Turkiye Klinikleri Journal of Health Sciences

.: ORIGINAL RESEARCH
Erken ve Geç İmplante Olan Çocuklarda Okuma, Konuşma ve Dil Gelişiminin Karşılaştırılması
Comparison of the Reading, Speech and Language Development on Early and Late Implanted Children
Bahtiyar ÇELİKGÜNa, Ferda AKDAŞb
aOticon, İstanbul, TÜRKİYE b Özel Academic Hospital, Kulak Burun Boğaz Hastalıkları Kliniği, İstanbul, TÜRKİYE
Turkiye Klinikleri J Health Sci. 2021;6(4):902-10
doi: 10.5336/healthsci.2020-80929
Article Language: TR
Full Text
ÖZET
 Amaç: Çalışmanın amacı; koklear implantın uygulama yaşının; okuma, konuşma ve dil gelişimi açısından etkisinin araştırılmasıdır. Gereç ve Yöntemler: Üç buçuk yaşından önce (15 katılımcı) ve sonra (15 katılımcı) implant olan çocuklar; alıcı-ifade edici dil, konuşma ve okuma becerileri açısından birbirleri ile okuma hızı ve becerileri açısından da normal işiten akranları (20 katılımcı) ile karşılaştırılmışlardır. 'Dedem' isimli okuma parçasının, videoya kaydedilerek okutulmasının ardından, parçaya ilişkin 5 soru katılımcılar tarafından yazılı olarak yanıtlanmıştır. Daha sonra sırası ile Türkçe Erken Dil Gelişimi Testi ve kelime tekrar testleri uygulanmıştır. Katılımcıların okuma video kayıtları, konuşma anlaşılırlığı açısından odyoloji ile ilgisiz 5 dinleyici tarafından Likert tipi ölçekle puanlanmıştır. Bulgular: Üç buçuk yaşından önce ve sonra implant olan çocuklar arasında; alıcı dil (p=0,259), ifade edici dil (p=0,515), kelime tekrar testleri (tek hece p=0,624, 2 hece p=0,744 ve 3 hece p=0,305) ve konuşma anlaşılırlığı (p=0,106) açısından anlamlı bir fark bulunmamıştır. Okuma ve cevaplama hızları açısından 2 grup arasında anlamlı bir fark bulunmazken, okuduğunu anlama alanında geç implant grubu anlamlı olarak daha başarılı bulunmuştur (p=0,041). Normal işiten grup ise okuma hızı (p=0,000) ve okuduğunu anlama becerisi (p=0,003) açısından erken ve geç implant gruplarından daha başarılı bulunmuştur. Sonuç: Çalışmamızda; erken implantasyonun tek başına alıcı-ifade edici dil, konuşma ve okuma becerileri açısından avantaj teşkil etmediği, işitme cihazı kullanım süresi, nitelikli işitsel rehabilitasyon ve aile desteğinin de son derece önemli olduğu, bu unsurların geç implantasyon yapılsa bile dil, konuşma ve okuma becerileri açısından gelişim fırsatı yaratabileceği sonucuna varılmıştır.

Anahtar Kelimeler: Koklear implant; dil gelişimi; okuduğunu anlama; koklear implant yaşı
ABSTRACT
 Objective: The aim of this study was to investigate the effect of cochlear implantation age on reading, speech and language development in early and late implanted children. Material and Methods: Children who were implanted before (15 participant) and after (15 participant) age of 3.5 were compared with each other in terms of receptive-expressive language, speaking and reading skills, and with their normal hearing peers (20 participants) in terms of reading speed and reading skills. Following the reading of the passage titled 'Dedem' in Turkish accompanied by a video recording, five questions regarding the passage were answered in writing by the participants. Then, Test of Early Language Development-third edition and word repeat tests were performed, respectively. The video recordings of the participants were scored in terms of speech intelligibility with a Likert-type scale by 5 listeners who are not related to audiology. Results: There was no significant difference among children who received implants before and after 3.5 years of age in terms of receptive language (p=0.259), expressive language (p=0.515), word repeat tests (one syllable p=0.624, two syllables p=0.744 and three syllables p=0.305) and speech intelligibility (p=0.106). While there was no significant difference between the two groups in terms of reading and answering times, the late implant group was found to be significantly more successful in reading comprehension (p=0.041). The normal hearing group was found to be more successful than the early and late implant groups in terms of reading time (p=0.000) and reading comprehension skills (p=0.003). Conclusion: Only early implantation does not constitute an advantage in terms of receptive-expressive language, speech and reading skills. Also, duration of hearing aid use, effective auditory-verbal rehabilitation and family support are also extremely important. These factors improve language, speech and reading skills even if late implantation performed.

Keywords: Cochlear implants; language development; reading comprehension; cochlear implantation age
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