听障儿童康复教育中的玩教具使用

玩教具在听障儿童康复教育活动中有着积极的作用.作为听障儿童学习中的一种工具,它起到的是辅助和中介作用,是引导和促进听障儿童学习的手段之一.本文从玩教具使用的意义、原则、策略等方面分别进行了理论阐述和举例说明.     

普通话儿童言语理解力测试(MPSI)

1 研发背景 随着科学技术的飞速发展和政府对听障儿童的日益重视,越来越多的听障儿童在出生后不久即能得到及时发现、诊断和干预.但这只是听障儿童成功康复的第一步,因为它只是让听障儿童有机会去聆听声音.听力康复的最终目标是让听障儿童能像健听儿童一样在日常生活的各种复杂环境中自如地与人沟通交流,要实现这一步必须在听力问题的早期发现、早期诊断和早期干预后,定期随访听觉言语发育情况,制订科学的个体化听觉言语康复计划,并根据评估结果进一步指导康复[1].     

浅谈听障儿童的早期融合教育

听障儿童融合教育是将听障儿童安置于普通幼儿园,并在普通幼儿园的环境中进行康复、融合的特殊教育模式,如何让听障儿童真正融入普通幼儿园教育是一个重要的研究课题.本文从听障儿童的特点出发,提出了一系列帮助听障儿童融入普通幼儿园学习、生活和游戏的方法,同时强调要提供听力补偿和语言康复等特殊教育服务,使得特殊教育与普通教育整合为一个系统.本文还探讨了融合教育对于听障儿童、健听儿童以及整个社会的积极意义.     

亲子游戏在听障儿童康复中的作用

以家长、小龄听障儿童为教学主体,亲子互动游戏为主要形式的教育教学活动,可以让听障儿童和家长建立良好的亲子关系,将听障儿童的语言学习生活化,发展听障儿童的认知能力,让听障儿童学会沟通和交流.同时,亲子互动游戏使家长成为听障儿童语言发展的伙伴和促进者.     

日本听障儿童“9岁界限”现象对我国听障儿童随班就读教育的启示

本文介绍了日本听障儿童“9岁界限”现象的历史背景、理论基础、成因及其对我国听障儿童随班就读教育的启示。针对口语和书面语的差异问题，笔者建议帮助听障儿童掌握丰富且正确的口语，为书面语打好基础；提高听障儿童的认知能力，有针对性地加强逻辑思维训练，从而胜任以书面语为主的学校教育。     

浅谈实施听能管理的具体措施

如何为听障儿童提供全面而专业的听力学服务和管理是听障儿童康复工作者要解决的首要问题.广东省残疾人康复中心从2010年起对中心的听障儿童实施听能管理,并制订了相关服务流程及实施细则.通过一年多的试行,听力师、家长、康复教师各司其职、共同参与、相互配合,使听力学服务得到了有效落实,听障儿童的助听效果和康复效果得到了有效保证.     

听障儿童汉语中介语现象研究

汉语是听障儿童的第二语言,其学习汉语与外国人学习汉语具有一定程度的相似性,中介语理论适用于听障儿童汉语学习的研究。听障儿童汉语中介语产生的主要原因和手语迁移、汉语规则泛化、学习策略、交际策略等相关,听障儿童汉语中介语具有个性与共性相结合、阶段性与反复性相结合的特点。     

省级康复机构低龄听障儿童康复训练情况调查

目的 了解我国省级听障儿童康复机构中3岁以下听障儿童的康复状况,探讨未来听障婴幼儿的康复模式.方法 采用问卷调查的方式,对全国省级听障儿童康复机构进行调查,重点调查2009年底前听障婴幼儿开始接受康复的时间和模式.结果 在省级康复机构最早接受康复指导和训练的听障儿童年龄为2个月,多采取由家长定期带小儿到机构接受训练的形式.同时结合定期举办家长培训班及指导家庭康复的方法 ;随着新生儿听力筛查的推广和普及,听障婴幼儿早期康复干预需求呈上升趋势,家长和机构对早期康复较过去更加重视.结论 政府对听障儿童的康复投入不断增加.低龄听障儿童的康复越来越受到重视;未来的康复应把低龄听障儿童作为重点,根据家庭、社会的需求,采取机构、社区、家庭等多种形式的康复教育,加大对家长的培训及社区家庭指导力度.     

