Thesis (M. Aud.)--University of Canterbury, 2009. / Typescript (photocopy). Includes bibliographical references (leaves 76-90). Also available via the World Wide Web.

Thesis (Ph. D.)--University of Missouri-Columbia, 1999. / Typescript. Vita. Includes bibliographical references (leaves 60-65). Also available on the Internet.

Thesis (M.Sc.) -- Memorial University of Newfoundland. 1973. / Typescript. Bibliography : leaves 98-104. Also available online.

Thesis (Ph. D.)--Ohio State University, 2005. / Available online via OhioLINK's ETD Center; full text release delayed at author's request until 2010 Aug 16.

IntroduÃÃo: A deficiÃncia auditiva, durante a infÃncia, resulta em dÃficit na recepÃÃo e expressÃo da linguagem comprometendo o desenvolvimento social, emocional, cognitivo e comunicativo do indivÃduo. A surdez, na infÃncia, à tÃo devastadora, que muitas vezes impede que a crianÃa desenvolva-se plenamente, obrigando-a à exclusÃo de seu meio social. Objetivo Geral: Estudar a perda auditiva em crianÃas atendidas em serviÃo de referÃncia. Objetivos especÃficos: Determinar a proporÃÃo dos principais fatores de risco para a perda auditiva; determinar os principais tipos e graus de perda auditiva; estabelecer o tempo mÃdio decorrido entre a suspeita da perda auditiva pela famÃlia e o primeiro diagnÃstico audiolÃgico; estimar a proporÃÃo de perda auditiva evitÃvel. Delimeamento do Estudo: estudo transversal. Local de estudo: ServiÃo de Audiologia do NÃcleo de AtenÃÃo MÃdica Integrada (NAMI) da Universidade de Fortaleza. Participantes: crianÃas da faixa etÃria de zero a 14 anos. VariÃveis estudadas: sexo, procedÃncia, profissional que encaminhou ao serviÃo, faixa etÃria, tempo mÃdio decorrido entre a suspeita da perda auditiva pela famÃlia e o primeiro diagnÃstico audiolÃgico, tipo de perda auditiva pela famÃlia e o primeiro diagnÃstico audiolÃgico, tipo de perda auditiva, grau da perda auditiva, fatores de risco para a deficiÃncia auditiva, surdez evitÃvel. Resultados: Foram avaliadas 488 crianÃas; a perda auditiva de qualquer tipo ou grau foi encontrada em 280 crianÃas (62,5%), destas, 165 (58%) eram do sexo masculino. Os pediatras responderam por apenas 1,8% dos encaminhamentos ao serviÃo, sendo a grande maioria encaminhada por otorrinolaringologista (42,9%). CrianÃas na faixa etÃria de 2 a 7 anos representaram a maio proporÃÃo de crianÃas avaliadas (49,3%), somente 1,3% das crianÃas tinham idade inferior a 1 ano. O tempo mÃdio, decorrido entre a suspeita de perda auditiva pela famÃlia e o primeiro diagnÃstico de surdez, foi de 3 anos e 2 meses. Dentre as crianÃas que apresentaram perda auditiva, verificou-se 66,4% de perdas sensorioneurais, 18,9% de perdas condutivas, 0,7% de perdas mistas e 13,9% de exames inconclusivos. Para as perdas auditivas sensorioneurais bilaterais, o grau profundo foi de maior ocorrÃncia (35,4%). Surdez potencialmente evitÃvel foi estimada em 57,4%. Para os provÃveis fatores etiolÃgicos, a hereditariedade foi predominante (22,0%), seguida pela rubÃola congÃnita, (13,9%). Os problemas condutivos representaram o total de 18,9% da amostra, seguidos pela caxumba com 9,6% a meningite, com 7,5% e o sarampo com 7,5%. ConclusÃes: Foi extremamente baixa a proporÃÃo de crianÃas avaliadas no primeiro ano de vida (1,3%), bem como o tempo mÃdio transcorrido entre a suspeita da perda auditiva pela famÃlia e o diagnÃstico de surdez (3 anos e 2 meses). As perdas de origem ambiental (rubÃola na gravidez, meningite, sarampo, problemas condutivas e caxumba) sobrepujaram as causas de origem hereditÃria e genÃtica, sendo responsÃveis por mais de 50% das perdas auditivas; consideradas casos de surdez evitÃvel. As perdas auditivas do tipo sensorioneural bilateral de grau severo e profundo foram as de maior ocorrÃncia (42,2%); sendo consideradas as de maior gravidade para o desenvolvimento da fala e linguagem da crianÃa. A divulgaÃÃo de mensagens para a comunidade enfatizando a importÃncia da saÃde auditiva para o desenvolvimento da crianÃa aliada a implantaÃÃo de medidas de prevenÃÃo contra a perda da audiÃÃo, estratÃgia de identificaÃÃo e encaminhamento das crianÃas de risco e, de serviÃos e profissionais de saÃde atentos ao problema podem consistir em soluÃÃes eficazes para reduzir o elevado nÃmero de casos de deficiÃncia, principalmente os relacionamentos à surdez evitÃvel, impedindo, dessa forma, que crianÃas possam ser acometidas por doenÃa tÃo devastadora e estigmatizante como a surdez. / Introduction: Hearing impairment in childhood, resulting in a deficit in language reception and expression of undermining the social, emotional, cognitive and communicative individual. Deafness in childhood is so devastating, that prevents the child to develop fully, forcing it to the exclusion of their social environment. General Objective: To study hearing loss