Abstract：
BACKGROUND: Despite the ability of cochlear implants (CIs) to provide children with access to speech, there is considerable variability in spoken language outcomes. Research aimed at identifying factors influencing speech production accuracy is needed.
OBJECTIVE: To characterize the consonant production accuracy of children with cochlear implants (CWCI) and an age-matched group of children with typical hearing (CWTH) and to explore several factors that potentially affect the ability of both groups to accurately produce consonants.
METHODS: We administered the Bankson-Bernthal Test of Phonology (BBTOP) to a group of 25 CWCI (mean age = 4;9, SD = 1;6, range = 3;2-8;5) implanted prior to 30 months of age with a mean duration of implant usage of 3;6 and an age-matched group of 25 CWTH (mean age = 5;0, SD = 1;6, range = 3;1-8;6). The recorded results were transcribed, and the accuracy of the target consonants was determined. Expressive vocabulary size estimates were obtained from a language sample using the number of different words (NDW). A parent questionnaire provided information about maternal education, duration of CIs experience and other demographic characteristics of each child.
RESULTS: The CWCI group demonstrated some similarities to, and some differences from, their hearing peers. The CWCI demonstrated poorer consonant production accuracy overall and in various phonetic categories and word positions. However, both groups produced initial consonants more accurately than final consonants. Whilst CWCI had poorer production accuracy than CWTH for all phonetic categories (stops, nasals, fricatives, affricates, liquids and glides and consonant clusters), both groups exhibited similar error patterns across categories. For CWCI, the factors most related to consonant production accuracy when considered individually were expressive vocabulary size, followed by duration of CI experience, chronological age, maternal education and gender. The combination of maternal education and vocabulary size resulted in the best model of consonant production accuracy for this group. For the CWTH, chronological age followed by vocabulary size were most related to consonant production accuracy. No combination of factors yielded an improved model for the CWTH.
CONCLUSIONS: Whilst group differences in production accuracy between the CWCI and CWTH were found, the pattern of errors was similar for the two groups of children, suggesting that the children are at earlier stages of overall consonant production development. Although duration of CI experience was a significant covariate in a single-variable model of consonant production accuracy for CWCI, the best multivariate model of consonant production accuracy for these children was based on the combination of expressive vocabulary size and maternal education.
CONCLUSIONS: What is already known on the subject Research has shown that a range of factors is associated with consonant production accuracy by CWCIs, including factors such as the age at implant, duration of implant use, gender, other language skills and maternal education. Despite numerous studies that have examined speech sound production in these children, most have explored a limited number of factors that might explain the variability in scores obtained. Research that examines the potential role of a range of child-related and environmental factors in the same children is needed to determine the predictive role of these factors in speech production outcomes. What this paper adds to the existing knowledge Whilst the consonant production accuracy was lower for the CWCIs than for their typically hearing peers, there were some similarities suggesting that these children are experiencing similar, but delayed, acquisition of consonant production skills to that of their hearing peers. Whilst several factors are predictive of consonant production accuracy in children with implants, vocabulary diversity and maternal education, an indirect measure of socio-economic status, were the best combined predictors of consonant production accuracy. What are the potential or actual clinical implications of this work? Understanding the factors that shape individual differences in CWCI speech production is important for effective clinical decision-making and intervention planning. The present findings point to two potentially important factors related to speech sound production beyond the duration of robust hearing in CWCI, namely, a lexical diversity and maternal education. This suggests that intervention is likely most efficient that addresses both vocabulary development and speech sound development together. The current findings further suggest the importance of parental involvement and commitment to spoken language development and the importance of receiving early and consistent intervention aimed both at skill development and parental efficacy.
OBJECTIVE: To characterize the consonant production accuracy of children with cochlear implants (CWCI) and an age-matched group of children with typical hearing (CWTH) and to explore several factors that potentially affect the ability of both groups to accurately produce consonants.
METHODS: We administered the Bankson-Bernthal Test of Phonology (BBTOP) to a group of 25 CWCI (mean age = 4;9, SD = 1;6, range = 3;2-8;5) implanted prior to 30 months of age with a mean duration of implant usage of 3;6 and an age-matched group of 25 CWTH (mean age = 5;0, SD = 1;6, range = 3;1-8;6). The recorded results were transcribed, and the accuracy of the target consonants was determined. Expressive vocabulary size estimates were obtained from a language sample using the number of different words (NDW). A parent questionnaire provided information about maternal education, duration of CIs experience and other demographic characteristics of each child.
