Young Hearing-impaired Children Research Articles

Correlation of the Size of Adenoids With Impedance Audiometry Findings.

Introduction Adenoid tissue is part of the first line of immunity of the upper aero-digestive tract. It is located in the postero-superior wall of the nasopharynx behind the choana.Adenoid hypertrophy, a common childhood disorder, significantly contributes to the pathogenesis of otitis media with effusion (OME), which is the leading cause of hearing impairment in young children. This condition can result in delayed speech, poor academic performance, and language development issues. Assessing the size of the adenoids and their correlation with OME is crucial, as undiagnosed cases can lead to complications such as atelectasis of the tympanic membrane and cholesteatoma. Clinical examination of the nose alone is often insufficient, and children do not cooperate for nasal endoscopy. Therefore, a lateral radiograph of the skull is considered the most reliable method for assessing the adenoid size. The size of the adenoids can affect Eustachian tube patency, which is reflected in the results of impedance audiometry. This study aimed to correlate the size of adenoids with impedance audiometry findings. Methods This cross-sectional observational study was conducted in the Department of Otorhinolaryngology of a tertiary care hospital from October 1, 2022, to March 31, 2024. A sample size of 50 patients was taken for the study. The inclusion criterion of selection of the patients included patients aged 3 to 15 years, who suffered from recurrent attacks of upper respiratory tract infections,particularly those with adenoid facies confirmed by X-ray with a non-perforated tympanic membrane. Exclusion criteria encompassed patients below 3 or above 15 years, and those with acute or chronic suppurative otitis media, craniofacial anomalies, or nasal pathologies like polyps.Adenoids were graded using X-ray imaging of the nasopharynx, and correlations between the adenoid size and impedance audiometry findings, such as middle ear pressure and compliance, were analyzed. Results The study assessed the relationship between the adenoid size and impedance audiometry findings, focusing on middle ear pressure and compliance, as well as the occurrence of OME. The results indicated a significant decline in middle ear pressure with increasing adenoid grades. Specifically, adenoid grade 1 had an average pressure of -3.50 daPa, while grade 4 had the lowest average pressure at -119.72 daPa. This trend was statistically significant with a p-value of 0.00042. Similarly, compliance values also decreased with higher adenoid grades. Grade 1 had an average compliance of 0.64 ml, whereas grade 4 had the lowest average compliance at 0.28 ml. This relationship was statistically significant, as indicated by a p-value of 0.0048. Additionally, the analysis showed that a significant majority of patients with enlarged adenoids also presented with OME, highlighting a strong association between adenoid hypertrophy and this condition. Conclusion The study concluded that larger adenoids wereassociated with lower middle ear pressure and reduced compliance. Additionally, a significant majority of patients with enlarged adenoids also had OME. This underscores the importance of evaluating adenoid hypertrophy in the context of OME due to its potential impact on childhood hearing and development.

The Role of the P1 Latency in Auditory and Speech Performance Evaluation in Cochlear Implanted Children.

Auditory deprivation affects normal age-related changes in the central auditory maturation. Cochlear implants (CIs) have already become the best treatment strategy for severe to profound hearing impairment. However, it is still hard to evaluate the speech-language outcomes of the pediatric CI recipients because of hearing-impaired children with limited speech-language abilities. The cortical auditory evoked potential (CAEP) provides a window into the development of the auditory cortical pathways. This preliminary study is aimed at assessing electrophysical characteristics of P1-N1 of electrically CAEP in children with CIs and at exploring whether these changes could be accounted for in auditory and speech outcomes of these patients. CAEP responses were recorded in 48 children with CIs in response to electrical stimulus to determine the presence of the P1-N1 response. Speech perception and speech intelligibility of the implanted children were further evaluated with the categories of auditory performance (CAP) test and speech intelligibility rating (SIR) test, respectively, to explore the relationship between the latency of P1-N1 and auditory and speech performance. This study found that P1 and N1 of the intracochlear CAEP were reliably evoked in children fitted with CIs and that the latency of the P1 as opposed to that of N1 was negative in relation to the wearing time of the cochlear implant. Moreover, the latency of the P1 produced significantly negative scores in both CAP and SIR tests, which indicates that P1 latency may be reflective of the auditory performance and speech intelligibility of pediatric CI recipients. These results suggest that the latency of P1 could be used for the objective assessment of auditory and speech function evaluation in cochlear-implanted children, which would be helpful in clinical decision-making regarding intervention for young hearing-impaired children.

