Institute of Physiology and Pathology of Hearing, Ul. M. Mochnackiego 10, 02-042, Warsaw, Poland; World Hearing Center, Ul. Mokra 17, Kajetany, 05-830, Nadarzyn, Poland.
Institute of Physiology and Pathology of Hearing, Ul. M. Mochnackiego 10, 02-042, Warsaw, Poland; World Hearing Center, Ul. Mokra 17, Kajetany, 05-830, Nadarzyn, Poland.
Int J Pediatr Otorhinolaryngol. 2021 Feb;141:110570. doi: 10.1016/j.ijporl.2020.110570. Epub 2020 Dec 16.
Hearing is one of our most important senses, and hearing ability has an enormous impact on a child's psychomotor development. Children with auditory perception disorders may show abnormal development in terms of speech, language, and communication skills, as well as other disorders involving the cognitive sphere, social-emotional interactions, and motor development. This paper describes different paths of psychomotor development in three 4-year-old children. All were born with bilateral profound sensorineural hearing loss and were implanted early on with a cochlear implant. A longitudinal study of the children's psychomotor development was done for 3 years from the time of cochlear implantation.
We present three children with congenital, profound bilateral sensorineural hearing loss. Psychomotor development was evaluated using the Children Development Scale (CDS) and the Psychomotor Development Evaluation Cards (PDEC). The three children were: Girl A (4 years 2 months 17 days) - a user of one CI, last assessment of psychomotor development (PDEC) was 37 months after CI activation; Boy B (4 years 3 months 21 days) - a user of two CIs, last assessment of psychomotor development (PDEC) was 39 months after activation of first CI; Boy C (4 years 1 month 5 days) - user of two CIs, last assessment of psychomotor development (PDEC) was 36 months after activation of the first CI.
Analysis of the results from Girl A showed very poor dynamics of development from the age of 12 months, when the first CDS evaluation was performed, up to the PDEC evaluation performed at age 4 years. The CDS score of Boy B showed a very high level of psychomotor development. The PDEC evaluation performed after 39 months of using the first CI showed that the psychomotor development of Boy B was consistent with his chronological age. Boy C presented an average level of psychomotor development (compared to typically developing children) in his CDS scores in the perioperative period and then at 4, 9, and 14 months after cochlear implantation. After 24 months, his CDS scores showed a high level of psychomotor development. After 3 years of CI use, the PDEC evaluation showed that Boy C had an average score in five tested areas, a high score in the area of fine motor skills and lateralization, and a low score in knowledge and learning competencies.
Children with bilateral profound hearing loss can present different paths of psychomotor development. Children who receive a CI may show an age-appropriate level of psychomotor development compared to typically developing children. However, a hearing, speech, and language rehabilitation specialist responsible for the child still needs to perform regular checkups to monitor all areas of psychomotor development. Also, the effects of the deaf child's environmental determinants on psychomotor development should be studied in detail. These determinants include the parents' emotional state, the parents' involvement in the child's rehabilitation, the family's quality of life, and the presence of deaf siblings. In particular, the difficulties encountered by the mother (or father) in being the parent of a deaf child may hinder the family from receiving adequate support.
听觉是我们最重要的感官之一，听力能力对儿童的心理运动发展有巨大影响。患有听觉感知障碍的儿童在言语、语言和沟通技能方面可能表现出异常发展，以及涉及认知领域、社会情感互动和运动发展的其他障碍。本文描述了三名 4 岁儿童的不同心理运动发展路径。他们均出生时双侧极重度感音神经性听力损失，并在早期植入了人工耳蜗。对儿童的心理运动发展进行了为期 3 年的耳蜗植入后纵向研究。
我们介绍了三名患有先天性、双侧极重度感音神经性听力损失的儿童。使用儿童发展量表（CDS）和心理运动发展评估卡（PDEC）评估心理运动发展。这三个孩子是：女孩 A（4 岁 2 个月 17 天）-一个 CI 用户，CI 激活后 37 个月进行最后一次心理运动发展评估（PDEC）；男孩 B（4 岁 3 个月 21 天）-两个 CI 用户，第一个 CI 激活后 39 个月进行最后一次心理运动发展评估（PDEC）；男孩 C（4 岁 1 个月 5 天）-两个 CI 用户，第一个 CI 激活后 36 个月进行最后一次心理运动发展评估（PDEC）。
对女孩 A 的结果分析表明，从她 12 个月进行第一次 CDS 评估到 4 岁进行 PDEC 评估，她的发展动态非常差。男孩 B 的 CDS 评分显示出非常高的心理运动发展水平。第一次 CI 使用 39 个月后进行的 PDEC 评估表明，男孩 B 的心理运动发展与他的实际年龄相符。男孩 C 在围手术期和耳蜗植入后 4、9 和 14 个月的 CDS 评分中表现出平均水平的心理运动发展（与正常发育的儿童相比）。植入后 24 个月，他的 CDS 评分显示出较高的心理运动发展水平。CI 使用 3 年后，PDEC 评估显示，男孩 C 在五个测试领域中平均得分，在精细运动技能和侧化方面得分较高，在知识和学习能力方面得分较低。
双侧极重度听力损失的儿童可能表现出不同的心理运动发展路径。接受 CI 的儿童与正常发育的儿童相比，可能表现出与其年龄相符的心理运动发展水平。然而，负责儿童的听力、言语和语言康复专家仍需要进行定期检查，以监测所有心理运动发展领域。此外，还需要详细研究聋儿环境决定因素对心理运动发展的影响。这些决定因素包括父母的情绪状态、父母对儿童康复的参与度、家庭生活质量以及聋儿兄弟姐妹的存在。特别是，聋儿母亲（或父亲）在作为聋儿父母时遇到的困难可能会阻碍家庭获得足够的支持。
