難聴児の療育

Size: px

Start display at page:

Download "難聴児の療育"

つねたけいなおか
5 years ago
Views:

1 Audiology Japan 52, , 2009 :

2 140 Audiology Japan 52, 2009 Downs MP 90dBSPL Hz Downs MP Joint Committee on Infant Hearing JCIH automated auditory brainstem response : AABR ABRotoacoustic emissions : OAE National Institute of Health NIH NICU JCIH early hearing detection and intervention programs : EHDI programs NICU universal newborn hearing screening : UNHS JCIH auditory neuropathy/dyssynchrony NICU ABR

3 141 NICU Thompson DC Review

4 142 Audiology Japan 52, 2009 ABR OAE

5 143

6 144 Audiology Japan 52, 2009 CT MRI behavioral observation audiometry : BOA conditioned orientation response audiometry : COR peep show test play audiometry BOA COR BOA COR warble tone BOA COR BOA COR auditory brainstem response: ABR auditory steady state response : ASSRotoacoustic emissions : OAE

7 145 warble tone 60 70dB HL 50 60dB HL 40 50dB HL 30 40dB HL 20 30dB HL 100% 90% 80% 70% 60% 50% 40% 30% COR 20% 10% BOA 0% 0M 5M 6M 11M 1Y0M 1Y5M 1Y6M 1Y11M 2Y0M 2Y5M 2Y6M 2Y11M 3Y0M 3Y5M 3Y6M 3Y11M 4Y0M 4Y11M 5Y0M 5Y11M N=324 ABR Hz ASSR

8 146 Audiology Japan 52, ABR ABR ASSR ASSR OAE BOA COR BOA COR ABR ABR ABR ABR BOA COR

9 NHS NHS 147

10 148 Audiology Japan 52, 2009 NHS NHS FM 169MHz 30m

11 149 LAN Rehabilitation in children with hearing loss Hiroshi Yamashita, Noriko Morita, Naoko Ujita Department of Otolaryngology, Yamaguchi Graduate School of Medicine Department of Otorhinolaryngology, Teikyo University School of Medicine Department of Communication Impairments, National Rehabilitation Center for Persons with Disabilities Hospital Hearing screening systems The transition and the present situation of worldwide and domestic newborn hearing screening are reported. The incidence of bilateral hearing loss was about in 1,000 infants. About and in 1,000 low risk and high risk infants had bilateral hearing loss, respectively. According to the survey questionnaire that was sent to all domestic department of otolaryngology which were recommended by the Otorhinolaryngological Society of Japan, 75 of the infants referred to the department of otolaryngology accepted audiologic and medical evaluations before 3 months of age and 15.6 of them had early intervention services. On the other hand, 14.3 of the infants who passed newborn hearing screening but were referred to the department of otolaryngology had hearing loss. The transition and the actual situation regarding hearing screening for three year old children which is legislated in Japan are also reported. Eight hundred and forty eight thousand, two hundred and eighteen children underwent hearing screening in Six hundred and twenty seven of them 0.07 had hearing loss. The number of children who had bilateral sensorineural hearing loss in 2007 was the same as it was in Both reports clarified that hearing rescreening systems subsequent to newborn hearing screening should be provided.

12 150 Audiology Japan 52, 2009 Audiological and medical evaluation for infants, toddlers and preschoolers Audiological and medical evaluation for infants, toddlers and preschoolers is quite different from such evaluation in adults. As for audiological evaluation, developmental assessment is also necessary to arrive at appropriate measures. The procedures and points in mind for behavioral audiometry behavioral observation audiometry, conditioned orientation response audiometry, peep show test and play audiometry, auditory brainstem response, auditory steady state response and otoacoustic emissions are explained. The medical evaluation is as follows : physical examination, clinical history, family history of childhood and onset of permanent hearing loss, identification of syndromes associated with early or late onset permanent hearing loss and radiologic and laboratory studies. Knowledge of pediatric hearing loss is mandatory so that otolaryngologists can evaluate synthetic and comprehensive hearing loss in children. Rehabilitation of children with hearing loss Although the current situation regarding rehabilitation of children with hearing loss in Japan still presents some problems, these children and their families now have more options for a possible institute and/or method for rehabilitation than before. Moreover, rehabilitation goal setting has been gradually changing, moving away from the idea of working towards obtaining normal hearing and rather approaching the viewpoint of living with being hard of hearing so that affected children can actively seek various possibilities in their own lives. Downs MP, Hemenway WG : Report on the hearing screening of neonates. Int J Audiol 3 : 72 76, 1969 Downs MP : The identification of congenital deafness. Trans Am Acad Ophthalmol Otolaryngol 74 : , 1970 Joint Committee on Infant Hearing : Screening for infant hearing. AAP Newsletter Supplement. Oct 1973 National Institute of Health : Early identification of hearing impairment in infants and young children. NIH Consensus Statement 11 : Joint Committee on Infant Hearing Year 2000 Position Statement : Principles and Guidelines for Early Hearing Detection and Intervention Programs. Pediatrics 106 : , 2000 Joint Committee on Infant Hearing Year 2007 Position Statement : Principles and Guidelines for Early Hearing Detection and Intervention Programs. Pediatrics 120 : , 2007 : Bubbico L, Tognola G, Greco A, et al : Universal newborn hearing screening programs in Italy : survey of year Acta Otolaryngol 128 : , 2008 : Thompson DC, McPhillips H, Davis RL, et al : Universal newborn hearing screening : summary of evidence. JAMA 286 : , 2001 :

13 151 : 107 : 109 : : 111 : : : 26 : : 111 : : JOHNS 16 : , 2000 : pp : ASSRAudiology Japan 49 : , 2006 : 10 : : 47 : : : Audiology Japan 51 : , 2008 : Reprint request : Hiroshi Yamashita Department of Otolaryngolgy, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi , JAPAN

202

202 201 Presenteeism 202 203 204 Table 1. Name Elements of Work Productivity Targeted Populations Measurement items of Presenteeism (Number of Items) Reliability Validity α α 205 α ä 206 Table 2. Factors of