Early detection and early intervention in children with hearing loss is essential for childhood language development. Methods for screening and hearing aid-related technology have both advanced. Furthermore, cooperation between ENT divisions and institutions for hearing-impaired children has recently become highly organized. At present, screening programs exist for hearing loss in newborns, 18-month olds, and 3-year olds. As a result, hearing problems can now be detected at an early age. This report describes two aspects of hearing screening: first, the history of education in hearing impaired children and audiometric evaluation in infants; and second, procedures for audiometric evaluations in infants and interventions in children diagnosed with delayed speech and language development or hearing problems. The scoring systems for behavioral observation audiometry, conditioned orientation response audiometry, and play audiometry tests performed at the Chiba Children's Hospital are also presented. In hearing screening for infants, it is very important to look at their development in its entirety. It is also essential to consider whether the development of infants is normal compared to that of other infants of the same age.
The authors conducted a comparative study of vocabulary capacity (VA) in nine congenitally deaf children treated by different methods of compensating hearing and wearied age. The conclusions were as follows. 1) Group A (three cases with a cochlear implant [C. I.] since age of 2 years) had VA abilities appropriate for their chronological age (C. A.) at 3 years 5 months of age. At that time the mother-child relationship stabilized. 2) Group B (three cases with C. I. since 6 years 6 monts of age and a hearing aid [H. A.] since 2 years 1 month) had VA abilities appropriate for C. A. at 6 years 3 months of age with a H. A.. The mothers were emotionally unstable, before the C. I. operation, but the mother-child relationship stabilized after the operation. 3) Group C (three children with H. A. since 1 years 3 months of age) had VA abilities appropriate for C. A. at 5 years 10 months of age, at the time their mothers were emotionally unstable. 4) If conditions for learning languate and speech are met in 1 or 2 years, up to the school age (for 6 years), deaf children had VA abilities appropriate for C. A., and there was no problem wearing the C. I. at 6 years of age.
Screening of newborn infants for hearing loss was started on a trial basis in Japan in 1997, but not all newborns were screened, meaning that many children with hearing loss are diagnosed more than 6 months after birth. To improve this situation we investigated why many children were diagnosed more than 6 months after birth. We reviewed the records of 31 patients with hearing loss (15 males, 16 females) at Tokyo University Hospital born in 1997-2003 who did not undergo newborn screening. In 80% of them the hearing loss was detected more than 18 months after birth. The first reason was that doctors told parents there was no problem, and to wait and see when they grow up. The second reason was nurses told parents there was no problem. If all the newborn underwent screening, fewer children would be diagnosed later. The results show that education of doctors and nurses in regard to children with hearing loss is most important.
This study examined the relation between sign and written language instruction combined with oral communication training of children before cochlear implantation and auditory-based language acquisition after surgery. We assessed language modality before and after cochlear implantation in five children who were implanted between 2 years and 4 years of age and who had received language training by the Kanazawa method. They showed significantly greater rates of improvement in auditory modality than children, although even at 24 months postimplantation the number of words obtained by the visual modality was still greater than obtained by the auditory modality. They had already increased the accuracy of their receptive vocabulary with sign language and written language, and that was useful in the process of establishing the auditory modality. The visual modality obtained before implantation provided important information to children in the auditory training process. We concluded that even before cochlear implantation language training based on the visual modality is useful for infant children with hearing impairment.
Introduction We assessed the efficacy of hyperbaric oxygenation therapy (HBO) for idiopathic sudden sensorineural deafness and considered concerning the adaptation standard of HBO. Materials and Methods A retrospective survey was conducted of 198 cases of idiopathic sudden sensorineural deafness treated at Kitasato University Hospital during the period from September 1998 to July 2005. The HBO group (124 patients) was treated by HBO, intravenous drip infusion of prostaglandin E1, steroids, vasodilators, and vitamins. The No-HBO group (control group, 74 patients) was treated by all of the above methods except HBO. We investigated the relationship between hearing recovery and HBO by logistic regression analysis. Results There were cases of cure in grades 4 of the HBO group, but it did not exist in Grade 4 of the No-HBO group. In regard to HBO There was no statistical significance in each grade. Conclusion Our study confirmed that as for HBO there is no necessity for grades 1, 2 and 3. In case of Grade 4 if the patient desires, we should treat with HBO.
Infants diagnosed with hearing loss before 6 months of age obtained significantly better language scores than infants diagnosed after 6 months of age, regardless of the degree of hearing loss. Thus, screening all infants, diagnosing hearing loss within 3 months, and instituting intervention within 6 months are recommended. In 2003 and 2004, newborn infants were screened for hearing by the two-stage auditory brainstem response in Tachikawa City as a model project in Tokyo. A total of 1506 (44%) infants were screened. Four infants (0.26%) required an auditory diagnostic test. The degrees of hearing loss of all four infants were checked in our hospital. One infant (0.066%) was diagnosed with bilateral severe to moderate hearing loss. He was sent to Higashiyamato Medical Center for the Severely Disabled, and his hearing loss has been followed by auditory brainstem response in our hospital. Three infants were diagnosed with unilateral severe hearing loss, and two of them were followed in our hospital. The family of the third infant moved to another city. The incidence of bilateral severe to moderate hearing loss in the newborns in our screening was almost the same as in other reports. Important things are how to explain the results of the examination to the patients' family and how to start early education and treatment, such as with cochlear implants, and how to maintain this project.
Assistive listening devices that can improve the sound environment of a classroom are necessary for students with impaired hearing. We evaluate that RASTI that was appreciable combination between Signal-Noise ratio (SNR) and the reverberation time (RT) was assumed to be an index and a tendency to the speech discrimination and subjective evaluation under noise and/or reverberation time for selection the assistive listening devices and improving sound environment for the students in the class room. Our results showed a correlation between sentence discrimination levels and RASTI, and when reverberation time was adjusted to 0 seconds, all subjects' evaluations improved. The necessity that was examined when we select assistive hearing device, digital hearing aid with directional microphone and FM system that can improve RT, we must consider not only SNR but also RT.
The purpose of this study was to retrospectively investigate fluctuations in hearing levels and the efficacy of hearing aids during the observation period in children with hearing loss, multiple disabilities, and motor disorders. Accurate hearing evaluations are difficult in children with multiple disabilities, and assessment of the efficacy of hearing aids is also difficult. Eighteen children with multiple disabilities and motor disorders were fitted with hearing aids, and auditory behaviors were investigated in the follow-up study. Eight patients had ABR thresholds corresponding to COR minimum response levels (MRLs), and the hearing level did not change in the advanced hard of hearing group. The behavioral hearing testing MRL level improved in six of the ten patients in the moderate hard of hearing group as they grew. Seventeen of the eighteen patients were able to use hearing aids, and nine patients had efficacy of hearing aids, four patients discontinued using of hearing aids. Two of the four patients who discontinued using hearing aids were under assessment for insertion of a cochlear implant. Hearing aids and cochlear implants were effective to development help of communications, although in many cases oral expression is difficult of the problem of the mind and body development and the vocal speech organ. It was necessary to adequately consider the physical condition and development in the repetition trouble child though of the early stage of the hearing aid was recommended in the hard hearing child of normal development.