台灣電子耳兒童現況調查研究－電子耳使用、聽覺能力、口語溝通能力表現

Cochlear Implanted Children in Taiwan Ⅰ: Device Use, Auditory Performance, and Communication Skills

王南梅(Nan-Mai Wang) ； 郭于靚(Yu-Ching Kuo) ； 黃國祐(Kuo-You Huang) ； 劉樹玉(Shu-Yu Liu) ； 劉俊榮(Chun-Jung Liu)

《台灣聽力語言學會雜誌》 22期 (2009/01) Pp. 55-85

https://doi.org/10.6143/JSLHAT.2009.01.03

摘要

國內人工電子耳植入術發展二十餘年，雖然電子耳術的醫療團隊技術水準、聽能復健團隊資源已經漸趨完整，但缺乏跨電子耳醫療中心之群體研究，尤其兒童電子耳使用現況，表現於口語溝通、聽覺能力、就學、學習、生活品質等項目，作為廣泛性之電子耳聽覺輔具使用成效，並進一步提供政府單位對聽覺輔具補助、聽障者福利政策的擬定與參考。本研究目的包括：一、提供現階段國內電子耳兒童使用者基本資料；二、提供電子耳使用現況；三、提供電子耳兒童之聽覺能力表現；四、提供電子耳兒童的口語溝通能力表現。研究方法：本研究方法以家長填答式問卷調查進行，受訪對象為國內七家電子耳中心醫學中心之18歲以下佩戴電子耳兒童，以描述統計方式進行資料分析。結果顯示229位電子耳兒童平均年齡9.75歲（2.3歲至18.8歲），電子耳植入時間以3.5歲分兩組（＜3.5歲、≧3.5歲），電子耳佩戴時間分三組（＜4年、4-6年、≧6年），總計六個組別。六組的男女比例接近、86.5%電子耳兒童僅具聽障，94.3%兒童領有重度以上聽障殘障手冊、79%聽損年齡在二歲以前、95.6%雙親聽力正常、76.9%兒童在學、64.6%佩戴電子耳後仍有不同程度之聽覺困難；而30.5%兒童有不同程度操作電子耳困難度，89.5%家長認為電子耳是正確決定。81.7%的電子耳獲得補助，平均補助金額35萬元，個案之間補助差異頗大。電子耳維修頻率每年約2次、維修金額每年約1萬2仟元。94.2%電子耳兒童曾接受聽能訓練，而其中由語言治療師執行者占74.7%，聽能訓練時間為3.05年。電子耳機型以澳洲Cochlear公司的機型最多占78.2%、63.4%電子耳語音處理器為口袋型；97%兒童經常且持續使用電子耳、每天使用時間80.6%在8-16小時之間。九類聽覺層級的聽能表現顯示，5.6%無法聽懂任何語音、76.3%使用者可以聽懂熟人以上的話語、58%使用者可以使用電話。77.3%使用者安靜環境下可以聽懂大部分對話、吵雜環境下只有38.9%可以聽懂大部分對話。60.8%兒童可以聽懂陌生人話語或使用電話交談；僅有40.2%使用者的口語清晰度可以讓大部分人聽懂。本調查提供國內現階段電子耳兒童對聽覺輔具使用現況，依其個案特色、輔具操作、補助、維修現況、到聽覺改善、口語溝通表現，雖然九成的家長都認為電子耳佩戴是相當正確的決定，然而使用者資料與各項能力表現，仍有改善空間。而未來政府單位需要規劃國家型聽覺研究中心，建立全國性電子耳使用者資料庫，提供衛生醫療、復健、教育、輔具、福利等政策參考，並進一步提供國內研究者進行跨專業領域與跨中心之全國性研究，以落實造福國內的聽障人口。

關鍵字

台灣電子耳兒童 ； 電子耳使用現況 ； 輔具補助 ； 聽覺表現 ； 口語溝通能力

並列摘要

Objectives: The objectives of this study were to examine: (1) demographic data of cochlear implanted children in Taiwan; (2) background information of implant use; (3) auditory performance of implanted children; and (4) communication skills of those children. Study Design: In a cross-sectional study, the parents of a representative sample of cochlear implanted children were invited to complete questionnaires regarding to children's background information, device use related information, auditory performance, and spoken communication skills. A parental questionnaire investigation was conducted on cochlear implanted children under age 18 from the cochlear implant centers of 7 major hospitals. A descriptive statistics was conducted to analyze data in SPSS v.12. Results: The results demonstrated that 229 respondents served as a valid sample with a mean age of 9.75 years (2.3-18.8y), six groups of children were classified based on their implantation age at 3.5 years, and three lengths of implant use. 86.5% of children had hearing disorders only, the age onset of hearing loss was before age 2 among 79% of children, 95.6% of children’s parents with normal hearing, and 76% of them studied at school. 64.6% of them had listening difficulties and 30% of them had difficulties operating their devices, and 59.4% of them used other hearing devices to supplement their implants. Totally 89.5% of respondents agreed that cochlear implantation was a right decision. 81.7% of implants were reimbursed, an average fee was NT $350,000. Yearly, the devices needed repair twice, the mean cost was NT $12,000. 94.2% of children had received auditory training, 74.7% of training was conducted by speech therapists, duration of training was 3.05 years. 78.2% of implant devices were Australian Nucleus products and 63.4% of speech processor were pocket type. 97% of children used the devices frequently and 80.6% of them used the devices within 8-16 hours daily. Auditory performance with CAPR indicated that 5.6% of children reached under level 3, 76.3% of them reached over level 6, and 58% of them could use telephone. Speech understanding showed 77.3% vs. 38.9% of children understood the majority of conversation in quiet or in noisy environment. Speech perception demonstrated 61% of children could understand strangers and 40.2% of children could be understood by a majority of listeners. Conclusion: This study has provided current status of device use, auditory performance, and communication skills among 229 cochlear implanted children in Taiwan. To establish a nationwide hearing research institute is a must to support policy making decisions for the Government also to upgrade social welfare for the hearing-impaired, also to conduct national research on hearing and hearing disorders.

並列關鍵字

Cochlear implanted children ； Device use ； Device reimbursement ； Auditory performance ； Oral communication skills

參考文獻

九十七年第三十四週內政統計通報。（檢自：http://www.moi.gov.tw/news_detail.aspx?type_code=01&sn=1324）

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