Acta Oto-Laryngologica
ISSN: 0001-6489 (Print) 1651-2251 (Online) Journal homepage: http://www.tandfonline.com/loi/ioto20
Audiological Treatment of Preschool Children With Hearing Impairments H. F. Fabritius, V. Gaustad & A. Kallset To cite this article: H. F. Fabritius, V. Gaustad & A. Kallset (1976) Audiological Treatment of Preschool Children With Hearing Impairments, Acta Oto-Laryngologica, 82:1-6, 268-270 To link to this article: http://dx.doi.org/10.3109/00016487609120902
Published online: 08 Jul 2009.
Submit your article to this journal
View related articles
Full Terms & Conditions of access and use can be found at http://www.tandfonline.com/action/journalInformation?journalCode=ioto20 Download by: [University of California, San Diego]
Date: 14 December 2015, At: 18:54
Acta Otolaryngol82: 268-270, 1976
AUDIOLOGICAL TREATMENT OF PRESCHOOL CHILDREN WITH HEARING IMPAIRMENTS
Downloaded by [University of California, San Diego] at 18:54 14 December 2015
H. F. Fabritius, V . Gaustad and A. Kallset From the Department of Audiology, Namdal Hospital, Namsos, and Vikhov School for the Hard-ofHearing, Vikhamar, Norway
Abstract. A system by which children with impaired hearing are given early audiological treatment is reported. The treatment has been carried out during short admissions to institution alternating with stays at home. Special training and instruction of the parents are important. The authors are of the opinion that this type of preschool training is suitable for regions with scattered population. Even a small institution with a limited staff can give treatment to a considerable number of children.
The importance of the early audiological treatment of children with severe hearing impairments is generally recognized. In cities and urban districts this treatment can nowadays easily be given, without admitting the child to an institution. But in districts with a scattered population and great travelling distances-as it is the case in many parts of Norway-other means of audiological treatment must be used. Here a temporary admission to an institution will be necessary. In Norway, we have three centres where audiological treatment in institution alternates with stays at home, combined with instruction of the parents. These centres are located in kesund, Gjovik and Namsos. They vary a little according to the density of population and geographical location. We shall give a brief survey of this work in Namsos and present some of our experiences, with reference to the medical, psychological and educational points of view. In connection with the E N T Department Acta Orolaryngol82
in Namsos there is a small preschool institution called the Hearing Annex. The children are received at the H.A. immediately when their handicap is recorded. If the child is younger than 3 years, it is always admitted together with one of the parents. The stay in the institution lasts only 1 week, but is repeated at intervals of some weeks. This first admission period is used mainly to inform and instruct the parents as to how to help the child in lipreading and auditory training, as well as in the use of various technical facilities, such as hearing aids and speech amplifiers. The child is trained to adapt socially. Gradually some individual guidance is introduced. We regard these stays in the H.A. at an early age as a valuable introduction to more permanent institutional life later after the age of 3 years. In the institution the children are divided into groups of 5 or 6, according to age, speech level and ability to adapt socially. Each group stays 3 weeks in the H.A., twice in the autumn and three times in the spring. One of the parents will always accompany the child and bring it back home. This gives the parents an opportunity to establish a most important contact with the individual members of the staff. During the “stay-at-home” period the parents-usually the mother-receives a work or training programme which is revised and discussed when a new institutional stay starts.