Development of the Jordanian Arabic early speech perception test

IntroductionThe Early Speech Perception (ESP) test has been previously used to assess speech perception skills in young hearing-impaired children. As the Arabic language is known to be diglossic, the purpose of this study was to develop a Colloquial Jordanian Arabic version (JAESP) of the ESP test and to check its usefulness. MethodsThe JAESP test encompasses four categories: detection of speech sounds, speech pattern perception, disyllabic word identification, and monosyllabic word identification. Picture boards representing the test materials were created and two equivalent lists for each test category were made. The word identification task was used to test a total of 43 children with reported normal-hearing abilities (15 children aged 3 years, 15 aged 4 years, and 13 aged 5 years). ResultsThe scores for all age groups were 98–100% for all test materials. Statistical analysis showed that there was no significant difference between age groups and between lists (p ˃ 0.05). ConclusionThe findings of this study indicate that the JAESP test materials are appropriate for Jordanian children who are at least 3 years old. Additional studies are needed to verify the validity of the test materials for Jordanian hearing-impaired children.

Long-term follow-up of auditory performance and speech perception and effects of age on cochlear implantation in children with pre-lingual deafness.

Background:The development of auditory and speech perception ability of children with hearing loss is affected by many factors after they undergo cochlear implantation (CI). Age at CI (CI age) appears to play an important role among these factors. This study aimed to evaluate the development of auditory and speech perception ability and explore the impact of CI age on children with pre-lingual deafness present before 3 years of age.Methods:Two hundred and seventy-eight children with pre-lingual deafness (176 boys and 102 girls) were included in this study, and the CI age ranged from 6 to 36 months (mean age, 19 months). Categorical auditory performance (CAP) was assessed to evaluate auditory ability, and the speech intelligibility rating was used to evaluate speech intelligibility. The evaluations were performed before CI and 1, 3, 6, 12, 18, 24, 36, 48, and 60 months after CI.Results:The auditory ability of the pre-lingually hearing-impaired children showed the fastest development within 6 months after CI (k = 0.524, t = 30.992, P < 0.05); then, the progress started to decelerate (k = 0.14, t = 3.704, P < 0.05) and entered a plateau at the 24th month (k = 0.03, t = 1.908, P < 0.05). Speech intelligibility showed the fastest improvement between the 12th and 24th months after CI (k = 0.138, t = 5.365, P < 0.05); then, the progress started to decelerate (k = 0.026, t = 1.465, P < 0.05) and entered a plateau at the 48th month (k = 0.012, t = 1.542, P < 0.05). The CI age had no statistical significant effect on the auditory and speech abilities starting at 2 years after CI (P > 0.05). The optimal cutoff age for CI was 15 months.Conclusions:Within 5 years after CI, the auditory and speech ability of young hearing-impaired children continuously improved, although speech development lagged behind that of hearing. An earlier CI age is recommended; the optimal cutoff age for CI is at 15 months.

Perception of Mandarin Chinese vowels in young hearing-impaired and normal-hearing children

The study investigated the perception of Mandarin Chinese vowels of 45 congenital hearing-impaired and 45 normal-hearing children aged 4 to 6. There were 30 children at each age group, half of which were hearing-impaired children. All of the hearing-impaired children received hearing aids or cochlear implants before the age of 5. In a picture identification task, listeners identified the target consonant-vowel word among 2–4 contrastive words. The target words and the other contrastive words differed only in consonants. Each target word represented a concrete object and was spoken by a young female native-Chinese talker. Sixteen of the target words ended with monophthong, twenty-two with diphthong and nine with triphthong. Age showed a significant effect on vowel perception for both groups. Normal-hearing children showed significantly better identification of all three types of vowels than hearing-impaired children at the age of 6, whereas the two groups had comparable performance at age of 4 and 5. For hearing-impaired children, a rapid development of diphthong perception occurred between 4 and 5 years old, while a rapid development of monophthong perception between 5 and 6. The effect of hearing loss severity and the use of hearing aids or cochlear implants will be discussed.

