Ashitani Michiko, Ueno Chiho, Doi Tadashi, Kinoshita Toshihiko, Tomoda Koichi
Department of Education, Shiga University, Japan.
Int J Pediatr Otorhinolaryngol. 2011 Nov;75(11):1431-5. doi: 10.1016/j.ijporl.2011.08.009. Epub 2011 Sep 8.
Functional hearing loss is a condition in which hearing is lost without actual pathology. In children, inattention during pure tone audiometry may be due in part to functional hearing loss. This study examined the issue of inattention as a psychological trait by analyzing the clinical features of functional hearing loss children in Japan.
Using the ADHD-Rating Scale IV, 97 functional hearing loss children were screened for inattention (27 boys, 70 girls; mean age 9 years 5 months, range 5-17 years). Those with high levels of inattention (Inattention group) were compared with others (Attention group) for clinical features statistically. Furthermore observed psychological clinical features were described.
36.1% were categorized in the Inattention group, which had more boys, lower in age, and had more physical, developmental, and environmental problems than the Attention group. Two groups had very different psychological feature.
In children's functional hearing loss, there exists a group with psychological trait of inattention. Three younger children 5-6 years old with attention problems showed no psychological problems, their FHL was considered to be caused by generalized maturation and development. Nearly all of the rest children showed psychological problems, supporting the notion that FHL in children is psychogenic in nature. Because clinical features in Inattention group children were different from the Attention group significantly, it was concluded that distinguishing the Inattention group as a subtype of functional hearing loss in children would be effective for both diagnosis and treatment. Larger scale studies with many angles needed for the inattention problem in FHL children.
功能性听力损失是一种没有实际病理改变却出现听力丧失的情况。在儿童中，纯音听力测试时注意力不集中可能部分归因于功能性听力损失。本研究通过分析日本功能性听力损失儿童的临床特征来探讨注意力不集中这一心理特质问题。
使用《注意缺陷多动障碍评定量表第四版》，对97名功能性听力损失儿童进行注意力不集中筛查（27名男孩，70名女孩；平均年龄9岁5个月，范围5 - 17岁）。将注意力不集中程度高的儿童（注意力不集中组）与其他儿童（注意力集中组）在临床特征方面进行统计学比较。此外，还描述了观察到的心理临床特征。
36.1%的儿童被归类为注意力不集中组，该组男孩更多，年龄更小，且比注意力集中组有更多的身体、发育和环境问题。两组的心理特征差异很大。
在儿童功能性听力损失中，存在具有注意力不集中心理特质的群体。3名5 - 6岁有注意力问题的年幼儿童未表现出心理问题，他们的功能性听力损失被认为是由普遍的成熟和发育引起的。几乎所有其他儿童都表现出心理问题，支持了儿童功能性听力损失本质上是心因性的观点。由于注意力不集中组儿童的临床特征与注意力集中组有显著差异，得出结论：将注意力不集中组作为儿童功能性听力损失的一种亚型进行区分，对诊断和治疗都将是有效的。对于功能性听力损失儿童的注意力不集中问题，需要从多个角度进行更大规模的研究。
