情绪能力训练在佩戴人工耳蜗和助听器儿童康复中的作用

Previous studies concerning the rehabilitation of hearing-impaired children mainly discussed the effect of wearing cochlear implants and hearing aids on children's language development. Some reserchers believe that a holistic rehabilitation and development plan should be made in order to help children wearing cochlear implants and hearing aids fully engage in school and everyday life activities. This holistic plan should take children's language competence, social-emotional competence development and learning abilities as well as some other aspects into consideration. This project, aimed at investigating the role of emotional competence training in the rehabilitation of hearing-impaired children and the correlation between language and emotional competence, will select children aged 2-6 with cochlear implants and hearing aids as main participants. By employing three training modules (emotional understanding and regulation paradigm, emotion-related language training and reading picture books with an emotional theme) and regular language training, we track and compare the different perfomances between the training group of cochlear implanted and hearing aids children and a control group on pre- and post- language and emtional competence tasks, differences in behavior observation and in parent and teacher assesments. The findings of this project can provide theoratical base and research data for compiling a language-emotion rehabilitation manual tailored for children with hearing impairment, thus, assist children with cochlear implant and hearing aids in improving their social interation and adpatation competence and reaching a full recovery.

目前有关听障儿童康复的研究主要集中在人工耳蜗和助听器对于他们语言发展的作用上。一些研究者认为，佩戴人工耳蜗和助听器儿童要能够真正融入正常的学校和社会生活，需要制定包括语言、社会-情绪能力发展、学习能力等方面全面提高的康复计划。本项目主要拟以2-6岁的人工耳蜗植入和佩戴助听器儿童为主要研究对象，通过三个模块的情绪训练（情绪理解与调节研究范式、与情绪有关的语言训练和图画书情绪主题阅读）和一般语言训练，追踪比较植入人工耳蜗和佩戴助听器训练组和控制组儿童在情绪能力和语言前、后测试任务、行为观察和父母、教师评价上的变化和差异，系统揭示情绪能力训练在康复中的作用，以及在康复过程中语言与情绪能力间的关联。项目研究结果可以为编制适宜于听力障碍儿童语言-情绪康复训练指导手册提供理论基础和实证数据，从而帮助人工耳蜗植入和佩戴助听器儿童提高社会交往和适应能力，实现全面康复。

大量研究表明，情绪能力是可以训练的。本项目通过语言和非语言范式进一步证明，佩戴人工耳蜗和助听器儿童在各项情绪理解能力发展滞后的基础上，采用研究范式和游戏的方式对来自三所聋童康复中心的儿童进行了训练，每组训练一个月，一对一进行，结果发现，两种训练方式对被试均产生了积极影响，他们的情绪理解成绩得到了显著提高。另外，我们采用Tobii X120眼动仪进行了三个序列研究。首先，对佩戴人工耳蜗和助听器儿童和正常儿童在观看高兴、悲伤、恐惧、愤怒和中性面孔时，对面孔的上半脸和下半脸、眼睛和嘴巴区域注视时的眼动轨迹进行了比较。结果发现，佩戴人工耳蜗和助听器儿童和正常儿童在观看表情面部时，均具有明显的上半脸偏好，即相较于下半脸，儿童会更多地注视上半脸。但正常儿童对眼睛区域的注视时间和注视次数要显著多于佩戴人工耳蜗和助听器儿童。同时，佩戴人工耳蜗和助听器儿童和正常儿童在注视恐惧和高兴面孔时，对嘴部区域的注视要高于生气、悲伤和中性面孔。以上结果提示我们，佩戴人工耳蜗和助听器儿童在注视表情面孔时存在眼神回避的倾向，面部表情识别能力的滞后可能与较少的眼睛注视行为有关。其次，在表情线索和言语线索一致和不一致时，比较佩戴人工耳蜗和助听器儿童和正常儿童对表情面部上下半脸的眼动轨迹。结果表明，正常儿童会更多地关注上半脸，而佩戴人工耳蜗和助听器儿童在有言语伴随时，会更多地注视下半脸。第三，对人工耳蜗、助听器和正常儿童在自主阅读和有声伴读条件下阅读有字和无字图画书时的眼动模式和阅读理解能力进行了考察。研究采用了2（阅读方式：有声伴读、自主阅读）×2（图画书类型：有字、无字）的被试间设计。结果表明，佩戴人工耳蜗和助听器儿童在阅读图画书时，对图片区域的关注要高于正常儿童；有声伴读条件下，两类儿童均更多地关注图片区域，对文字区域的关注会更晚。但随着时间的增加，两类儿童在有声伴读条件下，对文字的关注会逐渐增长。