Comparison of aural rehabilitation outcomes in presence and absence of back ground noise in hearing impaired children with and without attention deficit hyperactivity disorder (ADHD)

ObjectiveWe sought to understand the extend of improvement in seven major skills to determine the best rehabilitation approach in hearing impaired young children with and without attention deficit and hyperactivity disorder (ADHD). MethodsNewsha developmental scale was assessed in 40 hearing impaired children with and without ADHD in two conditions, in which seven major skills (hearing, speech, receptive language, expressive language, cognition, social communication, and motor skills) were evaluated. Two separate analyses were conducted, each after six months of rehabilitation. The first six months rehabilitation was done by controlling background noise level, while the other six months rehabilitation was performed with background multi talker babble noise, and ADHD and non ADHD children performance were compared. ResultsAfter the first six months of rehabilitation there were no significant difference in improvement in any of the major skills except for motor and cognition skills between hearing impaired ADHD and non ADHD children. After the second six months of rehabilitation the extend of improvement was equal in both groups. ConclusionThe equal improvement of hearing impaired ADHD and non- Children with ADHD support the benefits of rehabilitation program in both groups. In addition, it seems background multi talker babble noise can facilitate the process of rehabilitation in ADHD group. As a result, it is important to understand the specific needs of hearing impaired children with ADHD in rehabilitation program to provide the best services and increase the chance for success.

The Perception of Stress Pattern in Young Cochlear Implanted Children: An EEG Study.

Children with sensorineural hearing loss may (re)gain hearing with a cochlear implant—a device that transforms sounds into electric pulses and bypasses the dysfunctioning inner ear by stimulating the auditory nerve directly with an electrode array. Many implanted children master the acquisition of spoken language successfully, yet we still have little knowledge of the actual input they receive with the implant and specifically which language sensitive cues they hear. This would be important however, both for understanding the flexibility of the auditory system when presented with stimuli after a (life-) long phase of deprivation and for planning therapeutic intervention. In rhythmic languages the general stress pattern conveys important information about word boundaries. Infant language acquisition relies on such cues and can be severely hampered when this information is missing, as seen for dyslexic children and children with specific language impairment. Here we ask whether children with a cochlear implant perceive differences in stress patterns during their language acquisition phase and if they do, whether it is present directly following implant stimulation or if and how much time is needed for the auditory system to adapt to the new sensory modality. We performed a longitudinal ERP study, testing in bimonthly intervals the stress pattern perception of 17 young hearing impaired children (age range: 9–50 months; mean: 22 months) during their first 6 months of implant use. An additional session before the implantation served as control baseline. During a session they passively listened to an oddball paradigm featuring the disyllable “baba,” which was stressed either on the first or second syllable (trochaic vs. iambic stress pattern). A group of age-matched normal hearing children participated as controls. Our results show, that within the first 6 months of implant use the implanted children develop a negative mismatch response for iambic but not for trochaic deviants, thus showing the same result as the normal hearing controls. Even congenitally deaf children show the same developing pattern. We therefore conclude (a) that young implanted children have early access to stress pattern information and (b) that they develop ERP responses similar to those of normal hearing children.

Clinico-audio-radiological and operative evaluation of otitis media with effusion

Aims: Otitis media with effusion (OME) is a common cause of hearing and speech impairment in children. The correlation of the clinical, audiological, radiological, and intraoperative findings was carried out so as to make a protocol for early diagnosis and management of OME. It will help prevent the more serious sequelae of OME such as tympanosclerosis, chronic adhesive otitis media, and even chronic suppurative otitis media. Methods: 300 clinically diagnosed patients of OME were studied prospectively. Thereafter, patients underwent impedance audiometry, pure tone audiometry, and X-ray soft tissue nasopharynx for adenoids. The patients were given adequate medical treatment for 3 to 6 months, and the patients who did not respond to the treatment were subjected to adenoidectomy with ear examination under magnification and myringotomy with or without grommet insertion. Results: The mean age at presentation was 5.96 years. Only 32% patients gave a history of hearing loss. About 90% patients had mouth breathing, followed by snoring (84%). About 79% ears had abnormal tympanic membrane appearance and mobility; 65.5% had an abnormality on impedance audiometry; and 69.75% had an air condition threshold level of >20 dB. About 78% patients had either Grade III or Grade IV Adenoid hypertrophy. Adenoidectomy was done in all 300 patients with myringotomy in 472 ears. Grommets were inserted in 365 ears. There was a significant reduction in mean air conduction threshold with an improvement of 8.0 dB and 7.5 dB in right and left ears, respectively at 2 months postoperatively. At 6 th month postoperative, the average improvement from baseline dropped to 6.0 dB in right ear and 5.5 dB in the left ear. Conclusion: OME is the most frequent causes of silent hearing impairment in young children which needs a close vigil. All suspected children (on clinical and otoscopic findings) must be subjected to impedance audiometry and X-ray soft tissue nasopharynx for adenoids. After the failure of medical treatment for 3-6 months, the child should be subjected to myringotomy with adenoidectomy in the same sitting. Whenever a child is planned for tonsil or adenoid surgery, he/she must undergo evaluation for OME beforehand so that the child's hearing risk can be simultaneously taken care of in the same sitting.

