Research On Hearing And Speech Ability And Event-related Potentials In0-3Years Hearing Impaired Children

Purpose:This study observed the ability of hearing and speech in hearing impaired children between the ages of0and3in early intervention, analyze the effects of chronological age and wearing auxiliary device of time, explore the basic rules for listening and speech rehabilitation, assess the effectiveness of assisted listening devices and provide basis for subjective and objective evaluation.Methods:Based on the physiological age,45hearing loss children aged0-2years that were divided into7-12months group,13-18months group and19-24months group. According to auxiliary device type and speech ability score,38children aged2-3years with hearing impairment were divided into group A (hearing aids, MUSS score>22points,9chlidren), group B (hearing aids, MUSS score≤22points,9chlidren), group C (cochlear implant, MUSS score>22points,9chlidren) and group D (cochlear implant, MUSS score≤22points,11chlidren). Infant and toddler meaningful auditory integration Scale (IT-MAIS), meaningful use speech scale (MUSS), categories of auditory performance(CAP), speech intelligibility rating scale (SIR) were used to evaluate hearing and speech ability in hearing impaired children, analyzed the impact of age and the time of wearing auxiliary device, combined with event-related potentials (ERP) to compare the occurrence of mismatch negativity (MMN), MMN latency, MMN amplitude with9normal hearing children3years old, to discuss the latency and amplitude of MMN correlated with hearing and speech ability.Results:1.The development of hearing and speech ability between the ages of0and3in children with hearing impairment(1)With the growth of the age, hearing and speech ability gradually enhanced, IT-MAIS, CAP, MUSS, SIR score has developed rapidly within one year after wearing auxiliary device (Omonth,3months,6months,9months,12months) in deaf children. (2)Regardless of the chronological age and when wearing auxiliary device, the development trend of hearing and speech ability were the rapid growth of linear trend features in each period of auditory rehabilitation (p<0.05). IT-MAIS and MUSS score rised more obviously after wearing auxiliary device of0to6months, while CAP and SIR score grew more obviously7to12months.(3)According to the chronological age group of deaf children, IT-MAIS, CAP, MUSS and SIR score between the ages of7-12months were higher than the ages of13-18months and the ages of19-24months(p<0.05), while the ages range from13-18months of deaf children were much higher than19-24months(p>0.05).2. Research on event related potential in children with hearing loss between the ages of2and3years(1)MMN elicitationLexical tone MMN was elicited88.89%in normal hearing children, the currence of lexical tone MMN were87.5%、77.8%、89%and63.6%in deaf children group A-D.Pure tone MMN derivation rate was88.89%in normal hearing children, the currence of pure tone MMN were elicited87.5%、77.8%、89%and80%in deaf children group A-D.(2) MMN latencyLexical tone MMN latency was about197.22±34.72ms in normal hearing children, the latency of lexical tone MMN were about192.43±38.22ms,190.33±25.24ms,210.43±36.64ms and221.28±25.03ms in deaf children group A-D, the latency of group A-B were similar to normal hearing children, group C-D are much longer than normal hearing children and group A-B, the lexical tone MMN latency were no obvious difference between normal hearing children and deaf children (p>0.05).Pure tone MMN latency was about156.55±43.00ms in normal hearing children, the latency of lexical tone MMN were about177.28±45.75ms,189.73±25.67ms,176.85±30.96ms and170.42±36.84ms in deaf children group A-D, the latency of group A, group C and group D were similar to normal hearing children, group B are much longer than normal hearing children, the pure tone MMN latency were no obvious difference between normal hearing children and deaf children (p>0.05).(3) MMN amplitudeLexical tone MMN amplitude was about-2.41±2.91μV in normal hearing children, the amplitude of lexical tone MMN were about-0.36±1.97μV,0.87±1.29μV,-0.29±2.87μV and1.06±2.84μV in deaf children groups A-D, the amplitude of MMN in group A and group C were similar to normal hearing children (p>0.05), the amplitude of MMN were significantly reduced in group B and group D much compared with normal hearing children (p<0.05).Pure tone MMN amplitude was about-1.89±1.65μV in normal hearing children, the amplitude of lexical tone MMN were about-0.44±2.37μV,0.50±1.31μV,-0.34±2.73μV and0.83±1.19μV in deaf children groups A-D, the amplitude of MMN in group A and group C were similar to normal hearing children (p>0.05), the amplitude of MMN were obvious reduced in group B and group D compared with normal hearing children (p<0.05).3. Correlation of MMN Latency and amplitude with hearing and speech abilityLexical tone MMN latency and pure tone MMN latency were no significantly correlated with hearing and speech ability in hearing impaired children (p>0.05). lexical tone MMN amplitude was significantly negative correlated with MUSS score in group A(r=-0.773,p<0.05), IT-MAIS score was significantly negative correlated with pure tone MMN amplitude in group A (r=-0.757, p<0.05), Lexical tone MMN amplitude was significantly negative correlated with CAP score in group C(r=-0.797,p<0.05), IT-MAIS score was significantly negative correlated with pure tone MMN amplitude in group D (r=-0.823,p<0.05).Conclusion:1. The earlier time erter early intervention, the longer wear auxiliary listening device, the better effect of hearing and speech rehabilitation in0-2years deaf children. IT-MAIS and MUSS score rise more obviously after wearing auxiliary device of0to6months, while CAP and SIR score grow more obviously7to12months. 2. Good performers of hearing impaired children can be well perception and discrimination speech signal and pure tone signal, the ability of signal perception and preattention process in bad performers of hearing impaired children is much lower than normal hearing children and auditory cortex may be immature.3.The amplitude of MMN was negatively corelated with hearing and speech ability in hearing impaired children. It suggests that MMN amplitude testing may offer a means of predicting hearing and speech ability. Suggest a combined objective and subjective method to measure and evaluate, confirm mutually.