高度難聽兒에 對한 殘存聽力
A Study on Residual Hearing of Hearing Impaired Children
이규식, 김두희,
소속 상세정보
이규식 ( Rhee Kyu-Shik )
한국사회사업대학 특수교육연구소 청능연구실
김두희 ( Kim Doo-Hie )
경북대학교 의과대학 예방의학교실
KMID : 0371019730060010051
Abstract
高度難聽兒에 對한 殘存聽力을 調査하기 爲하여 1973年 3月 10日부터 同年 11月 28日까지 韓社大 附屬 聾學校 在學生 207名(初等 138名, 中等 47名, 高等 22名), 즉 男 135名, 女 72名을 對象으로 問診을 痛한 社會醫學的 背景調査와 特殊敎育硏究所 防音室에서 AS-105型 診斷用 TRIO 聽力測程器에 依한 聽力檢査結果, 다음과 같은 成績을 얻었으므로 이에 報告하는 바이다.
(1) 義務敎育인 初等敎育의 就學率도 正常兒에 있어서와 달리 難聽出現率에 比例하여 高度難聽兒에 있어서는 女子쪽이 顯著히 낮은 傾向이었고, 上級學校(中, 高)에 進學할수록 더욱 甚한 隔差를 보였다.
(2) 適齡期(初等 滿 6歲, 中等 12歲, 高等 15歲)에 入學한 學生은 11.3%, 學齡期 (初 6歲∼11歲, 中12歲∼14歲, 高 15歲∼17歲)에 在學하고 있는 學生은 45.9%(男 43.7%, 女 50%)이었다.
이러한 現象은 現場敎育이 期待에 副應치 못하며 障害兒童을 忌避하고 臨床的으로만 聽力을 改善할려는 父母의 學歷, 職業(農業과 販賣業이 50.8%) 및 心理的인 現象과 大部分의 耳鼻料病阮에 殘存聽力을 正確히 判斷할 수 있는 幼兒聽力檢査 施設이 없으므로 早期發見과 對策을 講究치 않는데 基因된다고 思料된다.
(3) 失聽이 될 수 있었던 原因은 大槪 先天性 23.6%(遺傳性 13.5%, 姙娠時異常 10.1%), 後天性 47.9%(痙? 11.6%, 紅疫 7.7%, 熱病 7.7%) 藥物中毒 3.4%, 腦膜炎 2.4%, 腦炎 1.5%, 其他 31.3%), 不明 28.5%인 傾向이었다.
(4) 失聽時期는 6個月 以內가 31.4%(先天性 24.2%), 生後 2∼3年 14.0%, 6∼12個月 11.6%, 1∼2年 9.7% 順으로 生後 3年內 失聽된 學生이 約 90%(138名)로 大部分이었다.
(5) 難聽原因에 따른 聽力損失度와 失聽時期와는 一定關係를 發見할수 없었으며 難聽種類別로는 全音性이 2名, 混合性이 8名이고 感音性이 97.5%(197名)로서 大部分이었다.
(6) 500 Hz 中心(B=a＋26＋c/4)의 平均 聽力損失度에 따른 殘廳實態는 正常聽力者 2名(自閉症 1名, 高度의 言語障害兒 1名), 41∼55dB의 殘廳을 가진 學生이 4.8%(10名), 56∼70dB가 19.3%(40名), 71∼90dB가 18.4%(38名), scale out(91 dB 이상)가 단지 23.3%(48名)였고, 檢査不能이 33.3%(69名)였는데 大部分이 初等 1∼2年生과의 精神薄弱을 겸한 重複障害兒도 多少있다. 適當한 訓練을 實施하였다면 正常兒와 類似하게 一般學校에서 在學이 可能한 相當數의 學生이 學校, 社會, 父母의 잘못으로 因 하여 聾이 아닌 相當數의 學生을 聾學生으로 만들었다고 생각하지 않을 수 없다.
(7) 補聽器裝用者는 12%(207名中 26名)에 不過했으며 이를 殘聽別로 보면 41∼55 dB의 殘聽을 가진 學生은 60%(10名中 9名), 56∼70dB 學生은 20%(40名中 8名), 71∼90 dB 學生은 13%(38名中 5名). scale out는 10%(48名中 5名), 檢査不能者는 3%(69名中 2名)로 補聽效果를 즉시 認識할수 있는 殘聽을 가진 者는 比較的으로 많은 學生이 裝用하고 있으나, 短時日에 補聽效果를 期待키 어려운 殘聽이 적은 學生은 裝用치 않고 있는 傾向이었다.
이現象은 大部分의 學生이 音에 對한 傾聽態度마저되어 있지 않아 敎師와 家庭의 補聽器에 對한 理解와 Acoustic method에 依한 聽態訓練에 對한 充分한 知識이 缺如된데 基因된다고 推定된다.
This paper illustrate residual hearing and socio-medical background on the hearing impaired children, 207 comming to Deaf School. attached to Hankuk Social Work College, Taegu, Korea.
The survey was performed through interview with their parents and testing by diagnostic audiometer (TRIO, AS 105 type) at soundproof room from March 10, to November 28, 1973.
The results obtained were as follows.
1) The attendance rate of the compulsory primary school was markedly lower tendency in female than male according to directly proportional to prevalence rate of deafness among them. If was showed the deeper gap in the more superior school (middle and high school).
2) Who entered at the suitable age to each school (six years old to primary school, 12 years to middle and 15 years to high) was 11. 3%. And who were enrolled in school age to each school (611 years for primary. 12-14 years for middle and 15-17 years for high) was 45.(9% (43.7% in male, 50.00/, in female).
3) As causative disease, congenital case, were 23.6% included of 13.5% of heredity and 10.1% of troubles during pregnancy; the total acquired cases were 47´9%, it was classified as 11.6% of convulsion from any other diseases, 7. 7% of measles, 7. 7 % of other febrile diseases, 3. 4% of drug (the most of streptomycin) intoxication, 2.4% of meningitis, 1. 5% of epidemic encephalitis and 31.3% of other diseases; and unknown cases were 28.5%.
4) 31.4% of who included congenital cases lost their hearing within six months -old, 11_ 6% in 611 11 months. 9. 7 % in.1-2 years old and 14.0% in 2-3years old, Consequently we obtained that the most cases 90. 0% were lost. their hearing within 3 years after birth.
5) According to qualities of hearing losses the most of cases were perceptive, 197(97.5%), only two cases were conductive, and eight cases were mixed.
6) The status of residual hearing according to average grade of hearing loss, B(= a+2b+c as table 13) were as follows. Two cases were normal (one was mute and another was severe speach disorder). Ten cases, moderate. Moderately severe cases were 40 (19.3%). Severe cases, 38(18.4%). Scale out, profound cases, 48 (23.3%). And impossible testing cases because that were infantile or had some mental disorder were 69 (33.3%).
7) The using rate of hearing aides was only 12.0%. Among them who had some more residual hearing and could showed hearing effect with hearing aide have used more many proportionary but who were difficult to expect that effect were rare.
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