Effects of digital noise reduction on speech perception for children with hearing loss.

Although numerous studies have investigated the effects of single-microphone digital noise-reduction algorithms for adults with hearing loss, similar studies have not been conducted with young hearing-impaired children. The goal of this study was to examine the effects of a commonly used digital noise-reduction scheme (spectral subtraction) in children with mild to moderately severe sensorineural hearing losses. It was hypothesized that the process of spectral subtraction may alter or degrade speech signals in some way. Such degradation may have little influence on the perception of speech by hearing-impaired adults who are likely to use contextual information under such circumstances. For young children who are still developing various language skills, however, signal degradation may have a more detrimental effect on the perception of speech. Sixteen children (eight 5- to 7-yr-olds and eight 8- to 10-yr-olds) with mild to moderately severe hearing loss participated in this study. All participants wore binaural behind the ear hearing aids where noise-reduction processing was performed independently in 16 bands with center frequencies spaced 500 Hz apart up to 7500 Hz. Test stimuli were nonsense syllables, words, and sentences in a background of noise. For all stimuli, data were obtained with noise reduction (NR) on and off conditions. In general, performance improved as a function of speech to noise ratio for all three speech materials. The main effect for stimulus type was significant and post hoc comparisons of stimulus type indicated that speech recognition was higher for sentences than that for both nonsense syllables and words, but no significant differences were observed between nonsense syllables and words. The main effect for NR and the two-way interaction between NR and stimulus type were not significant. Significant age group effects were observed, but the two-way interaction between NR and age group was not significant. Consistent with previous findings from studies with adults, results suggest that the form of NR used in this study does not have a negative effect on the overall perception of nonsense syllables, words, or sentences across the age range (5 to 10 yrs) and speech to noise ratios (0, +5, and +10 dB) tested.

Cochlear Implants as a Paediatric Day Surgery Service

Cochlear implantation is an evolving and innovative field, with advances being made all the time in the auditory rehabilitation of profoundly deaf patients. Throughout the different fields of surgery there is a drive to carry out procedures as day cases. Paediatric cochlear implantation has been shown to be a cost-effective healthcare intervention in profoundly hearing impaired young children (O’Neill et al., 2000), as well as for older children and adults. It has traditionally been considered an inpatient procedure, and to our knowledge there are no reports in the literature from units with a policy of day surgery cochlear implants. The procedure requires a 2to 3-hour general anaesthetic, and a head bandage is usually applied for 24 hours postoperatively. There is also an association with postoperative nausea and vomiting (PONV), and for these reasons patients conventionally have a 1or 2-night admission. Our aim in this pilot study was to describe the day surgery service which we provide, and to demonstrate that it is possible to provide a day case facility for paediatric patients undergoing cochlear implantation.

Infant hearing loss in South Africa: Age of intervention and parental needs for support

Hearing loss is referred to as the silent, overlooked epidemic in developing countries, and data reporting the mean age of diagnosis and intervention is virtually non-existent due to limited systematic or routine screening programs. The objective of this paper is to present findings of recent practice in early diagnosis and intervention services in an urban South African context, with specific reference to parental needs for support. Data was collected by means of questionnaire surveys for 54 parents of children with congenital or early-onset hearing loss, followed by focus group discussions conducted with 10 parents. The results of this study indicate the mean age of diagnosis to be 23 months (±18 SD), the mean age of initial hearing-aid fitting to be 28 months (±19 SD), and the mean age of enrollment into an early intervention program to be 31 months (±19 SD). In addition, results signify that this diverse and challenging population of parents of young hearing-impaired children largely depends on the ongoing support, guidance, and commitment of the pediatric audiologist.

