Clinical efficacy of structured institution-based teaching programme combined with family rehabilitation training in treatment of childhood autism / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the clinical efficacy of a structured institution-based teaching programme combined with family rehabilitation training in the treatment of childhood autism.</p><p><b>METHODS</b>One hundred children with autism were divided into a combination therapy group (n=50) and a control group (n=50). The children in the control group received a structured institution-based teaching programme, and the children in the combination therapy group received a family rehabilitation training besides the structured institution-based teaching programme. Comparisons were made between the two groups by the Autism Behavior Checklist (ABC) score, Autism Treatment Evaluation Checklist (ATEC) score, and Chinese version of Psychoeducational Profile (C-PEP) sore.</p><p><b>RESULTS</b>After 12-months training, each dimension score and total score of ABC in the combination therapy group were all significantly lower than those in the control group (P<0.05). The combination therapy group had significantly lower dimension scores and total score of ATEC than the control group (P<0.05). Each dimension score and total score of C-PEP were significantly higher in the combination therapy than in the control group (P<0.05).</p><p><b>CONCLUSIONS</b>As an effective treatment mode for childhood autism, structured institution-based teaching programme combined with family rehabilitation training is worthy of clinical promotion and application.</p>

Tone-pip auditory brainstem response and auditory steady-state response of infants with normal hearing / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To estimate tone-pip auditory brainstem response (tone-pip ABR) and auditory steady-state response (ASSR) thresholds to follow the development of hearing in four groups of normal babies through the first 6 month of life and to make a comparison between the tone-pip ABR and ASSR for 0.25 - 8 kHz frequency range at different groups.</p><p><b>METHODS</b>The tone-pip ABR and ASSR were recorded in four groups of normal hearing infants (160 ears) at the age of 2 - 4 day, 6 weeks, 3-month and 6-month. Tone-pip ABR and ASSR thresholds were established in 0.25, 0.5, 1, 2, 4 and 8 kHz stimuli.</p><p><b>RESULTS</b>For click ABR, the wave latency of I, III, V and inter-wave latency of I-III, III-V and I-V decreased as the age increase. The developmental changes were obvious in wave I and III before 6 weeks and 3 months respectively. Tone-pip ABR had the similar waveform as the click ABR. With the frequency increasing, their waveforms and wave latencies of I, III and V were getting better and shorter respectively. There was significant difference between the thresholds of tone-pip ABR and ASSR (all P < 0.05). The tone-pip ABR thresholds were significantly lower than those of ASSR from 0.5 to 8 kHz. Both ASSR and tone-pip ABR had similar audiograms for different age of infants with normal hearing.</p><p><b>CONCLUSIONS</b>The longitudinal findings presented in this study suggest that with the maturational development, the wave latency of I, III, V and inter-wave latency of I-III, III-V and I-V of tone-pip ABR decrease as the age increase, while the hearing sensitivity have no changes. Both tone-pip ABR and ASSR have stable frequency specificity. Compared to the ASSR, tone-pip ABR have lower response threshold and maybe nearer to the hearing level of the infant.</p>

Impact of the national hearing screening programme in China

China has a large population with different levels of medical care among the eastern, central and western areas. The national universal newborn hearing screening (UNHS) programme was initiated in 1999 and then progressively implemented nationwide. A "National UNHS Experts Group" was set up, formulating the national UNHS administration rules and technological specifications. 3 March had been named as national "ear-care day" since 2000 and such social activities help make deafness prevention work more widely accepted. UNHS in China presently has 3 phases due to disparities in economic development. 1) Implementation in stages: in economically under-developed areas. 2) Implementation completed: in the coastal cities. 3) Beyond basic UNHS: i) Development of a completed UNHS system including follow-up and quality control based on the neonatal disease screening system, ii) Exploration of a new public health care programme: simultaneous screening of newborn hearing and ocular disease, iii) Carrying out of a multi-centre study on high-risk factors and GJB2 gene mutations in newborn with non-syndromic hearing impairment. The incidence of newborn bilateral hearing loss was 2.22 per 1000, and 2.74 per 1000 for unilateral hearing loss. Though UNHS have been carried out widely in the eastern parts of China, there are difficulties for its implementation in the western regions. Economic development and technical expertise are the main restricting factors.

Simultaneous screening program for newborns hearing and ocular diseases / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To explore the model and the feasibility of newborn hearing and ocular disease simultaneous screening program and to study the birth prevalence of newborn hearing loss and newborn ocular diseases.</p><p><b>METHODS</b>The universal newborn hearing screening (UNHS) was performed using transient otoacoustic emission (TEOAE) in well baby nursery and by a two-stage TEOAE and auto auditory brainstem response (AABR) protocol in neonatal intensive care unit (NICU). The UNHS was simultaneous done with newborn ocular disease screening program. The examination technical method was following: the response to light, external inspection of the eyes and lids, pupil examination, red reflex examination, funduscope examination after pupil dilation for referral (for all newborn in NICU). The infants who were referred by two-stage hearing screening and/or had high-risk factors of hearing loss received following-up and routine audiological evaluation and personalized intervention from 6 months to 3 years of age. The cases had positive sign and (or) abnormal results of the ocular disease screening were referred for further examination by pediatric ophthalmologists.</p><p><b>RESULTS</b>A total of 16 800 children born in Jinan Maternal and Child Hospital from October 1, 2002 to April 30, 2005. Of these infants, 15 398 cases (91.7%) had access to the simultaneous screening program for hearing and ocular diseases. The incidence of congenital sensorineural hearing loss (SNHL) among infants who did UNHS was 0.312% (48/15 398) in bilateral and 0.227% (35/15 398) in unilateral; Of the 4 cases of congenital SNHL complicated with newborn ocular diseases: 1 profound SNHL (bilateral), auditory neuropathy with congenital cataract (bilateral), 1 mild SNHL (bilateral) with membrana papillaris perseverance (left) and 1 mild SNHL (bilateral) with retina vein dilatation (bilateral), 1 mild SNHL (right) with persistent hyaloid artery (bilateral). In all 15 398 newborns, 15 neonates with congenital cataract were detected (22 eyes, 0.10%). Twenty seven neonates with less than 1500 g birth weight admitted to NICU, retinopathy of prematurity was detected in 3 neonates (6 eyes).</p><p><b>CONCLUSION</b>Hearing loss and ocular diseases was not rare in neonatal and infancy. Newborn hearing and ocular disease simultaneous screening program was not only feasible but also effective in detecting hearing loss and (or) ocular disorders. Early intervention was important for the prevention or treatment of neonatal hearing loss and (or) ocular diseases, such as newborn hearing loss with congenital cataract, retinopathy of prematurity and so on.</p>