DEAF CHILD

Anton B. Darmawan

Definition

Deaf child is an impairment to communication at any age

Aetiology
1.

Hereditary

Mendelian law (sex linked) Severe deafness recessive Mild dominant 4 in 10.000 live births

2. Prenatal
Maternal illnes in first 3 or 4 months preganancy Rubella the commonest (30%) moderate to severe deafness Toxic influenza, nephritis, or drugs (aminoglycosides, thalidomide) in woman & fetus Congenital siphylis Congenital CMV

3. Natal Prematurity & birth injury 4. Neonatal Kernicterus from Rh incompatibility High tones deafness Dorsal & ventral cochlear nuclei; sup & inf coliculi and medial geniculate ganglia damage anoxia

Clinical Features

Severe or total deafness

Deaf-mutism Academic attainment limited Late development of speech Delayed progress at school Intelligence is normal

Lesser degree

Diagnosis

Personal and familiy history Otoscopic appearance Objective test Psychological assesment

DD

Aquired deafness before speech has developed--- meningitis Mental defectiveness--- DS Aphasia of central origin Dyslexia (word blindness) Autism

HEARING TEST IN CHILDREN (Gray, 1992)

Reflex test : 1. At birth, moro reflex 2. At 3 months, blinking and frowning 3. At 5 months, eyes turn toward a sound source 4. At 6 months, the head turns towards a sound source

Behavioural test (Gray,1992)

At 7 18 months, distraction test At 18 months 2,5 years, perform a simple test in response to the sound

Performance test

Between 2 and 5 years,the child may be asked verbally to perform tasks

Subjective test

Visual reinforced audiometry,

The young child is conditioned to press a button when a sound is heard.

Conditioned audiometry,

The child is taught to build a tower of bricks or to put bricks into a basket each time he hears the test sound

Objective test

ECochG BSER (BERA)

Treatment

Prophylactic

Avoidance of predisposing factors Estimation of parents Rhesus groups Screening test 7-9 months school entry (between 5 & 6 ages) Cochlear implants

Therapeutic

Educational

Auditory training Lip reading Sign language Speech training Family guidance