The use of buccal smears for a non-invasive screening of the 35delG mutation of the Connexin-26 gene in hearing impaired young children

Recent advances in genetic research indicate that about 50% of congenital deaf patients have a genetic background, with mutations in the Connexin-26 gene being the most frequent one. Screening methods for the genetic cause of deafness have so far mostly been based on the use of peripheral whole blood as DNA source. The use of buccal smears for the genetic screening of deaf patients presents an interesting alternative to drawing blood, especially in young children. In order to validate this method, we compared results from buccal smears from very young deaf children (age<or=3 years) and deaf patients older than 3 years with the results from blood samples deriving from the same patients. The detection of the 35delG mutation in the Connexin-26 gene was chosen to demonstrate the method's feasibility. Blood and buccal smears were collected for genetic analysis from 29 very young deaf children (Group 1: age<or=3 years) and 31 deaf patients older than 3 years (Group 2) during their clinical pre-evaluation for cochlear implantation. Genomic DNA was isolated from blood as well as from buccal smears. Yield of both sources was determined by photometric evaluation of the isolated DNA concentration. Genomic DNA isolated from blood and buccal smears was then submitted to PCR-mediated site-directed mutagenesis followed by BS1 YI restriction and electrophoresis. The results for 35delG detection in DNA originating from blood were compared to those of buccal smears. Quantitative DNA analysis showed that both sources provided adequate amounts of DNA for PCR. No significant difference was found between Group 1 and Group 2 considering either the DNA amount isolated from blood or from buccal smears. In all 60 patients, DNA isolated from blood revealed the same results concerning the presence of the 35delG mutation as DNA originating from buccal smears. This study demonstrates that buccal smears are an adequate, reliable source of genomic DNA providing material for genetic tests that can especially help to avoid drawing blood from very young children for the genetic screening of deafness.

Productivity of lexical categories in French-speaking children with cochlear implants

The productivity of lexical categories was studied longitudinally in a sample of 17 young hearing-impaired French-speaking children with cochlear implants. Age of implantation ranged from 22 months to 76 months. Spontaneous speech samples were collected at six-month intervals over a period of 36 months, starting at the one-word stage. Four general measures of their linguistic production (number of utterances, verbal fluency, vocabulary, and grammatical production) as well as 36 specific lexical categories, according to the CHILDES codes, were computed in terms of tokens, i.e., total number of words. Cochlear-implanted children (CI) were compared to a French database of normally hearing children aged 2–4 compiled by the first author. Follow-up results indicate that, at the two-year post-implantation follow-up, noun, and verb morphology was significantly impaired. At the three-year follow-up, the cochlear-implanted group had recovered on adjectives, determiners and nouns, main verbs, and auxiliaries. The two groups differed significantly in processing locative adverbs, prepositions, pronouns, and verbs (infinitive verb, modal, and modal lexical), but individual variability within the cochlear-implanted group was substantial. Results are discussed in terms of recovery and developmental trends and variability in the acquisition of lexical categories by French children two years and three years post-implantation.

Auditory performance of young children with hearing aids: the Nijmegen experience.

During recent years, significant progress has been made in the development of methods for screening hearing sensitivity in toddlers. Nowadays, in several countries, nationwide screening programmes are carried out. Much less attention has been paid to the next step, namely treatment of very young hearing-impaired children with hearing devices. A review of published data indicate that the DSL (Desired Sensation Level) hearing aid prescription method, developed especially for young children, is at least a good point to begin hearing aid fitting. DSL target values for gain and output seems to be adequate for young children. Documenting the benefit for hearing aid use in young children is still cumbersome. One option is to measure the development of basal auditory functions. A review of available data showed that for this purpose, speech material can only be used in children of 3 years and older. For children of 1 year and older, tests with environmental sounds can be applied. It is concluded that, although growing, there is a lack of tests and limited knowledge on how to optimize hearing aid fittings and how to document hearing aid benefit in toddlers.

Auditory training in severely and profoundly hearing impaired toddlers: the development of auditory skills and verbal communication

Three different tests are applied to evaluate the performance of very young hearing impaired children. Three subgroups were formed according to hearing loss. The sound identification test as well as the Reynell Developmental Scales proved to be useful but Early Scales of Communication did not differentiate well enough between the three subgroups.