江苏省3～7岁听障儿童与健听儿童学习能力的比较研究

目的 了解江苏省听障儿童的学习能力发育现状以及和本省健听儿童学习能力的差距.方法 采用希一内学习能力测验对60例3～7岁听障儿童和58例同龄健听儿童进行测试,采用t检验的统计方法对听障儿童和健听儿童的差异以及听障儿童群体的城乡差异进行分析.结果 ①听障儿童的学习能力商(88.3±16.16)和健听儿童的学习能力商(103.05±19.30)存在极显著性差异(t=4.452,p=0.000＜0.01);听障儿童在记颜色、看图联想、短视觉记忆、摆方木、完成图画5项分测验上明显落后于健听儿童,差别有统计学意义;②30例城市听障儿童的学习能力商(91.57±18.13)和30例农村听障儿童的学习能力商(85.03±13.47)有差别,但差别无统计学意义(t=1.585,P=0.118＞0.05);在记颜色、看图联想、短视觉记忆这3项分测验上,城市听障儿童得分显著高于农村听障儿童,差别有统计学意义.结论江苏省听障儿童的学习能力发育水平落后于本省的健听儿童;听障儿童群体在学习能力的某些方面存在城乡差别.要注意早期干预、家庭教育和听力补偿等因素对学习能力发育的影响,尽可能提高听障儿童的学习能力.     

前语言期听觉言语康复在听障儿童语言发展中的重要性

目的探讨前语言期听障儿童听觉言语康复的方法及重要性。方法与结果本文从六个方面阐述了前语言期听觉言语康复在听障儿童语言发展中的重要作用:交流需要是促进听障儿童语言发展的前提;"医教结合"是听障儿童语言发展的基础;家长与听障儿童的相互作用是听障儿童语言发展的基本要素;韵律因素是听障儿童语言发展中的首要特征;实时反馈是听障儿童语言发展的推动力;父母语言输入形式是影响听障儿童早期语言发展的重要因素。结论前语言期听觉言语康复在听障儿童语言发展中相当重要。健听儿童语言发展阶段的理论对听障儿童语言康复有着重要的指导意义,可以作为听障儿童听觉言语康复实践的指南。具体方法可归纳为:①在语言学习中强调交流;②父母所用的语言应该超过听障儿童现有的水平;③应该鼓励并不断巩固听障儿童进行交流,使他们的语言得到更好地发展;④父母应该首先对听障儿童的交流做出回答,而不是着眼于语言结构,并应通过自然语言进程提供如模仿、扩充等新的语言信息。     

Autonomous motivation is associated with hearing aid adoption

Objective: To use the self-determination theory of motivation to investigate whether different forms of motivation were associated with adults’ decisions whether or not to adopt hearing aids. Design: A quantitative approach was used in this cohort study. Participants completed the treatment self-regulation questionnaire (TSRQ), which measured autonomous and controlled motivation for hearing aid adoption. Sociodemographic data and audiometric information were also obtained. Study sample: Participants were 253 adults who had sought information about their hearing but had not consulted with a hearing professional. Participants were categorized as hearing aid adopters if they had been fitted with hearing aids 4–6 months after completing the TSRQ, and as non-adopters if they had not. Results: Multivariate logistic regression was used to examine associations between autonomous and controlled motivation, sociodemographic and audiometric variables, and hearing aid adoption (n = 160). Three factors were significantly associated with increased hearing aid adoption when the influence of other variables was accounted for: autonomous motivation, perceived hearing difficulty, and poorer hearing. Controlled motivation was not found to influence hearing aid adoption. Conclusion: These empirical findings that link autonomous motivation to decisions of hearing help-seekers have implications for the ways practitioners may evaluate motivation and could inform discussions with clients about hearing aid adoption.     

Otalgia as a result of certain temporomandibular joint disorders

INTRODUCTION: Different hypotheses of reasons for common incidence of temporomandibular disorders (TMD) and otalgia have been discussed. The hypothesis of this study was, that the high prevalence of otalgia in patients with TMD may result in part from pain in the M. masseter pars prof. or in the temporomandibular joint (TMJ) which, due to the close anatomic neighborhood, can feel like ear pain. MATERIAL AND METHODS: [corrected] We retrospectively analyzed the anamneses of 720 of our TMD-patients with regard to main treatment motivation: how many patients quoted "pain in the ear" as main treatment motivation and how many of them had no objective findings in the ear but muscle tenderness of the M. masseter prof. or objective findings in the TMJ. Using all pairwise multiple comparison procedures (Dunn's Method) we compared the frequency of muscle and joint findings in patients with ear complaints to two controls: Tinnituspatients and patients seeking orthodontic treatment. RESULTS: 51 of 720 patients quoted ear pain as main treatment motivation. 25 of them (49 %) had findings in the masseter muscle, 9 (18 %) in the joint and 15 (29 %) had findings in both the joint and the muscle. The frequency of findings in the controls was significantly (p < 0.001) lower. CONCLUSION: A significant fraction of patients seeking treatment due to pain in the ear have no findings in the ear, but in the TMJ and in the masseter muscle.     

