Objective: To track the growth of expressive vocabulary size in children with cochlear implantation (CI) over the first two years after activation, to compare the differences in expressive vocabulary development among different prosthesis configurations, and to establish milestones for expressive vocabulary development during this period. Methods: A total of 63 children (29 males, 34 females) who received CI before 30 months of age at the Department of Auditory Implantation, Shandong Provincial ENT Hospital, between October 2020 and December 2022 were enrolled. The mean age at CI activation was 16.0 months (SD=5.9). The Infant Checklist of the Early Vocabulary Inventory (EVI) for Putonghua was used to assess expressive vocabulary size at activation and 1, 3, 6, 9, and 12 months post-activation. The Toddler Checklist of the EVI was used at 18 and 24 months post-activation. Based on their hearing intervention mode, children were divided into three groups: unilateral CI (one CI, no contralateral intervention), bimodal stimulation (one CI plus a hearing aid in the contralateral ear), and bilateral CI (CI in both ears). SPSS 23.0 was used for descriptive statistics of expressive vocabulary size at different time points, and R software was used to analyze differences in vocabulary growth rates among the three groups. Results: At 24 months post-activation, expressive vocabulary size ranged from 7 to 677 in the unilateral CI group, 252 to 702 in the bimodal group, and 38 to 686 in the bilateral CI group. All children in three groups produced their first expressive word at 6 months post-activation. The bilateral CI group reached the 10-word milestone at 9 months post-activation, whereas the bimodal and unilateral CI groups reached this milestone at 12 months. All three groups reached the 50-word milestone at 18 months. Both the bimodal and bilateral CI groups reached the 100-word milestone at 18 months, whereas the unilateral CI group reached this milestone at 24 months. There were significant differences in the growth rate of expressive vocabulary among the three groups. Both the bilateral CI group and the bimodal group showed significantly faster growth than the unilateral CI group (P<0.01 for both). No significant difference in vocabulary growth rate was found between the bilateral and bimodal groups (P=0.43). Conclusions: Expressive vocabulary size increases rapidly during the first two years after CI activation in Putonghua-speaking children. Both the bimodal and bilateral CI groups demonstrate faster developmental trajectories than the unilateral CI group. The expressive vocabulary milestones established for Putonghua-speaking children with CI during the first two years post-activation can help clinicians and parents set appropriate expectations. When bilateral cochlear implantation is not an option, the use of a hearing aid in the contralateral ear can promote expressive vocabulary development and help prevent language delays. 目的： 通过追踪人工耳蜗植入（cochlear implantation，CI）儿童开机2年内表达性词汇的数量，比较不同补偿模式下表达性词汇发展的差异，确立CI儿童开机0~2年表达性词汇发展的里程碑。 方法： 选取山东省耳鼻喉医院听觉植入科2020年10月至2022年12月期间63例在2.5岁前行CI手术的儿童，其中男性29例、女性34例，开机时年龄为（16.0±5.9）个月。分别在开机时及开机后1、3、6、9、12个月，使用普通话早期词汇量表（Early Vocabulary Inventory for Putonghua Chinese，EVI）中的婴儿版词表来评估CI儿童表达性词汇的数量，在开机18、24个月时使用EVI量表幼儿版评估其表达性词汇的数量。按照CI儿童的听力干预模式，将其分为三组：单侧CI组（一侧佩戴人工耳蜗，对侧未干预）、双模组（一侧佩戴人工耳蜗，一侧佩戴助听器）以及双侧CI组（双侧佩戴人工耳蜗）。应用SPSS 23.0软件对CI儿童开机后不同时间点的表达性词汇量进行描述性统计，使用R软件分析不同补偿模式之间词汇发展的差异。 结果： CI儿童开机2年时单侧CI组表达性词汇的数量为7~677个，双模组表达性词汇的数量为252~702个，双侧CI组表达性词汇的数量为38~686个。三组均在开机后6个月出现首个表达性词汇；双侧CI组在开机9个月时达到10个表达性词汇，而双模组和单侧CI组则在开机12个月时才达到10词；双模组和双侧CI组开机后18个月时达到100词的里程碑；单侧CI组在开机18个月时达到50词的里程碑，在开机24个月时才达到100词的里程碑。三组在表达性词汇量增长速度方面存在差异，双侧CI组和双模组的增长速度显著快于单侧CI组，差异有统计学意义（P值均<0.01），双侧CI组与双模组在词汇量增长速度方面差异无统计学意义（P=0.43）。 结论： CI儿童开机后2年内表达性词汇数量迅速增长，双模组和双侧CI组表现出比单侧CI组更快的发展水平。本研究建立的普通话CI儿童开机0~2年表达性词汇发展的里程碑，可以帮助临床医生和家长设定合理的期望值。在无法同时植入双侧人工耳蜗时，对侧耳佩戴助听器，可以促进表达性词汇的发展，预防语言发展的延迟。.
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arXiv · 2006-09-06
arXiv · 2021-06-22