Common listening problems

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1. What should we do if we find that the child is deaf? Parents or the child’s caregivers should care about the child’s hearing. If the child is within 3 months of age, if they find that they can’t wake up loudly when sleeping, or the child has no response to the sudden clap sound when they are just asleep, they should first consider the hearing problem. If a child is less than 1 year old and can’t pay attention to a sudden or strange sound, the hearing impairment should be eliminated first. 2-3-year-old children still can’t speak or can only pronounce simply, so listening should be considered first. Once you find or suspect that your child has a hearing problem, go to the otology Department of the hospital as soon as possible to have a hearing test, make a clear diagnosis, and take medical or rehabilitation measures.

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2. What is the significance of BAEP in the diagnosis of deafness? The threshold of BAEP is usually the threshold of V wave. The response threshold of wave V of brainstem evoked potential in normal adults is generally 10-15 decibels higher than that of pure tone. The response threshold of infants is higher than that of adults, but the ratio of the response threshold to the auditory reflex threshold is relatively low. Brainstem evoked potential can only reflect the auditory ability of more than 2000 Hz. The test results can not reflect the hearing situation of less than 2000 Hz, but the test results of brainstem evoked potential are relatively objective and stable Early detection and location diagnosis of deafness are of great value.

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3. How to prevent deafness in childhood? Infectious deafness is a common frequently occurring disease in childhood, among which conductive deafness caused by children’s exudative otitis media and sensorineural deafness caused by mumps, high fever and other diseases are the most common. It is not easy to find in the early stage of childhood deafness, especially in the stage of infection when aminoglycoside antibiotics are often used for treatment. Therefore, prevention of infection and scientific medication are important measures to prevent deafness.

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4. How to protect the residual hearing of deaf children? It is important for normal hearing people to pay attention to the physiological health of the ear, but it is particularly important for deaf children to protect their residual hearing. If the noise can damage the hearing of normal people, it is no exception for the deaf children after the selection of hearing aids, or even more harmful, and more attention should be paid to hearing protection. The key to the protection of deaf children’s residual hearing is to choose a suitable hearing aid. If the hearing aid is commercialized, it is not correct to wear it directly from the store without being checked and matched by professionals, even it is a terrible threat to the residual hearing of deaf children. In fact, the hearing aid is not only a simple amplifier, but also equipped with tone adjustment, automatic gain control, peak clipping control and other functions for fine tuning. Professionals can select the hearing aid according to the hearing loss degree of the deaf children, the characteristics of the audiogram, and the hearing aid matching standard, so as to obtain a more satisfactory hearing compensation. Even if it is used in the market noise environment, it will not damage the disability of the deaf children Listening.

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5. What are the indicators for determining high-risk newborns? It is found that the time of deafness is an important factor related to the prevention, treatment and rehabilitation of deafness. At present, hearing screening of newborns has been listed as one of the routine tests of maternal and child health care in Beijing and other places in China In 1973, 1982, 1990 and 1994, the American Academy of Pediatrics infant hearing Federation put forward guidance suggestions on the background of infant’s hearing impairment, the identification of infant’s hearing impairment, as well as the hearing screening and early intervention for newborn and infant. There are ten standards for identifying whether the newborn is a high-risk newborn and the risk factors that may lead to sensorineural deafness Those with one or more of the following risk factors are high-risk newborns:

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(1) the child has a family history of congenital delayed hearing loss;

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(2) the mother of the child had a history of intrauterine infection, known or speculated sensory nervous diseases, such as rubella, herpess, syphilis, cytomegaloviruria and toxoplasmosis;

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(3) head and face deformities, such as abnormal shape of auricle and external auditory canal, disappearance of vertical groove of upper lip or low hairline, etc;

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(4) the child’s weight is less than 1500g;

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(5) hyperbilirubinemia, whose bilirubin level exceeds the index required by blood exchange;

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(6) ototoxic drugs were used in children for more than 5 days, and the scope of application was not only limited to aminoglycosides such as gentamycin, kanamycin, streptomycin and tobramycin, but also included the cyclic diuretics used in combination with aminoglycosides;

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(7) bacterial meningitis;

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(8) the children showed severe hypofunction at birth, including children whose Apgar score was 0-3 within 5 minutes, or children who could not breathe autonomously within 10 minutes, or children whose muscle tone was low until 2 hours at birth;

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(9) the long time of mechanical oxygen supply is more than 9 days, such as children with persistent pulmonary pressure;

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(10) syndrome coexisting with sensorineural hearing loss In the United States, congenital deafness accounts for 1 ‰ of the total number of newborns, while mild hearing loss after birth and deafness in childhood are more. Before the age of 3, children’s language is developing rapidly. If deaf children are not found at the age of 3, it will seriously affect their language learning and language development.

