Evaluation Of Long-term Effects Of Prevalent Status And Early Rehabilitation Of Children With Hearing Impairment

Rehabilitation of deaf children aims at the pre-school age children with hearing loss, and makes the deaf children obtain the medical, educational, social and occupational rehabilitation. There is no system to evaluate the rehabilitation effect completely to date. This study established the index system for long-term effectiveness of rehabilitation of deaf children and evaluated the institution rehabilitation with quality of life (QOL). The research includes three parts: (1)Acquiring the epidemiological data about the demand and utilization of the rehabilitation of the deaf children in Peking.(2)Evaluating the reality, economic efficient and feasibility of the universal newborns hearing screening(UNHS)plan(.3)Establishing the index system for long-term effectiveness of rehabilitation on deaf children and evaluating the institution rehabilitation. PART ⅠStudy on hearing disability among children aged 0-6 years in Peking, China. Sampling and methods 28709 children aged 0-6 years were tested with proportional, 2-phase stratified cluster sampling in Peking. The sensitivity and specificity of the screening instrument was more than 95%. Multiple databases were established based on EPIDATA, and the data analysis was performed with SPSS11.5 software. Results 1. The positive rate of hearing screening was 3.76%, and the prevalence of hearing disability in children aged 0-6 years was 1.04‰with the false negative rate of 0.14‰. The proportion of the profound, severe,moderate-severe and moderate hearing impairment were 30.8%,30.8%, 7.6% and 30.8% ,respectively. 2. The distribution of the hearing disability: (1) The prevalence of the hearing disability were 1.07‰and 0.77‰in urban area and in country respectively. (2) The prevalence was a little higher in male than female. (3) The prevalence was high in the children whose parents are in low degree of education and was also related to their parents'reproductive age. It was found that the best reproductive age of father and mother were 24-35 and 25-29 years old, respectively. 3. The risk factors of hearing disability included mother drinking during pregnancy, frequency of pregnancy, great stimulation and using of the computer during pregnancy and relatively low education degree of the father, the OR values (odd rate) of which were 48.9 (CI 0.98-2442.24 ),4.409 ( CI 1.73-11.217),57.838(CI 2.419-1556.99),85.431(CI 4.144-176.26)和14.174(CI 2.566-78.29), respectively. 4. 26.9 percent of the deaf children were in rehabilitation institutions, while 42.3 percent hadn't received any rehabilitation or therapy, the reason of which was that the parents thought them unnecessary and the relatively low income. It was found that the pure income was lower than 1000 yuan per month in approximately 10 percent families,and they still needed assists from the government. Conclusions 1. The prevalence of hearing disability was 1.04‰in Peking, which was lower than that of the relevant survey in China. The better heath care in women and children in Peking may interpret this difference. 2. The environmental factors were the main cause of the hearing disability,and only 2.7 percent was attributed to inheritance. The results of the case-control study suggested that the risk factors of hearing disability were mother drinking during pregnancy, frequency of pregnancy, great stimulation and using of the computer during pregnancy and relatively low education degree of the father. 3. Among the deaf children, 42.3 percent children hadn't received any rehabilitation or therapy. The cause of not bearing hearing aids was that the parents thought it not necessary and the lower income.PART ⅡA collective data analysis on the newborns hearing screening using DPOAE Data and methods TO evaluate the validity and feasibility of the universal newborns hearing screening (UNHS), the relevant literature was collected on newborns hearing screening and distortion-product otoacoustic emissions (DPOAE) between 1998 and 2004. Data were analyzed with meta-analysis. Results 1. The "refer"...