Gordon Karen A, Papsin Blake C, Papaioannou Vicky, Cushing Sharon L
Archie's Cochlear Implant Laboratory, The Hospital for Sick Children, Toronto, Canada.
Department of Communication Disorders, The Hospital for Sick Children, Toronto, Canada.
Semin Hear. 2021 Dec 9;42(4):381-388. doi: 10.1055/s-0041-1739371. eCollection 2021 Nov.
Children with hearing loss require early access to sound in both ears to support their development. In this article, we describe barriers to providing bilateral hearing and developmental consequences of delays during early sensitive periods. Barriers include late identification of hearing loss in one or both ears and delayed access to intervention with hearing devices such as cochlear implants. Effects of delayed bilateral input on the auditory pathways and brain are discussed as well as behavioral effects on speech perception and other developmental outcomes including language and academics. Evidence for these effects has supported an evolution in cochlear implant candidacy in children that was started with unilateral implantation in children with profound deafness bilaterally to bilateral implantation to implantation of children with asymmetric hearing loss including children with single-side deafness. Opportunities to enhance the developmental benefits of bilateral hearing in children with hearing loss are also discussed including efforts to improve binaural/spatial hearing and consideration of concurrent vestibular deficits which are common in children with hearing loss.
听力损失儿童需要尽早双耳获得声音以支持其发育。在本文中，我们描述了提供双耳听力的障碍以及早期敏感期延迟的发育后果。障碍包括单耳或双耳听力损失的识别延迟以及使用人工耳蜗等听力设备进行干预的延迟。讨论了双侧输入延迟对听觉通路和大脑的影响，以及对言语感知和包括语言与学业成绩在内的其他发育结果的行为影响。这些影响的证据支持了儿童人工耳蜗植入适应证的演变，从双侧极重度聋儿童的单侧植入发展到双侧植入，再到包括单侧聋儿童在内的不对称听力损失儿童的植入。还讨论了增强听力损失儿童双耳听力发育益处的机会，包括改善双耳/空间听力的努力以及对听力损失儿童中常见的并发前庭缺陷的考虑。
