Department of Communication Sciences and Disorders, University of Iowa, Iowa City, IA.
Department of Biostatistics, University of Iowa, Iowa City, IA.
Ear Hear. 2020 Jul/Aug;41(4):775-789. doi: 10.1097/AUD.0000000000000823.
There are very limited data regarding the spoken language and academic outcomes of children with mild to severe hearing loss (HL) during the elementary school years, and the findings of these studies are inconsistent. None of these studies have examined the possible role of aided hearing in these outcomes. This study used a large cohort of children to examine these outcomes and in particular to examine whether aided hearing moderates the effect of HL with regard to these outcomes.
The spoken language, reading, writing, and calculation abilities were measured after second and fourth grades in children with mild to severe HL (children who are hard of hearing; CHH, n = 183) and a group of children with normal hearing (CNH, n = 91) after the completion of second and fourth grades. Also, among the CHH who wore hearing aids, aided better-ear speech intelligibility index values at the age of school entry were obtained.
Oral language abilities of the CHH with mild and moderate HL were similar to the CNH at each grade. Children with moderately-severe HL (better-ear pure tone threshold >59 but <76 dB HL) had significantly poorer oral language and reading skills than the CNH at each grade. The children with mild and moderate HL did not differ from the CNH in oral language or reading. No differences were found between the CHH regardless of severity and CNH with regard to spelling, passage writing, or calculation. The degree to which hearing aids provided audible speech information played a moderating role in the oral language outcomes of CHH and this moderation of language mediated the relationship between the unaided hearing ability of the CHH and their academic outcomes.
As a group, children with mild and moderate HL have good outcomes with regard to language and academic performance. Children with moderately-severe losses were less skilled in language and reading than the CNH and CHH children with mild and moderate losses. Audibility provided by hearing aids was found to moderate the effects of HL with respect to these outcomes. These findings emphasize the importance of including the effects of clinical interventions such as aided hearing when examining outcomes of CHH.
对于轻度至重度听力损失(HL)儿童在小学期间的口语语言和学业成绩,相关数据非常有限,而且这些研究的结果也不一致。这些研究中没有一项研究检查了助听设备对这些结果的可能作用。本研究使用了一个大样本的儿童群体来检查这些结果,特别是检查助听设备是否可以调节 HL 对这些结果的影响。
在完成二年级和四年级后,对轻度至重度 HL(听力障碍儿童,CHH,n = 183)和一组正常听力儿童(CNH,n = 91)的儿童进行了二年级和四年级后的口语语言、阅读、写作和计算能力测量。此外,在佩戴助听设备的 CHH 中,在入学年龄时获得了助听较好耳语音清晰度指数值。
轻度和中度 HL 的 CHH 的口语语言能力与 CNH 在每个年级都相似。中度重度 HL(较好耳纯音阈值> 59 但<76 dB HL)的儿童在每个年级的口语语言和阅读技能都明显差于 CNH。轻度和中度 HL 的儿童在口语语言或阅读方面与 CNH 没有差异。CHH 无论严重程度如何,与 CNH 在拼写、段落写作或计算方面均无差异。助听设备提供可听语音信息的程度在 CHH 的口语语言结果中起调节作用,这种语言的调节作用介导了 CHH 的未助听听力能力与其学业成绩之间的关系。
作为一个群体,轻度和中度 HL 的儿童在语言和学业表现方面有很好的结果。中度损失的儿童在语言和阅读方面的技能不如 CNH 和 CHH 中轻度和中度损失的儿童。发现助听设备的可听度可以调节 HL 对这些结果的影响。这些发现强调了在检查 CHH 的结果时,包括临床干预措施(如助听设备)效果的重要性。