外周听觉功能正常伴语言发育迟缓儿童病因分析

目的探讨外周听觉功能正常伴语言发育迟缓儿童的病因及诊断.方法对39例经全面听力评估后证实为外周听觉功能正常而语言发育迟缓患儿进行调查并随访.结果具有宫内及围产期高危因素或新生儿疾病史的现象较普遍,自闭症和精神发育迟滞可能是导致儿童外周听觉功能正常而语言发育迟缓的常见病因.结论预防宫内及围产期高危因素或新生儿疾病是预防儿童语言发育迟缓的关键.发现外周听觉功能正常而语言发育迟缓儿童后应尽早将其转诊到心理卫生中心、儿科就诊,对其进行心理、言语语言康复.     

快速用力呼气法对发育迟缓儿童言语呼吸支持不足矫治的个案研究

目的探索快速用力呼气法对治疗发育迟缓儿童言语呼吸支持不足问题的有效性。方法采用单一被试单基线A-B实验设计，运用快速用力呼气法对1名存在言语呼吸支持不足问题的发育迟缓儿童进行康复训练，测量、分析训练前后的最长声时和平均言语强度。结果训练后，该儿童最长声时和平均言语强度显著提高。结论快速用力呼气法对解决发育迟缓儿童呼吸支持不足的问题是有效的。     

儿童分泌性中耳炎相关因素分析

近年来,儿童分泌性中耳炎的发病率呈逐渐上升的趋势,且越来越趋于低龄化.其病因复杂且反复发作,与多种因素相关,目前研究提示与咽鼓管功能障碍、感染、免疫等密切相关.儿童时期是言语、听觉、智力等发育的关键时期,听力下降可能会导致儿童注意力不集中、学习成绩下降等,严重者可引起患儿生长发育迟缓、言语与智力障碍、社会和情感发育延迟...     

145例学龄前言语语言障碍儿童病因及特征分析

目的 探讨145例学龄前言语语言障碍儿童的病因及临床特征.方法 回顾性分析2017年8月～2019年12月因言语语言障碍就诊的145例学龄前儿童的临床资料,包括Gesell发育评估量表、S-S语言发育迟缓检测量表、韦氏幼儿智力量表、听力学检查等结果,分析言语语言障碍患儿的病因及临床特点.结果 145例学龄前言语语言障碍...     

影响小儿语言言语发育的相关因素

目的探讨小儿言语发展规律，观察小儿语言发展的各个环节及进度，以便及时查清病因，尽早干预。方法选择1岁8个月～8岁语言发育迟缓患儿120例，通过倾听家人主诉、观察患儿现状，明确患儿言语发育迟缓原因，实施早期言语干预训练，比较训练前后的语言发展水平。结果120例语言发育迟缓患儿中91例为听力损失，占76％；29例为语言中枢发育迟缓、轻度孤独症倾向等，占24％。因听力损失导致语言发育迟缓病例配戴助听装置并进行言语训练后，听觉感知及语言表达能力均有显著改善。其余病例经个体综合能力训练6～12个月后，语言逐渐萌发，可看图认读。结论小儿语言言语的发育受多因素影响，家长应了解并掌握小儿语言发展规律，发现语言发育迟缓问题及时就医并进行适当干预，以保证小儿语言正常发展。健康成长。     

胃食管反流与儿童分泌性中耳炎相关性

分泌性中耳炎是影响儿童听力的最主要原因,也是导致儿童言语和认知发育迟缓的重要因素.该病发病率高,发病原因多,现有研究多集中在咽鼓管功能障碍、感染和免疫反应等方面.已有研究表明,反复发作的分泌性中耳炎与胃食管反流也有密切的关系,本文就两者相关性及进展做一综述.     

言语语言障碍儿童语言评估结果分析

目的 探讨对言语语言障儿童进行语言评估的意义.方法 运用S-S语言评估法,对349例言语语言障碍儿童进行语言评估,对结果进行分析. 结果 349例患儿中,语言发育迟缓113例,占32.37%(113/349),功能性构音障碍81例,占23.20%(81/349),儿童孤独症73例,占20.91%(73/349),脑瘫45例,占12.89%(45/349),精神运动发育迟滞20例,占5.73%(20/349),听力障碍8例,占2.29%(8/349),其它9例,占2.57%(9/349).结论 对言语语言障碍患儿进行语言评估,对早期诊断和治疗各类与儿童语言发育相关的疾病具有积极意义.     

