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Belova O.A.
Federal budget educational institution of higher professional education “Ryazan State University named for S.A. Esenin”, Natural Science and Geography Faculty, Assistant Professor, candidate of Medical science.
LONGITUDINAL STUDY OF MORPHOFUNCTIONAL CHANGES IN PUPILS WITH HEARING CHALLENGES (YEARS 2005-2011)
The abstract looks into the morphofunctions of children and teenagers with hearing challenges, employing data gathered since year 2000. We observe issues of maturity achievement and physical development in children from different academic phases. Key words: pupils, hearing challenge, impairment of sensory hearing system, developmental specifics, physic development, chronological age.
The appearance of various secondary school types, including corrective ones, has posed the task of studying the psychophysical, functional, and physical capabilities of the child’s organism. This makes it imperative, to improve our hospital care and therapy, and to develop new ways of recuperation for children and adults. Children who are deaf or hard of hearing are generally referred to the group of health-challenged children, and the restrictions imposed do not only concern their physical ability, but also ways and times in which information about the world around is given to those children through their ears, sparingly or even restrictively. As they grow and mature, thus changing their personalities (in ways that are distinctly different from children who can hear well). As children’s bodies grow, they mature as personalities, and in the cases under study, we often observe so-called anomalous development, which is displayed not only in impeded use of oral language (mastered slower) and is highly specific in the tempo of oral comprehension, whether it be vocabulary subtleties, or grammar logic; such children’s oral speech proper develops substantially slower. Thus, we face obstacles in the development of higher psychic activities. Even a minor hearing impairment often prevents a child from making steady progress, endangering his or her academic advancement and sometimes curtailing his life opportunities. In cases of partial loss of hearing, we do not only observe underdeveloped functions (corresponding to the sensory analyzer that is hurt), they will very often become distorted. A child who does not hear well uses language in specific ways, and this is not just a matter of poor vocabulary. This change leads to further distortions in comprehension, and the child has to perform in very specific conditions, where s/he is to learn and study. Clinical studies of children and teenagers show an array of clinical and physiological diversity that stems from underdeveloped speech, and often leads to hyperactivity, insufficient performance in intellectual work, frequent emotional changes, high affectivity, as well as minor problems with body balance and motor coordination.
The goal of our research is to study the morphophysical development and psychophysiological peculiarities in hearing-impaired children and teenagers, split into junior, middle, and senior age groups.
To achieve this goal, we posed the following objectives:
1. Study of morphophysical development in hearing-impaired children and teenagers, and computing the ratio of harmonious and disharmonious development cases in school;
2. Study of psychophysiological peculiarities of hearing-impaired children;
3. Developing recommendations for teachers that concern the organization of the academic process in classrooms of children with hearing challenges.
At present, the most widely spread and efficient method is the centile evaluation of physical development. It is simple in application, as centile charts provide all the computation that is necessary. Using 2-dimensional centile charts that correlate body height with body weight, and body height with chest circumference, we can judge the degree of harmony in a child’s development. A centile is one-hundredth part of a varying scale for any parameter indication. The evaluation of the biological age of junior pupils was based on the dental formula, whereas for middle and senior groups a biological formula was constructed. We employed an integrated approach to holistic examination of an organism, and to its functional systems. We took into consideration the fact that morphofunctional development and biological maturity (a highly labile system at that) of a person are in most cases a factor that reflects adjustments and adaptations of that person to his/her academic and educational environment. There, the leading somatometric criterion is the pupil’s height. The statistics obtained in our research were then subjected to analysis using MS Excel.
Up to now, a number of works have been published that address age dynamics of functional systems in schoolage population, but they do not include a full characteristic of the developmental stages for hearing-impaired pupils.
