婴幼儿期植入人工耳蜗的语前聋儿童单字声调产出特点

Production of Monosyllabic Tone in Prelingually Deaf Children with Cochlear Implants in Infancy and Toddlerhood

目的探究3岁以内单侧植入人工耳蜗、使用普通话交流且言语康复半年以上的语前聋儿童术后单字声调产出特点和发展规律。方法以19例3岁以内单侧植入人工耳蜗的语前聋儿童(CI组,生理年龄平均3.79±1.23岁,植入年龄平均1.28±0.55岁)和24例生理年龄与CI组匹配的正常听力儿童(NH组,生理年龄平均3.90±1.22岁)为研究对象,采用中国社会科学院语言研究所研发的《1.5至6岁普通话儿童发音测试(北京地区)》词表,用图片命名法(picture-naming)对儿童的发音进行录音,选取儿童产出的单字声调进行分析,分析两组儿童的声调产出表现,以及声调产出正确率与生理年龄、听力年龄、植入年龄的关系。结果①CI组的声调产出总正确率显著低于NH组(P<0.01),各声调偏误率显著高于NH组(P<0.01);②CI组的声调产出偏误模式与NH组类似,偏误率从高到低为阳平(35.97%)、上声(27.75%)、阴平(13.87%)、去声(9.50%),其偏误类型主要为替代错误,最易发生阳平和上声的相互替代;③随听力年龄的增长,CI组声调产出总正确率升高,各声调偏误率降低,声调偏误分布由分散趋于集中;CI组中听力年龄≥3岁儿童的声调产出总正确率平均为96.05%,个体声调产出总正确率均在90%以上;④CI组的声调产出总正确率与植入年龄无统计学相关性,与听力年龄(r=0.788)和生理年龄呈正相关(r=0.684)。结论3岁内植入人工耳蜗的语前聋儿童单字声调产出能力显著落后于正常听力儿童,但随听力年龄的增长逐渐提高,在术后3年趋于稳定;早期植入和进行有效言语康复有助于人工耳蜗植入儿童在术后获得更好的声调产出能力。

Objective To study the characteristics and development rules of monosyllabic tone production in Mandarin-speaking prelingually deaf children who received unilateral cochlear implants(CI)under 3 years old and speech rehabilitation for more than half a year,as well as the relationships between the accuracy of tone production and several demographic factors.Methods A total of 19 prelingually deaf children who received unilateral CI within 3 years old,at a mean age of 3.79 years(SD=1.23)(CI group)and 24 age-matched normal hearing(NH)children,at a mean age of 3.90 years(SD=1.22)(NH group)were recruited in this study.Productions of two groups were recorded during a picture-naming task with the word lists developed by Institute of Linguistics,Chinese Academy of Social Sciences and the monosyllabic tone production performance of two groups was analyzed.Results①The accuracy of tone production in CI group was significantly lower than that in NH group(P<0.01).②The error pattern of tone production in CI group was similar to that in NH group Tone 2(35.97%)had the highest error rate,followed by tone 3(27.75%),tone 1(13.87%)and tone 4(9.50%).And the main error type of tone production in CI group was substitution error,and the substitution between tone 2 and tone 3 was most likely to occur.③With the increasing of hearing age,the accuracy of tone production in CI group was improved and the distribution of error type of tone production tended to be concentrated.④The tone production accuracy score of CI children whose hearing age were more than 3 years old achieved 96.05%in average,and over 90%for individuals.⑤There was no statistical correlation between the accuracy of tone production in CI group and age at implantation,but it was positively correlated with hearing age(r=0.788)and chronological age(r=0.684).Conclusion Tone production capability for prelingually deaf children who received unilateral CI within 3 years old was far behind from NH children.However,with the increase of hearing age,tone production ability of CI children gradually improved,and its development tended to be stable 3 years after the implantation.Furthermore,early implantation and effective speech rehabilitation might be beneficial to tone production in prelingually deaf children with CI.