KATSAUS SISÄKORVAISTUTETTA KÄYTTÄVIEN AIKUISTEN KUULONVARAISEEN PUHEEN HAVAITSEMISEEN

Tämän artikkelin tarkoituksena on luoda katsaus sisäkorvaistutettakäyttävien aikuisten kuulonvaraiseen puheen havaitsemiseen. Erityishuomioon suomenkielisten aikuisten puheen havaitsemisen kuntoutumisessa.Artikkelissa perehdytään aluksi puheen havaitsemisen perusteisiin,sisäkorvaistutteen toimintaan ja puheen havaitsemisen mittausmenetelmiin.Sen jälkeen luodaan katsaus sekä germaanisia kieliä puhuvien aikuisten ettäsuomenkielisten aikuisten lauseiden, sanojen, vokaalien ja konsonanttientunnistukseen. Artikkelissa käsitellään kuntoutumisen kestoa sekäkuntoutumiseen yhteydessä olevia sisäkorvaistutetta käyttäviin aikuisiin jasisäkorvaistutteisiin liittyviä seikkoja. Lopuksi perehdytään viimeaikaisiinintensiivisiin kuulonharjoituksen kuntoutuskokeiluihin.Asiasanat: Konsonanttien tunnistus, kuntoutuminen, kuulovika, lauseiden tunnistus, sanojen tunnistus, vokaalien tunnistusKeywords: Consonant recognition, hearing impairment, rehabilitation, sentence recognition, word recognition, vowel recognition.

NÄKÖKULMIA SISÄKORVAISTUTETTA KÄYTTÄVIEN LASTEN PUHUTUN KIELEN KEHITYKSEEN JA KOMMUNIKAATIOON

Teemanumeron esipuhe

ESIPUHE: KATSAUKSIA SISÄKORVAISTUTETTA KÄYTTÄVIEN LASTEN PERHEIDEN KOKEMUKSIIN JA AIKUISTEN KUNTOUTUMISEEN

Teemanumeron esipuhe

ERRATUM

Puhe ja kieli 3/2010 ja 4/2010 numeroiden kahdessa artikkelissa annettiin toisistaan poikkeavaa tietoa kuulonsa menettäneiden ja synnynnäisesti vaikea-asteisesti kuulovikaisten lasten sisäkorvaistuteleikkaustenaloitusajankohdasta ja sisäkorvaistutetta käyttävien lasten määristä Suomessa (Sume, 2010, s. 189; Välimaa & Lonka, 2010, s. 131). Ensimmäinen kuulonsa menettänyt lapsi sai Suomessa sisäkorvaistutteen vuonna 1995 ja syntymästään asti vaikea-asteisesti kuulovikainen lapsi vuonna 1997 (Kokkonen, Mäki-Torkko, Roine, & Ikonen, 2009; Välimaa & Lonka, 2010). Arviot sisäkorvaistutteita käyttävien lasten määristä vaihtelevat hieman eri lähteissä, koska ne ovat riippuvaisia tehdyn kyselyn ajankohdasta ja vuosittain tehtävien sisäkorvaistuteleikkausten määrästä (esim. Jero & Kentala, 2007; Kokkonen ym., 2009). Tällä hetkellä tuorein painettu tieto löytyy Kokkosen ym.(2009) artikkelista. Tieto perustuu tutkijoiden keväällä 2008 toteuttamaan kyselyyn, jolloin istutekäyttäjiä oli Suomessa noin 500, joista noin puolet oli aikuisia (ks. myös Välimaa & Lonka, 2010). Teemanumeron toimittajat ja Puhe ja kieli –lehden päätoimittaja pahoittelevat lehteen lipsahtanuttakvantitatiivisen tiedon epätarkkuutta

