Stewart I F
Laryngoscope. 1984 Jun;94(6):784-99. doi: 10.1288/00005537-198406000-00011.
Otolaryngologists have accepted their role in the early diagnosis of the deaf and hard of hearing child: however, the social implications and habilitative programs embarked upon may often be regarded as unrelated to the practice of otolaryngology. The otolaryngologist is a key member of the team responsible for early detection and diagnosis, and he must become as involved with the available educational programs as are the other highly qualified competent individuals bringing expertise to the problem. The reason for emphasizing this area is that the otolaryngologist has witnessed a number of a major expansions in knowledge which have occurred in the past 15 years. These include: 1. Early identification of deafness through screening programs. 2. Early diagnosis through peripheral and brain stem evoked response audiometry. 3. Improvement in amplification in hearing aids. 4. Earlier placement in educational programs, many of which have been the center of controversy, particularly in the past 15 years. 5. Emphasis on continued research and development of programs such as the Cochlear Implant. A historical review of deaf education is presented together with an evaluation of the various claims made by the supporters of the auditory-oral vs. total communication techniques. No totally convincing argument for either system can be advanced. There is considerable doubt that the tri-stimulus, or total communication approach to teaching of the deaf, has any superiority over the auditory-oral approach. There are failures with both philosophies and the "deaf voice" is a stigma often associated with either system's graduates. A 13-year follow-up case study is presented in which the child was enrolled in an auditory-oral program. Comments are made as the child was followed through home training to preschool and on to complete integration in the regular school system. The implications of such a study for the Otolaryngologist, particularly with regard to early identification in order to avoid linguistic delay, are outlined.
然而，所开展的社会影响及康复项目往往可能被视为与耳鼻喉科的业务无关。耳鼻喉科医生是负责早期检测和诊断团队的关键成员，他必须像其他为解决该问题带来专业知识的高素质专业人员一样，积极参与现有的教育项目。强调这一领域的原因是，耳鼻喉科医生见证了过去15年中发生的许多重大知识扩展。这些包括：1. 通过筛查项目早期识别耳聋。2. 通过外周和脑干诱发反应测听进行早期诊断。3. 助听器放大功能的改进。4. 更早地安置在教育项目中，其中许多项目一直是争议的焦点，尤其是在过去15年。5. 强调对人工耳蜗等项目的持续研发。本文对聋教育进行了历史回顾，并对听觉口语教学法与全沟通教学法支持者提出的各种主张进行了评估。两种教学法都无法提出完全令人信服的论据。对于聋教育采用三刺激法或全沟通法是否比听觉口语法更具优势，存在很大疑问。两种教学理念都有失败的情况，“聋人的声音”往往是与这两种教学法培养出的毕业生相关的一个耻辱标志。本文介绍了一个13年的随访案例研究，该儿童参加了听觉口语项目。对该儿童从家庭训练到学前班，再到完全融入正规学校系统的过程进行了跟踪评论。概述了这样一项研究对耳鼻喉科医生的意义，特别是在早期识别以避免语言发育迟缓方面的意义。