Audiological treatment of preschool children Table I Number of children Average hearing loss
Schools Regular school
Downloaded by [University of California, San Diego] at 18:54 14 December 2015
School for the hard-of-hearing School for the deaf
4
11
8
Right ear, 76 ds, left ear, 80 dB Right ear, 93 dB, left ear, 87 dB Right ear, 103 dB, left ear, 108 dB
Every third week there is a staff meeting in the H.A. The teachers, the head of the toy library, the psychologist, the peripatetic teacher and the doctors discuss the children’s situation and status and the further programme. In the northern part of Norway there are few facilities for children with impaired hearing. As a consequence, the H.A. in Namsos serves children from a large region. They come from the five northernmost counties in Norway. The H.A. has been in operation for 7 years, and we find it is appropriate to give a survey of the results. The children are admitted to the H.A. at different age levels, depending upon the standard of diagnostic facilities and hearing treatment in their home district. Some of them have been admitted rather late. Con-
Table I1 ~~
~
Level of mental ability Mental ability far below average for the age group, IQ125 18-762959
Girls
Boys‘
0
0
0
0
0
0
8
4
Total
sequently, the audiological treatment in the H.A. has been of different duration. The minimum treatment in this series has been five admissions during 2 years and the maximum 20 admissions during 54 years. Twenty-three children had most of their preschool training in the H.A. Afterwards they had at least one year in a regular school or in a special school. Of the 23 children, 4 are in regular school, 11 in schools for the hard-ofhearing and 8 in the school for the deaf. The series of children is presented in Table I. The causes of impaired hearing were: Rubella, 11; erythroblastosis, 1; toxic otitis, 1; meningitis, 3; unknown, 5. Rubella, as the cause of impaired hearing in 11 out of 23 children is a highly important factor, although it does not have general significance. Psychological evaluation Psychological evaluation and intelligence tests have been performed in 21 of the 23 children. The tests have been carried out by five different psychologists, but most of the tests have been done by one of them. She has also made the total evaluation. Mainly non-verbal tests are used. A rough classification has been made according to Table 11. More than one-third of the children showed fluctuation in mental performance. Since nonverbal tests are used, the results of the tests and the child’s intelligence cannot be directly compared. The psychologist is more inclined to regard the results as a measure of the child’s total intellectual resources, which cor-
Table 111. Evaluation of 4 children in regular school Good
12 ~~
2 4
3 0
5 4
269
Below Medium medium
~
Speech development Social adaptability Professional status Able to use a hearing aid
1
4
3 0
1
2
0 0 1
4 Acta Otolaryngol82
270
H . F. Fabritius et al.
Table IV. Evaluation of 11 children in schools for the hard-of-hearing Good
Downloaded by [University of California, San Diego] at 18:54 14 December 2015
Speech development Social adaptability Professional status Able to use a hearing aid
5
Below Medium medium 2 3 4
must also be taken into consideration. There is no reason to believe that the educational evaluation of the children has been exceptionally mild.
4 1
Parents’ evaluation 1 We have based the preschool training upon cooperation with the parents. It was therefore 10 1 of great importance to have the parents’ opinion of our programme. We have asked respond to a high level. This may perhaps be them to answer a series of questions. Admission of small children to institutions explained by the preschool training. is undoubtedly a moot point. We asked the parents what they thought of the duration and Educational evaluation frequency of the admissions. None of the This evaluation has been made by teachers parents had any negative comments. working with the children in regular schools, The parents had no objections to staying schools for the hard-of-hearing and school for the deaf. We wanted to know the results of with their children in the institution for some preschool training in the following subjects: time. During this time, they established con(1) speech development, i.e. ability to express tact with other parents; they attended classes; oneself; (2) social adaptability, i.e. independ- they went to the kindergarten and the toy ence and contact; (3) professional status, i.e. library; they met medical and non-medical knowledge according to average level; (4) members of the staff. Some mothers found a prolonged absence from home difficult. All ability to use a hearing aid. parents appreciated the good care and the The following classification has been made: atmosphere provided for the children. But 1. Good. 2. Medium. 3 . Below medium. (Se they also suggested that normally developed Tab. 111-V). The findings show good agreement between children should have been integrated in the the results of psychological and educational institution. Three-quarters of the parents found the tests in children in the highest resource group. homework programme adequate, whereas Other factors-such as the degree of loss of one-quarter regarded it too extensive and difhearing and duration of preschool trainingficult to manage. 7 6
Table V. Evaluation of 8 children in school for the deaf
Speech development Social adaptability Professional status Able to use hearing aid Not using hearing aid
Acta Otoluryngol82
Good
Below Medium medium
5 5 5
2 2 1
7 1
1 1 2
ZUSAMMENFASSUNG Die Verfasser beschreiben einen Versuch, in dem sehr schwerhorige Vorschulkinder audiologisch behandelt werden. Dies geschieht durch kurze Internataufenthalte, die mit Aufenthalten zu Hause abwechseln. Dabei legt man besonderen Wert auf die Instruktion der Eltern. Die erzielten Resultate deuten nach Meinung der Verfasser darauf hin, daB diese Art von Vorschultraining gut fur schwach bevolkerte Gegenden geeignet ist. Man kan dadurch mit einer kleinen Institution und wenigen Mitarbeitern verhaltnismaig vielen Kindern audiologische Behandlung erteilen.
