Abstract
Background: The authors set a goal to analyze the problem of management of simultaneous medical and educational follow-up of premature children during the 1st year of life under the conditions of out-patient department of a large hospital (by the example of consulting and diagnostic centre of Morozov Children Municipal Clinical Hospital). Patients and methods: Audiologic examination was performed in 293 premature children. Ninety three children with the consequences of perinatal central nervous system damage were included into the program of correctional diagnostic medical and educational rehabilitation (they were examined by otolaryngologist-audiologist, neurologist and logopedist). Results: Premature children even with normal hearing function at the age of 3 months have very high level of prespeech development retardation (from 75 to 96%), depending on their gestation age. Conclusion : Logopedics examination of premature children at the age of 3 months allows to reveal signs of their mental retardation (motor activity, aural perception, communicative, cognitive and emotional spheres, prespeech activity) in the overwhelming majority of cases.
Highlights
The authors set a goal to analyze the problem of management of simultaneous medical and educational follow-up of premature children during the 1st year of life under the conditions of out-patient department of a large hospital
Patients and methods: Audiologic examination was performed in 293 premature children
Ninety three children with the consequences of perinatal central nervous system damage were included into the program of correctional diagnostic medical and educational rehabilitation
Summary
Наиболее частая причина нарушения социальной адаптации недоношенных детей — тяжелая задержка психомоторного развития вследствие перенесенного перинатального поражения центральной нервной системы (ЦНС). Сочетание патологии ЦНС и поражения слухового анализатора у недоношенных детей объясняется «как общностью происхождения и свойств рецепторов улитки и нервной системы, так и едиными патоморфологическими механизмами формирования нарушений слуха» [4]. При обследовании детей в 3 мес жизни у 83 (89%) были выявлены последствия гипоксически-ишемического поражения ЦНС; у 10 (11%) — последствия ее гипоксически-геморрагического повреждения в виде следующих синдромов: у 90 (97%) — синдрома двигательных нарушений (мышечная дистония, аддукторный спазм и др.), у 92 (99%) — вегето-висцеральной дисфункции, у 17 (18%) — нервно-рефлекторной гипервозбудимости, у 84 (90%) — темповой задержки психомоторного развития. Перинатальное поражение ЦНС также служит фактором риска задержки психомоторного развития ребенка, что подтверждено в многочисленных работах Г.
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