人工耳蜗植入儿童术后韵母识别能力跟踪评估

目的 通过对566例2～6岁听力障碍儿童植入人工耳蜗后韵母识别能力的康复效果跟踪评估,分析儿童人工耳蜗植入年龄、性别、康复时间对韵母识别能力康复效果的影响,探讨听障儿童韵母识别能力发展的特点和规律.方法 本研究采用全国聋儿康复系统通用的<听障儿童听觉能力评估标准及方法>中的韵母识别词表进行听觉能力评估.采用人工耳蜗植入年龄、性别、康复时间三因素混合实验设计,因变量为人工耳蜗植入儿童的韵母识别率.应用统计学软件SPSS 16.0进行数据分析.结果 人工耳蜗植入儿童的韵母识别能力随康复时间延长,韵母识别率显著提高(P＜0.001);康复时间和儿童年龄对韵母识别能力的交互效应显著(P＜0.001),年龄越小的儿童进步越大;儿童性别对韵母识别能力的主效应不显著(P＞0.05).结论 人工耳蜗术后韵母识别能力随康复训练时间的延长快速发展,年龄越小发展越快;听觉强化训练时间至少要经过12个月,韵母识别能力才能相对稳定,对于2岁年龄组听觉强化训练时间要超过1年.     

语前聋儿童人工耳蜗术后语音识别研究

目的对语前聋人工耳蜗植入患儿的语音识别情况进行研究,初步探讨耳蜗植入者的语音识别情况及其影响因素。方法实验对象包括40名植入语前聋人工耳蜗儿童及20名听力正常儿童,采用口语给声、开集测试的方式测试其韵母及声母识别率,研究植入年龄和教育交流方式对结果的影响。结果（1）耳蜗植入儿童的韵母识别率高于其声母识别率;（2）3岁前植入的儿童的语音识别率高于3岁后的植入儿童,且植入年龄与语音识别率呈负相关;（3）采用听觉口语法的儿童比采用综合交流法的儿童,具有更好的语音识别率。结论对于耳蜗植入儿童而言,声母比韵母更难掌握;植入时间较早、利用口语交流的儿童可以从人工耳蜗中获得更多的益处。     

植入人工耳蜗与配戴助听器儿童的音位对比识别难度分析

目的 探讨植入人工耳蜗与配戴助听器的儿童声母和韵母音位对比识别的异同点和难点,为制定听觉言语康复方案提供依据.方法 对23名配戴助听器儿童、17名植入人工耳蜗儿童采用声母和韵母音位对进行音位对比识别评估,应用难度分析法对得分进行分析.结果 当人工耳蜗儿童重建听阈与配戴助听器的儿童的助听听阈平均值基本一致时:①87对声母中共有38对音位对难度基本一致,占总数的43.7%;在声母音位对识别难点方面,人工耳蜗儿童共有27对"较难",12对"很难",配戴助听器的儿童共有28对"较难"、11对"很难";其中,两类儿童卷舌音与非卷舌音声母难度一致性达100%.但两类儿童相同方式不同部位、送气音与不送气音、相同部位不同方式音位的一致性均在40%以下;②92对韵母中两类儿童共有43对音位对难度基本一致,占总数的46.7%;在韵母音位对识别难点方面,人工耳蜗儿童共有21对"较难",两类儿童前鼻音与后鼻音韵母音位对难度的一致性高达66.7%,两类儿童相同结构相同开口音位时的一致件最低,仅达27.8%.结论 在声母和韵母音位对比识别方面.植入人工耳蜗的儿童与配戴助听器的儿童的识别难度既有相同点,也有不同点.配戴助听器的儿童声母识别难点主要与"f"有关,而人工耳蜗儿童识别的难点主要与"s"和"t"音相关的音位对有关.两组儿童韵母识别难点多数与鼻韵母有关.     

双侧人工耳蜗植入对儿童听觉识别能力影响的个案研究

目的考察双侧和单侧配戴人工耳蜗对儿童听觉识别的影响。方法本研究采用实验法和观察法。通过实验法在安静环境下使用听觉评估导航系统对幼儿的双耳和单耳进行测试。识别材料主要选择韵母识别、声母识别、单音节词声调识别、双音节词识别、短句识别。言语信号的强度为70dB SPL。通过观察法观察儿童在日常生活中双耳和单耳的表现，考察双耳与单耳在日常生活中的差异。结果实验结果表明，在声调识别和双音节词识别方面，该儿童识别率都达到100％。在韵母方面，双侧略好于单侧。在声母识别和短句识别方面，双侧人工耳蜗的语音识别率远高于单侧。在日常生活中，儿童双侧配戴人工耳蜗比单侧的言语识别率．听觉定向都要好。结论双侧人工耳蜗提高了患者的言语识别率，尤其体现在声母识别和短句识别方面。     

