配戴助聽器孩童之語音知覺表現

The Speech Perception Performance in Children with Hearing Aids

杜嘉煒(Chia-Wei Tu) ； 吳俊良(Jiunn-Liang Wu) ； 楊惠美(Hui-Mei Yang)

《台灣耳鼻喉頭頸外科雜誌》 55卷4期 (2020/12) Pp. 201-207

https://doi.org/10.6286/jtohns.202012_55(4).201

摘要

背景：助聽器常是聽能療育的第一步，本研究目的期望透過評估助聽器配戴聽損兒童之語音知覺測驗，綜觀其語音知覺表現；並探討可能的影響因子，嘗試找出適合與不適合助聽器之使用者，並為其選擇較合適的聽能復健方式。方法：從2016年4月至2017年11月間於成大醫院耳鼻喉部調校助聽器的雙側聽損兒童中，收集個案之聽損及配戴助聽器等基本資料，以華語語音辨識測驗、學齡前兒童中文語彙毗鄰測驗等兩種語音知覺測驗施測，進行結果分析。結果：共收錄35名雙側配戴助聽器的個案，平均年齡為15.9歲，確診年齡為3.5歲，開始配戴年齡為4.0歲，配戴期間為11.4年。華語語音辨識測驗的平均正確率為80.3%；學齡前兒童中文語彙毗鄰測驗平均正確率為35.9%，兩項間具有顯著的高相關性（r = 0.64, p ＜ 0.001）。在影響因子的探討，只有優耳聽力損失程度可以分別有效預測華語語音辨識測驗的表現及語彙毗鄰測驗的表現。優耳聽損小於75 dB和75-90 dB的個案表現明顯優於聽損大於90 dB的個案。結論：本研究顯示配戴助聽器個案在日常聽語溝通上仍存在一定的困難，且存在很大的個體間差異。其語音知覺的表現僅受到優耳聽力損失程度影響。當裸耳平均聽閾大於90 dB時，助聽器所能提供之助益相當有限。應建議及早接受人工耳蝸植入以獲得更好的聽能。

關鍵字

hearing impairment ； hearing aids ； speech perception（聽力損失 ； 助聽器 ； 語音知覺）

並列摘要

BACKGROUND: The purpose of this study was to evaluate speech perception performance among children with hearing aids through speech perception test. Based on the examination results, we tried to identify possible confounders and determine the adverse affecting factors of hearing aids. Hence, we could choose the most appropriate aural rehabilitation modality for hearing-impaired children. METHODS: We recruited bilaterally hearing-impaired children who underwent hearing aids adjustment in National Cheng Kung University Hospital otolaryngology department during Apr. 2016 to Nov. 2017. All subjects received Mandarin Speech Discrimination Test (M-SDT) and Mandarin Lexical Neighborhood Test (M-LNT). Both test scores, together with demographic information and audiological results were analyzed. RESULTS: We totally enrolled 35 binaural hearing aids users. The mean age was 15.9 years old. The average age of hearing impairment diagnosis was 3.5 years old. They started hearing aid fitting at the average age of 4.0 years old and had used hearing aids for the average duration of 11.4 years. The average accuracy rate of M-SDT is 80.3% (SD: 12.1%, ranged from 38.8% to 98.8%). The average accuracy rate of M-LNT was 5.9% (SD: 28.3%, ranged from 2% to 88%). Significant positive correlation (r = 0.64, p ＜ 0.001) was found between the two tests. Among influencing factors, the only effective predictor of M-SDT (T = 4.992, p ＜ 0.001, R-squared: 0.446) and M-LNT (T = 51.333, p ＜ 0.001, R-squared: 0.623) was the severity of hearing impairment. Testing age and duration of hearing aids fitting were not effective predictors of speech perception performance. Subjects with unaided pure tone average (PTA) better than 75 dB HL and in the range of 75 to 90 dB HL have better performance than subjects with PTA worse than 90 dB HL. CONCLUSIONS: This study showed children with hearing aids still have some difficulties in daily communication, while significant individual difference exist. The speech perception performance is only affected by hearing level of the better ear. When an unaided PTA shows worse than 90 dB HL, a recommendation for cochlear implantation should be made.

並列關鍵字

hearing impairment ； hearing aids ； speech perception