難聴を伴う重複障害児に補聴器装用指導を行い, 補聴器装用が困難であった症例の問題点と対応の方法について検討した。1)54例中10例が補聴器をいやがって外す, 不随意運動などのために外れてしまうなどの理由から, 補聴器の常用に至らなかった。関連要因は個々の症例によって異なったが, 補聴器装用年齢や知的障害, 運動機能障害の程度との関連が推測された。2)難聴, 多発小奇形, 精神運動発達遅滞を伴う1症例に補聴器装用および言語・コミュニケーション指導を行った。正確な聴力検査が困難, 耳介が小さい, コードを引っ張って補聴器を外す, 家族が相手をしないと外すなどの問題点に対応した補聴器の選択や指導を行い, 1年3カ月を要したが, 補聴器の常用が可能となった。また, 装用閾値の改善, 聴性行動の発達, 音声言語の理解・表出, コミュニケーション行動の発達が認められた。

The purpose of this study is to describe the problems and management of hearing aid fitting in multiplehandicapped children. 1) Fifty-four multiple-handicapped children with hearing impairment were fitted with hearing aids, and development of auditory behavior and communication skills were evaluated in the follow-up study. Ten children had difficulty adjusting to the use of hearing aids, because they did not like to the presence of earmolds in their ears. Some of the children with cerebral palsy were unable to keep the hearing aids on their ears because of involuntary movements. 2) A threeyear process of adjustment to the use of a hearing aid in the case of a 19-month-old child with multiple minor anomalies, hearing impairment, and mental retardation is reported. A hearing aid could not be attached to her ear, because whenever her mother put the hearing aid on her ear, she would pull the wire of the earphone. After four months, a programmable behind-the-ear type of hearing aid was prescribed. It became possible to fit the child with a hearing aid during the daytime, and some improvement in her auditory behavior, communication skills, and language development was noted at three years of age after 15 months of hearing aid usage.

国立情報学研究所で電子化