选配助听器儿童日常生活模式下听说能力研究

The Factors of Aural/Oral Performance in Quiet and Noise of Children with Hearing Aids

目的探讨选配助听器儿童日常生活模式下听说能力发育特征及影响因素。方法将144例选配助听器的儿童分为:选配时月龄<12个月者50例,13~36个月43例,37~60个月33例,61~108个月18例;其中,轻度听力损失5例、中度20例、中重度72例、重度40例、极重度及以上7例。采用父母评估孩子听说能力量化表(parents evaluation of aural/oral performance of children,PEACH),分别在选配助听器0、3、6、9、12、24个月时进行听说能力评估,分析助听器使用时间、选配月龄、听力损失程度、助听器价格及监护人受教育程度等因素对其日常生活模式下听说能力的影响。结果 (1)随着助听器使用时间延长,儿童听说能力得分呈现显著增长趋势,安静环境下显著高于噪声环境下(P<0.01);(2)选配助听器时月龄显著影响其早期听说能力发展,选配时月龄<12月组PEACH得分增长迅速,且该组佩戴助听器24个月后,其得分与37~60月和61~108月组差异有统计学意义(P<0.05)。(3)初次选配助听器时(评估时间为0个月),轻度听力损失组PEACH得分与中度、重度组差异有显著统计学意义(P<0.01);选配助听器3个月和9个月时,中度组与重度、极重度组PEACH得分差异有统计学意义(P<0.05)。结论儿童助听器选配时年龄越小,其听觉言语能力进步速度越快;听力损失程度越轻,早期听觉言语发育水平越高。

Objective To study the developmental characteristics and influencing factors of hearing and listening ability in children with hearing aid(HA).Methods Participants were 144 young children who received HAs between 3 to 108 months old.Auditory ability in quiet and noise were evaluated by the parents evaluation of aural/oral performance of children(PEACH).The evaluation was performed pre-operation and 3,6,9,12 and 24 months intervals of the HA use.Results①With the increase of hearing aid use time,children's listening and speaking ability score showed a significant increase trend,quiet environment was significantly higher than the noise environment(P<0.01).②The age of choice significantly affected the development of early listening and speaking ability.③At initial evaluation,there was a statistically significant difference between the score of mild hearing loss group and the score of moderate and severe hearing loss group(P<0.01).At 3 and 9 months,the scores of mild group,moderate group and severe group showed statistical difference(P<0.05).④At 24 months of hearing aid,the education level of the first guardian had an effect on the scores of the children tested(P<0.05),and the other factors had no effect on the scores.Conclusion The younger the children's wear hearing aids,the faster their hearing and speech ability get improved.The lower the degree of hearing loss,the higher the level of early hearing and speech development.