儿童语言发育迟缓相关因素分析

目的分析儿童语言发育迟缓相关因素,以便及时明确诊断、早期干预。方法对2004年1月至2005年5月139例除外外周听力障碍的语言发育迟缓的患儿生长发育史、既往史、家族史以及母亲孕期和围产期情况进行相关性分析。结果男性患病率高于女性,患儿的运动发育/语言环境与语言发育有明显相关性(r=2.480,P<0.01)。母亲孕期及围产期高危因素与语言发育明显相关(r=0.882,P<0.01)。剖宫产作为非正常分娩与语言发育迟缓也有一定的相关性(r=0.712,P<0.05)。结论出生前后的不利因素与儿童语言发育相关,特别是宫内及围产期高危因素明显相关。语言发育迟缓的先天因素可能不仅包括遗传基因,还包括母亲孕期及围产期的不利因素。后天的语言环境对儿童的语言发育也起着重要的作用。对伴有运动发育落后和精神发育障碍的儿童应重视观察其语言发育情况。     

嗓音言语障碍儿童的筛选

1973年起日本学生健康调查中列入嗓音言语异常的项目。嗓音言语障碍儿童的筛选,进行方式如下:第一阶段,让学生用中等音强说适当单词(姓名等),然后转为一般检查。如有怀疑,进行第二阶段检查:(1)嗓音检查,如音高、音强、声时,以发现声嘶和变声障碍;(2)言语检查,如构语功能、言语发育程度、节律、单词异常,以发现构语障碍(畸变、置换、省略等)、腭裂嗓音言语(开放性鼻音)、言语发育迟缓(查病因)、节律障碍(口吃、言语过速)。检查用语分三组(横须贺市):第一组14个日语单词,凡发现有口吃音或不清晰音时作出标记;第二组顺次读出50音图,凡有口吃或不清晰音作出标记;第三组日常言语,凡有嘶哑、鼻音、嗓     

儿童听力筛查的必要性

儿童时期尤其是婴儿期,即使听觉输入仅有轻微改变也会导致明显的言语发育迟缓 ,进而对其后期的学习和社会交流产生不良影响[1 ] .随着新生儿听力筛查在全球范围的普遍实施 ,先天性听力损失和早期获得性听力损失的确诊时间大大提前 ,为后期的干预和康复争取了时间.然而与新生儿听力损失的发病率(0.1% )相比 ,儿童听力损失的发病率却明显增高.     

Severe hearing loss in Pallister-Killian syndrome

Pallister-Killian syndrome is a rare disorder characterised by a specific combination of anatomic anomalies, mental retardation and lack of speech acquisition due to tetrasomy 12p. Hearing loss does not seem to be characteristic for this syndrome, although it was reported in several cases. We present the case of a girl first seen in our department at the age of 6 months. A severe sensory hearing loss was confirmed by subjective and objective audiometry. The child was successfully equipped with hearing aids. In the literature almost all children with Pallister-Killian syndrome are described as not developing verbal speech. Surprisingly their hearing abilities were not examined systematically. We advise audiological testing of children with Pallister-Killian syndrome.     

113例聋儿的助听及言语发育调查分析

目的了解0~6岁聋儿的助听、言语发育及交流情况。方法自制调查问卷表,随机对2005年2~5月在北京同仁医院耳科门诊就诊的113例双侧听力损失儿童的助听、语训、言语发育及交流能力等进行调查,并对相关数据作统计学分析。结果113例中助听器佩戴者85例(75.22%),其中,助听后语训者占51.76%(44/85),助听后无语训者占48.24%(41/85),无助听无语训者28例,占24.78%(28/113);无助听无语训者中重度聋以上23例,占82.14%(23/28)。70%的中度聋儿存在构音障碍和言语交流障碍;重度和极重度聋儿中,97.03%存在构音障碍,88.12%有不同程度的言语障碍和交流障碍。结论中-重度聋以上聋儿,无助听和无语训比例偏高,言语障碍和交流障碍较明显。加强聋儿家长对佩戴助听器和言语训练必要性的宣传和教育具有非常重要和深远的意义。     

