Publication: Erken ve geç implante olan çocuklarda okuma, konuşma ve dil gelişiminin karşılaştırılması
Abstract
1. ÖZET Bu tezin amacı, işitme kayıplı çocukların habilitasyonu veya rehabilitasyonunu sağlamak için kullanılan koklear implantın uygulama zamanının; okuma, konuşma ve dil gelişimi açısından etkisinin araştırılmasıdır. Bu amaçla, 3.5 yaşından önce ve sonra implant olan çocuklar alıcı ve ifade edici dil, konuşma ve okuma becerileri açısından karşılaştırılmıştır. Çalışmaya normal işiten 7-12 (ortalama: 9 ) yaş arası 20 öğrenci ile 3.5 yaşından önce ve sonra implant olan 30 koklear implantlı çocuk dahil edilmiştir. Normal işiten çocuklarda herhangi bir nörolojik, dil ve otolojik problemin olmaması göz önüne alınmıştır. Tüm koklear implantlı çocuklar, bilateral ileri veya çok ileri derecede sensörinöral işitme kaybına sahiptir ve yaş aralığı 7-12’dir (ortalama: 9.53). Koklear implantlı çocuklarda, prelingual dönemde işitme kaybı tanısı alması, en az 1 yıl koklear implant deneyimi olması ve okuma-yazma bilmesi şartları aranmıştır. Hastalara öncelikle “dedem” isimli okuma parçası okutulmuş ve okuma sırasında hasta, videoya alınmıştır. Ardından hastadan okuma parçasına ilişkin beş adet soruyu yazılı olarak cevaplaması istenmiştir. Daha sonra koklear implantlı hastalara Tedil testi uygulanmış ve ardından tek, iki ve üç heceli kelime listeleri görsel ipucu olmaksızın sunularak tekrar etmeleri istenmiştir. Araştırma neticesinde 3.5 yaşından önce ve sonra implant olan çocuklar arasında alıcı ve ifade edici dil ve konuşma becerisi açısından anlamlı bir fark bulunmamıştır. Okuma becerisi incelendiğinde iki grup arasında okuma ve cevaplama hızları arasında anlamlı bir fark bulunmazken okuduğunu anlama alanında geç implant grubu anlamlı olarak daha başarılı bulunmuştur. Elde edilen bulgular, implantasyon zamanı ile birlikte ailenin sosyokültürel ve ekonomik seviyesi, çocuğun tanı yaşı ve erken dönem cihazlandırılması, implant sonrası verilen işitme eğitiminin de konuşma, dil ve okuma becerilerini doğrudan ya da dolaylı olarak etkilediğini göstermiştir. Okuma, konuşma, dil, TEDİL 2.
Comparison of the Reading, Speech and Language Development on Early and Late Implanted Children The aim of this thesis was to investigate the effect of cochlear implantation age on reading, speech and language development in early and late implanted children. Therefore, the children who receive implants before and after 3.5 years of age were compared in terms of receptive and expressive language, speech and reading ability. 15 early and 15 late implanted children, ranging between 7-12 years (mean: 9.53) were to the study. 20 normal hearing children, ranging between 7-12 years (mean: 9) were used as controls. Normal hearing subjects had no neurological, language and otological problems. All implanted children had bilateral severe or profound sensorineural hearing loss. Prelingually deafened cochlear implant recipients who use their implants at least for 1 year and who are literate met the criteria of inclusion to the study. Primarily, all participants read the “dedem” reading passage. Then were asked five questions about the reading passage and written answers were required. As well as they were recorded while they were reading. Subsequently, cochlear implanted children were assesed with “Test of Early Language Development” after this, respectively, monosyllabic, bisyllabic and three syllabic word lists were used to assess the speech discrimination. In our study, significant relationship between the early cochlear implantation and the receptive and expressive language development was found. There was no significant relationship between the early cochlear implantation and the reading ability and speech intelligibility. Our data have shown age of implantation, family's socio-cultural and economic level, age of detection of hearing loss and duration of hearing aid use, post-implant auditory and verbal rehabilitation directly or indirectly affected children reading, speech and language skills. Key Words: Reading, speech, language, TELD
Comparison of the Reading, Speech and Language Development on Early and Late Implanted Children The aim of this thesis was to investigate the effect of cochlear implantation age on reading, speech and language development in early and late implanted children. Therefore, the children who receive implants before and after 3.5 years of age were compared in terms of receptive and expressive language, speech and reading ability. 15 early and 15 late implanted children, ranging between 7-12 years (mean: 9.53) were to the study. 20 normal hearing children, ranging between 7-12 years (mean: 9) were used as controls. Normal hearing subjects had no neurological, language and otological problems. All implanted children had bilateral severe or profound sensorineural hearing loss. Prelingually deafened cochlear implant recipients who use their implants at least for 1 year and who are literate met the criteria of inclusion to the study. Primarily, all participants read the “dedem” reading passage. Then were asked five questions about the reading passage and written answers were required. As well as they were recorded while they were reading. Subsequently, cochlear implanted children were assesed with “Test of Early Language Development” after this, respectively, monosyllabic, bisyllabic and three syllabic word lists were used to assess the speech discrimination. In our study, significant relationship between the early cochlear implantation and the receptive and expressive language development was found. There was no significant relationship between the early cochlear implantation and the reading ability and speech intelligibility. Our data have shown age of implantation, family's socio-cultural and economic level, age of detection of hearing loss and duration of hearing aid use, post-implant auditory and verbal rehabilitation directly or indirectly affected children reading, speech and language skills. Key Words: Reading, speech, language, TELD