儿童选配助听器后前语言交流能力发育

摘要

目的：本研究利用“录像分析法”对聋儿选配助听器后前语言交流能力进行评估和分析，为制定合理的康复训练计划提供临床依据。方法研究对象为60名选配助听器的语前聋儿童。选配助听器时年龄为4-49个月，平均22.4±14.6个月。根据选配助听器时的听力损失程度将儿童分为A组（中度听力损失，11名）、B组（重度听力损失，36名)、C组（极重度听力损失，13名)。另外根据耳聋儿童选配助听器时的年龄，将儿童分为a组（选配助听器时年龄≤2岁，41名)、b组（选配助听器时年龄＞2岁，19名)。使用“录像分析法”分别在选配后0（初次选配时）、3、6和12个月对儿童的轮流交流、视觉交流、主动交流和听觉注意四项前语言交流能力进行评估。结果 A、B、C三组儿童选配助听器一年内轮流交流及听觉注意能力得分均呈显著增长（P<0.05），而视觉交流及主动交流能力得分均无显著变化（P>0.05）。a、b两组儿童选配助听器一年内轮流交流能力得分均呈显著增长（P<0.05）。a组儿童选配助听器一年内听觉注意能力得分无显著增长（P>0.05）。b组儿童选配助听器一年内听觉注意能力得分呈显著增长（P<0.05）。a、b两组儿童选配助听器一年内视觉交流和主动交流能力得分均无显著变化（P>0.05）。结论耳聋儿童使用助听器时间越长，前语言交流能力越好。聋儿听力损失程度越轻，选配助听器后前语言交流能力发育速度越快。录像分析法可用于评估分析选配助听器后聋儿前语言交流能力。%Objective The aim of this study is to evaluate preverbal communication skills in children with hearing aids, to provide a basis for establishing a hearing and speech habilitation program. Methods Sixty children with hearing aids participated in this study. They all had prelingual hearing loss and aged from 4 to 49 months (mean=22.4 months) at hearing aid fitting. According to their hearing levels, children in this study were divided into three groups, i.e. those with moderate hearing loss (group A, n=11), severe hearing loss (group B, n=36), or with profound hearing loss (group C, n=13). According to their age at hearing aid fitting, they were divided into two groups, i.e. those who were fitted under the age of 2 (group a, n=41) and those who were fitted when older than 2 years old (groups b, n=19). Tait video analysis was used to as-sess preverbal communication skills, including turn-taking, eye-contact, autonomy and auditory awareness, and was per-formed at 0, 3, 6 and 12 months after hearing aid fitting. Results The mean scores of turn-taking and auditory-awareness showed significant improvements within the first year after hearing aid fitting for groups A, B and C (P<0.05), while there were no significant differences in mean scores of eye-contact and autonomy (P>0.05). The mean scores of turn-taking showed significant improvements within the first year after hearing aid fitting for groups A, B and C (p<0.05), while there were no significant differences in mean scores of Eye-contact and Autonomy (p>0.05). The mean scores of Turn-taking showed significant improvements within the first year after hearing aid fitting for groups a and b (p<0.05). The mean scores of Auditory-awareness showed no significant improvement within the first year after hearing aid fitting for group a (p>0.05), while there was significant difference for group b (p<0.05). There were no significant differences in mean scores of Eye-contact and autonomy (p>0.05) within the first year after hearing aid fitting for groups a and b. Conclusion:The longer the children use the hearing aids, the better they achieve the preverbal communication skills. The lighter the children have the hearing loss, the faster they develop the preverbal communication skills. Video analysis is a useful tool to access prever-bal communication skills in children with hearing aids.