Defects of the hearing analyzer in a child should be regarded in a different light from those in an adult person. When hearing deteriorates at a mature age, the person’s speech has already been formed, and the defect mainly affects oral comprehension as part of communication. When hearing is impaired at a younger age, the fact influences social, psychophysiological and psychic development. First, hearing impairment negatively influences speech development, which means faulty performance of the basic communicative function, most closely dependent on the development level of the hearing sensory system. In some
cases, this is diagnosed as initial delay of psychic development, which makes prospects of positive change even more doubtful. The most noticeable delay occurs in the development of the children’s thinking, especially verbal and logical thinking. Hearing impairment reduces communicative opportunities for the child, preventing self-fulfillment of the child (and then, teenager), making obstacles in the process of the young person’s entering the world of adults. Early deafness makes it difficult to correctly develop speech skills, being a leading risk factor in such children, and if deafness developed before speech aquisition, dumbness comes together with it. The basic difference between partial and complete loss of hearing is that in the case of the former, people can at least partially learn speech skills using their hearing analyzer, when they can discern speech spoken at an average intensity. Medically, the diagnosis “hard of hearing” is used for people who discern only loud speech. Deafness is complete loss of hearing or such a degree of its loss that is only correctable with hearing aids. Hearing impairment is a bilateral reduction of auditory acuity, which causes comprehension difficulties, but when the loudness increases, comprehension quality becomes sufficient. There exist several factors that are responsible for hearing loss, and they frequently grouped into three categories. The first category is hereditary factors, accounting for up to 50% of deaf patients. Hereditary deafness or low hearing may combine with other pathologies of body organs or systems (problems with eyesight, osteo- and muscular pathologies, nervous system, endocrine, et al.). the science of genetics has addressed hearing problems and found that human gametes contain up to 50 various genes that affect auditory acuity. If either parent suffers from hereditary deafness, the risk of inborn deafness in his/her child increases. Where both parents are deaf, this condition is likely to be inherited by their child with even greater probability, which is over 50-60%. Another group of factors responsible for that is endogenic and exogenic influence on the embryo is hearing analyzer (when no hereditary factors were active), which may also lead to inborn deafness.
The mother’s health problems during pregnancy are also very important, such as German measles, influenza, parotitis, et al. Hearing may be affected by the use of ototoxic antibiotics. Other causes of hearing impairment are: birth traumas, application of tongs to the new-born’s head during delivery, eardrum surgery, traumatic breaks in the hearing-bone system, adenoid vegetations, etc. It is sometimes hard to find the initial cause of hearing impairment. They are sometimes combined in their effect. Yet, the same cause may lead to different forms of hearing impairment or deafness. Various sources state that 4-6% of the world’s population suffer from hearing impairment, and the majority of them can be considered patients who are hard of hearing.
Children with hearing impairment display specific patterns in their physical, functional and psychic development, which predetermine their physical development. Among hearing-challenged children, we observe a higher occurrence of fault in posture, scoliosis, droop, contracted thorax, alar scapula, and platypodia. At that age body, indica-
tors in such children are also rather different from children who can hear well (height, weight, chest circumference, vital lung capacity, muscular strength of the back, abdomen and chest). As early as at 2 or 3 years of age, children’s life becomes arranged in a routine that ensures positive development of all physiological processes. One of the most important tasks of physical education is body tempering. This enhances immunity to colds and infections, endurance to temperature contrasts, training the nervous and cardiovascular systems. For normal physical and psychic development, the child needs physical activity. The mastering of basic motor activity is very important for children with hearing impairment. This is practiced in class as well as in everyday activities. The morning set of physical exercises lasts 4-12 minutes, depending of the child’s age. Besides special times for exercise, children move independently, too. They are physically active before breakfast, between classes, during walks, at game, before going to bed. Educators should not constantly interrupt such activity, even if for the sake of orderly and quiet classroom procedure.
Physical education is an indispensable part of general education proper, for hearing-impaired children as well as for their peers. Physical education serves a function within all-round development. The pupils should be educated not only in the intellectual sense, but physically, too. The more harmoniously a person develops the greater chances s/he will have to solve their problems in future. Physical education performs a major role in improving children’s health condition. When physical activity is organized for hearing-challenged children, we should take into consideration their medical cases: nearly all of them have had serious illnesses, including brain diseases, which have brought about the hearing impairment. It is imperative to know when the child developed deafness: before s/he started to speak, or after mastering oral speech. The degree of hearing loss also needs to be taken into account: is the child’s deafness complete, or can we rely on remaining hearing in the course of education and upbringing?
Physical education of the deaf is aimed at all-round development of their personality, achievement of medical, educational, behavioral, and corrective-compensational tasks. The primary goal of physical education in school for the hearing-challenged is to raise physically fit people, prepared for socially beneficial work activity, to compensate for the limitations in activity in this category of school-pupils.
Our evaluation of pupils’ physical development in the secondary boarding school for the hearing-challenged has yielded the following data: out of 100 pupils, 62.3% have shown harmonious development, 24.73% - disharmonious development, and the remaining 12.9%, acutely disharmonious.
A gender split of these results looks as follows: 26 (27.96%) girls and 32 (34.41%) boys develop harmoniously. 10 girls (10.75%) and 13 boys (13.98%) develop disharmoniously, and acute disharmony is observed in 8 girls (8.60%) and 4 boys (4.30%)
Therefore, comparison between boys and girls in their physical development levels has yielded veritable results in
the following groups. Boys aged 11-13 show greater harmony of development, and girls show less harmony. We can account for this by the fact that girls start growing in height 2 years earlier than boys do, and for girls this process is not as intensive as for boys. In this age group, the basic body dimensions are higher in girls. Moreover, in the age group of
17-19, girls show greater harmony than boys do. The explanation is that by this time, girls’ bodies have finished growing, mostly. Therefore, sharp changes of weight and height are not typical of girls, whereas boys’ growth tempo only slows down at the end of the period.
