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PubMed1999

Parents' awareness and knowledge of the special needs of their hearing-impaired child.

We surveyed parents of school-aged hearing impaired children to investigate their awareness and knowledge of the special needs of their child, especially in the area of the usage of hearing aids and methods of communication. Questionnaires were distributed to parents of hearing impaired children at 13 special schools for the deaf in Malaysia. Out of 1,267 questionnaires given out, 787 (62.1%) were completed and returned. Results of the survey indicated the majority of parents (68.6%) suspected hearing loss late, that is after their child's first birthday, and there was a significant time lag before the suspicion was confirmed. Over 82.8% of the children were diagnosed only after 1 year of age, with 41.3% being diagnosed after 3 years of age. Hearing aids were fitted late (mean = 5.32 years; SD = 2.66). Hearing aid ownership was influenced by the factors of socio-economic level and ethnic group (p < 0.01) whereas knowledge of use and proper care of the aids was influenced by socio-economic level (p < 0.01). Communication methods were generally inappropriate with 41.3% of the mothers and 48.5% of the fathers reporting ignorance of Bahasa Malaysia Kod Tangan, the sign language that is commonly used by their children. The parents' choice of communication method was not significantly influenced by socio-economic level or ethnic group. The study revealed the present inadequate state of services available for the rehabilitation of children with congenital hearing impairment.

Adolescent↗
PubMed1981

The ethics of experiments on higher animals.

It has been demonstrated over the last decade that some higher animals can learn sign language and communicate with humans. This finding radically alters some earlier conceptions of animals as being non-sentient, and forces a re-evaluation of the use of higher animals in research. The ethics of using animals are examined in this paper in relation to postulated levels of consciousness, and in relation to experimental design and experimental goals. In particular, an attempt is made to classify experimental situations with regard to potential psychological trauma, and to examine in detail the ethics of using higher animals in psychological research and situations in which such use can be justified. Analysis concentrates on the scientific ramifications of ethical use of animals, and concludes that in the majority of cases, ethical treatment and scientific approach are synonymous.

Animal Care Committees↗
PubMed2000

Communication barriers for deaf employees: Needs assessment and problem-solving strategies.

Deaf people experience higher rates of unemployment and underemployment and earn lifetime wages that are between $356,000 and $609,000 less than their comparably educated normally hearing counterparts. This results in a substantial loss of earning power and career identity for members of this underutilized population of workers. This article examines how communication difficulties pose a major barrier to employment retention and advancement for deaf employees. These barriers exist (a) within the employee in terms of nonfluent use of English and reliance upon American Sign Language, (b) with the employment site, and (c) with agency service personnel. Primarily, these barriers reflect a lack of understanding of the cultural and communication needs of deaf people. Strategies to ameliorate these barriers include a model of long-term employment support using an ecological framework.

Journal Article↗
PubMed1989

Neuropsychological and behavioral sequelae of amitriptyline overdose in infancy.

This study reports on the neuropsychological and behavioral problems of a 3(1/2) year-old boy who was poisoned by his Nanny with a massive dose of amitriptyline hydrochloride subsequent to a period of supranormal development. At the age of 8 months, the child was discovered at home in respiratory distress (he was "blue and not breathing"). Blood gases and toxin screens revealed a serum level of 1065 ng/ml for amitriptyline. The parents have reported a series of serious behavioral and emotional problems since this incident. Neuropsychological data gathered recently at the age of 3(1/2) years indicated a variety of nonfocal signs. Language development, serial processing skills, and attentional mechanisms showed the greatest degree of impairment.

Journal Article↗
PubMed2004

[The symptomatic treatment of amyotrophic lateral sclerosis].

Patients with amyotrophic lateral sclerosis (ALS) have symptoms of progressive muscle weakness, of disturbed speech and swallowing, and in the terminal phase those of respiratory weakness. Treatment options, in particular those for excessive weight loss and respiratory weakness, should be introduced to the patients and their families when the patient is emotionally capable and before dysarthria severely hampers communication. Special equipment for keeping the patient as mobile as possible should be made available much earlier than in the case of other diseases of the muscles as in ALS progression is much faster. Cramps, pathological crying or laughter, spasms, and spasticity can all be treated by medication. When speech can no longer be understood, adaptive strategies such as sign language, mime, posture and communication apparatus varying from a note pad to advanced computer systems can be used. Sialorrhoea, caused by difficulty swallowing with its accompanying danger of aspiration can be halted by the use of medication, by radiotherapy and by the injection into the salivary glands of botulin A toxin. Weight loss, also a result of dysphagia, can be avoided by eating frequent small meals or if necessary performing a percutaneous endoscopic or radiological gastroscopy. Excess mucus in the respiratory tract can be treated with anticholinergics. Difficulty in coughing up thick and sticky mucus cannot always be adequately helped. Respiratory weakness is treatable by external respiratory supportive therapy using a nasal mask, as well as invasive respiratory support via a trachcostoma and by treating the symptoms of respiratory weakness. The latter form of treatment is palliative and forms part of terminal care. During the terminal phase restlessness, anxiety, pain, and dyspnoea require the most attention. Treatment requires careful multidisciplinary cooperation.