植入人工耳蜗与配戴助听器儿童背景噪声下的声调识别

目的 探讨植入人工耳蜗与配戴助听器儿童在声调识别方面是否存在差异,分析背景噪声对听障儿童声调识别的影响.了解在噪声环境中听障儿童声调识别的特点.方法 采用2X4两因素混合实验设计,比较植入人工耳蜗与配戴助听器儿童在不同信噪比条件下(SNR=+12,+6,0 dB)的声调识别能力;采用单因素方差分析,比较不同声调组合识别对听障儿童的难易程度.结果 ①在重建或补偿听阈相似时,植入人工耳蜗与配戴助听器儿童声调识别能力的差异不显著;②在不同信噪比条件下,两组儿童声调识别能力的差异极其显著;③两组儿童均最易分辨一声与四声的差异,最难分辨二声与三声的差异.结论 只要重建或补偿听阈在最适范围,听障儿童便具有一定的声调识别能力,但噪声会对其产生极大的影响.     

学龄前听障儿童助听后言语流畅性的特征及影响因素

目的 分析学龄前听障儿童助听后言语流畅性的特征,探讨辅听装置、年龄、性别、语训时长对其言语流畅性的影响.方法 以109例3.5~6.5岁学龄前健听及听障儿童为研究对象,其中健听儿童30例(健听组),双耳佩戴助听器的听障儿童28例(助听器组),右耳植入人工耳蜗的听障儿童26例(人工耳蜗组),同时佩戴助听器和人工耳蜗双耳双模式助听的听障儿童25例(双模式组),通过主题对话的形式分别采集各组儿童的语音样本,比较各组儿童在自发性言语语言任务下的语速、停顿、重复和拖延差异;分析辅听装置、年龄、性别、语训时长等因素对听障儿童言语流畅性的影响.结果 ①健听组儿童的语速显著高于其他三组(P<0.05),健听组停顿次数显著低于人工耳蜗组(P=0.001)和双模式组(P=0.032);健听组拖延次数显著低于助听器组(P=0.001)和双模式组(P=0.001),极显著低于人工耳蜗组(P<0.001);②不同性别听障儿童语速、停顿、重复次数和拖延次数差异无统计学意义(P>0.05),而助听器组语速显著高于人工耳蜗组(P=0.045),人工耳蜗组停顿次数显著高于助听器组(P=0.028);3.5~5岁听障儿童语速显著低于5.1~6.5岁组(P=0.042);语训0~2.5年听障儿童语速显著低于语训>2.5年者(P=0.002),停顿及重复次数均高于语训>2.5年者(分别P=0.047,P=0.02).结论 听障儿童的语速低于健听儿童,停顿次数、拖延次数高于健听儿童;年龄、辅听装置、语训时长影响学龄前听障儿童的言语流畅性,性别影响不大.     

人工耳蜗植入患者术后汉语声韵调识别能力临床分析

目的分析人工耳蜗（CI）植入患者术后普通话单音节声母、韵母、声调的识别能力差异,对比单双侧植入和植入时长对单音节识别的影响。方法选取单侧和双侧CI患者共63例,其中男35例,女28例,平均年龄（23.45±16.30）岁,CI植入时长（2.81±2.41）年。使用信度效度经已认证的单音节识别测试材料进行测试,记录每个患者声母、韵母、声调和总体的识别率得分情况。结果共获得70个测试结果：CI患者对声母、韵母和单音节总识别率均低于声调识别率且差异具有统计学意义（P=0.000 3;P=0.000 3;P=0.030 3）。对单音节总识别率超过50%的CI患者,声调识别率相比声母、韵母、单音节识别率显著性增高（P<0.005）。对于总识别率小于50%的患者,虽然声韵母识别率均低于声调识别率,但仅有韵母和声调之间差异具有统计学意义（P=0.018 9）。单双侧CI患者声调识别率差异无统计学意义(P>0.05),患者佩戴时长与单音节识别的相关性较弱。结论CI患者的声调识别效果较单音节以及声母和韵母更具有优势,声调识别会在使用CI一定时间后趋于较高水平。植入侧别对其影响较小。     