RESULTS: The CWCI group demonstrated some similarities to, and some differences from, their hearing peers. The CWCI demonstrated poorer consonant production accuracy overall and in various phonetic categories and word positions. However, both groups produced initial consonants more accurately than final consonants. Whilst CWCI had poorer production accuracy than CWTH for all phonetic categories (stops, nasals, fricatives, affricates, liquids and glides and consonant clusters), both groups exhibited similar error patterns across categories. For CWCI, the factors most related to consonant production accuracy when considered individually were expressive vocabulary size, followed by duration of CI experience, chronological age, maternal education and gender. The combination of maternal education and vocabulary size resulted in the best model of consonant production accuracy for this group. For the CWTH, chronological age followed by vocabulary size were most related to consonant production accuracy. No combination of factors yielded an improved model for the CWTH.
CONCLUSIONS: Whilst group differences in production accuracy between the CWCI and CWTH were found, the pattern of errors was similar for the two groups of children, suggesting that the children are at earlier stages of overall consonant production development. Although duration of CI experience was a significant covariate in a single-variable model of consonant production accuracy for CWCI, the best multivariate model of consonant production accuracy for these children was based on the combination of expressive vocabulary size and maternal education.
CONCLUSIONS: What is already known on the subject Research has shown that a range of factors is associated with consonant production accuracy by CWCIs, including factors such as the age at implant, duration of implant use, gender, other language skills and maternal education. Despite numerous studies that have examined speech sound production in these children, most have explored a limited number of factors that might explain the variability in scores obtained. Research that examines the potential role of a range of child-related and environmental factors in the same children is needed to determine the predictive role of these factors in speech production outcomes. What this paper adds to the existing knowledge Whilst the consonant production accuracy was lower for the CWCIs than for their typically hearing peers, there were some similarities suggesting that these children are experiencing similar, but delayed, acquisition of consonant production skills to that of their hearing peers. Whilst several factors are predictive of consonant production accuracy in children with implants, vocabulary diversity and maternal education, an indirect measure of socio-economic status, were the best combined predictors of consonant production accuracy. What are the potential or actual clinical implications of this work? Understanding the factors that shape individual differences in CWCI speech production is important for effective clinical decision-making and intervention planning. The