Speech and language evaluation for cochlear implant

Objective: In the last decade, cochlear implantation (CI) has achieved great progress in quantity and research in China. But our researches on speech audiometry, the major index of CI, is relatively slow, or it is hard to compare with European, Australian and American results. Based on the review of the development and application of English speech audiometry, this paper mainly analyzed the composition, testing method and applicative range of the existing English speech test materials and introduced the primary speech and language evaluation tool recommended by the present American expert committee. This paper also made some suggestions for further researches on Chinese evaluation tools, which was anticipated to be useful for the domestic development in this field, based on the review of Chinese tests and aimed on the present evaluation tool. Data sources: Articles related to auditory researches during January 1964 to April 2004 were searched by the computer with the searching words of "cochlear implant, speech audiometry" in Medline. The language of the articles was limited to English. Corresponding articles during January 1998 to April 2004 were searched manually or by computer in "Chinese Journal Clinical Rehabilitation" periodicals with the searching words of "cochlear implant, speech and language evaluation, cochlear implant". The language of the articles was limited to Chinese. Data selection: Totally 39 national and international original literatures regarding cochlear implant evaluation were selected. Original literatures of non-randomized researches were excluded while original literatures of non-blindness researches were not excluded. Data extraction: In 39 literatures regarding cochlear implant evaluation, 32 of them were in accordance with the criteria. The rest 7 articles were excluded due to the repetition of the same research. The selected 32 articles regarding cochlear implant evaluation were classified and arranged for literature review. Data synthesis: The development characteristic of cochlear implant is the significant improvement in speech and language differentiation in the recent years. With the relaxation of indicators and the decrease in the age of CI, all kinds of word lists and sentence lists for clinical application become available. The characteristic of new evaluation method is to apply the easy, difficulty-increased (adding noise, etc.) and multiple balanced materials into different periods. The problems of Chinese mandarin word list are that there is no uniformed format and there are no further modified testing materials with the development of techniques. Conclusion: Speech and language communication is the main purpose of CI, and understanding the speech and language is the first step. So, speech and language evaluation is one of the most important indicators for the effectiveness after CI. Based on the existing materials and clinical application, we should edit our main word lists according to the speech audiometry, the international standards of speech and language evaluation, and Chinese linguistic rules at the same time.