Amyotrophic Lateral Sclerosis↗
PubMedDate not supplied

Electromyographic analysis of the masseter and temporal muscles in oralized deaf individuals.

Deaf individuals show a number of difficulties related to the functionality of the stomatognathic system, mainly by reason of the little or no use of facial musculature during speech either due to the use of sign language or to the difficulty that these individuals have in articulating words. The stomatognathic system muscles play important roles in functions such as mastication, deglutition, and phonation. This study aimed to assess, by means of computerized bilateral electromyography (EMG), masseter and temporal muscles of 12 oralized deaf individuals in clinical activities that involve part of this masticatory musculature and compare this system's functionality with that of 12 normal listening individuals, performing the same activities. An 8-channel K6-I EMG Light Channel Surface Electromyography device was used (Myo-Tronics Co.Seattle, WA, USA), in addition to disposable double electrodes covered with silver chloride (Duotrodes; Myo-tronics Co., Seattle, WA) containing a conductor gel (Myogel- Myo-tronics Co., Seatlle, WA). The averaged rectified EMG values were normalized with reference to the EMG amplitude induced by a maximum bite force. The statistical analysis confirmed that there were any significant differences between the groups, clinical activities, and muscles, and also effects of interaction among them. The analysis made use of Variance Analysis (ANOVA). Significant differences (p < 0.01) for both muscles were found among the clinical conditions, with deaf individuals showing greater electromyographic activity for both muscles for the clinical activity protrusion. Deaf individuals showed a lower muscular activity for clinical activities that demanded a greater masseter and temporal muscular activity such as mastication, mouth opening and closing, and dental compression. Greater electromyographic values were found for both deaf individuals and healthy controls during clinical activities of mastication and dental compression. Based on the obtained data, we concluded that deaf individuals showed a lower activity of the masticatory musculature than healthy individuals; the differences were significant at the level of p < 0.01 between the performed clinical activities; and all deaf individuals and healthy controls showed greater electromyographic values for mastication and dental compression.

Adolescent↗
PubMedDate not supplied

Deaf women's experiences and satisfaction with prenatal care: a comparative study.

BACKGROUND AND OBJECTIVES: The quality of communication between physician and patient is a major contributor to patient satisfaction and treatment adherence. Deaf patients who use American Sign Language experience significant communication barriers in most medical settings. This study investigated factors impacting deaf patients' satisfaction with prenatal care and prenatal care disparities between deaf and hearing women. METHODS: Questionnaires modified from Omar and Schiffman's prenatal satisfaction measure were administered to 23 deaf and 32 hearing women. RESULTS: Deaf women were less satisfied than hearing women with physician communication and less satisfied with overall care. Deaf women's expectations about provision of interpreter services being met or exceeded was significantly associated with overall satisfaction. Hearing women had more prenatal care appointments and reported receiving more information from their doctors. CONCLUSIONS: Maximizing communication effectiveness with deaf patients results in better prenatal care and improved patient satisfaction. Good communication includes conveying concern and making efforts to ensure that whatever communication methods used are effective.

Communication Barriers↗
PubMed2006

User needs evaluation of workplace accommodations.

This study examined the multi-faceted issues surrounding workplace accommodation for workers with disabilities. A user needs survey of 510 disabled individuals examined the types of technology and accommodations needed to perform work and employment-related activities. Workers with disabilities used a variety of workplace accommodations to overcome difficulties with functional limitations. Some differences existed in the types of accommodations used by older and younger workers who had the same functional limitation. Workers of all ages were not likely to report mental limitations, and those who did were not likely to utilize workplace accommodations, with the exception of some memory strategies. For those with hearing loss, younger workers used sign language more frequently, while pre-retirement and retirement age workers used more hearing aids. Working age adults with vision impairments used electronic documents, Braille, and CCTVs more than pre-retirement or retirement age workers. Regardless of age, workers reporting functional limitations often received no workplace accommodations.