一例5岁聋儿音位识别能力、构音能力评估结果与分析

目的通过聋儿音位识别能力、构音能力评估结果与分析,为制定聋儿康复计划提供依据。方法选择1例在康复中心训练的5岁聋儿作为被试,采用《儿童音位识别能力评估》词表在安静房间中进行听觉识别能力评估。采用《构音语音能力评估》词表进行幼儿声母、韵母、声调、构音清晰度评估。结果该幼儿声母识别率为68.9%,韵母识别率为84.48%,声调识别率为100%,需要有针对性地进行最小音位对比的训练。构音语音清晰度为33.3%,相对年龄小于2岁半,构音清晰度发展落后两年,需进行构音能力训练。结论正确的评估与矫治,是提高聋幼儿言语流畅性和清晰度的基础和前提。     

听障儿童连续语音能力早期干预的个案研究

目的利用自编的连续语音训练材料对听障儿童进行干预,以提高其连续语音能力。方法采取单一被试研究方法,分别对1名植入人工耳蜗和1名配戴助昕器儿童干预前后的评估结果进行对比分析。结果植入人工耳蜗儿童基线期和干预期数据呈极显著差异,配戴助听器儿童基线期和干预期数据呈显著差异。结论通过针对性训练,听障儿童的连续语音能力得到提高,为临床康复提供了理论与实践依据。     

3～5岁听障儿童与健听儿童言语清晰度的比较研究

目的探讨3～5岁听障儿童与健听儿童言语清晰度的差异,为听障儿童康复训练提供参考依据。方法以黄昭鸣一韩知娟词表为测试材料,分别测试3～5岁听障儿童114名和健听儿童36名的言语清晰度得分,并进行对比研究。结果①性别和年龄的差异无统计学意义（P〉0．05）;②儿童类型的差异有统计学意义（P〈0．05）,听障儿童在3～5岁3个年龄段的言语清晰度均显著低于健听儿童;③两组儿童声母清晰度和韵母清晰度差异均有极显著统计学意义（P〈0．01）,声调清晰度差异存在显著统计学意义（P〈0．05）。结论3～5岁听障儿童的言语清晰度明显落后于同龄健听儿童,且以声母和韵母的差异最为突出,应重视对听障儿童的言语清晰度训练。     

Speech Recognition in a Noisy and Reverberant Environment with and without Earmuffs

The effect of earmuffs on speech recognition in conditions comparable to an actual environment was studied with the use of sentences, words and nonwords. The speech level was adjusted to 60 and 85 dBA. White noise was used at signal-to-noise ratios (S/N) of 0, +5, and +10 dB. The reverberation times were 2.1 and 1.6s. In quiet conditions at normal speech level (60 dBA), the perception was better without earmuffs than with them. At a high noise level, equal or better scores were achieved with ear protectors. At high speech and noise levels (85 dBA, S/N 0), the benefit of earmuffs was clearly demonstrated. Also with longer reverberation, the use of ear protectors increased the perception scores, especially at high speech and noise levels.     

Sentence recognition in noise: Variables in compilation and interpretation of tests

Abstract

Tests of sentence recognition in noise constitute an essential tool for the assessment of auditory abilities that are representative of everyday listening experiences. A number of recent articles have reported on the development of such tests, documenting different approaches and methods. However, both the development and interpretation of these tests require careful consideration of many variables. This article reviews and categorizes the stimulus, presentation, subject, response, and performance variables influencing the development and interpretation of tests of sentence recognition in noise. A systematic framework is utilized to document published findings on these variables. Recommendations and guidelines, based on test performance requirements and test objectives, are provided concerning the interpretation of results and the development of new test materials.

Sumario

La ECoG ha mostrado desde hace mucho que complementa el diagnóstico de la MD, primariamente por la medición de la tasa de amplitud SP/AP. Aunque se reporta en la literatura como una prueba de alta especificidad para este trastorno, la sensibilidad de la ECoG, en la población general de MD, se mantiene relativamente baja (rango de 20-65%), El presente estudio evaluó la sensibilidad y la especificidad del protocolo de ECoG que empleamos para pacientes con sospecha de MD, que incluyó la medición de la amplitud y las áreas de los SP y AP ante clicks (para derivar las tasas de amplitud y de área de SP/AP) y la amplitud del SP ante bursts tonales de 1000 y 2000 Hz. Se condujo un cuadro de revisión retrospectivo para comparar los resultados de de la ECoG de 178 pacientes sospechosos de MD, con su diagnóstico eventual. Las medidas de la mayor sensibilidad y especificidad (determinadas utilizando un análisis logístico de regresión) incluyeron: amplitud del PS, área del PS, tasa de área SP/AP y área total de SP-AP. Los valores de sensibilidad y especificidad asociados con esas medidas fueron de 92% y 84%, respectivamente. El valor de sensibilidad fue considerablemente mayor que el previamente reportado y esto es atribuible a la inclusión de mediciones de área en nuestro protocolo.     

