CAJ | 학술논문

目的：分析人工耳蜗植入后儿童前语言交流能力的发展规律，探讨其与其它听觉及言语评价指标的相关性，为早期听觉言语康复评估提供依据。方法对23例接受国产人工耳蜗植入术的语前聋儿童进行一年的随访，手术月龄12～66个月，平均35±3个月。分别于开机时及开机后1、3、6、9、12个月使用录像分析法对患儿的轮流交流、主动交流、视觉交流及听觉注意4项前语言交流能力进行分析和评估；同时使用听觉行为分级（CAP）、言语可懂度分级（SIR）问卷对其听觉和言语能力进行评估。结果随术后开机时间延长，患儿的轮流交流和听觉注意能力呈显著增长趋势（P＜0．05），前6个月增长较快（P＜0．05），后6个月缓慢增长（P＞0．05）；患儿主动交流和适时的视觉交流能力得分较低，两者差异无统计学意义（P＞0．05）；患儿 CAP 和 SIR 得分与轮流交流和听觉注意能力相关。结论随着人工耳蜗使用时间的延长，患儿逐步建立了听/说的交流模式；前语言能力评估结果与CAP 和 SIR 得分有相关性，三者结合可相互印证并能更全面准确地对人工耳蜗植入术后儿童早期听觉、语言和交流能力进行评估。
목적：분석인공이와식입후인동전어언교류능력적발전규률，탐토기여기타은각급언어평개지표적상관성，위조기은각언어강복평고제공의거。방법대23례접수국산인공이와식입술적어전롱인동진행일년적수방，수술월령12～66개월，평균35±3개월。분별우개궤시급개궤후1、3、6、9、12개월사용록상분석법대환인적륜류교류、주동교류、시각교류급은각주의4항전어언교류능력진행분석화평고；동시사용은각행위분급（CAP）、언어가동도분급（SIR）문권대기은각화언어능력진행평고。결과수술후개궤시간연장，환인적륜류교류화은각주의능력정현저증장추세（P＜0．05），전6개월증장교쾌（P＜0．05），후6개월완만증장（P＞0．05）；환인주동교류화괄시적시각교류능력득분교저，량자차이무통계학의의（P＞0．05）；환인 CAP 화 SIR 득분여륜류교류화은각주의능력상관。결론수착인공이와사용시간적연장，환인축보건립료은/설적교류모식；전어언능력평고결과여CAP 화 SIR 득분유상관성，삼자결합가상호인증병능경전면준학지대인공이와식입술후인동조기은각、어언화교류능력진행평고。
Objective The aim of this study is to summarize preverbal communication skills in children with cochlear implants,and to provide a clinical baseline of assessment in early stage after cochlear implantation.Methods 23 prelingually deaf children with homebred cochlear implants participated in this study.The age at cochlear im-plantation ranged from 12 to 66 months with a mean of 35 months.The evaluation was performed at switch-on ses-sion and 1,3,6,9 and 12 months after the first programming session.Tait video analysis was used to assess the preverbal communication skills including turn-taking,autonomy,eye contact and auditory awareness.CAP and SIR were used to evaluate the auditory and speech abilities.ResuIts The skills of turn-taking and auditory aware-ness increased significantly,especially in the first six months after switch-on session (P<0.05).The scores of autonomy and eye contact were relative low and there were no significant differences during the first year after surgery (P>0. 05).There was a correlation between the score of CAP/SIR and turn-taking or auditory awareness.ConcIusion Children with cochlear implants established vocal-auditory mode of early communicative behavior over time.Pre-verbal communication skills CAP and SIR have relativity and can comprehensively evaluate the auditory,speech and communication skills of children with cochlear implants.