in children seen in a reference. Specific Objectives: To determine the proportion of major risk factors for hearing loss and determine the main types and degrees of hearing loss; establish the average time between the suspicion of hearing loss for the family and the first audiological diagnosis, estimate the proportion of hearing loss avoidable. Delimeamento Study: cross sectional study. Place of study: Department of Audiology, Center for Integrated Medical Attention (NAMI) at the University of Fortaleza. Participants: children aged zero to 14 years. Variables studied: sex, origin, who referred to the service professional, age group, median time from suspicion of hearing loss for the family and the first audiological diagnosis, type of hearing loss for the family and the first audiological diagnosis, hearing loss, degree of hearing loss, risk factors for hearing loss, deafness avoidable. Results: We evaluated 488 children, hearing loss or degree of any kind was found in 280 children (62.5%) of these, 165 (58%) were male. Pediatricians accounted for only 1.8% of referrals to the service, with most being referred by ENT (42.9%). Children aged 2-7 years represented the proportion of children assessed in May (49.3%), only 1.3% of children aged less than one year. The average time elapsed between the hearing loss suspected by the family and the first diagnosis of deafness was 3 years and 2 months. Among children who had hearing loss, there was 66.4% sensorineural loss, conductive hearing loss of 18.9%, mixed 0.7% loss and 13.9% of inconclusive examinations. For bilateral sensorineural hearing loss, the profound degree was more frequent (35.4%). Deafness potentially avoidable was estimated at 57.4%. Probable etiological factors, heredity was predominant (22.0%), followed by congenital rubella (13.9%). The problems conductive represented a total of 15 18.9% of the sample, followed by mumps, meningitis 9.6%, 7.5% to 7.5% and measles. Conclusions: It was extremely low percentage of children assessed in the first year of life (1.3%), and the average time between the suspicion of hearing loss for the family and the diagnosis of deafness (3 years 2 months). The loss of environmental origin (rubella during pregnancy, meningitis, measles, mumps and conductive problems) overcame the causes of hereditary and genetic, accounting for more than 50% of hearing loss, deafness considered preventable. The sensorineural hearing loss bilateral severe and profound were the most frequent (42.2%) are considered the most serious for the development of speech and language of the child. The dissemination of messages to the community emphasizing the importance of hearing health to child development coupled with the implementation of preventive measures against hearing loss, strategy identification and referral of children and risk, services and health professionals aware of problem may consist of effective solutions to reduce the high number of cases of disability, especially relationships with deafness prevented, preventing in this way, children can be affected by such a devastating and stigmatizing disease such as deafness.

This qualitative study concerns the notion of being 'heard’, with a focus on the counselling relationship. The term ‘hearing’ is used as a metaphorical concept and its definition forms part of the investigation. The study initially focuses on the hard of hearing client and their position between the Deaf and hearing worlds. Hard of hearing people are viewed as an important client group whose needs are frequently overlooked. There is a review of the literature relevant to the hard of hearing individual and disability in the counselling relationship. This is followed by a broader consideration of the meaning of ‘hearing’. Included in this literature is ‘hearing’ from the perspective of developmental psychology relating to non-verbal communication, ‘hearing’ through language and ‘hearing’ the other. Following a methodological discussion, an adapted Foucauldian discourse analysis is applied to interview data from nine hard of hearing participants. The findings illustrate dominant discourses in action and also discourses of resistance. The dominant discourses suggest the power and politics involved in the counselling venture and the resistance shows the alternative subject positions the participants created and their agency in the process of being ‘heard’. Following this analysis, a discussion develops, which involves ideas around embodied and ethical 'hearing' in both the research process and within counselling. The study does not aim to provide any stability to the notion of ‘hearing’ in the counselling relationship, but contributes to the field of counselling psychology in creatively exploring the ambiguous term.

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