CAJ | 학술논문

目的：探讨听力言语发育异常儿童的听力状况及听力言语异常对总体发育进程所产生的不同影响，以便及时发现听力言语轻微异常的早期迹象，积极医治与防御。方法选取6个月～8岁处于听力言语发育未达到正常小儿发育进程标准的56例儿童，详细了解小儿既往史、现病史、家族史、养育环境等成长过程的相关因素。对56例经临床听力学客观、主观听力测试均显示具有不同程度的听力损失特征的小儿进行听力言语评估，据不同的诱发因素指导相应的预防及医治护理措施。结果小儿听力损失左右耳各频率段听力损失程度不等同缺失的特征（听力在35～120 dB ），时常掩盖实际真实的听力情况，难以引起重视。小儿生长发育进程中不显性的隐匿性听力、语言问题，特别是前语言阶段难以发现，致使其中16例4～8岁小儿平时对声音不能完全做出反应，语言简单、含糊不清，学习受限；20例小儿对声音无明显察知，时常以肢体语言表示所需，与同龄听力正常小儿语言发育不一致，直至2～4岁后就诊。新生儿听力筛查、复筛均未通过，且小儿听力损失程度为20～90 dB，小儿对声音时有反应，即使配助听器也时戴时不戴，虽已参与训练且无连贯性，家长认为以后还会自然发育，以致等待1．5～2岁后就诊，延迟及早形成条件化反射。结论酷似正常的听力语言问题在小儿动态发育过程中的早期阶段常是不显性的，随着年龄逐渐增长，轻微异常迹象会有所显现，对此了解并熟悉掌握小儿听力语言发育进程的时间规律，排除相关因素影响，可尽早发现听力语言偏离及时就医，缩短小儿生长发育的落差。
목적：탐토은력언어발육이상인동적은력상황급은력언어이상대총체발육진정소산생적불동영향，이편급시발현은력언어경미이상적조기적상，적겁의치여방어。방법선취6개월～8세처우은력언어발육미체도정상소인발육진정표준적56례인동，상세료해소인기왕사、현병사、가족사、양육배경등성장과정적상관인소。대56례경림상은역학객관、주관은력측시균현시구유불동정도적은력손실특정적소인진행은력언어평고，거불동적유발인소지도상응적예방급의치호리조시。결과소인은력손실좌우이각빈솔단은력손실정도불등동결실적특정（은력재35～120 dB ），시상엄개실제진실적은력정황，난이인기중시。소인생장발육진정중불현성적은닉성은력、어언문제，특별시전어언계단난이발현，치사기중16례4～8세소인평시대성음불능완전주출반응，어언간단、함호불청，학습수한；20례소인대성음무명현찰지，시상이지체어언표시소수，여동령은력정상소인어언발육불일치，직지2～4세후취진。신생인은력사사、복사균미통과，차소인은력손실정도위20～90 dB，소인대성음시유반응，즉사배조은기야시대시불대，수이삼여훈련차무련관성，가장인위이후환회자연발육，이치등대1．5～2세후취진，연지급조형성조건화반사。결론혹사정상적은력어언문제재소인동태발육과정중적조기계단상시불현성적，수착년령축점증장，경미이상적상회유소현현，대차료해병숙실장악소인은력어언발육진정적시간규률，배제상관인소영향，가진조발현은력어언편리급시취의，축단소인생장발육적락차。
Objective To explore children with audition symptom as normal but heterophthongia impacting on the process of their growth , and try to find out the symptom of abnormal speech and hearing to prevent and cure early .Methods Fifty six children were selected at the age of 6 months to 8 years old whose development of audition and speech had not reached the normal norm and known their information relative growth factors such as medical history , present illness , family medical history and environment of growth inside out .We assessed the speech and audition of all cases by clinical objective and subjective audition test and they shown different level of audition damage .We provided different methods to prevent and cure disorders according to inducing factors .Results The characteristic of children , whose right and/or left ear had different damage ( earshot:35 -120 dB ) , usually could not arouse attention especially at early linguistic stage because of inapparent hearing and speech disorders .The delayed diagnosed audition problem already leaded that sixteen children from 4 -8 years old acquired the problems of inappropriate response to voice , simple and vague language and restricted study and twenty cases obtained no response to voice , delayed development of audition comparing with peers , and expressed their demand by body language until 2 to 4 years old until they sought medical advice .Neonatal audition had not passed first and second screen and the level of audition damage were at range of 20-90 dB; however , parents believed neonate could develop naturally when neonate grown up so that they attended training without consistency and worn hearing aid incontinuity .These kind of behavior leaded that neonate acquired medical treatment until 1.5 to 2 years and some reflections had been built up or delayed . Conclusions Children with a similar audition as normal children but heterophthongia are unapparent at early stage, but it will slight show out when they grow up .Parent should comprehend the children ’ s process of hearing and language development and try to find out language and hearing problem as earlier as possible .Early detection could decrease growth gab between children with audition problems and normal children .