耳聋程度对选配助听器婴幼儿言语产出能力的影响

The Effects of Hearing Level on Speech Production in Infants with Hearing Aids

目的研究不同程度耳聋婴幼儿选配助听器后言语产出能力的规律,探讨耳聋程度对患儿言语产出能力的影响,为这类婴幼儿听觉言语康复提供参考。方法 32名选配助听器的中重度和极重度语前聋婴幼儿为研究对象,选配助听器年龄为3～34个月,平均16±9个月。根据耳聋程度(0.5～4kHz平均气导听阈)将患儿分为三组,A组为中度耳聋听阈为(41～60dB HL,5例),B组为重度耳聋听阈为(61～80dB HL,9例),C组为极重度耳聋听阈(≥81dB HL,18例)。分别在助听器选配前及选配后1、3、6、9、12个月时采用有意义使用言语量表(meaningful use of speech scale,MUSS)对各组患儿的言语产出能力进行评估。结果经多个独立样本比较的秩和检验,随助听器使用时间的延长,B组和C组患儿言语产出能力得分显著提高(P<0.05),而A组患儿无显著提高(P>0.05);经两样本比较的秩和检验,A、B两组患儿间在助听器选配前和选配后1、3、6、9、12个月各评估阶段的言语产出能力得分的差异均无显著统计学意义(P>0.05);A与C及B与C各两组患儿之间在上述各评估阶段言语产出能力得分的差异也无显著统计学意义(P>0.05)。结论重度和极重度聋婴幼儿在选配助听器1年内其言语产出能力随助听器使用时间的延长而逐渐提高;耳聋程度对选配助听器婴幼儿言语产出能力存在一定影响。

Objective The aim of this study is to evaluate the development of speech production in infants with different hearing levels after hearing aid fitting,to investigate the effects of hearing level on speech production and provide a clinical database for their hearing and speech habilitation.Methods 32infants participated in this research,ranging in age at hearing aid fitting from 3to 34months with a mean of 16months.They all had prelingual hearing loss.According to their hearing levels,they were divided into three groups.Infants in group A were with moderate hearing loss（41～60dB HL）.Infants in group B were with severe hearing loss（61～80dB HL）.Infants in group C were with profound hearing loss（81dB HL）.The meaningful use of speech scale（MUSS）was used to evaluate their speech production skills.The evaluation was performed before hearing aid fitting and 1,3,6,9, 12months after fitting.Results Speech production scores of infants with hearing loss showed significant improvements with time of hearing aid use for group B and C by rank sum test（P0.05）,while improvements were not statistically significant for group A（P0.05）.There were no significant differences in speech production scores between group A and B,group A and C,group B and C at each evaluating interval by rank sum test（P0.05）.Conclusion Speech production skills of infants with hearing loss improved gradually within the first year after hearing aid fitting.The hearing level in infants with hearing aids had influence to a certain extent on the development of speech production.