|Alternative Title||An Approach to the Rehabilitation of Prelingually Deaf Children After Cochlear Implantation
|Place of Conferral||心理研究所
本研究总结了语前聋小儿人工耳蜗植入术后在听力言语康复训练环境下的言语语言获得规律，探讨了康复速度的影响因素。被试为2001～2005年人工耳蜗植入术后一个月开机即来我院康复训练的2～5岁小儿64例，采用小组训练 7个月以上，回家后继续按语训教师的计划家庭训练。 研究结果：研究指标为①能正确发音单复韵母总数的50%、②开始听觉复述、③自主说出第一个有特定意义的词、④能说出70个词汇（并由此进入三音词及双词句阶段）的康复时间。这四个指标分别为108.0±7.7天、115.0±7.8天、135.3±10.9天、200.3±13.9天。2～3岁组开机后平均10个月进入正常幼儿园。2～5岁内的不同年龄组、不同性别组在言语进程各阶段的康复时间均无显著性差异；不同智商组在言语进程各阶段的康复时间均有显著性差异（均为P<0.01）；佩戴助听器与否在言语进程各阶段的康复时间均有显著性差异（均为P<0.01）。 结论：研究发现2～5岁语前聋小儿人工耳蜗植入术后，在听力言语康复训练环境下的言语语言发生发展顺序与正常小儿相同，即简单发音阶段、连续音节阶段（咿呀学语阶段）、学话萌芽阶段、单词话语阶段、双词话语阶段；但言语进程各阶段时间明显缩短，考虑与被试的与生理年龄紧密相关的认知水平有关。智力因素是影响康复速度的重要因素，高智商组言语语言获得速度较普通智商组快；高年龄者并未因认知优势而康复速度增快,甚至减慢，考虑因言语语言获得关键期内晚暴露于语言环境所至，因而提示语前聋小儿应早期手术、早期康复；术前佩戴助听器早期给予听觉刺激可使聋儿受益，提高术后的康复速度；2—5岁小儿言语语言康复速度与性别无关。
关键词：人工耳蜗 言语治疗 儿童康复|
|Other Abstract||An Approach to the Rehabilitation
of Prelingually Deaf Children After Cochlear Implantation
Zheng Xiujin(Medical Psychology)
Directed by Professor Yin WenGang
Objective: To sum up the acquirement rule of speech and language capability which is for the prelingually deaf children after cochlear implantation by listening and language rehabilitation training and to investigate the factors that affect rehabilitation speed. Method: Sixty-four children received a cochlear implant at the age of 2 to 5 years from 2001 to 2005. They begin to be trained under group pattern after switch on 1 month. The whole training program lasted more than 7 months; after that, according to the teacher’s plan the training program was to be continued at home. Result: The period is 108±7.7 days that they can pronounce correctly 50 percent of all of simple-finals and compound-finals, the period is 115.0±7.8 days that they begin auditory repeating, the period is 135.3±10.9 days that they can speech the first specific word independently and the period is 200.3±13.9 days that they can speak 70 words and come into tri-gamut-word and two-word sentence period. The patient that is the group at the age of 2-3 years can take part in normal kindergarten after switch on about 10 months. There are no significant differences in various grades of speech-language development with different age groups and so do with different sex groups. There are significant differences in various grade of speech-language development with various IQ group (P<0.01) and so do with using and not using hearing aids before implantation. Conclusion: From the research we find that the speech and language development sequence is the same level between the prelingually deaf children of 2 to 5 years who received cochlear implant after speech training and normal children and which are stages of uncomplicated sound production, continuous syllabic (babbling), speech sprout, single-word utterances and two-word utterances in proper order. The time is short significantly and the reason is that cognition capability is enhanced along with the increase of age. The intelligence is main factor that affect rehabilitation speed and the speed in the group of high IQ is faster than common IQ. It is not because of the dominance cognition of the senior group that makes the increasing of the rehabilitation, it even makes slowly. The reason of which is that the senior group are exposed the language environment too late to achieve speech and language development. So we should perform an operation and training early. The effectiveness of rehabilitation after cochlear implantation is improved by using hearing aids before implantation. The reason is auditory stimulate can be benefit of to deaf children. The rehabilitation speeds in the children at the age of 2 to 5 years have nothing to do with sex.
Key words: cochlear implant; speech therapy; paediatric rehabilitation|
郑秀瑾. 语前聋小儿人工耳蜗植入术后的言语康复[D]. 心理研究所. 中国科学院心理研究所,2007.
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