老年性聋患者单音节识别特征分析*--附24例报告

目的研究老年人单音节言语识别能力,分析高龄老年性聋患者单音节言语识别的特征.方法12例(22耳)80岁以上男性老年性聋患者作为研究组(以下简称80+组),12例(24耳)80岁以下男性老年性聋患者作为对照组(以下简称80-组),两组分别接受普通话单音节识别率测试,测试强度采用最优测试强度,即0.5 kHz、1 kHz、2 kHz、4 kHz 4个频率纯音听阈的平均值(4FA)以上30 dB或最大舒适强度.比较80+组和80-组的最优言语识别得分.对单音节最优识别得分与预测最大言语识别率(PBmax预测)进行相关分析.结果在最优测试条件下,80-组平均得分为(76.5±19)%,80+组平均得分为(54.1±26)%,80-组得分显著高于80+组(P=0.0015).80-组的单音节识别得分与PBmax预测显著相关(r=0.721,P<0.001).80+组的单音节识别得分与PBmax预测相关(r=0.602,P=0.003).结论80岁以上高龄老年性聋患者言语识别得分与纯音听力相关性低于80岁以下老年性聋患者.     

A study of recorded versus live voice word recognition

Abstract

Objective: To determine administration times for word recognition presented via monitored live voice (MLV) and compact disc (CD) recordings. Design: A quasi-experimental design was used. Fifty-word NU-6 lists were presented in three conditions: (1) MLV, (2) short ISI CD recording, and (3) long ISI CD recording. Study sample: Listeners with normal hearing (NH) and hearing impairment (HI) participated in this study. Results: Average administration time using MLV was significantly shorter than using recorded word lists for both groups of listeners. MLV presentation to the NH listeners was significantly faster than the MLV presentation to the HI listeners. There were no significant differences between groups in the administration times for any of the recorded lists (long or short ISI). Considerably more variability in administration time was observed for MLV presentation compared to recorded presentations. Conclusions: MLV presentation was about one minute faster than the shortest CD recording of the NU-6 fifty-item word lists, but it was only 49 seconds quicker when administering tests to individuals with hearing loss. Because the majority of our patients are hearing impaired, the difference of 49 seconds is not clinically significant. This difference is even less when 25-item word lists are used.

Sumario

Objetivo: Determinar los tiempos de presentación para el reconocimiento de palabras presentadas con voz viva monitorizada (MLV) o con grabaciones de disco compacto (CD). Diseño: Se utilizó un diseño quasi-experimental. Se presentaron listas NU-6 de cincuenta palabras en tres condiciones: (1) MLV, (2) grabación corta ISI CD y (3) grabación larga ISI CD. Muestra de estudio: Participaron en este estudio personas con audición normal (NH) y con pérdida auditiva (HI). Resultados: El tiempo promedio de presentación usando MLV fue significativamente más corto que al usar listas grabadas de palabras, en ambos grupos. La presentación con MLV en personas del grupo NH fue significativamente más rápida que la presentación MLV a las personas del grupo HI. No se apreciaron diferencias significativas entre ambos grupos en los tiempos de presentación con cualquiera de las listas grabadas (ISI larga o corta). Se observó una variabilidad considerablemente mayor en los tiempos de administración con material MLV, comparado con las presentaciones grabadas. Conclusiones: La presentación con MLV fue cerca de un minuto más rápida que las grabaciones más cortas en CD de las listas de palabras NU-6 de cincuenta cada una, pero fue solamente 49 segundos más rápida cuando se presentaron las pruebas a personas con pérdida auditiva. Como la mayoría de nuestros pacientes tiene problemas auditivos, la diferencia de 49 segundos no es clinicamente significativa. Esta diferencia es incluso menor cuando se usan listas de 25 palabras.     

Comparison of bilateral and unilateral cochlear implants in children with sequential surgery

Objective

The objective of this study was to evaluate the effect of bilateral versus unilateral cochlear implants and the importance of the inter-implant interval.

Methods

Seventy-three prelingually deaf children received sequential bilateral cochlear implants. Speech recognition in quiet with the first, second and with both implants simultaneously was evaluated at the time of the second implantation and after 12 and 24 months.

