听力障碍儿童助听后听觉及言语能力发育的相关性

The Relationship between the Development of Auditory and Speech in Children with Hearing Loss after Hearing Aid Fitting

目的分析不同评估阶段、耳聋程度、助听器选配年龄听障儿童助听前后的言语能力发育随听觉能力发展变化的关系,探讨听障儿童助听后听觉与言语能力发育的相关性。方法选取19例听障儿童,男14例,女5例,助听器选配年龄3~8岁,平均5.42±1.86岁,其中选配年龄≤6岁组11例、>6岁组8例;中度听力损失组10例,重度听力损失组9例。使用有意义听觉整合量表(meaningful auditory integration scale,MAIS)及有意义使用言语量表(meaningful use of speech scale,MUSS)评估助听前及助听后1、3、6、9、12个月患儿的听觉能力及言语能力发育情况,并对评估结果进行线性相关与回归分析。结果 MAIS与MUSS得分存在线性相关(R=0.774,P<0.05);助听前后不同评估阶段MAIS与MUSS得分均存在线性相关,助听前及助听后1、3、6、9、12个月的R值分别为0.710、0.774、0.814、0.819、0.707、0.649;助听前后MAIS中3~6题(声音觉察)及7~10题(声音理解)与MUSS得分存在线性相关(R值分别为0.768和0.794,均为P<0.05)。助听前后不同选配年龄组患儿MAIS与MUSS得分均存在线性相关(≤6岁组R=0.808,>6岁组R=0.775,均为P<0.05)。助听前后不同耳聋程度组患儿MAIS与MUSS得分均存在线性相关(中度耳聋组R=0.771,重度耳聋组R=0.787,均为P<0.05)。结论听障儿童助听后听觉与言语能力发育密切相关,言语能力随听觉能力的提高而增强,耳聋程度越轻、助听器使用时间越长、年龄越小的听障儿童助听后言语能力随听觉能力提高而进步越明显。

Objective To study the relationship between the development of auditory and speech in children with hearing loss after hearing aid fitting and discuss the development of speech with the ability of auditory in children at different stages of evaluation,with different degrees of hearing loss and different ages respectively.Methods A total of 19children（14boys and 5girls）with hearing loss participated in this study.The age at hearing aid fitting ranged from 3to 8years old with a mean of 5.42±1.86 years old.According to their hearing levels,the children in this study were divided into two groups：the moderate hearing loss group（n=10）and the severe group（n=9）.According to their ages at hearing aid fitting,all children in this study were divided into two groups：the lessthan or equal to six years old（n=11）and greater than six years old（n=8）.MAIS and MUSS were used to evaluate their abilities of auditory and speech at pre-fitting,1,3,6,9and 12 months after hearing aids were worn respectively.A linear and regression analysis was done in the statistic procedure.Results There was a significant correlation between the scores of MAIS and MUSS（R=0.774,P〈0.05）.There was also a significant correlation between the scores of MAIS and MUSS for the different evaluating stages respectively.The correlations were pre-fitting（R=0.710,P〈0.05）,1month after hearing aid fitting（R=0.774,P〈0.05）,3months after hearing aid fitting（R=0.814,P〈0.05）,6months after hearing aid fitting（R=0.819,P〈0.05）,9months after hearing aid fitting（R=0.707,P〈0.05）,12 months after hearing aid fitting（R=0.649,P〈0.05）.There was also a significant correlation between the scores of MAIS and MUSS for MAIS（items 3~6）（Sound awareness）and MAIS（items 7~10）（Sound understanding）.The correlations for MAIS（items 3~6）were（R=0.768,P〈0.05）,and for MAIS（items 7~10）（Sound understanding）（R=0.794,P〈0.05）.There was also a significant correlation between the scores of MAIS and MUSS for different group of ages.The correlations for the group of6years old were（R=0.808,P〈0.05）,and for the group of the≥6years old（R=0.775,P〈0.05）.There was also a significant correlation between the scores of MAIS and MUSS for different groups of hearing loss levels.The correlation for the group of moderate hearing loss was（R=0.771,P〈0.05）,and the group of severe hearing loss（R=0.787,P〈0.05）.Conclusion The development of auditory ability is closely related to the speech ability.The speech abilities increase with the improvement of auditory abilities.The less severe the hearing loss is,the longer the use of hearing aids,the younger the children are,the better the speech ability improved with auditory ability development after hearing aid fitting.