present findings point to two potentially important factors related to speech sound production beyond the duration of robust hearing in CWCI, namely, a lexical diversity and maternal education. This suggests that intervention is likely most efficient that addresses both vocabulary development and speech sound development together. The current findings further suggest the importance of parental involvement and commitment to spoken language development and the importance of receiving early and consistent intervention aimed both at skill development and parental efficacy.
摘要：
背景：尽管人工耳蜗（CI）具有为儿童提供语音的能力，口语结果有相当大的可变性。需要进行旨在识别影响语音生成准确性的因素的研究。
目的：表征人工耳蜗（CWCI）儿童和年龄匹配的典型听力（CWTH）儿童的辅音产生准确性，并探讨可能影响的几个因素。
方法：我们对25个CWCI组（平均年龄=4；9，SD=1；6，范围=3；2-8；5）进行了Bankson-Bernthal语音测试（BBTOP），在30个月之前植入，平均植入物使用时间为3；6，年龄匹配的25个CWTH组（平均年龄=5；6，SD=0，6。记录的结果被转录，并确定了目标辅音的准确性。使用不同单词的数量（NDW）从语言样本中获得表达词汇量估计。一份家长问卷提供了有关母亲教育的信息，CI经历的持续时间和每个孩子的其他人口统计学特征。
结果：CWCI小组表现出一些相似之处，和一些差异，他们的听力同行。CWCI总体上以及在各种语音类别和单词位置中表现出较差的辅音产生准确性。然而,两组产生的初始辅音比最终辅音更准确。虽然在所有语音类别中，CWCI的制作精度都比CWTH差(停止，鼻部,摩擦，影响，液体和滑翔和辅音簇)，两组在不同类别中表现出相似的错误模式.对于CWCI，当单独考虑时，与辅音产生准确性最相关的因素是表达词汇量，其次是CI经验的持续时间，实际年龄,母亲教育和性别。母亲教育和词汇量相结合，为该组提供了最佳的辅音生成精度模型。对于CWTH来说,按时间顺序排列的年龄，其次是词汇量，与辅音产生的准确性最相关。没有因素组合产生CWTH的改进模型。
结论：虽然发现CWCI和CWTH之间的生产精度存在差异，两组孩子的错误模式相似，这表明孩子们正处于整体辅音生成发展的早期阶段。尽管在CWCI的辅音产生精度的单变量模型中，CI经验的持续时间是一个重要的协变量，但这些孩子的辅音产生精度的最佳多变量模型是基于表达词汇量和母亲教育的结合。
结论：关于该主题的已知研究表明，一系列因素与CWCI的辅音生成精度有关，包括植入年龄等因素，植入物使用的持续时间，性别,其他语言技能和母亲教育。尽管有许多研究检查了这些孩子的语音产生，大多数人探索了可能解释所获得分数变异性的有限因素。需要研究一系列与儿童有关的因素和环境因素在同一儿童中的潜在作用，以确定这些因素在言语产生结果中的预测作用。本文对现有知识的补充虽然CWCI的辅音制作精度低于其典型的听力同行，有一些相似之处表明这些孩子正在经历类似的事情，但是延迟了,获得辅音制作技能，以他们的听力同行。虽然有几个因素可以预测植入物儿童的辅音产生准确性，词汇多样性和母亲教育，间接衡量社会经济地位，是辅音产生精度的最佳组合预测因子。这项工作的潜在或实际临床意义是什么？了解影响CWCI言语产生个体差异的因素对于有效的临床决策和干预计划很重要。当前的发现指出了与CWCI中健壮听觉持续时间之外的语音产生有关的两个潜在重要因素，即词汇多样性和母亲教育。这表明干预可能是最有效的，可以同时解决词汇发展和语音发展。当前的发现进一步表明，父母参与和致力于口语发展的重要性，以及接受旨在技能发展和父母效能的早期和一致干预的重要性。
目的：表征人工耳蜗（CWCI）儿童和年龄匹配的典型听力（CWTH）儿童的辅音产生准确性，并探讨可能影响的几个因素。
方法：我们对25个CWCI组（平均年龄=4；9，SD=1；6，范围=3；2-8；5）进行了Bankson-Bernthal语音测试（BBTOP），在30个月之前植入，平均植入物使用时间为3；6，年龄匹配的25个CWTH组（平均年龄=5；6，SD=0，6。记录的结果被转录，并确定了目标辅音的准确性。使用不同单词的数量（NDW）从语言样本中获得表达词汇量估计。一份家长问卷提供了有关母亲教育的信息，CI经历的持续时间和每个孩子的其他人口统计学特征。
结果：CWCI小组表现出一些相似之处，和一些差异，他们的听力同行。CWCI总体上以及在各种语音类别和单词位置中表现出较差的辅音产生准确性。然而,两组产生的初始辅音比最终辅音更准确。虽然在所有语音类别中，CWCI的制作精度都比CWTH差(停止，鼻部,摩擦，影响，液体和滑翔和辅音簇)，两组在不同类别中表现出相似的错误模式.对于CWCI，当单独考虑时，与辅音产生准确性最相关的因素是表达词汇量，其次是CI经验的持续时间，实际年龄,母亲教育和性别。母亲教育和词汇量相结合，为该组提供了最佳的辅音生成精度模型。对于CWTH来说,按时间顺序排列的年龄，其次是词汇量，与辅音产生的准确性最相关。没有因素组合产生CWTH的改进模型。
结论：虽然发现CWCI和CWTH之间的生产精度存在差异，两组孩子的错误模式相似，这表明孩子们正处于整体辅音生成发展的早期阶段。尽管在CWCI的辅音产生精度的单变量模型中，CI经验的持续时间是一个重要的协变量，但这些孩子的辅音产生精度的最佳多变量模型是基于表达词汇量和母亲教育的结合。
结论：关于该主题的已知研究表明，一系列因素与CWCI的辅音生成精度有关，包括植入年龄等因素，植入物使用的持续时间，性别,其他语言技能和母亲教育。尽管有许多研究检查了这些孩子的语音产生，大多数人探索了可能解释所获得分数变异性的有限因素。需要研究一系列与儿童有关的因素和环境因素在同一儿童中的潜在作用，以确定这些因素在言语产生结果中的预测作用。本文对现有知识的补充虽然CWCI的辅音制作精度低于其典型的听力同行，有一些相似之处表明这些孩子正在经历类似的事情，但是延迟了,获得辅音制作技能，以他们的听力同行。虽然有几个因素可以预测植入物儿童的辅音产生准确性，词汇多样性和母亲教育，间接衡量社会经济地位，是辅音产生精度的最佳组合预测因子。这项工作的潜在或实际临床意义是什么？了解影响CWCI言语产生个体差异的因素对于有效的临床决策和干预计划很重要。当前的发现指出了与CWCI中健壮听觉持续时间之外的语音产生有关的两个潜在重要因素，即词汇多样性和母亲教育。这表明干预可能是最有效的，可以同时解决词汇发展和语音发展。当前的发现进一步表明，父母参与和致力于口语发展的重要性，以及接受旨在技能发展和父母效能的早期和一致干预的重要性。