Results

Mean bilateral speech recognition 12 and 24 months after the second implantation was significantly higher than that obtained with either the first or the second implant. The addition of a second implant was demonstrated to have a beneficial effect after both 12 and 24 months. Speech recognition with the second implant increased significantly during the first year. A small, non-significant improvement was observed during the second year. The inter-implant interval significantly influenced speech recognition with the second cochlear implant both at 12 and 24 months, and bilateral speech recognition at 12 months, but not at 24 months.

Conclusions

A small, but statistically significant improvement in speech recognition was found with bilateral cochlear implants compared with a unilateral implant. A major increase in speech recognition occurred with the second cochlear implant during the first year. A shorter time interval between the two implantations resulted in better speech recognition with the second implant. However, no definitive time-point was found for when the second implant could no longer add a positive effect.     

Postlingual adult performance in noise with HiRes 120 and ClearVoice Low,Medium, and High

Abstract

Objectives

The study's objectives were to evaluate speech recognition in multiple listening conditions using several noise types with HiRes 120 and ClearVoice (Low, Medium, High) and to determine which ClearVoice program was most beneficial for everyday use.

Methods

Fifteen postlingual adults attended four sessions; speech recognition was assessed at sessions 1 and 3 with HiRes 120 and at sessions 2 and 4 with all ClearVoice programs. Test measures included sentences presented in restaurant noise (R-SPACE^TM), in speech-spectrum noise, in four- and eight-talker babble, and connected discourse presented in 12-talker babble. Participants completed a questionnaire comparing ClearVoice programs.

Results

Significant group differences in performance between HiRes 120 and ClearVoice were present only in the R-SPACE^TM; performance was better with ClearVoice High than HiRes 120. Among ClearVoice programs, no significant group differences were present for any measure. Individual results revealed most participants performed better in the R-SPACE^TM with ClearVoice than HiRes 120. For other measures, significant individual differences between HiRes 120 and ClearVoice were not prevalent. Individual results among ClearVoice programs differed and overall preferences varied. Questionnaire data indicated increased understanding with High and Medium in certain environments.

Discussion

R-SPACE^TM and questionnaire results indicated an advantage for ClearVoice High and Medium. Individual test and preference data showed mixed results between ClearVoice programs making global recommendations difficult; however, results suggest providing ClearVoice High and Medium and HiRes 120 as processor options for adults willing to change settings. For adults unwilling or unable to change settings, ClearVoice Medium is a practical choice for daily listening.     

噪声下汉语语句识别表在视、听、视＋听三种模式下的等价性研究

目的验证新编中文普通话版嘈杂语噪声下语句识别表在视、听、视＋听三种模式下的等价性。方法招募27名听力正常人,采用二因素（视听模式、测试表号）重复测量实验设计,分别在单视觉．单听觉（65dB SPL言语强度、-6dB信噪比）及视听结合三种模式下,在声场中完成对27张嘈杂语噪声下语句识别表的言语识别率测试。三种视听模式及测试表号在所有受试者中均衡排布。结果综合三种视听模式的识别率,27张表的识别率无显著性差异（F=0．929,P=0．568）。视．听、视＋听三种模式下的语句识别率分别为33．4±14．1％、40．9±14．4％、91．4±7．3％,两两之间均表现出显著性差异。结论视觉信息的补充,可有效提高噪声下的语句感知能力。新编中文普通话版嘈杂语噪声下语句识别表在视。听、视＋听三种模式下均等价,可用于人工耳蜗植入疗效的评估。     

唇读信息对正常人语句识别的影响

目的通过单视觉(唇读)、单听觉、视觉与听觉结合对正常青年人言语识别率的对比测试来说明唇读对语句识别的影响。方法选择正常听力青年大学生27名,分别在只看视频(唇读)、只听声音、视频和声音结合的情况下用新编中文普通话版嘈杂语噪声下语句识别表测试其言语识别率。结果在单视觉、单听觉和视觉与听觉结合的情况下,27例受试者平均言语识别率分别为33.1%±10.1%、40.8%±10.6%、91.5%±3.9%,视觉与听觉结合情况下的平均言语识别率显著高于单视觉、单听觉,差异有统计学意义(P<0.05)。结论在噪声环境下,唇读信息可明显提高正常人对语句识别的能力。     

语音数据库在言语障碍儿童康复中的应用分析

语音数据库已初步应用于言语障碍儿童的康复治疗,为便于全面了解语音数据库技术对儿童言语障碍康复的影响和意义,更好地在言语功能客观评估与康复训练中利用这一技术,本文就其对儿童言语障碍治疗的成效、在言语障碍儿童康复中的应用特点以及目前研究中存在的主要问题进行了探讨.