Diagram 1.
Physical development of childern with hearing impairment
We conducted a correlative analysis of the following basic parameters of physical development, using the Mis-crosoft Excel application, and this yielded the following results. In the age group of girls between 7 and 9, there is a direct dependence between height and weight, and weight and chest circumference (i.e., as the height increases, so do the person’s body weight and chest circumference), and the differences between the indicators of height and chest circumference are not verifiable. In the next age group of 10-11-year-old girls, there is a direct-proportional positive correlation between each pair of the indicators stated above. A similar pattern is observed in 12-13-year-old girls. In girls’ groups of 14-15 and 16-19 direct proportional, dependence exists only between weight and chest circumference (as the former increases, so does the latter). Among 7-9-year-old boys, there is a direct-proportional positive correlation between each pair of the indicators stated. In boys’ groups of 10-11, direct-proportional dependence exists only between weight and chest circumference (as the former increases, so does the latter). In boys’ groups of 12-13 and 14-1, there is a direct-proportional positive correlation between each pair of the indicators stated. And in boys’ groups of 16-19 correlative dependence between the parameters does not exist at all. When we compare our results with those in published data, we observe that the general trends of school-age physical development are to be found in both sources, with a few deviations.
In the period between 7 and 9, the development of primary school children proceeds very intensively, and it is rather stable. Here belongs the so-called “half-height increase”, when the child’s weight approaches 70% of an adult person’s weight, and this growth chiefly concerns the limbs. In our case, this regularity was characteristic both of boys and girls, and the correlative dependences found reflect the intensity of body growth and development in that period.
Between 10 and 11 come the most complex and contradictory events of postnatal ontogenesis, forming its critical period. According to other research, growth processes at the beginning of the period slow down, and at the end, they accelerate again. There are clear-cut differences in the development of boys and girls both in growth and maturity patterns and in gender-specific change of organism. Girls start developing lipopexia in a new way, and acquire mammal glands. In our case, girls display direct-proportional positive correlative dependence among all the indicators stated. Boys do not show such correlation, which leads us to the supposition that growth tempo and body development decelerate at that age, and this conclusion is supported by available publications.
According to published data, the process of girls’ development accelerates until 13-14 years of age, and then it slows down. Growth acceleration in boys becomes noticeable when they arrive at 13-14, and by 15-16, they are taller and heavier than girls. The growth of boys is longer and more intensive that that of girls. In both genders, height increment happens approximately one year faster than weight increase. The period of active sexual development (boys of 14-16 and girls of 12-14) demonstrates the opposite: weight is gained faster than height. Following puberty, the growth tempo slows down and gradually the weight-height correlation becomes similar to that of an adult body. Between 12-13 and 15-16, there is a puberty leap in height, when teenagers achieve their definitive height. The shape of the body acquires gender-specific qualities: broad chest and narrow hips in young men, and a clear-defined waistline and broad hips in girls. The puberty leap in height is an important stage in the sexual maturity of girls. In the cases of girls (12-13 years old) that we have observed, there is a direct-proportional correlative dependence among all the indicators, which is confirmed from published data, too. And in the age period of 14-15 correlative dependences do
not show, which can be explained by the disbalance existing between weight and height in that period, and general deceleration of growth processes.
In boys’ groups of 12-13 and 14-15, there is a direct-proportional correlative dependence among all the indicators stated above, i.e. increase of one indicator of physical development leads to increase in another; all these data are supported by published studies, too.
The absence of such correlation in the groups of girls and boys of 16-19 is due to the sharp decrease in the tempo
of growth in height and weight. Also, this deceleration in girls happens at the beginning of the period, and in boys, at its end. Full correspondence between the biological and the chronological age occurred in 7.69% of girls and in 10% of boys. The other 92.31% of girls and 90% of boys showed delay of the biological age as compared to the chronological age. It should be noted that this delay was mainly observed in the junior age group, while in the senior group it was similar to the development of other secondary school pupils or even exceeded that.
Diagram 2
Correlation between the biological and chronological age in childern with hearing impairment
100,00%
90,00% -80,00% -70,00% 60,00% -50,00% 40,00% -30,00% -20,00% -10,00% 0,00%
□ Correlation
□ Delay
Girls
Boys
The problem of increasing the efficiency of the organism and its specific systems through change of external environment for school pupils with hearing impairment requires multifactor approaches for objective diagnosing of pupils’ problems.
