| Objective1To analyze and summarize the methods, regularity and experience of hearing assessment by dynamically assessing the hearing abilities of135prelingual deaf children after rehabilitation training.2On the basis of the results of analyzing the hearing ability assessment during the rehabilitation training of prelingual deaf children, to direct the hearing and language rehabilitation organizations choosing the way of rehabilitation treating and training for the prelingual deaf children.3According to the effects of the hearing rehabilitation training by assessing dynamically in135prelingual deaf children, to analyze the affective factors on the rehabilitative effect for providing a theoretical evidence to elevate the effect of prelingual deaf children rehabilitation training.Methods1Subjects and Methods1.1Inclusive and Exclusive Criteria The inclusive criteria of the prelingual deaf children:all of the children wore two hearing aids more than twelve hours per day. In primary training, they were trained under six years old and in six months after wearing hearing aids. The children lived and were trained in the Hearing and Speech Rehabilitation Center of Foshan City all day except the festivals and holidays. They could go home or play with their parents interactively in festivals and holidays. In the training time, they were trained by professional teachers with the same teaching materials of China Disabled Person’s Federation. Exclusive criteria:the children with congenital diseases (such as heart and brain diseases), cerebral palsy, autism, dysnoesia or cochlear implantation were excluded.1.2Objects and Groups According to the ages when being received the primary training,135prelingual deaf children (57girls and78boys) were involved and classified into three groups:greater than5years old,4-5years old and less than4years old. According to the hearing loss, they were classified into two groups:severe and profoud hearing loss. According to the deviation intelligence quotient(DIQ), they were classified into three groups:middle(DIQ≥84), superior(DIQ≥132) and upper-middle. According to the aid hearing time, they were classified into two groups: more and less than three months. Their ages were between two years and eight months and five years and night months. The average age was4.30+0.85years old.1.3Contents and Methods of the Assessment The hearing abilities of the prelingually deaf children before training, six months and twelve months after training were evaluated by using the Hearing and Language Assessment of Hearing-impaired Children in the testing room of Hearing and Speech Rehabilitation Center of Foshan City. The assessing results were referring to the standard of hearing-ability rehabilitation which was formulated by Sun Xibin. At the same time, the intelligence (learning ability) of children was evaluated with the Hiskey Nebraska Test of Learning Aptitude, and then their DIQs were accounted. If a child was less than3years old when he or she came to the Rehabilitation Center, the assessment was not taken untill the child was or more than3year old.1.3.1Assessment of hearing-ability Contents of the Assessment:The hearing-ability assessment word list and typical assessment program of hearing-impaired children were used to evaluate the hearing-ability of the objects. The assessments included sounds of natural environment, final recognition, initial recognition, number recognition, monosyllable intonation recognition, ambisyllable intonation recognition, monosyllable word recognition, ambisyllable word recognition, trisyllable word recognition and clause recognition. There was10points for each item, and the total point was100.Methods of the Assessment:Testers were teachers and/or otologists who had a qualification and experience of professional training, and can adeptly operate the assessment abide by the rules. In order to avoid the subjective effects of testers, more than three testers were usually required together to participate the assessment, and at lest twice assessments for each item were necessary. An AV equipment was used in the assessment of the natural environment sounds. The assessments of hearing-ability were carried out by litsening and identifying the pictures. The results were defined three clsses on the basis of the total scores:it was "third clss" if the total score above seventy, it was "second class" if above eighty, and it was "first class" if above ninety.1.3.2Intelligence (learning ability) Test The Hiskey Nebraska Test of Learning Aptitude(H-NTLA) was used as a test tool. The eight items were taken, such as countersinking the bead, recollecting colors, recognizing pictures, making a connection while looking at a picture, folding paper, recalling after watching in short time, building block, and drawing. The deviation intelligence quotient(DIQ) was caculated according to Hiskey Nebraska Test of Learning Aptitude (edition in1994).Results1The hearing of135prelingual deaf children in6and12months after training had great improvement. The average scores before and6and12months after training were51.33±9.44,70.19±9.43and87.55±6.15respectively, which were significant differences between before and after training (t=16.42and t=37.35, P<0.01). The effective rate of the rehabilitation was100%. Using the Multiple Factor Analysis of Variance to analyze, it was found that there were significant differences in age and hearing loss (P<0.01), but gender (P>0.05).2Undergone rehabilitation in the same conditions (wearing two hearing aids and using more than twelve hours per day, the same mode of rehabilitation training), it was found that there were significant differences between different ages, hearing loss, DIQ and aid hearing using time (P<0.01). There were significant inverse correlations between age (r=-0.620), hearing loss (r=-0.505) and hearing-ability. There were significant direct correlations between DIQ (r=0.562), aid hearing using time (r=0.519) and hearing-ability. The younger, lower hearing-loss, higher DIQ, longer aid hearing using time of the objects, the better of the training effect. No significant differencs were found between different gender (p>0.05).Conclusions1The prelingual deaf children with wearing hearing-aids, being trained by professional teachers with teaching materials of China Disabled Person’s Federation may achieve relative effect after6months of training and outstanding effect after12months of training.2The results of the assessment for the prelingual deaf children undergone rehabilitation training of hearing indicate that the children can achieve noticeable results through normative and regulatory rehabilitation training. An appropriate amd dynamical assessment method can objectively reflect the training effect and improve the reliability of the assessment. The concentrated training integrated with familial training can obtain a better results of rehabilitation. The assessment of hearing-ability is an effective method for the assessment of rehabilitation effect. This assessment method does not desire high conditions and expensive equipments of audiometry, suggests to adjust the intensity of training according to the score.3Early diagnosis and intervention are very important to the rehabilitation of hearing-ability. The age of diagnosis and intervention is a key influencing factor to the results of hearing-ability, that is, the younger, the better result of the assessment. The same is as the hearing aids using time. The best time of diagnose and intervention is under4years old.4The level of hearing-loss is also an important influencing factor to the hearing-ability rehabilitation. Children with severe hearing loss can gain a better result than who with profoud hearing loss.5The DIQ is a factor of influence on the rehabilitation effect. The higher DIQ, the better results of the training. 6Gender is not a factor of influence on the rehabilitation effect. |
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