テクノロジーの効果的活用を促す小児聴覚臨床のあり方

Suggestions for the management of the hearing-impaired young children to promote the effective use of new technology

　テクノロジーの進歩は，聴覚障害児の早期発見を可能にし，重度聴覚障害児への聴覚補償の可能性を拡大した．しかしながらハビリテーションの効果は，「早期発見」「聴覚補償機器の進歩」「家族の理解・支援体制」「適切な早期療育・教育」などの総合的な結果である．すなわち，早期発見と優れた聴覚補償機器の早期装用は，「聴覚活用に必要な条件」の一部を整えたにすぎない．実際，早期に人工内耳を装用したにもかかわらず，十分な聴覚活用に至らない事例も少なくない．条件を活用するのは「人」，つまり早期療育・教育に携わる言語聴覚士などの専門家であり，そして親や家族である．そこでテクノロジーを活用する際に必要な臨床的視点として，①「聴覚障害」についての理解，②聴覚活用のための聴覚学習，③言語聴覚士の臨床スキル，の3点を挙げ考察を加える．

　Progress in technology has enabled the early identification of hearing impairment and expanded the possibilities of hearing compensation for the profoundly hearing-impaired children.　However, the efficacy of aural habilitation should be considered as the combined result of all the following factors:early identification, improvements of the hearing devices, family support systems, and adequate early habilitation process.　In other words, early identification and early fitting of the best hearing device are not the only factors that are necessary for hearing management.　Among the children who received their cochlear implants at an early age, there are some cases that could not develop their auditory skills.　The efficacy of the aural habilitation really depends on the people who interact with the hearing-impaired child, namely, the speech-language-hearing therapist as the aural habilitation specialist, and the child's family members.　In this paper I will discuss clinical foundations to promote effective uses of new technology, focusing on the following aspects : ①understanding of hearing loss,②auditory learning to use the auditory modality,③clinical skills that are necessary for the aural habilitation specialist.