Some phonological characteristics of the speech of normal-hearing children of deaf parents

Articulation and stress patterns of 5 hearing children of deaf parents were studied. The children's phonological processes were compared with those of children from normal-speaking homes and with those of their deaf mothers to identify similarities and differences. The phonological processes used most frequently by these children were those that have been identified as common processes among children from hearing homes. None of the children adopted, with any frequency, the less typical productions found in their mother's speech. This was also true for one of the children who was observed to produce articulation and stress patterns resembling "deaf" speech. Possible factors relating to the children's adoption of the standard speech model rather than deaf speech are discussed.     

Language development disorders--studies of preschool children of the Leipzig special language school]

Children with severe speech disorders were examined to determine the causes of their abnormal speech development. Thirty-seven preschool and school-age children were followed up and results compared. All children had low intelligence quotients, with most of the children coming from low social backgrounds. However, both of these factors (intelligence and low social background) had no influence on the improvement of speech levels after therapy. Two-thirds of the children with moderate conductive hearing losses showed improvement after therapy, so that the effect of this hearing loss was believed to be a significant cause for the development of speech disorders. An early evaluation must be performed by a qualified phoniatrican or pediatric audiologist when children are 1.5 years old and are not able to construct words.     

Comparative studies of hearing in children by recording reflex reactions and long-latency auditory evoked potentials

Hearing thresholds at speech frequencies in children with neurosensory hypoacusis were measured by three methods: orientation reflex (OR), wink reflex (WR) and brain acoustic evoked responses (BERA). Hearing thresholds measured by recording OR and WR were compared in 115 children (232 comparisons) and were found to coincide in about 92% of cases. Hearing thresholds at speech frequencies were measured by recording OR, WR and BERA in 55 children (103 comparisons) and were found to coincide in about 70% of cases. The discrepancy in the thresholds, especially when measured by means of BERA and WR, was seen mainly in the children who suffered from neurosensory hypoacusis and other CNS disorders (oligophrenia, residual manifestations of birth cerebral palsy with mental retardation, symptoms of sensory alalia). It is concluded that the method of recording WR allows a sufficiently accurate measurement of hearing thresholds. However, a comprehensive examination should be performed using all three methods to reveal concomitant diseases.     

Language and speech perception outcomes in hearing-impaired children with and without connexin 26 mutations

This study addressed the question of whether a hearing loss caused by mutations in the connexin 26 gene had a significant effect on language and speech perception outcomes in children using cochlear implants or hearing aids. The families of children who had participated in two previous studies of language development were invited to participate in this genetic study. From the 52 children whose families agreed to participate, 15 children with connexin 26 mutations in both chromosomes were identified. After taking into account other factors which are known to affect language development and speech perception in children with impaired hearing, no significant differences were found between the 15 children where connexin 26 was known to be the cause of deafness and the other 37 children in the study.     

Frequency of hearing disorders in children with langerhans' cell histiocytosis

BACKGROUND: The aims of the study were to find out the frequency of hearing disorders in children with Langerhans' cell histiocytosis (LCH) and to find out possible risk factors for hearing disorders due to the disease itself and the therapy. PATIENTS AND METHODS: 30 patients with LCH were examined audiologically by using standard audiometric procedures. In cases of central nervous system (CNS) lesions, brainstem evoked response audiometry (BERA) was done additionally. A significant hearing disorder was defined as a hearing impairment affecting speech, thus being characterized by the following features: Both ears should present either conductive and/or sensorineural hearing loss of at least moderate degree. The frequencies important for speech development (1 - 4 kHz) had to be affected. Also, prolongation of BERA interpeak latencies was regarded as a significant hearing impairment, because those children had an increased risk for a central auditory and speech processing disorder. RESULTS: In our study 3 patients had a significant hearing disorder according to our definition. The prevalence of a significant hearing disorder is increased in patients with LCH compared to the prevalence of permanent hearing disorders in German children. We found the following risk factors for the development of a significant hearing disorder: LCH of the temporal bone, CNS lesions. CONCLUSIONS: We recommend periodical audiological follow up examinations for LCH patients with lesions of the temporal bone and/or the brain. BERA is indicated in cases with CNS lesions, because central auditory and speech processing disorders are possible in those patients.     