康复教师职业倦怠及应对策略

康复教学质量在很大程度上取决于教师的工作积极性和创造性。康复教师的职业倦怠是影响工作积极性和创造性的重要因素，一方面影响康复教学效果，另一方面也影响教师自身的身心健康。只有建立一个全方位的支持系统，妥善解决康复教师职业倦怠问题，才能使康复教师更加投入地工作，从而更有效地提高康复效果，促进听障儿童的健康发展。     

Rehabilitation approaches to promote successful unilateral and bilateral fittings and avoid inappropriate prescription

Successful hearing aid fitting occurs when the person fitted wears the aid/s on a regular basis and reports benefit when the aid/s is used. A significant number of people fitted with unilateral or bilateral hearing aids for the first time do not continue to use one or both aids in the long term. In this paper, factors consistently found in previous research to be associated with unsuccessful fitting are explored; in particular, the negative attitudes of some clients towards hearing aids, their lack of motivation for seeking help, inability to identify goals for rehabilitation, and problems with the management of the devices. It is argued here that success in hearing aid fitting involves the same dynamics as found with other assistive technologies (e.g., wheelchairs, walking frames), and is dependent on a match between the characteristics of a prospective user, the technology itself, and the environments of use (Scherer, 2002). It is recommended that for clients who identify concerns about hearing aids, or who are unsure about when they would use them, and/or are likely to have problems with aid management, only one aid be fitted in the first instance, if hearing aid fitting is to proceed at all. Rehabilitation approaches to promote successful fitting are discussed in light of results obtained from a survey of clients who experienced both successful and unsuccessful aid fitting.     

Assessment of motivational changes in tinnitus sufferers. A study of the transtheoretical model

OBJECTIVES: Cognitive-behavioural treatment of chronic tinnitus needs active cooperation and motivation in patients. The transtheoretical model (TTM) defines the behavioural change using six different stages of change (SoC). In this study, we examined SoC in patients with tinnitus via a new self-rating instrument. SAMPLE AND METHODS: An item-pool, consisting of 48 questions, was administered to 125 tinnitus sufferers in a cross-sectional study. In addition to data on tinnitus history, the tinnitus strain (THI, German: TB-12), scores of anxiety and depression (HADS-D), and life quality (SF-12) were assessed. RESULTS: Four SoC could be identified empirically: (1) precontemplation, (2) contemplation/preparation, (3) action/maintenance, and (4) termination. Associations of the SoC with socio-demographic and tinnitus related data, as well as with the instruments applied, conformed with the theory. CONCLUSIONS: The results confirm the transfer of SoC theory to patients with tinnitus.     

Revisiting Bloodstein's Anticipatory Struggle Hypothesis from a psycholinguistic perspective: A Variable Release Threshold hypothesis of stuttering

This paper reviews Bloodstein's (1975) Anticipatory Struggle Hypothesis of stuttering, identifies its weaknesses, and proposes modifications to bring it into line with recent advances in psycholinguistic theory. The review concludes that the Anticipatory Struggle Hypothesis provides a plausible explanation for the variation in the severity of stuttered disfluencies across speaking situations and conversation partners. However, it fails to explain the forms that stuttered disfluencies characteristically take or the subjective experience of loss of control that accompanies them. The paper then describes how the forms and subjective experiences of persistent stuttering can be accounted for by a threshold-based regulatory mechanism of the kind described in Howell's (2003) revision of the EXPLAN hypothesis. It then proposes that shortcomings of both the Anticipatory Struggle and EXPLAN hypotheses can be addressed by combining them together to create a ‘Variable Release Threshold’ hypothesis whereby the anticipation of upcoming difficulty leads to the setting of an excessively high threshold for the release of speech plans for motor execution. The paper also reconsiders the possibility that two stuttering subtypes exist: one related to formulation difficulty and other to difficulty initiating motor execution. It concludes that research findings that relate to the one may not necessarily apply to the other.     

