Kindliche Hör- und Sprachentwicklungsstörungen, Diagnostik und Genetik

Zusammenfassung

Dieses Übersichtsreferat gibt Einblicke in wichtige phoniatrisch/pädaudiologische Teilaspekte der frühkindlichen Hör-und Sprachentwicklung mit dem Ziel, die diagnostischen und therapeutischen Wege an der Schnittstelle HNO zu Phoniatrie/Pädaudiologie aufzuzeigen.

Das universelle Neugeborenen-Hörscreening, das seit dem 01.01.2009 für jedes Neugeborene zur Verfügung steht, wird im ersten Themenblock besprochen. Unter Berücksichtigung eines Beschlusses des gemeinsamen Bundesausschusses (G-BA) wird der Ablauf des Neugeborenen-Hörscreenings von der Geburtsklinik bis hin zur Konfirmationsdiagnostik dargestellt.

Der zweite Themenblock umfasst die pädaudiologische Diagnostik. Nach Bestätigung einer permanenten frühkindlichen Hörstörung hat die Ursachenforschung eine wichtige Bedeutung. Dementsprechend wird auf die genetisch bedingten Hörstörungen und die intrauterine Zytomegalie Virusinfektion (CMV) eingegangen. Die CMV-Infektion stellt wahrscheinlich die häufigste Ursache einer erworbenen Hörstörung dar. Ferner erfolgt eine Abgrenzung zu der häufigsten passageren Hörstörung, dem Paukenerguss, der in einigen Fällen aufgrund seiner Ausprägung eine Relevanz für das Hörvermögen und die Sprachentwicklung hat und daher behandlungsbedürftig ist.

Der dritte Themenblock ist die frühkindliche Sprachentwicklung in den ersten 3 Lebensjahren. Diese ist nach heutigem Kenntnisstand entscheidend für den weiteren Sprach- und Schriftspracherwerb des Kindes. Zunächst wird ein kurzer Abriss der Sprachentwicklung mit Einführung in die aktuelle Nomenklatur gegeben, gefolgt von den Auffälligkeiten der frühen Sprachentwicklung und deren Diagnostik.

Bewusst werden nur Teilaspekte der frühen Hör- und Sprachentwicklung betrachtet. Wichtige Teilbereiche, wie die Indikation zur Cochlea Implantation im ersten Lebensjahr oder auch bei einseitiger Taubheit, sind aufgrund ihrer Komplexität nicht Thema dieses Beitrags.

Abstract

Hearing Impairment and Language Delay in Infants: Diagnostik and Genetic

This article gives an overview on important aspects of hearing and language development of infants and toddlers.

Newborn hearing screening is implemented in Germany for all infants since January 2009. The realization of early postnatal hearing screening is regulated by a publication of the “Gemeinsamer Bundesausschuss”. It regulates the measurement method (TEOAE or AABR screening) and differs between healthy and sick newborns. It also rules the timetable of rescreening and if it still fails of paedaudiological follow up.

The second part refers to objective and subjective assessment of hearing loss and different important issues of permanent childhood hearing impairment are discussed. Especially CMV infection by materno-fetal transmission and hereditary hearing loss is addressed in comparison to otitis media with effusion.

Speech and language development in the first three years of live and the corresponding nomenclature is introduced in the last part. Different parent questionnaires are well established in evaluation of early language acquisition. An early diagnosis of language delay is possible and therapeutic measures can be established to prevent further social and psychological problems.

Schlüsselwörter

Neugeborenenhörscreening - Hörscreeningzentralen - Pädaudiologische Diagnostik - Sprachentwicklungsstörung - Genetische Hörstörungen

Key words

newborn hearing screening - organization of newborn hearing screening - pedaudiological diagnosis - speech and language delay - genetic hearing loss

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