Adult↗
PubMed1990

Speech perception with the nucleus cochlear implant in children trained with the auditory/verbal approach.

Five children between the ages of 6 to 10 years using the Nucleus 22-electrode cochlear implant were tested on a battery of speech-perception tests. None of the five children used any sign language before implantation, and all received extensive training in auditory/verbal rehabilitation postimplantation. Performance ranged from 81 to 97 percent correct on the Matrix Test, from 24 to 80 percent correct on the WIPI test, from 33 to 73 percent correct on a 10-choice vowel recognition test, from 19 to 50 percent correct on a 13-choice consonant recognition test, from 2 to 46 percent words correct on a PB-K word list, from 4 to 71 percent words correct on a recorded BKB sentence test, and from 8 to 71 percent words correct on a live-voice BKB sentence test. In four of the five children, significant lipreading enhancement was observed on consonant recognition and two prelinguistically deafened children demonstrated some open-set word recognition.

Child↗
PubMed1989

[An infant's "forbidden games" (related to six cases of severe merycism)].

Merycism (pondering, in Anglo-Saxon Literature) is an affectation that has become rare in infants but which is still news because of its potential severity. Although psychosomatic by nature, it compromise the vital prognosis if the diagnosis isn't made and appropriate psychotherapeutical measures taken in good time. Based on six cases of severe merycism, the author studies the sign-language and the diagnostic in order to specify the positive elements that must have brought about the illness. A psychopathological hypothesis of the aberrant behavior leading to this "heavy thinking" is put forth. The various psychopathological mechanisms at play in this problem are then shown based on how frustratingly isolated the baby is. Finally, treatment by intensive nurturing and its behavioral components is described as well as the evolution to a half-way point. The ending goes back to the affective meaning of the problem.

Behavior Therapy↗
PubMed1988

Hearing loss and associated handicaps in preschool children.

In the Greater Stockholm area, 251 children born in 1976 to 1980 had hearing loss of such a degree that they needed hearing habilitation at the time of school entrance (prevalence rate 2.8/1,000). The prevalence rates of profound hearing loss (greater than 50 dB pure tone average) and monoaural deafness were both 1.0/1,000. The etiology of the hearing loss was heredity in 45%, unknown in 35%, sequelae of otitis media in 2% and related to high-risk histories in 18%. The high-risk history group includes the eight last known cases of congenital rubella. One associated handicap was present in 25%, two extra handicaps in 6.4% and three in 1.2%. Moreover, in 17% Swedish or Swedish sign language was not the vernacular. Nineteen different languages were represented among the children. Thus, an optimal habilitation program should not be based solely on the type of hearing handicap.

Child↗
PubMedDate not supplied

[Vibrations in deafness and psychosis].

Vibratory transmission is one of the first principles ofthe verbo-tonal method for the deaf child. Besides wrist vibrators, vibrating floor is a useful aid in communication with the autistic child. Complementary to oral or sign language, vibratory communication is full of possibilities in child deafness and psychosis.

Autistic Disorder↗
PubMed1988

Recency and suffix effects in pictures as a function of recall method.

Two studies compared recency and suffix effects in pictures. In Experiment 1, which used strict serial recall, the recall curve for the control condition fell sharply until the final position when it exhibited a small but significant amount of recency. No suffix effects were present. In Experiment 2, a modified free recall condition exhibited a U-shaped serial position curve and significant recency. Picture and graphic suffixes led to small, reliable end-of-sequence suffix effects, but spoken suffixes did not. Thus pictures appear to lead to recency and suffix effects similar to those produced by static visual alphanumeric stimuli when strict serial recall is used. With a modified free recall procedure, recency is enhanced and suffix effects appear. The implications of the results with pictures and of differences between the two recall procedures are discussed with respect to literature in the area on pictures (Cohen, 1972) and American Sign Language (Krakow & Hanson, 1985; Shand & Klima, 1981). Additionally, some new methods of defining and analyzing recency, which are also applicable to primacy, are proposed and used in the paper to bring out more clearly the effects present.

Association Learning↗
PubMed1987

[New aspects in the therapy of laryngeal tumors from the surgeon's viewpoint].

New techniques in tumor diagnosis allow us to improve and to refine the surgical procedure of partial laryngectomy. The first aim remains the radical tumor resection. After that we postulate a better functional surgery. Improvements were also realized using surgical voice restoration during and after laryngectomy. Technique and results are described with the use of voice prosthesis and tracheostoma valves for non-sign language speech. The treatment of laryngeal cancer today means cooperation between radiotherapy, oncology and ENT-surgery. Therefore the discussion of new developments in ENT-tumor surgery is of interest.

