Pay attention to hearing impairment of infants and children

Hearing impairment (deafness) is the most common birth defect of human beings, which is a common disease leading to language communication disorders, and also one of the most important disabling factors. The results of the second national sample survey of disabled people published in December 2006 show that there are 2004 million people with hearing disability only, only second to the rate of physical disability. In normal newborns, the incidence of bilateral congenital deafness is about 1 ‰ to 3 ‰. If calculated by the population of 19 million born in China every year, an average of 30000-40000 deaf children will be added every year. With the growth of newborn age, the proportion of children with permanent hearing loss will continue to increase. The incidence of children with hearing impairment before the age of 5 will rise to 2.7 ‰, and the incidence of adolescence can reach 3.5 per thousand. The incidence is the sum of phenylketonuria, congenital hypothyroidism and congenital adrenal hyperplasia.

As we all know, normal listening is the premise of language learning. Deaf children are lack of language stimulation and environment, the heavy can lead to deaf mute, the light will lead to language and speech disorders, low social adaptability, attention deficit and learning difficulties, as well as psychological and behavioral problems. Therefore, hearing impairment is very harmful to children. We must be alert to and pay attention to children’s hearing impairment.

Common clinical phenomena and typical cases:

1. This kind of phenomenon is often encountered in the hearing and otology clinic. When the child is over two years old, he can’t speak (because the parents are too careless, they are anxious until other children can speak, and their children can’t speak). The parents bring him to the hospital for treatment. In this case, most of the children are finally diagnosed with hearing impairment. At this time, it’s a little late for children to find out the existence of hearing problems, because children have missed the best learning period for a period of time. Although intervention (such as hearing aid fitting or cochlear implant) is started at this time, it will eventually affect the development of children’s language ability. In serious cases, it’s difficult for children to enter the normal kindergarten and primary school, thus affecting their healthy growth and giving The family is a great burden. It shows that children’s hearing impairment must be intervened early.

2. The hearing and otology clinic often encounters hearing problems after the birth of the child (found during the hearing screening of the newborn), and the hearing aids (some are still very good hearing aids) have been tested before the age of one year, but they still can’t speak when they are over two years old, so they come to ask the doctor why? Most of this situation shows that the hearing aids don’t work, that is, they haven’t been tested well (many parents help in the market In fact, the debugging of the hearing aid is very important, and it needs to be debugged many times to reach a gradually accurate process. It is very professional, and it is better to go to a professional hospital for matching) and auditory language rehabilitation training have not kept up. Another situation is that the hearing loss is too heavy and the hearing aid has no effect. At this time, cochlear implant should be carried out as early as possible. In addition to early intervention (to the regular hospital), the intervention should be in place and the auditory language rehabilitation training should be carried out.

3. Typical case 1: there is an 18-year-old freshman majoring in language. His parents brought him to see a doctor and said that the child always said that his ears are a little back, so he needs to be examined by a doctor. The child may have a little difficulty in hearing since he was a child, but his parents don’t believe him (in this case, the hearing loss may be light, which is most likely to be ignored by the parents. Sometimes the child can hear well, sometimes not, especially the academic performance is not good, the parents always feel that their children are very disobedient, find an excuse for the poor academic performance, and ignore him as a result). Now they go to university, University The classroom is too big. Sometimes it’s very hard to listen to the teacher’s lecture at the back. The listening problem is more prominent. After going to university, parents feel that children don’t need to be partial to them, so they believe him a little, so they bring him to the hospital to check his hearing. The result of the examination is that there is light to moderate hearing impairment. Later, the hospital equipped him with hearing aids. Now everything is very good in class. This shows that children with mild to moderate hearing impairment are most likely to be ignored by parents, which deserves attention.

