Fellendorf G W
Otolaryngol Clin North Am. 1975 Feb;8(1):187-218.
The management of a hearing impaired child involves the family as well as the child himself, especially when the child is very young. Delivery systems therefore must include the parents as an integral part of the delivery chain and be sensitive to the parents' need to understand the treatment or therapy and, when appropriate, to sustain it in the home. Health care services that have educational implications have been termed eduhealth, which in the case of the hearing impaired child, refers to such services as the early detection of hearing loss, the proper fitting of hearing aids, the prompt treatment of upper respiratory infections that might lead to further hearing loss, and vision screening. The otolaryngologist, audiologist, and parent all have eduhealth responsibilities. Professionals in medicine and allied fields, although well trained and experienced in their specialities, are rarely prepared to meet all the needs of the young hearing impaired child and his parents with appropriate services and in the manner most appropriate for them. Some agencies, however, have demonstrated comprehensive capabilities in this area. In referring a family to a delivery system, the otolaryngologist should establish to his own satisfaction that the requisite skills are present. Common complaints of parents of hearing impaired children are the lack of communication with the physician and clinician, which is frequently the result of the vocabulary used by the specialist and the limited time spent with the parents during visits. The result can be parental failure to follow instructions and possibly irreversible damage to the child's development of listening, language, and speech skills. The eduhealth delivery service index is a new attempt to measure the effectiveness of systems for the delivery of education and health care services to young hearing impaired children and their parents. It has been demonstrated in a limited population and may prove useful in the comparison of delivery systems. The otolaryngologist is urged to become better acquainted with the various elements of delivery systems and to be cautious in accepting claims of comprehensive quality services until verified by his own experience or the reports of actual consumers of the services offered.
对听力受损儿童的管理涉及家庭以及儿童自身，尤其是当儿童还非常年幼时。因此，服务提供体系必须将父母纳入其中，使其成为服务链中不可或缺的一部分，并要考虑到父母了解治疗或疗法的需求，在适当的时候还要考虑到父母在家中持续进行治疗的需求。具有教育意义的医疗保健服务被称为“教育医疗”，对于听力受损儿童而言，这包括诸如听力损失的早期检测、助听器的正确适配、对可能导致听力进一步损失的上呼吸道感染的及时治疗以及视力筛查等服务。耳鼻喉科医生、听力学家和家长都负有教育医疗方面的责任。医学及相关领域的专业人员尽管在各自的专业领域接受过良好的培训且经验丰富，但他们很少能准备好以最适合的方式为听力受损的幼儿及其父母提供所有适当的服务并满足他们的所有需求。然而，一些机构已在这方面展现出全面的能力。在将家庭转介至某个服务提供体系时，耳鼻喉科医生应确保该体系具备所需技能，让自己满意。听力受损儿童的家长常见的抱怨是与医生和临床医生缺乏沟通，这往往是由于专家使用的专业词汇以及就诊时与家长相处的时间有限所致。结果可能是家长未能遵循医嘱，进而可能对儿童的听力、语言和言语技能发展造成不可逆转的损害。教育医疗服务提供指数是一项新的尝试，旨在衡量为听力受损的幼儿及其父母提供教育和医疗服务的体系的有效性。它已在有限的人群中得到验证，可能在比较不同的服务提供体系时发挥作用。敦促耳鼻喉科医生更好地了解服务提供体系的各个要素，并在经过自身经验或服务实际消费者的报告证实之前，谨慎对待有关全面优质服务的说法。
