先天性听力损失婴幼儿认知发育特征的追踪研究  

The longitude study on the mental development of congenital hearing-impaired infants and toddlers

作　　者：杨影[1,2,3] 王丽燕[2] 孙喜斌[2,3] 王永明[4] 鲍永清 徐胜林 林海英 宋蕾 钟迪 王坚 张奎彪 刘洋[8] 张园园[8] 

机构地区：[1]南昌大学第二附属医院耳鼻咽喉头颈外科,330006 [2]华东师范大学言语听觉科学教育部重点实验室 [3]滨州医学院特殊教育学院 [4]安徽省残疾人康复研究中心 [5]上海市聋儿康复中心 [6]陕西省聋儿康复中心 [7]深圳市特殊需要儿童早期干预中心 [8]北京市残疾人康复服务指导中心

出　　处：《中华耳鼻咽喉头颈外科杂志》2015年第10期799-804,共6页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

基　　金：卫生行业科研专项基金（201202005）

摘　　要：目的观察生理年龄和佩戴辅听装置对先天性听力损失婴幼儿认知发育特征的影响，进一步分析认知能力各能区与相关影响因素之间的相关性。方法80例接受听力干预和康复训练的0～2岁重度及以上先天性听力损失婴幼儿，依据接受干预时的生理年龄（1岁组和2岁组）和辅听装置类型（助听器组和人工耳蜗组）进行分组，采用Griffith认知发育量表对各组听障婴幼儿的运动、个人与社会、听力言语、手眼协调、操作等能力进行阶段性评估，包括干预前（0个月）、干预后6个月和干预后12个月三个时间点。应用SPSS17．0统计软件进行重复测量方差分析和相关性分析。结果在听力干预和康复训练1年的过程中，听障婴幼儿听觉言语能力、操作能力和总体认知能力发展迅速，各阶段间的差异有统计学意义（P值均〈0．05）；而运动、个人与社会、手眼协调能力的发展相对平缓，各阶段问的差异无统计学意义（P值均〉0．05）。1岁组听障儿童的个人与社会能力明显高于2岁组（P〈0．05），人工耳蜗植入患儿听觉言语能力的发展明显优于佩戴助听器的儿童（P〈0．05）。总体认知能力与各能区发展均呈正相关（P值均〈0．01），与听力干预时的生理年龄呈负相关（P值均〉0.05）。结论先天性听力损失婴幼儿听觉言语和认知能力的发展与干预的康复时间呈正比，干预越早认知能力发展越好。在重度及以上听障婴幼儿中，人工耳蜗植入的听觉言语康复效果明显优于助听器。Objective To explore the effect of chronological age and acoustic device in cognitive development of congenital hearing-impaired infants and toddlers, and analyze the correlation of abilities in cognitive development with other factors. Methods Depending on chronological age （ 1 year old group and 2 years old group） and acoustic device （hearing aids and cochlear implantation）, locomotor, personal- social, hearing and speech, hand and eye co-ordination, performance tests in Griffith Cognitive Development Scale were used to assess the cognitive development of 80 hearing-impaired infants and toddlers aged 0-2 years, including before intervention（0 month）, after intervention（6, 12 months）. Datas were analyzed by Repeated Measurements and Pearson Correlation Test. Results During 1 year hearing intervention and rehabilitation, hearing and speech, performance and cognitive were extremely significant difference for each phase of early intervention （ P 〈 0. 01 ）, the development of locomotor, personal-social, hand and eye co-ordination were no significant difference （P 〉 0. 05 ） . Personal-Social in 1 year old group with hearing impairment was much higher than 2 years old group P 〈 0.05 ）. Hearing and speech in cochlear implanted group with hearing loss was much higher than hearing aids group. Cognitive development was positive correlation with various region development P 〈 0.01 ）, and was negatively correlated with chronological age （P 〉 0. 05）. Conclusions Cognitive development is proportional to recovery time. The chronological age of early intervention obviously affect deaf children＇s cognitive development. The ability of hearing and speech in cochlear implanted children is superior to children with hearing aids in severe and profound hearing impaired children.

关 键 词：听力受损者 听力障碍康复 认知 婴儿 

分 类 号：R764[医药卫生—耳鼻咽喉科]