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Therefore, hearing screening for newborns is an important means of early detection of deafness. Especially for high-risk newborns (within 28 days of birth) and high-risk infants (29 days to 2 years old after birth) hearing screening is more important.

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6. What are the advantages of wearing hearing aids for both ears? Hearing aids for deaf children have many advantages. First, they have stereo effect, which is conducive to sound source orientation. Second, it can eliminate the effect of head shadow, reduce the obstacle of head to the high-frequency sound in the direction of sound source, and is conducive to listening to high-frequency sound. Third, it has psychoacoustic effect. When the volume is the same, the sound of hearing aids on both ears is louder than that on one ear. Fourth, it has the function of silence. In the noisy environment, the hearing ability and speech recognition rate of hearing aids with two ears are better than those with one ear. Fifthly, the two ears are equipped with bands to transmit sound to the two cerebral hemispheres.

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7. How to help the deaf children to carry out the adaptive training of hearing aids? The adaptive training of hearing aids is a key part of wearing good hearing aids for the deaf children, and it is very important to cultivate the listening interest of the deaf children at this stage. Deaf children should first wear hearing aids for a long time. First, they should listen to some beautiful music, animal songs, musical instruments and other simple sounds in a quiet room. Then the deaf children can be arranged to listen to the voice in public places such as outdoor, and their auditory response and discomfort can be observed. The parents should carefully record the response and give it to the hearing aid fitting professionals. One of the important contents of hearing aid adaptability training is to be able to listen to the test tone, i.e. 1000 Hz internal tone. The acceptance criteria for deaf children to pass this phase is to be able to distinguish whether there is a test sound and be able to make an action response. After hearing aid adaptability training, professionals can evaluate hearing aid effect of deaf children.

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8. Can auditory development be divided into several stages? Generally speaking, the development of normal people’s hearing can be divided into eight stages, as shown in the figure, the concept of hearing is formed from the perception of hearing. ? auditory awareness refers to the instinct of the human ear to respond to the sound;? Auditory attention refers to the conscious listening, including psychological factors, the training in this stage is very important to cultivate the deaf children’s listening interest and habits;? Auditory orientation refers to the direction of identifying the sound source, and the normal baby has the ability to find the sound source in 4 months;? Auditory recognition refers to the ability to distinguish the similarities and differences of several sounds Auditory memory refers to the simultaneous memory of sound signals and their meanings on the basis of auditory recognition through the comprehensive analysis of the cerebral cortex;? Auditory selection refers to the ability to selectively listen to a certain sound in more than two kinds of sounds, and to be able to hear the sound they want to hear;? Auditory feedback refers to the process of self-regulation when deaf children pronounce and speak, and the tone and volume of people’s speech are both It is adjusted by auditory feedback; the concept of hearing refers to the understanding of the essence of sound signals, not only heard but also understood, based on the above seven stages and through the thinking activities of the brain The above eight stages are interrelated and interdependent, from low level to high level, from simple to complex, spiraling up. In fact, it is a step-by-step process of repeatedly recognizing, distinguishing and remembering sounds, and finally forming the concept of hearing.

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9. Why do rehabilitation education for deaf children need to be carried out as early as possible? 0-3 years old is the fastest period of brain development for children, and also the most critical period of language learning. The best period is before 7 years old, and the plastic period is from 7 to 12 years old. In this case, deafness will seriously affect children’s hearing and speech development, but also affect other aspects of development. If deaf children can be found in time, they should wear appropriate hearing aids as early as possible, so that they can receive all kinds of sound and language stimulation in their parents’ arms and receive scientific rehabilitation training, the development of deaf children in all aspects will be close to normal children, and the quality of rehabilitation will be higher. Therefore, early detection of deafness, wearing appropriate hearing aids as soon as possible and carrying out rehabilitation training as soon as possible have become an important principle in the rehabilitation of deaf children, which is the principle of early intervention.

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10. What is rehabilitation assessment? That is to use the hearing, speech rehabilitation assessment tools and Xi Nei children’s learning ability test tools to test the hearing, speech and learning ability of deaf children, so as to understand their current level and development direction, modify and adjust training objectives and plans to make them more suitable for the needs of deaf children