摘要
建立人工耳蜗植入儿童康复效果评估指标体系,对观察人工耳蜗植入儿童的听觉言语语言能力、追踪康复效果、比较不同类型人工耳蜗的性能等都非常重要。本研究在前人研究的基础上,采用《听障儿童听觉能力评估标准及方法》作为评估工具,对韵母识别、声母识别、声调识别、单音节词识别、双音节词识别和短句识别能力六项听觉能力评估指标进行了标准化研究,并在人工耳蜗植入儿童术后一年的康复训练中应用此六项指标,对听觉康复效果进行跟踪评估。
研究内容及结果包括以下方面：
1.通过对健听儿童进行声母、韵母、声调、单音节词、双音节词和短句识别能力评估,对六项评估指标进行标准化研究。
(1)修订了3岁及以上各年龄段人工耳蜗植入儿童的韵母、声母、声调、单音节词、双音节词和短句识别能力的评估标准。
(2)制定了2岁年龄段人工耳蜗植入儿童韵母、声母、声调、单音节词、双音节词和短句识别能力评估标准。
2.对2-6岁人工耳蜗植入儿童应用此六项评估指标进行一年的听觉康复跟踪评估,探讨了人工耳蜗植入儿童听觉能力的发展特征。
(1)随着康复时间的延长,韵母、声母、声调、单音节词、双音节词和短句识别率增高,标准差变小。韵母、声母、声调、单音节词、双音节词和短句识别能力评估标准适合人工耳蜗植入儿童的康复效果评估。
(2)耳蜗植入年龄越小,韵母、声母、声调、单音节词、双音节词和短句识别能力发展越快。人工耳蜗植入儿童至少要接受12个月的韵母、声调、单音节词、双音节词和短句识别能力的强化训练,对于小龄儿童,强化训练时间要超过一年；对声母识别能力的康复,强化训练时间必须超过一年
(3)康复前6个月是人工耳蜗植入儿童韵母、声母、声调、单音节词、双音节词和短句识别能力发展的关键期,在此期问人工耳蜗的调试、优化至关重要,因此,人工耳蜗植入儿童必须在此期间完成对植入耳蜗的调试、适应和优化。
(4)耳蜗植入年龄越小,韵母、声母、声调、单音节词、双音节词和短句识别能力增长幅度越大。小年龄组(2-3岁)的增长幅度要大于大年龄组(4-6岁)。
It's very important to observe hearing and speech&language ability, to track rehabilitation and compare the performance of different types of artificial cochlea that establishing hearing evaluation indexes for cochlear implantation children. To Standardize vowel, consonant, monosyllable, disyllable, phrase and sentence indexes when using assessment standards and methods for Hearing impaired children's auditory and speech&language ability in our study. On the same time, using the six indexes to track one-year rehabilitation for cochlear implantation children
The following are the contents and results of our study:
1. To Standardize Vowel, consonant, monosyllable, disyllable, phrase and sentence indexes by evaluating normal hearing children
(1) The evaluation criteria of the vowel, consonant, tonal, monosyllabic Word, two-syllable words and phrase recognition for cochlear implant children over3years old are revised.
(2) The evaluation criteria of the vowel, consonant, tonal, monosyllabic Word, two-syllable words and phrase recognition for cochlear implant children of2years old are developed.
2. To dissuss the feature of auditory of cochlear implant children when using the six indexes to evaluate their auditory in one-year auditory training.
(1) The traing time is longer, thescore of the vowel, consonant, tonal, monosyllabic Word, two-syllable words and phrase recognition are higher. The standards are adapt to evaluate auditory rehabilitation of cochlear implant children.
(2) Cochlear implants younger, rapid development are got. Cochlear implants younger, growth are larger. The training time of CI children for vowel, monosyllable, disyllable rehabilitation are at least one year, but for small-age children, the time are exceed one year. And for consonant and phrase and sentence perception, the time are all exceed one year.
(3) First6months are a critical period of hearing development for cochlear implantation children, during this period, it's essential to debugging, optimization of cochlear. So we must finish debugging, optimization of implanted cochlear.
(4) Age and rehabilitation time are the important factors to influence the increasing degree of vowel, consonant, monosyllable, disyllable, phrase and sentence. The increasing degree of small-age teams are higher than old-age children. With the progress of rehabilitation, the growth rate in different rehabilitation periods reduced one by one.
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