4. Typical case 2: a father and son. The father is 31 years old and the son is nearly 3 years old. Almost two and a half years ago, Grandpa and his son brought their little grandson to see a doctor (that is to say, his grandson failed to pass the hearing screening for newborns in the local area). The doctor tested his hearing and found that there was hearing loss but there was residual hearing. At that time, he matched a pair of hearing aids and instructed them how to carry out family rehabilitation for their children. During the guidance, he found that the father was a congenital deaf mute People, but it seems that they can hear some more. It’s suggested to test the father’s hearing. As a result, the father and son’s hearing loss are almost the same. It’s suggested to test the father’s hearing aids as well. Finally, the grandfather tested the father and son’s hearing aids. Now the situation is that the grandson of the grandfather has gone to the normal kindergarten, and there is not much difference between the normal children’s listening and language, while his son’s language ability has improved very little.

The above shows the harm of congenital deafness to infants and children, and also shows that the final language development level of children depends on the time when they are found and intervened (if infants and children can be intervened in time, it usually starts at six months, most children can go to normal kindergarten and primary school, and integrate into normal society). That’s why congenital deafness is advocated all over the world at present Early detection, early diagnosis and early intervention should be carried out for hearing impairment of children.

How to find the hearing impairment of infants and children in the early stage?

The magic weapon for early detection of deafness: newborn hearing screening: (BOLD) newborn hearing screening refers to the rapid preliminary test (primary hearing screening) of hearing from hearing screening technician to obstetrics department during the period of hospitalization (generally 48-72 hours after birth) for each new born child. The results of the initial test are “passed” and “not informed” To show that children are divided into two groups: those who pass the screening and those who fail the screening. The “passed” newborn shows that the hearing function is basically normal, and those who fail to pass the screening should be re screened within 42 days after birth; the “passed” newborn also shows that the hearing function is basically normal, while those who fail to pass the re screening need to go to the hearing diagnosis center of the otolaryngology department of the hospital for further hearing examination before 3 months of age, and finally determine whether there is real hearing damage, and the degree and degree of hearing damage So as to achieve the purpose of early discovery.

It is necessary to mention that although the newborn passes the primary and secondary screening, it will suffer from various causes in the future growth process, resulting in hearing impairment. Some studies have shown that the incidence of delayed hearing impairment in infants under 5 years old is close to the incidence of neonatal congenital hearing impairment. Therefore, the hearing problems of infants and young children should be paid attention to all the time in the process of their growth.

Delayed hearing impairment in infants and young children

The daily performance of hearing loss in infants and young children: (BOLD) in general, adults with hearing impairment can complain about themselves, or judge whether their hearing is normal by whether there is a barrier in their language communication. But for infants and young children, it is specially pointed out that infants and young children before the age of 3 are unable to express because their language ability has not been formed. Therefore, parents should always pay attention to and regularly observe children’s interest and response to voice and things related to voice. For example, the door closing sound, toy sound, other knocking sound, whether it is easy to blink at the loud sound, shake the head and face or even wake up when falling asleep, etc., if it feels that its hearing behavior and response are abnormal, it should be diagnosed in the hospital immediately.

Preliminary judgment of hearing loss in infants and young children:

1-3 months: no response to the sudden loud noise (such as door closing, firecrackers, clapping in the ear), etc.

3-6 months: do not look for the sound source when there is sound.

6-9 months: do not look at the person or object mentioned in the speech.

9-12 months: unable to respond to movement instructions, such as: give the ball to me.

12-15 months: I haven’t said the first word yet, such as father, mother, lamp and car.

15-18 months: indifferent to the call from the next room or far away.

18-24 months: not yet able to use two words.

24-30 months: less than 100 words can be said.

30-36 months: fail to use 4-5 words.

After the newborn hearing screening process, the primary and secondary screening results are not passed, in the hospital was diagnosed with hearing loss, we should actively treat. If the doctor says that it does not belong to the treatment scope of drugs and surgery, it is necessary to find a professional within six months to help your child test and equip hearing aids, and if necessary, cochlear implant. If the child passes the screening, but in the process of growing up, suspected of abnormal hearing behavior and response, he should be diagnosed in hospital immediately.