Oberklaid F, Harris C, Keir E
Department of Ambulatory Paediatrics, Royal Children's Hospital, Parkville, VIC., Australia.
Clin Pediatr (Phila). 1989 Sep;28(9):397-403. doi: 10.1177/000992288902800902.
One hundred thirty-three children with school problems referred to a hospital-based multi-disciplinary clinic were screened audiologically to determine the frequency of auditory problems, and to determine whether one could predict auditory problems from clinical data. Ninety-three (69.9%) failed one or more parts of the screening procedure. Twenty-two children (7.9% of the total group) had abnormal hearing acuity, 33 (30.6%) abnormal speech discrimination in noise, and 73 (62.4%) abnormal short term auditory memory. These figures are significantly higher than those found in a representative sample of school children. Not one of 16 items from parent and teacher questionnaires and neurodevelopmental findings predicted auditory acuity or speech in noise problems; there were correlations between short term auditory memory items and parental and teacher rating of a language problem, teacher rating of reading and sequencing problem, and neurodevelopmental finding of auditory sequencing problem. In view of this inability to clinically predict auditory processing deficits, the authors suggest that a full audiological assessment, including short term memory and speech in noise testing, is warranted as part of the evaluation of children with learning difficulties.
133名因学习问题被转诊至一家医院多学科门诊的儿童接受了听力筛查，以确定听力问题的发生率，并确定能否根据临床数据预测听力问题。93名（69.9%）儿童在筛查程序的一个或多个部分未通过。22名儿童（占总样本的7.9%）听力敏锐度异常，33名（30.6%）在噪声环境中的言语辨别能力异常，73名（62.4%）短期听觉记忆异常。这些数字显著高于在有代表性的学龄儿童样本中发现的数字。家长和教师问卷中的16项内容以及神经发育检查结果均无法预测听力敏锐度或噪声环境中的言语问题；短期听觉记忆项目与家长和教师对语言问题的评分、教师对阅读和排序问题的评分以及听觉排序问题的神经发育检查结果之间存在相关性。鉴于无法从临床上预测听觉处理缺陷，作者建议，作为对学习困难儿童评估的一部分，进行全面的听力评估，包括短期记忆和噪声环境中的言语测试是必要的。
