早期言语－语言发育的客观评估  

Objective assessment of early speech and language development： A tutorial review

作　　者：郑芸[1] 李刚 

机构地区：[1]四川大学华西医院耳鼻咽喉-头颈外科听力中心／听觉言语科学实验室,成都610041 [2]House耳研所人类交流科学和听觉装置实验室,美国加利福利亚州洛杉矶市CA90057

出　　处：《中国听力语言康复科学杂志》2010年第4期10-18,共9页Chinese Scientific Journal of Hearing and Speech Rehabilitation

基　　金：国家”十一五”科技支撑计划（项目编号：2007BA118B12） 本文的撰写得到了美国洛杉矶House耳研所、四川大学华西医院、科利尔（香港）有限公司和丹麦唯听公司的支持,特此致谢!

摘　　要：本文回顾了用于客观评估听障儿童（经早期诊断和干预配戴助听器或植入人工耳蜗）言语感知能力的测试工具的研发、验证和使用的英文期刊文章。重点介绍了既有英文版又有相应中文版的评估工具。在使用这些评估工具进行测试时需要考虑诸多方面的问题。首先是研究健听儿童的言语一语言发育规律，这是评估听障儿童的基准。儿童言语和语言在最初几年的迅速发展使得相关研究的进行较为复杂和困难。使用一系列评估方法对以英语为母语的儿童进行言语感知能力测试的有效性已经得到证明。该套评估工具包括早期语前听觉发育测试、简单的闭合式单词识别测试、在安静或存在竞争性声音环境下进行的闭合式句子识别测试、在安静或噪声环境下进行的开放式句子识别测试。本文将对这套评估工具及其已经研发成功并开始应用于临床的中文版本进行介绍。这两套评估工具的使用能够客观地评估经过干预后听障儿童的康复效果，从而更好地评估康复策略，给予家长建议以及确认和解决出现的问题。同时，这套评估工具的中文普通话版和英文版所具有的共同特征有助于来源于不同语言环境的研究结果进行相互交流，从而使听力保健专业人士在世界各国研究结果的基础上确立最好的、规范的临床实践方法。This paper reviews research published in English describing the development, validation, and use of assessment tools for objective evaluation of pediatric speech perception following early identification of hearing impairment and intervention with hearing aids or cochlear implants. Emphasis is placed on those assessment tools for which both English and Mandarin versions exist. Several challenges in these evaluations are considered. A primary challenge is to obtain knowledge of the trajectory for normal speech and language development, which serves as a reference for evaluation of hearing impaired children. This challenge is compounded by the extremely rapid development of speech and language over the first few years of life. An evaluation strategy that uses a hierarchically structured assessment battery comprising measures of early prelingual auditory development, simple closed-set word recognition, closed set sentence recognition in quiet or in the presence of a competing background sound, followed by open-set sentence recognition in quiet and in noise has proven effect in evaluations of English-speaking children. The tests comprising this battery are reviewed, together with a similar battery of recently developed tests for use in evaluations of Mandarin-speaking children. Both batteries yield objective evidence of progress in habilitation following intervention that can be used to evaluate habilitation strategies, counsel parents, and identify and troubleshoot problems efficiently. Moreover, the common features of the English and Mandarin assessment batteries can facilitate the exchange of results of outcomes research from different language environments, which, in turn, allows hearing health care professionals to establish best practices based on research findings from throughout the world.

关 键 词：言语感知 早期言语和语言发育 儿童康复效果评估 说普通话的听障儿童 

分 类 号：R764.5[医药卫生—耳鼻咽喉科]