Département d'Orthophonie, Université du Québec à Trois-Rivières, Canada.
National Technical Institute for the Deaf, Rochester Institute of Technology, NY.
Am J Speech Lang Pathol. 2019 Nov 19;28(4):1673-1691. doi: 10.1044/2019_AJSLP-18-0161. Epub 2019 Sep 12.
Purpose The increasing prevalence of pediatric cochlear implantation over the past 25 years has left little doubt that resulting improvements in hearing offer significant benefits to language development for many deaf children. Furthermore, given the documented importance of access to language from birth, there has been strong support for providing congenitally deaf children with implants as early as possible. Earliest implantation, in many ways, has become the "gold standard" in pediatric cochlear implantation, on the assumption that it is the key to language development similar to that of hearing children. Empirical evidence to support this assumption, however, appears more equivocal than generally is believed. This article reviews recent research aimed at assessing the impact of age at implantation on vocabulary and grammatical development among young implant users. Method Articles published between 2003 and 2018 that included age at implantation as a variable of interest and in which it was subjected to statistical analysis were considered. Effect sizes were calculated whenever possible; we conducted a multivariate meta-analysis to compare outcomes in different language domains. Results Taken together, findings from 49 studies suggest that age at implantation is just one of a host of variables that influence vocabulary and grammatical development, its impact varying with several factors including whether age at implantation is treated as a dichotomous or continuous variable. Results from a meta-analysis showed significant differences across language domains. Conclusion The pattern of results obtained indicates the importance of considering various child, family, and environmental characteristics in future research aimed at determining how early "early implantation" needs to be and the extent to which age at implantation, duration of implant use, and other factors influence language and language-related outcomes. Supplemental Material https://doi.org/10.23641/asha.9789041.
在过去的 25 年中，儿童人工耳蜗植入的患病率不断增加，这无疑表明，听力的改善为许多失聪儿童的语言发展带来了显著的益处。此外，鉴于从出生起就获得语言的重要性已得到证实，人们强烈支持尽早为先天性失聪儿童提供植入物。在许多方面，最早的植入已成为儿科人工耳蜗植入的“金标准”，因为人们假设这是与听力正常的儿童类似的语言发展的关键。然而，支持这一假设的实证证据似乎比人们普遍认为的更为模棱两可。本文回顾了最近旨在评估植入年龄对年轻植入使用者词汇和语法发展影响的研究。方法：考虑了 2003 年至 2018 年期间发表的、将植入年龄作为感兴趣的变量并对其进行了统计分析的文章。只要有可能，就计算了效应量；我们进行了多变量荟萃分析，以比较不同语言领域的结果。结果：49 项研究的综合结果表明，植入年龄只是影响词汇和语法发展的众多变量之一，其影响因包括植入年龄是作为二分类变量还是连续变量处理等多种因素而异。荟萃分析的结果显示了语言领域的显著差异。结论：所获得的结果模式表明，在未来旨在确定“早期植入”需要多早以及植入年龄、植入使用时间以及其他因素对语言和语言相关结果的影响程度的研究中，考虑各种儿童、家庭和环境特征的重要性。补充材料：https://doi.org/10.23641/asha.9789041.
