Minimalno oštećenje sluha kod dece sa razvojnom disfazijom

Abstract

U formuli slušnog hendikepa, samo gubitak sluha sa srednjom vrednošću većom od 25 dB se razmatra kao moguća smetnja u slušanju. Ova niska vrednost se koristi za evaluaciju sluha kako odraslih osoba tako i dece, sa stavom da odrasli nemaju teškoća u komunikaciji sve dok njihovo oštećenje sluha ne pređe nivo od 25 dB u području između 500 Hz i 3000 Hz. Pitanje je koliko je realno da se ove vrednosti koje važe za odrasle primene kao norma za dečji uzrast, jer gubitak sluha bilo kog stepena koji se pojavi kod dece može dovesti do pojave govorno-jezičkih deficita i/ili teškoća u učenju i može uticati na kognitivni i socioemocionalni razvoj. Danas većina autora smatra da je 15 dB najniži nivo urednog sluha kod dece i da minimalni gubitak sluha počinje od ove granice praga sluha. Definisanje urednog praga sluha na 15 dB ima svoje opravdanje koje leži u prirodi glasova, jer najveći deo govorne energije nose vokali i zvučni konsonanti. Bezvučni konsonanti se zbog svojih karakteristika često nalaze ispod praga percepcije i kod osoba urednog sluha u toku spontane konverzacije. Deca koja uče govor i gramatičke odnose u jeziku imaju potrebu da čuju jasno sve glasove da bi ih adekvatno ugradili u perceptualne obrasce. Cilj ovog istraživanja je bio da se ispita auditivna percepcija kod dece sa razvojnom disfazijom. Uzorak je činilo 25-oro dece sa razvojnom disfazijom i 20 dece tipičnog govorno-jezičkog i slušnog razvoja, uzrasta 5-8 godina, kod koje su primenjeni impedancmetrija, tonalna audiometrija, TEOAE, DPOAE i govorna audiometrija. Rezultati primenjenih testova pokazuju da decu sa razvojnom disfazijom treba tretirati kao decu sa minimalnim senzorineuralnim oštećenjem sluha

In formula of hearing handicap, only hearing impairment with mean value higher than 25dB is considered as possible disturbance in listening. This low value is used for evaluation of hearing ability in adults as well as in children, with the attitude that adults do not have difficulties in communication until their hearing impairment does not exceed level of 25dB in the area between 500Hz and 3000Hz. The question is, how realistic is that these values that are valid for adults apply as the norms for children age, because hearing loss of any degree that appears in children, can lead to speech and language deficits or learning disabilities, and can impact on cognitive and socioemotional development. Nowadays, most authors consider that 15dB is the lowest level of regular hearing ability in children, and that minimal hearing loss starts from this hearing threshold. Defining of regular hearing threshold at 15dB, has its justification that lies in the nature of the voices, because the most of speech energy is carried by vowels and consonants. Voiceless consonants, because of their characteristics, are very often below the threshold of perception and in persons with normal hearing ability during spontaneous conversation. Children that learn to speak and to apply the grammatical relations in language, have need to hear clearly all voices, in order to properly incorporate them in perceptual pattern. The purpose of this research was to examine auditive perception in children with developmental dysphasia. The sample comprised 25 children with developmental dysphasia and 20 children with typical hearing and speech-language development, aged 5- 8 years, in which they applied impendancemetry, tonal audiometry, TEOAE, DPOAE and speech audiometry. Obtained results indicate that children with developmental dysphasia should be treated as children with minimal sensoryneural hearing impairment.