语前聋小儿人工耳蜗植入术后的言语康复

An Approach to the Rehabilitation of Prelingually Deaf Children After Cochlear Implantation Zheng Xiujin(Medical Psychology) Directed by Professor Yin WenGang Abstract Objective: To sum up the acquirement rule of speech and language capability which is for the prelingually deaf children after cochlear implantation by listening and language rehabilitation training and to investigate the factors that affect rehabilitation speed. Method: Sixty-four children received a cochlear implant at the age of 2 to 5 years from 2001 to 2005. They begin to be trained under group pattern after switch on 1 month. The whole training program lasted more than 7 months; after that, according to the teacher’s plan the training program was to be continued at home. Result: The period is 108±7.7 days that they can pronounce correctly 50 percent of all of simple-finals and compound-finals, the period is 115.0±7.8 days that they begin auditory repeating, the period is 135.3±10.9 days that they can speech the first specific word independently and the period is 200.3±13.9 days that they can speak 70 words and come into tri-gamut-word and two-word sentence period. The patient that is the group at the age of 2-3 years can take part in normal kindergarten after switch on about 10 months. There are no significant differences in various grades of speech-language development with different age groups and so do with different sex groups. There are significant differences in various grade of speech-language development with various IQ group (P<0.01) and so do with using and not using hearing aids before implantation. Conclusion: From the research we find that the speech and language development sequence is the same level between the prelingually deaf children of 2 to 5 years who received cochlear implant after speech training and normal children and which are stages of uncomplicated sound production, continuous syllabic (babbling), speech sprout, single-word utterances and two-word utterances in proper order. The time is short significantly and the reason is that cognition capability is enhanced along with the increase of age. The intelligence is main factor that affect rehabilitation speed and the speed in the group of high IQ is faster than common IQ. It is not because of the dominance cognition of the senior group that makes the increasing of the rehabilitation, it even makes slowly. The reason of which is that the senior group are exposed the language environment too late to achieve speech and language development. So we should perform an operation and training early. The effectiveness of rehabilitation after cochlear implantation is improved by using hearing aids before implantation. The reason is auditory stimulate can be benefit of to deaf children. The rehabilitation speeds in the children at the age of 2 to 5 years have nothing to do with sex. Key words: cochlear implant; speech therapy; paediatric rehabilitation

心算年老化的认知心理机制及功能磁共振成像研究

Mechanisms underlying cognitive psychology and cerebral physiological of mental arithmetic with increasing are were studied by using behavioral methods and functional magnetic resonance imaging (fMRI). I. Studies on mechanism underlying cognitive psychology of mental arithmetic with increasing age These studies were accomplished in 172 normal subjects ranging from 20 to 79 years of age with above 12 years of education (Mean = 1.51, SD = 1.5). Five mental arithmetic tasks, "1000-1", "1000-3", "1000-7", "1000-13", "1000-17", were designed with a serial calculation in which subjects sequentially subtracted the same prime number (1, 3, 7, 13, 17) from another number 1000. The variables studied were mental arithmetic, age, working memory, and sensory-motor speed, and four studies were conducted: (1) Aging process of mental arithmetic with different difficulties, (2) mechanism of aging of mental arithmetic processing. (3) effects of working memory and sensory-motor speed on aging process of mental arithmetic, (4) model of cognitive aging of mental arithmetic, with statistical methods such as MANOVA, hierarchical multiple regression, stepwise regression analysis, structural equation modelling (SEM). The results were indicated as following: Study 1: There was an obvious interaction between age and mental arithmetic, in which reaction time (RT) increased with advancing age and more difficult mental arithmetic, and mental arithmetic efficiency (the ratio of accuracy to RT) deceased with advancing age and more difficult mental arithmetic; Mental arithmetic efficiency with different difficulties decreased in power function: Study 2: There were two mediators (latent variables) in aging process of mental arithmetic, and age had an effect on mental arithmetic with different difficulties through the two mediators; Study 3: There were obvious interactions between age and working memory, working memory and mental arithmetic; Working memory and sensory-motor speed had effects on aging process of mental arithmetic, in which the effect of working memory on aging process of mental arithmetic was about 30-50%, and the effect of sensory-motor speed on aging process of mental arithmetic was above 35%. Study 4: Age, working memory, and sensory-motor speed had effects on two latent variables (factor 1 and factor 2), then had effects on mental arithmetic with different difficulties through factor 1 which was relative to memory component, and factor 2 which relative to speed component and had an effect on factor 1 significantly. II. Functional magnetic resonance imaging study on metal arithmetic with increasing age This study was accomplished in 14 normal right-handed subjects ranging from 20 to 29 (7 subjects) and 60 to 69 (7 subjects) years of age by using functional magnetic resonance imaging apparatus, a superconductive Signa Horizon 1.5T MRI system. Two mental arithmetic tasks, "1000-3" and "1000-17", were designed with a serial calculation in which subjects sequentially subtracted the same prime number (3 or 17) from another number 1000 silently, and controlling task, "1000-0", in which subjects continually rehearsed number 1000 silently, was regarded as baseline, based on current "baseline-task" OFF-ON subtraction pattern. Original data collected by fMRI apparatus, were analyzed off-line in SUN SPARC working station by using current STIMULATE software. The analytical steps were composed of within-subject analysis, in which brain activated images about mental arithmetic with two difficulties were obtained by using t-test, and between-subject analysis, in which features of brain activation about mental arithmetic with two difficulties, the relationship between left and right hemisphere during mental arithmetic, and age differences of brain activation in young and elderly adults were examined by using non-parameter Wilcoxon test. The results were as following: