| Objective: To evaluate the mental health of paediatric cochlear implant(CI)users,and analyze the relationship between the dimensions of movement,cognitive ability,emotion and will,sociality,living habits and language and hearing and speech rehabilitation,so as to provide reference for making rehabilitation plans for paediatric CI users.Methods: A total of 98 children with prelingual deafness were selected as the research subjects,who were given CI in the Department of Otolaryngology,Lanzhou University Second Hospital from 2018 to 2022.Before CI,they were diagnosed as bilateral severe to profound sensorineural hearing loss.The participants were assessed using the Mental Health Survey Questionnaire for 3～6-year-old children,which includes movement,cognitive ability,emotion and will,sociality,living habits,and language.Age at implantation,time of implant use,listening modes,inner ear deformity,preoperative residual hearing and aided sound-field thresholds on mental health were investigated and scores of the above-mentioned six dimensions were analyzed.Categories of auditory performance scale(CAP),the speech intelligibility rating scale(SIR),the meaningful auditory integration scale(MAIS)and the meaningful use of speech scale(MUSS)were used to score hearing and speech abilities.Then the mean scores of those who met the standard criteria of Mental Health Survey Questionnaire for 3～6-year-old children in every dimension were compared with the mean scores of those who did not.Results:1.According to the participants’ actual age at the time of investigation,they were divided into 36～48 months group(26 cases),49～60 months group(43 cases)and 61～72months group(39 cases).Qualification rates were higher for movement,but lower for cognition,sociality and language.2.In terms of age at implantation,the participants were divided into ≤36 months group(51 cases)and >36 months group(47 cases).The scores in all dimensions of the≤36 months group were higher than those of the >36 months group.Significant differences(P<0.05)were observed in movement,cognitive ability,emotion and will,sociality and language.Age at implantation was significantly negatively correlated with the scores in all the six dimensions.3.According to time of implant use,the participants were divided into ≤12 months group(32 cases),13～24 months group(43 cases)and >24 months group(23 cases).The scores of each group show that the longer the duration of implant usage,the higher the scores on all dimensions.Compared with the ≤12 months group and the 13～24months group,the >24 months group scores significantly higher in cognitive ability,sociality and language.Time of implant use were significantly positively correlated with the scores in the above three dimensions.4.According to their listening modes,the participants were classified into UCI group(29 cases),CI+HA group(14 cases)and BCI group(55 cases).The scores of the latter two groups were higher than those of UCI group in all dimensions,and statistical significance(P<0.05)was observed in cognitive ability,sociality and language.5.According to their inner ear conditions,the participants fell into normal inner ear group(56 cases)and inner ear deformity group(42 cases).The scores of inner ear deformity group were higher than those of normal inner ear group in all dimensions,but there was no significant difference(P>0.05).6.According to preoperative residual hearing,the participants were divided into residual hearing group(62 cases)and non-residual hearing group(36 cases).The scores of residual hearing group were higher than those of non-residual group in movement,emotion and will,but there was no significant difference(P>0.05).7.Among the 98 participants,75 children completed the aided sound-field thresholds assessment.According to their aided sound-field thresholds,75 children were classified into 23～36 d B HL group(36 cases)and 36.25～54 d B HL group(39cases).The scores of the 23～36 d B HL group were higher than those of 36.25～54 d B HL group in four dimensions,but there was no significant difference(P>0.05).Aided sound-field thresholds were significantly negatively correlated with the scores in sociality dimension.8.Based on whether the participants met the standard criteria for each dimension of the Mental Health Survey Questionnaire for 3～6-year-old children,they were divided into two groups(yes or no).The mean scores of CAP,SIR,MAIS and MUSS of the yes group in the five dimensions were higher than those of the no group,and there was a statistical significance(P<0.05)in cognitive ability.Their scores of CAP and MAIS showed statistical significance(P<0.05)in sociality,and the scores of SIR showed statistical significance(P<0.05)in language.Conclusions:1.The scores of paediatric CI users with prelingual deafness were generally low,and especially lower than those of normal hearing children of the same age in six dimensions of mental health.2.The factors affecting the six dimensions of the mental health of children with prelingual deafness after CI mainly include age at implantation,time of implant use,listening modes,inner ear conditions,preoperative residual hearing,aided sound-field thresholds,etc.The younger age at implantation,the higher scores in the six dimensions of the mental health they have;and the longer time of implant usage,the higher they score in six dimensions of the mental health.Compared with children who have unilateral cochlear implantation(UCI),those who have bilateral cochlear implantation(BCI)or UCI+hearing aid(HA)score higher in six dimensions of the mental health.3.The mental health status of prelingually deaf children after CI is closely related to their auditory and speech abilities.It indicates that speech and communication play significant roles in the mental health of CI children.4.Timely attention should be paid to paediatric CI users’ mental health and corresponding psychological interventions should be actively carried out when abnormalities are found so as to make personalized rehabilitation plans. |
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