Increasing motivation changes subjective reports of listening effort and choice of coping strategy

Abstract

Objective: The purpose of this project was to examine the effect of changing motivation on subjective ratings of listening effort and on the likelihood that a listener chooses either a controlling or an avoidance coping strategy. Design: Two experiments were conducted, one with auditory-only (AO) and one with auditory-visual (AV) stimuli, both using the same speech recognition in noise materials. Four signal-to-noise ratios (SNRs) were used, two in each experiment. The two SNRs targeted 80% and 50% correct performance. Motivation was manipulated by either having participants listen carefully to the speech (low motivation), or listen carefully to the speech and then answer quiz questions about the speech (high motivation). Study sample: Sixteen participants with normal hearing participated in each experiment. Eight randomly selected participants participated in both. Results: Using AO and AV stimuli, motivation generally increased subjective ratings of listening effort and tiredness. In addition, using auditory-visual stimuli, motivation generally increased listeners’ willingness to do something to improve the situation, and decreased their willingness to avoid the situation. Conclusions: These results suggest a listener's mental state may influence listening effort and choice of coping strategy.     

Occupational hearing loss: an aural rehabilitation program for workers and their spouses, characteristics of the program and target group (participants and nonparticipants)

Until very recently, aural rehabilitation programs designed specifically for workers with occupational hearing loss were nonexistent in the Province of Quebec. A pilot study has been conducted to test and develop suitable services for these workers and their spouses, and to explore the factors causing them to seek (or on the other hand, avoid) professional assistance. A trial rehabilitation program was set up for this purpose. Results of a questionnaire conducted among program participants showed that the main factors leading to enrollment in the program were the acknowledgement of moderate or severe hearing handicap and the recognition of the need for help (particularly with problems such as tinnitus and stress, and in using strategies to facilitate communication). These results lend support to the idea of adopting a new approach to rehabilitation services for occupational hearing loss workers. According to the findings of the study, only a very small percentage of workers and spouses participated in the rehabilitation program, despite measures taken to adapt it to their needs. Low enrollment in the rehabilitation program suggests the need for: (1) a more well-defined target population, (2) strategies to promote greater understanding, awareness, and acceptance of hearing handicap on the part of occupational hearing loss workers and peoples surrounding them, (3) education at the work place and in society in general to increase motivation and awareness of the benefits of aural rehabilitation services, (4) integration of the program within the general health program in the work place, (5) measures to enhance the credibility of professionals in the rehabilitation services, (6) general and specific programs and follow-up services, and (7) more accessible services.     

Erfassung der Veränderungsmotivation bei Tinnituspatienten

Objectives

Cognitive-behavioural treatment of chronic tinnitus needs active cooperation and motivation in patients. The transtheoretical model (TTM) defines the behavioural change using six different stages of change (SoC). In this study, we examined SoC in patients with tinnitus via a new self-rating instrument.

Sample and methods

An item-pool, consisting of 48 questions, was administered to 125 tinnitus sufferers in a cross-sectional study. In addition to data on tinnitus history, the tinnitus strain (THI, German: TB-12), scores of anxiety and depression (HADS-D), and life quality (SF-12) were assessed.

Results

Four SoC could be identified empirically: (1) precontemplation, (2) contemplation/preparation, (3) action/maintenance, and (4) termination. Associations of the SoC with socio-demographic and tinnitus related data, as well as with the instruments applied, conformed with the theory.

Conclusions

The results confirm the transfer of SoC theory to patients with tinnitus.     

Motivational factors in aphasia therapy: Research suggestions

Following Wepman (1953), the process of recovery from aphasia is seen as involving stimulation, motivation, and facilitation. The most adequate studies of aphasia therapy outcome focus on facilitation to the virtual exclusion of stimulation and motivation, although clinical experience suggests their importance. Motivation includes both the subjective and experiential aspects of the patient's response to aphasic disablement (anxiety, feelings of inadequacy) and the quality of the speech-therapist/ patient alliance during the treatment. Retrospective studies utilizing sufficiently improved aphasics and ratings of the patient-therapist alliance are suggested as preliminary means of defining “motivation” in this context more accurately. Research approaches are also outlined which would assess the importance of and interaction between the three factors implicated in recovery for therapeutic outcome.