Genetische Ursachen bei Störungen der Sprachentwicklung mit/ohne allgemeine Entwicklungsstörung

Mental retardation (MR) has a prevalence of about 2%, and developmental speech disorders with unknown cause about 7%. Very often, developmental delay represents an early warning sign of later developmental problems, such as mental retardation and other developmental disorders (DD). Prognosis depends on many factors, most notably the limiting factor provided by the severity of the underlying brain dysfunction and its consequences for communication, cognition and other behaviour. Chromosomal aberrations are the major cause of MR and also play a role in mild forms of DD and speech acquisition delay. ENT specialists are confronted with children with DD or language acquisition disorders. If the suspicion of hearing impairment as the cause of problems in daily life is not confirmed in a patient, ENT specialists should also consider genetic causes in the differential diagnosis.     

Effect of residual hearing prior to cochlear implantation on speech perception in children.

We examined the impact of residual hearing prior to cochlear implantation on pre- and postimplantation speech perception outcomes in children. Stimulation of the auditory system prior to implantation because of the presence of residual hearing is important for development of the central auditory pathways, whereas, in the absence of such stimulation, the pathways show less development. We hypothesized that children who had some degree of residual hearing preimplantation achieve better speech perception skills than their peers with poorer hearing. From the 133 children followed in our program, we identified 37 children who had an audiometric pure-tone average of better than 95 dB HL in the better ear at any time preimplantation. Psychophysical speech perception measures, the Word Identification Picture Inventory and the Phonetically Balanced Kindergarten list, in these children were compared with those of 96 implanted children who had poorer hearing prior to implantation. Children with more residual hearing showed higher speech perception scores both before implantation and over their first year of implant use than children with poorer hearing, suggesting that there is an advantage in having a greater degree of residual hearing preimplantation. We suggest that this advantage is promoted, in part, by the greater potential for auditory stimulation provided by high-gain hearing aids in children with greater degrees of residual hearing. This advantage appears to be maintained at least over 1 year postimplantation, yet the rates of development of postimplantation speech perception are not different between the groups. We suggest that this may be due to the unique aspects of electrical stimulation from a cochlear implant. Our findings suggest that it is important to minimize the delay of speech perception skills in the preimplantation phase, particularly in children with poor residual hearing. This can be accomplished by implanting children with congenital severe to profound hearing loss at young ages and children with acquired hearing loss soon after the onset. Also, auditory stimulation prior to implantation should be maximized through the consistent use of hearing aids and therapy that emphasizes development of auditory skills.     

The influence of potentially limiting factors on paediatric outcomes following cochlear implantation

OBJECTIVE: Children with isolated hearing impairment who have received cochlear implant at the optimal age mostly achieve remarkable results that are assessed by objective speech perception and production measurements. Different outcomes may be expected in case of conditions which may have a negative impact on postoperative performance. The aim of this study was to assess the influence of potentially limiting factors on postimplant outcomes. METHODS: Four groups of examinees (11 in total) were involved by the study: (A) four children with additional disabilities, (B) three children with cochlear malformation and/or ossification, (C) three reimplanted children, (D) a child with retrocochlear (cochlear nerve) pathology. Hearing, speech perception and production were examined by pure tone audiogram, speech audiogram, categories of auditory performance, speech intelligibility rating, listening progress profile, and monosyllabic trochee polysyllable test. Postoperative positive life changes were assessed by a questionnaire. RESULTS: Group A: perception skills better than expected, less satisfactory speech development. Group B: good sound perception, poor understanding. Group C: after reimplantation undisturbed conditions for continuation of optimal rehabilitation course. Group D: unsatisfactory results of pure tone hearing as well as speech perception and production. CONCLUSION: In spite of unfavourable conditions all examinees, except a child with retrocochlear pathology, were found to have a considerable benefit after cochlear implantation (with regard to obvious heterogeneity within each group). Evaluation of success, especially in children with multiple handicaps, also has to include subjective indicators of positive life changes, even those not directly associated with hearing.