【摘要】 目的探讨听力障碍婴幼儿语言、语音及认知早期干预的效果和早期干预的临床模式。方法将56例10个月~2岁的听力障碍婴幼儿分为两组,20例配戴助听器并接受系统语言康复的患儿为干预组,36例未接受治疗的患儿为未干预组。采用Gesell发育量表对56例患儿及28例正常对照组儿童进行语言及认知评估;采用普通话语音测试对56例患儿的语音发育状况进行评估,比较干预组、未干预组和正常儿童的语言、语音和认知发育水平。结果(1)干预组患儿的言语能DQ(92.25±17.32)高于未干预组(70.44±29.99),差异有统计学意义(P=0.00),干预组患儿与正常儿童言语能DQ(100.29±8.86)的差异无统计学意义(P=0.07)。未干预组患儿的言语能DQ低于正常儿童,差异有统计学意义(P=0.00)。等级相关分析显示,干预组患儿的语言康复水平与听力损失程度的相关性无统计学意义(P=0.27)。(2)干预组患儿应人能DQ(101.40±7.66)高于未干预组(83.94±22.09),差异有统计学意义(P=0.00),干预组患儿与正常儿童应人能DQ(101.68±13.83)的差异无统计学意义(P=0.93);未干预组患儿的应人能DQ低于正常儿童,差异有统计学意义(P=0.00);粗动作、细动作和应物能DQ3组比较,差异均无统计学意义。(3)干预组除1例极重度听力障碍患儿的/d/发音异常外,其他患儿辅音发音正常。未干预组中重度、重度患儿各有1例表现为/d/发音异常,极重度患儿中/d、m/发音异常6例,其他患儿正常。干预组除2例极重度患儿声调异常外,其他患儿的声调正常。未干预组中度、中重度、重度和极重度患儿中声调异常分别为2例、1例、1例和12例。结论未干预听力障碍婴幼儿的语言、语音和认知水平明显落后于正常儿童,早期干预能显著改善听力障碍患儿的语言、语音和认知能力。已经建立有效的早期干预临床模式。更多还原

【Abstract】 Objective To investigate the efficacy of early intervention on language , pronunciation and cognitive developments of infants and toddlers with hearing loss and to build up an early intervention model. Methods Fifty-six children with moderate to profound sensorineural hearing loss aged 10 months to 2 years were divided into two groups. 20 children, aged 10 months to 2 years, received early intervention services after wearing hearing aids for 6~18 months, and 36 children, aged 11 months to 2 years, didn′t receive any intervention. The type and degree of hearing loss were measured by a series of auditory tests. Language and cognitive developments of the children with hearing loss and 28 age, and sex-matched children with normal hearing, aged 10 to 23 months, were evaluated by the Gesell developmental schedules. The results were expressed as developmental quotient (DQ). Pronunciation test in mandarin Chinese was adopted to evaluate the speech development of the 56 children with hearing loss. Results (1) The language DQ according the Gesell developmental schedules of the children with hearing loss who received early intervention was (92.25±17.32), significantly higher than those children with hearing loss who didn′t receive intervention (70.44±29.99,P=0.00), whixh was significantly lower than that of the normal hearing children (P=0.00). However, there was no significant difference in language DQ between the children who received early intervention and the normal hearing children. There was no significant correlation between the degree of hearing loss and language DQ in the children who received early intervention (P=0.27). (2) The personal-social developmental quotient (DQ) of the children who received intervention was (101.40±7.66), significantly higher than that of the children who didn′t receive intervention (83.94±22.09,P=0.00), that were significantly lower than that of the children with normal hearing (P=0.00) . However, there were no significant difference in the personal-social DQ between the children who received early intervention and the children with normal hearing. No significant differences in the gross motor ability, fine motor ability and adaptive ability were observed between the two groups of children with hearing loss and normal hearing children. (3)The consonant pronunciation of the children with moderate to severe hearing loss who received early intervention was normal. Among those children only one case with profound hearing loss had/d/ error. The consonant pronunciation of the children with moderate hearing loss who didn′t receive early intervention of those was normal. One case with moderate-severe hearing loss and one case with severe hearing loss had/d/ errors. Six cases with profound hearing loss had/d、m/ errors. The tone of the children with moderate to severe hearing loss who received early intervention was normal. Three cases with profound hearing loss exhibited tone errors. Among the children who didn′t receive early intervention, tone errors were found in two cases with moderate hearing loss, one case with moderate-severe hearing loss, one case with severe hearing loss, and twelve cases with profound hearing loss showed. Conclusion The language, pronunciation and cognitive developments of the children who don′t receive early intervention are significantly lower than those of the children with normal hearing. Early intervention can significantly improve the language, speech and cognitive abilities of children with hearing loss.更多还原