听力言语发育异常儿童早期发现与干预的重要性分析  

Importance analysis of early detection and prevention for children abnormal with abnomal hearing and speechdy

作　　者：李海珍[1] 郑秀瑾[1] 张趁[1] 黄东升[1] 张文露[1] 孙雪萍[1] 

机构地区：[1]首都医科大学附属北京同仁医院儿科100730

出　　处：《中华现代护理杂志》2014年第35期4469-4473,共5页Chinese Journal of Modern Nursing

摘　　要：目的：探讨听力言语发育异常儿童的听力状况及听力言语异常对总体发育进程所产生的不同影响，以便及时发现听力言语轻微异常的早期迹象，积极医治与防御。方法选取6个月～8岁处于听力言语发育未达到正常小儿发育进程标准的56例儿童，详细了解小儿既往史、现病史、家族史、养育环境等成长过程的相关因素。对56例经临床听力学客观、主观听力测试均显示具有不同程度的听力损失特征的小儿进行听力言语评估，据不同的诱发因素指导相应的预防及医治护理措施。结果小儿听力损失左右耳各频率段听力损失程度不等同缺失的特征（听力在35～120 dB ），时常掩盖实际真实的听力情况，难以引起重视。小儿生长发育进程中不显性的隐匿性听力、语言问题，特别是前语言阶段难以发现，致使其中16例4～8岁小儿平时对声音不能完全做出反应，语言简单、含糊不清，学习受限；20例小儿对声音无明显察知，时常以肢体语言表示所需，与同龄听力正常小儿语言发育不一致，直至2～4岁后就诊。新生儿听力筛查、复筛均未通过，且小儿听力损失程度为20～90 dB，小儿对声音时有反应，即使配助听器也时戴时不戴，虽已参与训练且无连贯性，家长认为以后还会自然发育，以致等待1．5～2岁后就诊，延迟及早形成条件化反射。结论酷似正常的听力语言问题在小儿动态发育过程中的早期阶段常是不显性的，随着年龄逐渐增长，轻微异常迹象会有所显现，对此了解并熟悉掌握小儿听力语言发育进程的时间规律，排除相关因素影响，可尽早发现听力语言偏离及时就医，缩短小儿生长发育的落差。Objective To explore children with audition symptom as normal but heterophthongia impacting on the process of their growth , and try to find out the symptom of abnormal speech and hearing to prevent and cure early .Methods Fifty six children were selected at the age of 6 months to 8 years old whose development of audition and speech had not reached the normal norm and known their information relative growth factors such as medical history , present illness , family medical history and environment of growth inside out .We assessed the speech and audition of all cases by clinical objective and subjective audition test and they shown different level of audition damage .We provided different methods to prevent and cure disorders according to inducing factors .Results The characteristic of children , whose right and/or left ear had different damage （ earshot：35 -120 dB ） , usually could not arouse attention especially at early linguistic stage because of inapparent hearing and speech disorders .The delayed diagnosed audition problem already leaded that sixteen children from 4 -8 years old acquired the problems of inappropriate response to voice , simple and vague language and restricted study and twenty cases obtained no response to voice , delayed development of audition comparing with peers , and expressed their demand by body language until 2 to 4 years old until they sought medical advice .Neonatal audition had not passed first and second screen and the level of audition damage were at range of 20-90 dB; however , parents believed neonate could develop naturally when neonate grown up so that they attended training without consistency and worn hearing aid incontinuity .These kind of behavior leaded that neonate acquired medical treatment until 1.5 to 2 years and some reflections had been built up or delayed . Conclusions Children with a similar audition as normal children but heterophthongia are unapparent at early stage, but it will slight show out when they grow up .Parent should comprehend the children ’

关 键 词：听力障碍 儿童 发病原因 

分 类 号：R764[医药卫生—耳鼻咽喉科]