ISSN: 0001-6489 (Print) 1651-2251 (Online) Journal homepage: http://www.tandfonline.com/loi/ioto20
Audiological Treatment of Preschool Children With Hearing Impairments H. F. Fabritius, V. Gaustad & A. Kallset To cite this article: H. F. Fabritius, V. Gaustad & A. Kallset (1976) Audiological Treatment of Preschool Children With Hearing Impairments, Acta Oto-Laryngologica, 82:1-6, 268-270 To link to this article: http://dx.doi.org/10.3109/00016487609120902
Published online: 08 Jul 2009.
Submit your article to this journal
View related articles
Full Terms & Conditions of access and use can be found at http://www.tandfonline.com/action/journalInformation?journalCode=ioto20 Download by: [University of California, San Diego]
Date: 14 December 2015, At: 18:54
Acta Otolaryngol82: 268-270, 1976
AUDIOLOGICAL TREATMENT OF PRESCHOOL CHILDREN WITH HEARING IMPAIRMENTS
Downloaded by [University of California, San Diego] at 18:54 14 December 2015
H. F. Fabritius, V . Gaustad and A. Kallset From the Department of Audiology, Namdal Hospital, Namsos, and Vikhov School for the Hard-ofHearing, Vikhamar, Norway
Abstract. A system by which children with impaired hearing are given early audiological treatment is reported. The treatment has been carried out during short admissions to institution alternating with stays at home. Special training and instruction of the parents are important. The authors are of the opinion that this type of preschool training is suitable for regions with scattered population. Even a small institution with a limited staff can give treatment to a considerable number of children.
The importance of the early audiological treatment of children with severe hearing impairments is generally recognized. In cities and urban districts this treatment can nowadays easily be given, without admitting the child to an institution. But in districts with a scattered population and great travelling distances-as it is the case in many parts of Norway-other means of audiological treatment must be used. Here a temporary admission to an institution will be necessary. In Norway, we have three centres where audiological treatment in institution alternates with stays at home, combined with instruction of the parents. These centres are located in kesund, Gjovik and Namsos. They vary a little according to the density of population and geographical location. We shall give a brief survey of this work in Namsos and present some of our experiences, with reference to the medical, psychological and educational points of view. In connection with the E N T Department Acta Orolaryngol82
in Namsos there is a small preschool institution called the Hearing Annex. The children are received at the H.A. immediately when their handicap is recorded. If the child is younger than 3 years, it is always admitted together with one of the parents. The stay in the institution lasts only 1 week, but is repeated at intervals of some weeks. This first admission period is used mainly to inform and instruct the parents as to how to help the child in lipreading and auditory training, as well as in the use of various technical facilities, such as hearing aids and speech amplifiers. The child is trained to adapt socially. Gradually some individual guidance is introduced. We regard these stays in the H.A. at an early age as a valuable introduction to more permanent institutional life later after the age of 3 years. In the institution the children are divided into groups of 5 or 6, according to age, speech level and ability to adapt socially. Each group stays 3 weeks in the H.A., twice in the autumn and three times in the spring. One of the parents will always accompany the child and bring it back home. This gives the parents an opportunity to establish a most important contact with the individual members of the staff. During the “stay-at-home” period the parents-usually the mother-receives a work or training programme which is revised and discussed when a new institutional stay starts.
