學前微聽損、中重度以上聽損及聽常兒童語言發展能力之探究

The Differences in Language Performance between Children with Minimal Hearing Loss, Moderately Severe to Profound Hearing Loss, and Typical Hearing

余雅筑(Ya-Chu Yu)

指導教授 ： 趙本強

中原大學/人文與教育學院/特殊教育研究所/碩士(2021年)

https://doi.org/10.6840/cycu202100707

摘要

本研究旨在探討3到5歲學前微聽損兒童、中重度以上聽損兒童及聽常兒童語言發展能力之差異，以及微聽損兒童、中重度以上聽損兒童不同背景變項下和語言能力之相關性，並調查家長及教師對學前微聽損兒童於日常生活中的行為表現觀察。本研究採用修訂學前兒童語言障礙評量表之標準化測驗，及自編微聽損兒童日常生活行為表現之調查問卷作為研究工具，選取3到5歲學前微聽損兒童41位、中重度以上聽損兒童41位及聽常兒童30位作為研究對象。透過描述性統計、常態分佈檢定、獨立樣本t檢定／U
檢定、雙因子變異數分析、皮爾遜積差相關進行資料分析，根據研究結果歸納出以下結論：
一、微聽損組與聽常組整體的語言表現相近，中重度以上聽損組的語言表現則較差，但未達顯著差異。
二、微聽損3歲組之分測驗 T 分數與輔具佩戴起始月齡、語言理解、口語表達和語言發展皆有顯著負相關；表示輔具佩戴起始月齡越小，語言表現也會越好。
三、微聽損3歲組聽語介入起始月齡和語言理解呈現顯著負相關；表示越早開始聽語介入，則語言理解的表現越好；然而，聽語介入時長和語言理解呈現顯著正相關，表示當介入時間越久，則語言理解表現越好。
四、微聽損4歲組和5歲組之不同背景變項與語言表現未達顯著相關。
五、中重度以上聽損3歲組之語言理解分測驗T分數，與聽語介入起始月齡呈現顯著負相關、和聽語介入時長呈現顯著正相關；表示當聽語介入起始月齡越小，語言理解表現越好；當介入時間越長，語言理解表現越好。
六、中重度以上聽損4歲組之語言理解、口語表達、語言發展分測驗T分數，與聽語介入時長皆有顯著正相關；表示聽語介入時間越長，分測驗的表現越好。
七、中重度以上聽損5歲組之不同背景變項與語言表現未達顯著相關。
八、採不分齡方式分析結果：微聽損組無任何背景變項和語言表現有顯著相關；中重度以上聽損組的聽語介入時長和語言理解T分數有顯著正相關，表示當聽語介入時間越長，則語言理解表現越好。
九、調查問卷結果顯示，不論家長或教師，有7到8成都認為微聽損兒童在吵雜環境下難以遵循指令；約9成表示微聽損兒童大部分可以或總是可以回應遠處的聲音，而最容易忽略後方的聲音。
十、調查問卷結果顯示，家長及教師皆認為塞擦音（家長：52.2%；教師：52.9%）和擦音（家長：52.2%；教師：41.2%）是微聽損兒童最容易發不清楚的語音，且多為替代之錯誤類型；7成的家長或教師認為微聽損兒童大部分能理解抽象語詞，且9成認為微聽損兒童說話的清晰度非常清楚或大部分清楚；2到3成則認為微聽損兒童使用的句子較同年紀的聽常兒童簡單。
十一、調查問卷結果顯示，約7至8成的家長及教師觀察到微聽損兒童多是使用口語與他人互動；約半數認為微聽損兒童在校參與團體活動的程度很積極；另外，有4成教師認為微聽損兒童在上午時注意力較難集中、3成教師則認為是下午。
十二、微聽損組個別差異大，標準化測驗對微聽損組檢測異常的面向不夠全面，完整的評估還需仰賴主要照顧者於日常生活中的觀察。
最後根據本研究結論提出相關建議，以作為相關專業團隊人員、教育現場教師、家長及未來研究者之參考。

關鍵字

微聽損 ； 語言發展能力

並列摘要

The present study aimed to investigate 1) the difference in language performances among 3- to 5-year-old children with minimal hearing loss, moderately severe-to-profound hearing loss and typical hearing, 2) the relationship between demographic factors and language performances in children with hearing loss, and 3) the auditory-related behaviors of children with minimal hearing loss.
Forty-one children with minimal hearing loss, 41 children with moderately severeto-profound hearing loss, and 30 children with typical hearing loss were recruited. The standardized Revised Preschool Language Assessment was utilized to assess children’s receptive and expressive language skills, and a self-developed questionnaire was applied to collect information about auditory-related behaviors of children with minimal hearing loss in daily life for parents and teachers. Descriptive statistic and Mann-Whitney U test, two-way ANOVA, and Pearson's product-moment correlation were performed. The present findings are listed below:
1. No significant difference in language performance was found among children with
minimal hearing loss, moderately severe-to-profound hearing loss and typical hearing.
2. Significant negative relationships were detected for the age of hearing aids with receptive language, expressive language, and language development in 3-year-old children with minimal hearing loss. The earlier a child is fitted with hearing aids, the better is the language performance.
3. Significant negative correlation was found between the age at intervention and receptive language in 3-year-old children with minimal hearing loss. The earlier the child is enrolled in intervention, the higher is the score of receptive language.
4. No significant effect was observed between demographic factors and language
performance in 4- to 5-year-old children with minimal hearing loss.
5. Children of age 3 with moderately severe-to-profound hearing loss were found with significant correlations of their age at intervention to intervention duration and receptive language. . The earlier the intervention initiated and longer duration of intervention, the better outcome of receptive language presents.
6. Significant correlations were found between the intervention duration and receptive language, expressive language, and language development in 4-year-old children with moderatelysevere-to-profound hearing loss.
7. No significant effects were found between demographic factors and language performance in 5-year-old children with moderate and severe-to-profound hearing loss.
8. The results of auditory related behaviors questionnaire revealed that listening in noisy environment is challenging for 70-80% of the children with minimal hearing loss.
9. Approximately 90% of the children with minimal hearing loss could often or always respond to the sound in distance, but often tended to ignore sound behind them.
10. Affricates and fricatives were difficult to pronounce clearly for children with minimal hearing loss. Phoneme substitution was the error type presented most frequently. Around 90% of the teachers and parents considered the speech of children with minimal hearing loss intelligible. About 20-30 % of teachers and parents identified that the child with minimal hearing loss tended to use more simplified sentence structure compared to their peers.
11. 70-80% of teachers and parents reported that the child mostly used oral communication and 50% reported the child was active in school activities. Around 40% of the teachers noticed that the child with minimal hearing loss was more frequently inattentive in the morning.
12. Individual differences in the minimal hearing loss group are large, and standardized tests are not comprehensive enough to detect abnormalities in the minimal hearing loss group. Observation of the main caregiver in daily life is also necessary as more comprehensive evaluation for children with minimal hearing loss.
According to the present findings, clinical implications and suggestions were discussed in Discussion.

並列關鍵字

minimal hearing loss ； language development

參考文獻

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