新生兒聽力缺損之篩檢與照護需求

Issues Related to Screening and Caring for Newborns With Hearing Impairments

人類聽力自胎兒20週開始發展至孩童三歲前完成。造成聽力缺損的原因有：先天基因或後天感染等因素；孩童聽力若有缺損且延誤最佳治療時機，則影響範圍不僅包括個人的聽取能力，也對語言發展、智力及學習表現、社交及心理發展等有負面效應。目前聽力篩檢工具主要有兩種：短暫誘發耳聲傳射（transient evoked otoacousticemission）、自動聽性腦幹反應（automatedauditory brainstem response, aABR），其中aABR具有較高的敏感性、特異性以及較低的偽陽性和轉介率，為多數地區採用。在得知新生兒聽力缺損的當下，父母的情緒通常是倍感壓力與焦慮。病童在就醫與成長過程中，父母需外界醫療、經濟、社會或教育等多方面的資訊與協助，以渡過困難時刻。本文藉由文獻整理與報告，期能提供醫護人員於個案照護的參考。

The critical period for auditory development in humans begins at around the 20th gestational week and continues until 3 years of age. Both genetic and environmental factors are known to cause impaired hearing. Without early identification and intervention, hearing-impaired children face a high risk of experiencing significant difficulties with speech and language development, social behavior, and emotional functioning. Two types of commonly used hearing screening technologies include transient evoked otoacoustic emission (TEOAE) and automated auditory brainstem response (aABR). aABR is considered to have high sensitivity and specificity, to have a relatively low referral rate, and to generate a relatively low rate of false-positive results in identifying newborn hearing impairment. The present paper outlines the psychosocial issues that are commonly experienced by parents of hearing- impaired children. Parents and other family members may benefit from medical, financial, social, and education supports in order to facilitate their adjustment to this challenging situation. The relevant literature is reviewed and recommendations for improving care for this population are provided.