 13 children with bilateral cochlear implants (BiCIs; aged 28-37 mo), and 13 age-matched normal-hearing (NH) children. Four contrast pairs were tested: 1) place + voicing, 2) place, 3) voicing, and 4) reduced voice-onset-time cue. Using standard processing strategies, electrodograms showing pulsatile stimulation patterns were created retrospectively to assess the spectral-temporal cues delivered through the clinical speech processors.

RESULTS

As a group, children with BiCIs were able to discriminate all consonant contrasts at a level that was above chance, but their performance was poorer than NH children. Larger individual variability in discrimination performance was found in children with BiCIs. Stepwise regression revealed that, in the place contrast, chronological age was correlated with improved discrimination performance among children with BiCIs.

CONCLUSION

Children with BiCIs were able to discriminate consonant contrasts using fine-grained spectral-temporal cues above chance level but more poorly than their NH peers. Electrodogram analysis confirmed the access to spectral-temporal cues in the consonant contrasts through clinical speech processors. However, the cue saliency might not have be enough for children with BiCIs to achieve the same discrimination accuracy as NH children.

摘要

假设

2 至 3 岁的人工耳蜗植入儿童可以使用精细的声学线索进行辅音辨别。

背景

为了最大限度地提高口语交流的效果,为患有严重至重度耳聋的儿童提供了早期人工耳蜗植入(<2 岁)。对于他们识别言语声音的辅音对比的能力知之甚少。

方法

使用声音到达范式收集行为反应,在 13 名双侧人工耳蜗植入物(BiCIs;年龄 28-37 个月)和 13 名年龄匹配的正常听力(NH)儿童中测量了辅音对比辨别能力。测试了四个对比对:1)位置+发声,2)位置,3)发声,和 4)减少声音起始时间线索。使用标准处理策略,创建了回顾性电图表以评估通过临床语音处理器提供的频谱-时间线索。

结果

作为一个群体,BiCIs 儿童能够以高于机会的水平辨别所有辅音对比,但他们的表现不如 NH 儿童。BiCIs 儿童的辨别表现个体差异较大。逐步回归显示,在位置对比中,BiCIs 儿童的年龄与辨别表现的提高呈正相关。

结论

BiCIs 儿童能够使用精细的频谱-时间线索辨别辅音对比,高于机会水平,但不如他们的 NH 同龄人。电图表分析证实了通过临床语音处理器在辅音对比中获得了频谱-时间线索。然而,对于 BiCIs 儿童来说,线索的显著性可能不足以达到与 NH 儿童相同的辨别准确性。

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