Humans↗
PubMedDate not supplied

Deaf and hearing parents' perceptions of family functioning.

The purpose of this descriptive study was to compare Deaf and hearing parents' perceptions of family functioning. The Feetham Family Functioning Survey (FFFS) was administered in American Sign Language on videotape to 40 Deaf mothers and fathers and in its original written English form to a comparison group of 40 hearing mothers and fathers. There were no statistically significant differences in FFFS discrepancy (D) subscale scores among Deaf versus hearing parents. Deaf and hearing parents' scores on the FFFS importance (C) subscale items were used to identify the 10 areas of family functioning most important to the parents. Agreement among Deaf and hearing parents was noted on 7 of 10 items ranked as most important. One difference was that Deaf parents ranked leisure/recreational activities as more important than hearing parents.

Adult↗
PubMed1993

[The relation of speech to the right and left cerebral hemispheres].

Verbal speech functions are localized in right-handed subjects nearly exclusively and in left-handed ones mostly in the left hemisphere. Much information on these functions has been obtained by studying patients affected with spontaneous damages, as well as after hemispherectomy, after severing the corpus callosum, and during electric stimulation of the brain in neurosurgical procedures. In the presylvian region of the hemisphere dominant for speech, a region for the production and identification of speech was found, surrounded by an area for shortterm verbal memory. The predominance of the right ear in recognizing verbal stimuli, established by the dichotic test, applies to the population rather than to the individual. The substance of verbal dominance of the left hemisphere lies in the prevalence of its capacity to distinguish rapid acoustic sequences and to produce them. Observations made on deaf-mute patients with sign language have demonstrated that humans possess a genetically determined ability to develop speech, regardless the modality. Speech functions of the right hemisphere concern mostly nonverbal prosodic components of speech.

Deafness↗
PubMed1997

A European perspective on pediatric cochlear implantation, rehabilitation services, and their educational implications.

OBJECTIVE: To assess the educational implications of pediatric cochlear implantation from the perspective of the implant team. METHODS: Coordinators of pediatric cochlear implant teams throughout Europe took part in a survey using forced-choice questions. Fifty-four centers were originally sent the questionnaire; 41 centers replied. RESULTS: Of 504 children planned to receive cochlear implants in Europe during 1996, 54% (273/504) were aged 2-5 years and 12% (60/504) aged 0-2 years, indicating a trend toward pediatric implantation in younger children. There is a strong commitment to rehabilitation in the teams; 66% (27/41) employ a teacher of the deaf, the ratio of medical/audiological to rehabilitation personnel is 1:2, and 76% (31/41) of the implant teams visit local educators. Of all the children receiving implants to the date of this report, 23% were considered to be in unfavorable educational environments; these were environments where children were taught with an emphasis on sign language and little expectation from audition, and mainstream provision without support from experienced teachers of the deaf. CONCLUSION: There is a high staff input to children with cochlear implants from implant rehabilitation personnel over and above the input received in the educational environment. Hence, it is important for the school and the implant team to mutually agree on their shared responsibilities. Moreover, as the provision of service is variable and inconsistent, the development of guidelines for practice in each country should ensure consistency of rehabilitative and educational support to children with cochlear implants.

Adolescent↗
PubMed1997

Auditory perceptual abilities in a child with a nucleus and a Clarion cochlear implant.

This case study will review the performance of a 7-year-old female who was implanted at the age of 3 years 9 months with a Nucleus 22 channel device. This child was deafened from pneumococcal meningis at the age of 8 months and was placed in an early intervention program which uses simultaneous communication (i.e. speech with sign language). The teaching staff of this particular educational setting has collaborated closely with the Cochlear Implant Center at Manhattan Eye, Ear and Throat Hospital and the team's teacher of the deaf. The child utilized the implant on a daily basis for a period of 2 years 10 months. Performance on a variety of auditory perceptual tests were obtained at 1 year and two year intervals. After almost 3 years of implant use, the child suffered an internal receiver failure. The Nucleus device was explanted and the child was implanted with a Clarion Cochlear Implant System. Performance on a similar set of auditory perceptual tests obtained after 3 and 6 months use indicated better performance with the Clarion device. In addition to the scores on the individual tests, a comparison questionnaire was used to obtain impressions from the parents and the school personnel. Results should be reviewed with caution since this study investigates the responses of a single child who uses each of these two different implants and cannot be generalized.

Cochlear Implantation↗