图像引导人工耳蜗干预对言语障碍儿童构音和语音加工影响的探索性研究。

文献信息

中文摘要

目的： 据推测，人工耳蜗（CI）频谱清晰度不佳可能导致CI儿童出现构音和语音加工缺陷。因此，旨在改善频谱分辨率的CI编程技术可能改善构音和语音加工技能（即语音意识以及语音和音位再编码）。
方法： 我们分析了21名伴有构音和语音加工缺陷的CI儿童（4.7-13.1岁）的构音和语音技能，这些儿童参加了一项为期2年的延迟等待名单随机对照试验，该试验考察图像引导人工耳蜗编程（IGCIP）。在该临床试验中，参与者被随机分配在研究期间的不同时间点接受IGCIP。我们在21名儿童的子集中评估了构音和语音加工随时间的变化。此外，我们完成了IGCIP对构音和语音加工技能影响的探索性分析。
结果： 仅构音相对于年龄常模有所改善，语音加工则没有改善。在研究的第一年中，IGCIP对构音或语音加工没有统计学显著影响。然而，与未接受IGCIP的参与者相比，在研究第一年内接受IGCIP的参与者在构音评分上确实表现出更大且具有临床意义的改善。
结论： 在CI儿童中，构音缺陷随时间改善，但语音加工缺陷没有改善。未来研究应在更大的伴有构音缺陷的CI使用者样本中评估IGCIP对构音的影响，以阐明其在此类改善中的作用。

英文摘要

PURPOSE: Poor spectral clarity from cochlear implants (CIs) has been hypothesized to contribute to articulation and phonological processing deficits among children with CIs. Therefore, CI programming techniques that aim to improve spectral resolution may lead to improvements in articulation and phonological processing skills (i.e., phonological awareness as well as phonological and phonetic recoding).
METHOD: We analyzed the articulation and phonological skills of 21 children with CIs (4.7-13.1 years old) with articulation and phonological processing deficits who were enrolled in a 2-year waitlist-deferred randomized controlled trial examining image-guided cochlear implant programming (IGCIP). In the clinical trial, participants were randomly assigned to receive IGCIP at varying time points throughout the study. Change over time in articulation and phonological processing was assessed in the subset of 21 children. Additionally, an exploratory analysis of the effect of IGCIP on articulation and phonological processing skills was completed.
RESULTS: Only articulation, not phonological processing, improved relative to age norms. IGCIP did not have a statistically significant effect on articulation or phonological processing in the first year of the study. However, participants who received IGCIP within the first year of the study did exhibit larger and clinically meaningful improvements in articulation scores compared with those who did not receive IGCIP.
CONCLUSIONS: Articulation deficits, but not phonological processing deficits, improved over time among children with CIs. Future studies should assess the impact of IGCIP on articulation within a larger sample of CI users with articulation deficits to clarify its role in such improvements.