儿童听力科普常识
宁耳听力贴心关怀您的听力。。。。。。
如何判断您的孩子是否有听力障碍呢?
我们先来看看听力正常的孩子听觉发育及行为特征;
1~3个月:会对声音产生反射性反应、如惊跳、哭闹等
3~6个月:能够寻找声源并区分不同的声音
6~9个月:定位反应:对一些声音表示关注(如室外的动物、车、雨声)
9~12个月:能够说一些较为简单的叠词,如爸爸、妈妈、哥哥等
12~15个月:对简单语言的反应:小声呼唤(姓名、妈妈、再见)、随音乐摆动身体、模仿单音
15~18个月:识别身体部位和物品:眼、耳、嘴、鞋、衣、帽等
18~21个月:识别自己熟悉的物品:玩具马、狗、飞机、皮球等
21~24个月:有一定的词,句能力:听力接近于成人水平、指出熟悉的画或图片
2岁之后:基本与成人一致
您也可以从以下几个方面的迹象,早期发现孩子的听力问题:
1,听觉反应迟钝
●睡觉异常安静很少被大声吵醒;
●叫名字不回头次数较多;
●对大声有反应,对小声不理会
●对拍手关门声有反应,对X不敏感;
●听声音时习惯将头转向一侧。
2,语言发育迟缓
●10个月仍不会发“baba”,“mama”等声音;
●1岁半时仍不会说12个有意义的词;
●2岁左右只会说1~2个词,如“爸爸”、“妈妈”
●某些音发不准,如“3”、“4”、“7”、“10”等;
●只会重复别人的话,不理解别人说话的内容。
3,日常行为及交流
●平时性格暴躁,不听指挥;
●平时较为孤独,不愿交流;
●别人和他说话,他不看别人;
●注意力不集中,常常答非所问;
●反问较多,常把电视音量放大;
●唱歌或做操时,常合不上节拍。
儿童听力检查
新生儿听力筛查常见流程:出生72小时–OAE初筛;42天–OAE、AABR复筛;3个月–诊断(OAE、ABR\ASSR);对确诊为性听力障碍的患儿应当在出生后6个月内进行相应的临床医学和听力学干预。
1,※客观检查(无需孩子配合的测试)
●耳声发射(OAE):如果婴儿有蜗性听力损失,就不会产生耳声发射,OAE测就通不过。
●自动听性脑干反应(AABR):自动听性脑干反应(AABR)可以反映外耳、中耳、耳及蜗神经通路的功能,测试不通过,说明听觉通路上可有问题。
●多频稳态脑干听觉诱发电位(ASSR)可对婴幼儿及智者进行详细的听力评估。其应用范围为:气导、骨导、声场测试(包括裸耳和助听)为验配助听器及其助听效果评定提供听力学依据。
●声阻抗:帮助确认孩子的中耳是否出现病变。
※适合无法进行主观检测的孩子
2,主观检查(需要孩子主观进行反应的测试)
●常用于6个月以内的婴儿(以及无法配合其他主观测试的孩子):行为观察测听法(BOA),即通过观察幼儿对声音的非条反应来评估听力的一种方法。
●常用于7个月~2.5岁的小儿:视觉强化测听法(VRA),即通过建立幼小儿童的“听–社条件反射的方法来获得听力阈·直。
●常用于2.5~6岁的小儿;游戏测听法(PA),即把测听过程融合在儿童游戏活动中增加儿童的兴趣,顺利完成测听的方法。
客观测听的主要作用是帮助医生确诊患儿的听损部位、验配助听器的主要指标还需以主观测听为准。
3,检查结果
1、什么性质的听力损失?
传导性听力损
病变部分一般分布在外耳或中耳。
听损程度一般在轻度到中度之间。
感音神经性听力损失
外耳及中耳无问题,耳蜗或听神经对声音的感知出现问题。
听损程度不等,一般呈低频好高频差的斜坡型听力曲线。
混合性听力损失
具备传导性和感音神经性的双重特点。
一般来说,随年龄增长而产生的双耳听力下降大部分属于感音神经性听力损失。
2,什么程度的听力损失?