SISÄKORVAISTUTETTA KÄYTTÄVIEN LASTEN MORFOSYNTAKTISET TAIDOT: MONITAPAUSTUTKIMUS

Tutkimuksen tavoitteena oli kuvata kolmen sisäkorvaistutetta 3;11–5;2 vuottakäyttäneen lapsen morfosyntaktisia taitoja produktiivisen syntaksin indeksin(IPSyn) suomenkielisellä versiolla. Istutelasten taitoja verrattiin kuuloiän jasukupuolen sekä kronologisen iän ja sukupuolen perusteella kaltaistettujenverrokkien taitoihin. Sisäkorvaistutelasten ja kuuloiän ja sukupuolensekä kronologisen iän ja sukupuolen mukaan kaltaistettujen verrokkiennominirakenteiden pisteissä ei juuri ollut eroa. Istutelasten verbirakenteidenIPSyn-pisteiden keskiarvo sijoittui näiden kahden verrokkiryhmän keskiarvojenväliin. Istutelasten morfosyntaktisten taitojen hajonta oli suuri erityisestituotetuissa verbi- ja lauserakenteissa. Näyttäisi siltä, että IPSynin suomalaisversiosoveltuu hyvin sisäkorvaistutelasten morfosyntaktisten taitojen arviointiin.Avainsanat: kuulovika, morfosyntaktiset taidot, sisäkorvaistuteKeywords: cochlear implant, hearing impairment, morphosyntactic skill

Antenatal and neonatal risk factors in very preterm children were associated with language difficulties at 9 years of age

Aim: This Finnish study compared language and reading abilities between schoolchildren born at a very low gestational age (VLGA) of <32 weeks and at term and analysed any associations between antenatal and neonatal risk factors and language skills in the VLGA group. Methods: We prospectively followed 76 children born at a VLGA and 50 children born at term when they reached a mean age of 9.0 (8.1–10.0) years. They attended mainstream schools and had no severe neurosensory disabilities. Receptive language ability, rapid naming and word reading were evaluated using standardised tests. Results: Children in the VLGA group had lower scores for receptive language abilities (median 55.0 vs. 57.0, p = 0.01) and word reading (mean 4.4 vs. 5.1, p = 0.03) than the children in the term group. In the VLGA group, foetal growth restriction was associated with lower scores for rapid naming, early intraventricular haemorrhage was associated with poor word reading and respiratory distress syndrome was associated with poor rapid naming (p < 0.05). Conclusion: Schoolchildren born at a VLGA had more difficulties with receptive language abilities and word reading than children born at term. Foetal growth restriction and early neonatal morbidities were associated with language difficulties.publishedVersionPeer reviewe

Home-Applied Dual-Light Photodynamic Therapy in the Treatment of Stable Chronic Periodontitis (HOPE-CP)—Three-Month Interim Results

A single-site, randomized clinical trial was designed to determine the efficacy of regular home use of Lumoral® dual-light antibacterial aPDT in periodontitis patients. For the study, 200 patients were randomized to receive non-surgical periodontal treatment (NSPT), including standardized hygiene instructions and electric toothbrush, scaling and root planing, or NSPT with adjunctive Lumoral® treatment. A complete clinical intraoral examination was conducted in the beginning, at three months, and at six months. This report presents the three-month results of the first 59 consecutive randomized subjects. At three months, bleeding on probing (BOP) was lower in the NSPT + Lumoral®-group than in the NSPT group (p = 0.045), and more patients in the NSPT + Lumoral®-group had their BOP below 10% (54% vs. 22%, respectively, p = 0.008). In addition, patients in the NSPT + Lumoral®-group improved their oral hygiene by visible-plaque-index (p = 0.0003), while the NSPT group showed no statistical improvement compared to the baseline. Both groups significantly reduced the number of deep periodontal pockets, but more patients with a reduction in their deep pocket number were found in the NSPT + Lumoral® group (92% vs. 63%, p = 0.02). Patients whose number of deep pockets was reduced by 50% or more were also more frequent in the NSPT + Lumoral®-group (71% vs. 33%, p = 0.01). Patients with initially less than ten deep pockets had fewer deep pockets at the three-month follow-up in the Lumoral® group (p = 0.01). In conclusion, adjunctive use of Lumoral® in NSPT results in improved treatment outcomes at three months post-therapy

Spoken Language Skills in Children With Bilateral Hearing Aids or Bilateral Cochlear Implants at the Age of Three Years

