Department of ORL, Christchurch Public Hospital, Christchurch, New Zealand.
Southern Cochlear Implant Programme, Christchurch, New Zealand.
Otol Neurotol. 2023 Mar 1;44(3):e133-e139. doi: 10.1097/MAO.0000000000003793. Epub 2023 Jan 8.
The universal newborn hearing screening (UNHS) was fully implemented across New Zealand by 2010 to improve outcomes for children with prelingual deafness. A previous audit undertaken by our center, the Southern Cochlear Implant Programme (SCIP), demonstrated that UNHS has significantly reduced the time to referral and surgery for cochlear implants in these children.
This study aims to evaluate the relationship between earlier implantation and language development, the time taken to achieve age-appropriate language, and the effect of socioeconomic status on language skills.
This is a retrospective cohort study comparing prelingual children with severe to profound bilateral hearing loss who underwent cochlear implantation in SCIP before and after the introduction of the UNHS. The language outcomes were assessed using the Preschool Language Scale and/or the Peabody Picture Vocabulary Test. For the purpose of our study, the standard scores of these tests were expressed as global language scores (GLS). GLSs between 85 and 115 are considered within normal range for age. The socioeconomic status was categorized based on the New Zealand Index of Deprivation (NZDep).
Children in the post-UNHS group (46/95 children) were referred to SCIP and received CI at a significantly earlier age (mean = 7 vs 20 mo, p = 8.95E-10, and mean = 13 vs. 24.7 mo, p = 1.43E-07). At 2 years postimplantation, the GLS was significantly higher in the post-UNHS group (mean scores = 93.3 vs. 79.1, p = 0.0213). The scores remained statistically higher in the post-UNHS group when assessed at 3 and 4 years postimplantation. At 2, 3, and 4 years postimplantation, there is a significant linear decrease in GLS with increasing age at cochlear implantation. We found no correlation between NZDep and GLS.
Children identified through UNHS have the advantage of earlier diagnosis, earlier hearing intervention, and longer duration with the implants, and they can achieve age-appropriate spoken language after 2 years of implantation.
新西兰于 2010 年全面实施新生儿普遍听力筛查（UNHS），以改善语前聋儿童的预后。我们中心（南耳蜗植入项目[SCIP]）之前进行的一项审计表明，UNHS 显著缩短了这些儿童转诊和接受耳蜗植入的时间。
本研究旨在评估早期植入与语言发展之间的关系、达到年龄适宜语言的时间以及社会经济地位对语言技能的影响。
这是一项回顾性队列研究，比较了在 SCIP 接受耳蜗植入的语前聋且患有严重至极重度双侧听力损失的儿童，这些儿童分为 UNHS 引入前后。使用学前语言量表和/或 Peabody 图片词汇测试评估语言结果。为了我们的研究目的，这些测试的标准分数表示为整体语言分数（GLS）。85 到 115 的 GLS 被认为是年龄正常范围内。社会经济地位根据新西兰贫困指数（NZDep）进行分类。
UNHS 后组（46/95 名儿童）被转介到 SCIP，并在更早的年龄（平均 = 7 与 20 个月，p = 8.95E-10，和平均 = 13 与 24.7 个月，p = 1.43E-07）接受 CI。植入后 2 年，UNHS 后组的 GLS 显著更高（平均得分= 93.3 与 79.1，p = 0.0213）。在植入后 3 年和 4 年评估时，UNHS 后组的分数仍然保持统计学上更高。植入后 2、3 和 4 年，GLS 随着耳蜗植入年龄的增加呈显著线性下降。我们没有发现 NZDep 与 GLS 之间存在相关性。
通过 UNHS 发现的儿童具有更早诊断、更早听力干预和更长的植入时间的优势，他们可以在植入后 2 年达到年龄适宜的口语语言。
