先天性听力损失婴幼儿的听觉能力追踪调查

Follow up study on auditory development of congenital hearing-impaired infants and toddlers

目的 探讨以家庭为基础早期干预的听障婴幼儿听觉能力发展特点,为听障儿童康复方案的制定和康复效果评估提供依据.方法 追踪北京、上海、西安、合肥、深圳5个市康复机构2012-2014年的80例0～2岁听障婴幼儿,依据生理年龄进行分组,＜12个月归为1岁组,＞12个月归为2岁组,采用声母、韵母和双音节识别测试方法对听觉能力进行阶段性的评估（干预前0个月、干预后6、12、18、24个月）,用重复测量方差分析进行统计.结果 在听障儿童1岁组和2岁组中,韵母、声母和双音节词的康复时间和生理年龄主效应差异有统计学意义（P＜0.05）,l岁组的韵母、声母和双音节词识别能力在干预6个月和12个月低于2岁组（P＜0.05）;经过2年的听力干预和康复训练,听障婴幼儿的声母、韵母、双音节词识别率分别达到88％±11％、90％±11％和92％±9％,分别有18％、30％、47％听障儿童的声母、韵母、双音节词识别率达到100％,70％听障儿童的听觉能力可以达到90％以上.结论 听力干预生理年龄和康复时间是影响听障儿童听觉能力发展的主要因素,经过2年的听力干预和康复训练,70％听障儿童听觉能力达到一级,已具备很好的听觉识别能力和言语可懂度.

Objective To study the characteristics of auditory ability development in hearingimpaired infants and toddlers under home-based early intervention,and provide the theoretical basis for the development of rehabilitation and assessment strategies.Methods The clinical data was collected from subjects from 5 provinces between 2012 and 2014 in China.A total of 80 subjects were enrolled and divided into 2 groups with 1 year interval according to chronological age.Initials,finals and disyllable words in Auditory Ability Test were used to assess the auditory development before intervention （0 month） and after intervention （6,12,18,24 months）.Data was analyzed by repeated measures analysis of variance.Results In 1 age group and 2 age group,the main effect of recovery time and chronological age were significantly different in initials,finals and disyllable （P 〈 0.05）.The recognition ability of initials,finals and disyllable words in 1 age group were less than 2 age group at 6-and 12-month after early intervention （P 〈 0.05）.After 2 years hearing intervention and rehabilitation,the recognition rates of initials,finals and disyllable words were 88% ± 11% 、90% ± 11% and 92% ±9%,respectively.18%,30% and 47%,respectively,hearing-impaired children achieved full score in initials,finals and disyllable words.70% hearing-impaired children reached more than 90% recognition ability in initials,finals and disyllable words.Conclusions The chronological age and recovery time are principle factors for auditory development in hearing-impaired children;70% hearing-impaired children have reached grade A after 2 years hearing intervention and rehabilitation,and performed well in hearing identification and speech intelligibility.