Objectives: Early hearing aid (HA) fitting and cochlear implants (CIs) aim to reduce the effects of hearing loss (HL) on spoken language development. The goals of this study were (1) to examine spoken language skills of children with bilateral HAs and children with bilateral CIs; (2) to compare their language skills to the age-norms of peers with normal hearing (NH); and (3) to investigate factors associated with spoken language outcomes. Design: Spoken language results of 56 Finnish children with HL were obtained from a nationwide prospective multicenter study. Children with HL comprised two groups: children with mild-to-severe HL who used bilateral HAs (BiHA group, n = 28) and children with profound HL who used bilateral CIs (BiCI group, n = 28). Children's spoken language comprehension, expressive and receptive vocabulary, and phonological skills were compared with normative values of children with NH at the age of three years. Odds ratio (OR) was calculated to compare proportions of children below age-norms in BiHA and BiCI groups. Factors associated with spoken language outcomes were modeled with analysis of covariance. Results: At the age of 3 years, 50%-96% of children with HL performed 1 SD or more below the mean of the normative sample of age-peers with NH in spoken language skills, depending on the language domain. Receptive vocabulary and phonological skills were the most vulnerable language domains. In receptive vocabulary, 82% of the children in the BiHA group and 50% of the children in the BiCI group scored 1 SD or more below the normative mean. The BiHA group was 4.4 times more likely to have poorer receptive vocabulary than the BiCI group. In phonological skills, 96% of children in the BiHA group and 60% of the children in the BiCI group scored 1 SD or more below the normative mean. The BiHA group was 18.0 times more likely to have poorer phonological skills than the BiCI group. The analysis of covariance models showed that unaided pure-tone average, PTA(0.5-4 kHz), had a significant effect on spoken language comprehension in the BiHA group. For the BiCI group, age at HL diagnosis and age at CI activation had a significant effect on expressive vocabulary. High maternal level of education had a significant effect on language comprehension and expressive vocabulary and female gender on phonological skills. Conclusions: At the age of 3 years, especially receptive vocabulary and phonological skills caused difficulties for children with HL showing also considerable individual variation. Children with bilateral HAs seemed to be more likely to have poorer receptive vocabulary and phonological skills than children with bilateral CIs. A variety of factors was associated with outcomes in both groups. Close monitoring of spoken language skills of children with HL is important for ensuring similar opportunities for all children with HL and timely intervention, when needed.Peer reviewe

Spoken Language Skills in Children With Bilateral Hearing Aids or Bilateral Cochlear Implants at the Age of Three Years

Objectives: Early hearing aid (HA) fitting and cochlear implants (CIs) aim to reduce the effects of hearing loss (HL) on spoken language development. The goals of this study were (1) to examine spoken language skills of children with bilateral HAs and children with bilateral CIs; (2) to compare their language skills to the age-norms of peers with normal hearing (NH); and (3) to investigate factors associated with spoken language outcomes. Design:Spoken language results of 56 Finnish children with HL were obtained from a nationwide prospective multicenter study. Children with HL comprised two groups: children with mild-to-severe HL who used bilateral HAs (BiHA group, n = 28) and children with profound HL who used bilateral CIs (BiCI group, n = 28). Children's spoken language comprehension, expressive and receptive vocabulary, and phonological skills were compared with normative values of children with NH at the age of three years. Odds ratio (OR) was calculated to compare proportions of children below age-norms in BiHA and BiCI groups. Factors associated with spoken language outcomes were modeled with analysis of covariance. Results: At the age of 3 years, 50%-96% of children with HL performed 1 SD or more below the mean of the normative sample of age-peers with NH in spoken language skills, depending on the language domain. Receptive vocabulary and phonological skills were the most vulnerable language domains. In receptive vocabulary, 82% of the children in the BiHA group and 50% of the children in the BiCI group scored 1 SD or more below the normative mean. The BiHA group was 4.4 times more likely to have poorer receptive vocabulary than the BiCI group. In phonological skills, 96% of children in the BiHA group and 60% of the children in the BiCI group scored 1 SD or more below the normative mean. The BiHA group was 18.0 times more likely to have poorer phonological skills than the BiCI group. The analysis of covariance models showed that unaided pure-tone average, PTA(0.5-4 kHz), had a significant effect on spoken language comprehension in the BiHA group. For the BiCI group, age at HL diagnosis and age at CI activation had a significant effect on expressive vocabulary. High maternal level of education had a significant effect on language comprehension and expressive vocabulary and female gender on phonological skills. Conclusions: At the age of 3 years, especially receptive vocabulary and phonological skills caused difficulties for children with HL showing also considerable individual variation. Children with bilateral HAs seemed to be more likely to have poorer receptive vocabulary and phonological skills than children with bilateral CIs. A variety of factors was associated with outcomes in both groups. Close monitoring of spoken language skills of children with HL is important for ensuring similar opportunities for all children with HL and timely intervention, when needed.</p