Audiological treatment of preschool children Table I Number of children Average hearing loss
Schools Regular school
Downloaded by [University of California, San Diego] at 18:54 14 December 2015
School for the hard-of-hearing School for the deaf
4
11
8
Right ear, 76 ds, left ear, 80 dB Right ear, 93 dB, left ear, 87 dB Right ear, 103 dB, left ear, 108 dB
Every third week there is a staff meeting in the H.A. The teachers, the head of the toy library, the psychologist, the peripatetic teacher and the doctors discuss the children’s situation and status and the further programme. In the northern part of Norway there are few facilities for children with impaired hearing. As a consequence, the H.A. in Namsos serves children from a large region. They come from the five northernmost counties in Norway. The H.A. has been in operation for 7 years, and we find it is appropriate to give a survey of the results. The children are admitted to the H.A. at different age levels, depending upon the standard of diagnostic facilities and hearing treatment in their home district. Some of them have been admitted rather late. Con-
Table I1 ~~
~
Level of mental ability Mental ability far below average for the age group, IQ125 18-762959
Girls
Boys‘
0
0
0
0
0
0
8
4
Total
sequently, the audiological treatment in the H.A. has been of different duration. The minimum treatment in this series has been five admissions during 2 years and the maximum 20 admissions during 54 years. Twenty-three children had most of their preschool training in the H.A. Afterwards they had at least one year in a regular school or in a special school. Of the 23 children, 4 are in regular school, 11 in schools for the hard-ofhearing and 8 in the school for the deaf. The series of children is presented in Table I. The causes of impaired hearing were: Rubella, 11; erythroblastosis, 1; toxic otitis, 1; meningitis, 3; unknown, 5. Rubella, as the cause of impaired hearing in 11 out of 23 children is a highly important factor, although it does not have general significance. Psychological evaluation Psychological evaluation and intelligence tests have been performed in 21 of the 23 children. The tests have been carried out by five different psychologists, but most of the tests have been done by one of them. She has also made the total evaluation. Mainly non-verbal tests are used. A rough classification has been made according to Table 11. More than one-third of the children showed fluctuation in mental performance. Since nonverbal tests are used, the results of the tests and the child’s intelligence cannot be directly compared. The psychologist is more inclined to regard the results as a measure of the child’s total intellectual resources, which cor-
Table 111. Evaluation of 4 children in regular school Good
12 ~~
2 4
3 0
5 4
269
Below Medium medium
~
Speech development Social adaptability Professional status Able to use a hearing aid
1
4
3 0
1
2
0 0 1
4 Acta Otolaryngol82
270
H . F. Fabritius et al.
Table IV. Evaluation of 11 children in schools for the hard-of-hearing Good
Downloaded by [University of California, San Diego] at 18:54 14 December 2015
Speech development Social adaptability Professional status Able to use a hearing aid
5
Below Medium medium 2 3 4
must also be taken into consideration. There is no reason to believe that the educational evaluation of the children has been exceptionally mild.
4 1
Parents’ evaluation 1 We have based the preschool training upon cooperation with the parents. It was therefore 10 1 of great importance to have the parents’ opinion of our programme. We have asked respond to a high level. This may perhaps be them to answer a series of questions. Admission of small children to institutions explained by the preschool training. is undoubtedly a moot point. We asked the parents what they thought of the duration and Educational evaluation frequency of the admissions. None of the This evaluation has been made by teachers parents had any negative comments. working with the children in regular schools, The parents had no objections to staying schools for the hard-of-hearing and school for the deaf. We wanted to know the results of with their children in the institution for some preschool training in the following subjects: time. During this time, they established con(1) speech development, i.e. ability to express tact with other parents; they attended classes; oneself; (2) social adaptability, i.e. independ- they went to the kindergarten and the toy ence and contact; (3) professional status, i.e. library; they met medical and non-medical knowledge according to average level; (4) members of the staff. Some mothers found a prolonged absence from home difficult. All ability to use a hearing aid. parents appreciated the good care and the The following classification has been made: atmosphere provided for the children. But 1. Good. 2. Medium. 3 . Below medium. (Se they also suggested that normally developed Tab. 111-V). The findings show good agreement between children should have been integrated in the the results of psychological and educational institution. Three-quarters of the parents found the tests in children in the highest resource group. homework programme adequate, whereas Other factors-such as the degree of loss of one-quarter regarded it too extensive and difhearing and duration of preschool trainingficult to manage. 7 6
Table V. Evaluation of 8 children in school for the deaf
Speech development Social adaptability Professional status Able to use hearing aid Not using hearing aid
Acta Otoluryngol82
Good
Below Medium medium
5 5 5
2 2 1
7 1
1 1 2
ZUSAMMENFASSUNG Die Verfasser beschreiben einen Versuch, in dem sehr schwerhorige Vorschulkinder audiologisch behandelt werden. Dies geschieht durch kurze Internataufenthalte, die mit Aufenthalten zu Hause abwechseln. Dabei legt man besonderen Wert auf die Instruktion der Eltern. Die erzielten Resultate deuten nach Meinung der Verfasser darauf hin, daB diese Art von Vorschultraining gut fur schwach bevolkerte Gegenden geeignet ist. Man kan dadurch mit einer kleinen Institution und wenigen Mitarbeitern verhaltnismaig vielen Kindern audiologische Behandlung erteilen.
