1~6岁人工耳蜗植入儿童普通话言语感知的发展规律探索

Exploration of the Development Mandarin Speech Perception during the Rehabilitation Critical Period for 1-6 Years Old Children with Cochlear Implants

目的探索1~6人工耳蜗植入儿童术前及术后18个月内言语感知能力的发展规律。方法选取31例人工耳蜗植入儿童作为被试,采用标准版普通话言语感知测试(mandarin early speech perception test,MESP)与简易版普通话早期言语感知测试(low-verbal mandarin early speech perception test,LV-MESP),选取7个时间点(术前、开机当天、开机后1、3、6、12和18个月)做纵向追踪,进行普通话言语感知测试。结果能够完成MESP的人数随时间延长而显著增多,术后12个月能够完成MESP的人数显著高于术后3个月,术后18个月能够完成MESP的人数显著高于术后6个月。不能完成LV-MESP的人数随时间延长而显著减少,术后12个月时不能完成LV-MESP的人数显著低于术后6个月,能够完成的人数无显著变化。结论LV-MESP是MESP的有益补充,人工耳蜗开机后康复训练1年期是听障儿童听觉言语发育的关键期,也是言语感知能力提高的敏感期,科学有效的人工耳蜗调试和康复训练可以促进听障儿童言语感知能力的逐步提高。

Objective To investigate the speech perception development in hearing-impaired children 18 months after cochlear implant surgery.Methods 31 cochlear implanted children were recruited and examined at 7 time points(before cochlear implantation,on the day of CI activation,1st,3rd,6th,12th and 18th months after CI activation,called Pre,M0,M1,M3,M6,M12,M18 for short respectively)using the Mandarin Early Speech Perception Test(MESP)and low-verbal Mandarin Early Speech Perception Test(LV-MESP).Results The number of children who could attend MESP increased significantly as the duration with CI increased.The Children who could attend MESP at M12 were significantly more than which at M3 and children who could attend MESP at M18 were significantly more than that at M6.The number of children who could not attend LV-MESP reduced significantly as the duration with CI increased.The Children who could not attend LV-MESP at M12 were significantly less than which at M6.And there was no significant difference on number of children who can attend LV-MESP as the duration with CI increased.Conclusion LV-MESP is a useful complement to MESP.Moreover,the number of children could attend MESP or could attend LV-MESP significant changed from M3/M6 to M12,indicating a fast maturation period,which might be a key period for hearing and speech development,and a sensitive period for speech perception of cochlear implanted children.Systematic CI mapping and professional rehabilitation training can promote the speech perception development for cochlear implanted children.