验配师根据听力检测报告单,计算出平均听力损失程度,单位分贝(dB)。并根据听力分级标准判断听损程度。世界卫生组织听力障碍分级标准:
正常:0—25dB 重度:61—80dB
轻度:26—40dB 极重度:>80dB
中度:41—60dB
选择儿童助听器
如果孩子已确定患有听力损失,那您知道该如何帮他选择助听器,让他尽早回归有声世界吗?奥迪康听力给您以下建议:
1,能听到声音吗?听到声音是听清以及理解语言的前提,是回归有声世界的重要一步。而助听器的功率大小决定了孩子是否能够得到足够的响的补偿。因此助听器的功率是您首要考虑的因素。
2,能听到多少?正常人耳能听到20Hz-20000Hz范围内各种音调的声音。我们将这种范围称为频宽。因此助听器的频宽就决定了您的孩子能听见多少声音。一般而言,儿童比成人需要更宽的频响范围来分辨/s、c等清辅音,它们在语言中承担着重要角色。因此在给儿童选择助器时,更应该考虑较宽的频率补偿范围。

3,声音处理真实吗?患有听力损失的耳朵比正常耳朵能听到的声音大小范围要窄,助听器必须将正常耳朵能听到的声音全部压缩到听损患者的听觉动态范围内。很多有助听器佩戴经验的人会说:“还是以前的模拟机声音真实”。没错,因为模拟机使用的是没有压缩的放大模式3声音处理真实吗?声音自然真实。但是模拟机的缺点就是“声音小了听不见、声音一大就吵”,而现在的数字机很好的解决了这“大小声”的问题。但是由于压缩功能的开启也不可避免的会让声音变得失真怪异。那么,我们就需要寻找一款既能让孩子听到的都是真实自然不失真的声音,而且在嘈杂环境中又不会觉得吵的助听器。
4,能自动降噪吗?我们生活在一个充满噪声的环境中。对于初生的婴幼儿来说,由于接触噪声的机会较少,所以我们的建议是把降噪系统关闭以确4能自动降噪吗?保他能聆听到各种声音但是随着孩子年龄的增长,接触噪声的机会也会逐渐增加(学校、公园、超市等)那么助听器能否在这些嘈杂环境中自主的分辨出哪些是需要放大的言语信号,哪些是需要降低的噪声信号,并分别进行处理就非常重要了。
5,有针对儿童的辅助功能吗?儿童的耳廓小且柔软,如果选配耳背机必须选择小巧轻薄的机身,这能防止“招风耳”的产生。耳背机因X在外面,因此杰出的5有针对儿童的防潮防汗设计能有效应对孩子的日常活动环境。由于幼儿无法主辅助功能吗?观表达助听器的当前状态,因此为这些孩子挑选助听器时,应选择有“指示装置”的产品,以方便家长和老师了解助听器的当前工作状态。
案 例
姓名:蒋XX

性别:男 年龄:9岁
助听器佩戴时间:6年
原配机型:W品牌助听器2台
助听器佩戴史及基本听觉功能:
两岁时在当地儿童医院检查出有听力损失,XW品牌助听器两台。四年后再次更换W品牌助听器佩戴至今。该儿童能进行基本交流但经常需要重复语句或词才能听得明白,回答问题时声音响亮但不能很好的控制自己讲话的响度,吐字不够清晰,且自述上课时虽然是在排但老师讲话的声音还是听不清楚,下课的X也听不到(小孩在正常学校随班就读)。
验配机型:
1,小老虎 Safari900SP两台 2,蓝牙伴侣和蓝牙麦克风
两周后家长反馈: 1,以前只要助听器戴的时间一长孩子就不愿再戴老是说耳朵疼换了这个助听器之后孩子再也没有说过耳朵疼。(原来使用的是675电池的助听器)
2,能听到一些以前没听到过的声音:“吃棒棒糖的吸吮声”、“上下课的X”等,并且说话的口齿也比以前清楚很多。
3,以前由于孩子还小不会反应,只有家长在叫他没反应的时候才会发现原来助听器已经没有电了。现在从助听器的外部指示器上就能很直观的了解到助听器当前的工作状态。
4,以前在嘈杂的环境中(KFC、麦当劳)和孩子交流要等孩子的注意力完X中在自己身上并助动机
且要面对面才能交流。现在即使孩子低着头吃薯条时交流也基本顺畅。
5,上课时请老师佩戴蓝牙麦克风,孩子能清晰的听到老师上课的内容,提升学习的效率。
分析:
● 小巧轻薄的机身减轻孩子耳朵的负担;
● 直观的“外部指示器”帮助家长更好的了解助听器当前工作状态;
● 宽频技术帮助孩子听到更多声音;
●“空间净噪”帮助孩子在噪声环境中更好的交流;
● 麦克风能加强孩子语言训练;随班就读听清老师讲课。有效解决距离回声和环境噪音带来的困难。
以上案例证明:给孩子选配助听器只是步,如何选择一个适合孩子的助听器才是重点
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