Otological problems in children with Turner's syndrome

Ear and hearing disorders are common problems among girls and women with Turner's syndrome. During infancy and childhood the girls often suffer from repeated attacks of acute otitis media and later in life the women frequently complain of a rapid onset of social hearing problems due to sensorineural hearing impairment. A study of 56 girls aged 4–15 years with Turner's syndrome was performed to investigate the prevalence of eardrum pathology and hearing impairment in young children and teenagers with Turner's syndrome. A possible relation to karyotype was also investigated. A high prevalence (61%) of recurrent acute otitis media was found in the study group and 32% had been treated with ventilation tubes. Fifty-seven percent showed eardrum pathology, such as effusion, myringosclerosis, atrophic scars, retraction pockets and perforations. Auricular anomalies were noted in 23% of the cases, most commonly in the 45,X group. The audiometric analysis showed conductive hearing loss (air–bone gap>10 dB HL) in 43% and the typical sensorineural dip in the middle frequencies was found in 58% of the girls, of whom the youngest was 6 years old. Four percent were using hearing aids. The data of this study further confirm that the dip is progressive over time and may be detectable as early as at the age of 6, giving a chance to predict a future hearing loss. The findings emphasize the importance of regular otological examinations and audiological evaluations of all girls with Turner's syndrome early in life.

Cortical evoked response to acoustic change within a syllable.

To investigate whether the evoked potential to a complex naturally produced speech syllable could be decomposed to reflect the contributions of the acoustic events contained in the constituent phonemes. Auditory cortical evoked potentials N1 and P2 were obtained in eight adults with normal hearing. Three naturally produced speech stimuli were used: 1) the syllable [sei]; 2) the sibilant [s], extracted from the syllable; 3) the vowel [ei] extracted from the syllable. The isolated sibilant and vowel preserved the same time relationships to the sampling window as they did in the complete syllable. Evoked potentials were collected at Fz, Cz, Pz, A1, and A2, referenced to the nose. In the group mean waveforms, clear responses were observed to both the sibilant and the isolated vowel. Although the response to the [s] was weaker than that to [ei], both had N1 and P2 components with latencies, in relation to sound onset, appropriate to cortical onset potentials. The vowel onset response was preserved in the response to the complete syllable, though with reduced amplitude. This pattern was observable in six of the eight waveforms from individual subjects. It seems likely that the response to [ei] within the complete syllable reflects changes of cortical activation caused by amplitude or spectral change at the transition from consonant to vowel. The change from aperiodic to periodic stimulation may also produce changes in cortical activation that contribute to the observed response. Whatever the mechanism, the important conclusion is that the auditory cortical evoked potential to complex, time-varying speech waveforms can reflect features of the underlying acoustic patterns. Such potentials may have value in the evaluation of speech perception capacity in young hearing-impaired children.

Characteristics of hearing families and their young hearing-impaired children: Early intervention through preschool

Characteristics of hearing families and their young hearing-impaired children: Early intervention through preschool

Predictors of outcome in children with otitis media with effusion.

Otitis media with effusion (OME) is the commonest cause of hearing impairment in young children. The fluctuating nature of the condition makes identification of those with persistent disease difficult without subjecting each child to a period of 'watchful waiting'. The aim of this study was to determine if the outcome of this observation period could in any way be predicted. The study involved the retrospective analysis of 517 children, aged 3-15 years (mean 5 years and 4 months) in whom the diagnosis of OME had been established. All children had been subjected to an observation period before a decision on surgery was taken. There was a significant correlation between the degree of hearing loss at presentation and after the period of observation. Sex was not a reliable predictor of outcome, but age less than 4 years and presentation in autumn or winter were associated with a poor audiometric outcome. This study identifies a predictive influence on the resolution of OME for these three factors and points the way for future research aimed at identifying the subgroup of children with OME who would benefit from early surgical intervention.

聾学校0〜5才早期教育部門の学習形態について : 聾学校の建築計画に関する研究 その2

This paper aims at obtaining the effective knowledge in architectural planning for the section of the early education in the deaf schools founded for the chirdren of 0-5 years old having disability in auditive sense through the analysis of the learning style. Also in the results of the analysis, the following characteristics in the early education in the deaf schools were to be noticed. 1) Hearing impaired young children's mothers who should play important role in daily guidance participate in the activity as members of the learning mass in almost all the schools. 2) Therefore as a learning mass, the fundamental learnig mass is formed by the hearing impaired young children+the mother+teachers. 3) Based on the said fundamental learning mass in 0-2 years old section, guidance for the individuals and groups is made. 4) In 3-5 years old section, including the guidance for individuals conducted in the said fundamental learning mass and the taking-out learning, the auditory learning by forming a variety of learning masses large, middle, and small in scale is in execution.