Deaf-mute or deaf-mutism - This is a congenital or acquired in the dolingual period a lack of hearing, which prevents the development of speech. The main clinical manifestations are deafness, dumbness, distortion of the voice, vestibular and behavioral disorders, excessively developed facial expressions. The diagnosis is based on the data of the study of sound perception, ABR test, neuroimaging methods and DNA diagnostics. There is no specific treatment. Rehabilitation activities include hearing aids, sign language learning and articulation.

General information

There are two main forms of deaf-dumbness - congenital and acquired. The second option occurs in more than 70% of the total number of patients. Over 50% of cases of congenital form of the disease are provoked by genetic mutations. According to the statistics of the world otolaryngology, the prevalence of deaf-dumbness is higher in areas with a high frequency of closely related marriages. About 35% of cases of acquired hearing loss occur in the first year of a child's life, 25% - in the second. Boys and girls get sick with the same frequency. In total, about 200 thousand deaf and dumb people live on the territory of the Russian Federation.

Causes of deafness

The underlying cause is always congenital or early acquired hearing loss. Dumbness occurs secondarily as a result of an inability to learn and reproduce words. Congenital deaf-dumbness can be triggered by the following factors:

• Congenital infections.Most often these are diseases from the group of TORCH infections: toxoplasmosis, rubella, cytomegaly, herpes infection, syphilis, hepatitis B.
• Genetic mutations.Deafness is a member of over 400 genetic syndromes. The most common syndromes are Waardenburg, Stickler, Pendred, Alport, brachio-otorenal syndrome, type II neurofibromatosis, Mondini's dysplasia, Refsum's disease, and biotinidase deficiency.
• Intrauterine intoxication.Congenital deafness can cause abuse of alcohol and drugs while carrying a child, as well as contact with chemicals in the workplace.

In cases of acquired deaf-dumbness, the child's hearing is present at the time of birth, but after a short period of time it sharply deteriorates or completely disappears. The reason may be:

• Birth trauma of a newborn.An incorrectly chosen method of delivery and incorrect use of obstetric aids can lead to damage to the anatomical structures of the middle and inner ear, cortical centers of the brain.
• Lesion of the inner ear, auditory nerve.Recurrent labyrinthitis, complicated course of Meniere's disease, bilateral cochlear neuritis and congenital malformations of the inner ear can cause dysfunction of the organ of Corti and, as a result, deafness.
• Ototoxic medicines.Hearing loss can be a side effect of antibiotics from the polypeptide and polymyxin groups, some aminoglycosides, and loop diuretics.
• Infectious diseases.Cerebrospinal meningitis, scarlet fever, measles, typhoid fever, syphilis, influenza, diphtheria, and whooping cough can lead to deafness.

Pathogenesis

The leading disorder in deaf-dumbness is persistent hearing impairment or its complete absence. The causes of deafness can be structural abnormalities, infectious and inflammatory diseases of the inner ear or directly the sound-receiving apparatus (organ of Corti), the auditory nerve and the posterior parts of the superior temporal gyrus - Wernicke's area. The speech centers (frontal gyrus - Broca's zone) and organs of the articulatory apparatus are not affected. With congenital deafness, a child from birth does not perceive surrounding sounds, including human speech, which makes it impossible to study it - secondary dumbness is formed. With hearing loss over the age of 1 year, children already have some vocabulary, but in the absence of special measures for the development of speech, the acquired skills are quickly lost.

Symptoms of deaf-dumbness

In the absence of targeted diagnostics of hearing in a newborn, the disease can go unnoticed for a long time. In the first months of life, children show reflex crying and screaming due to the normally functioning central nervous system and organs of the speech apparatus. Normally, at the age of 6-7 months, the child begins to imitate the speech of others and pronounce the first syllables ("ma-ma", "pa-pa"), and at 1 year his vocabulary is about 10 full words. With deaf-dumbness, such speech activity is completely absent, mimicry develops strongly compensatory. In some cases, the child makes isolated sounds in an attempt to imitate the movement of the parents' lips.

With acquired deaf-dumbness, which has arisen in children over 2 years old, the child abruptly stops perceiving external sounds - does not respond to his name, does not respond to music, etc. At 3-4 years old, children may complain of tinnitus or a sharp loss of hearing ... At the same time, already formed speech is distorted - it becomes excessively loud or quiet, chanted, monotonous. Some children develop a low or high timbre of voice atypical for gender and age. The severity of vestibular disorders directly depends on the etiopathogenetic variant of deaf-dumbness. They are often limited to a poor sense of balance, especially in the dark or with closed eyes. At the age after 3 years, mental disorders occur - isolation, alienation, irascibility and irritability. In rare cases, opposite behavior changes are observed - excessive gaiety, sociability and mobility.

Complications

Lack of speech activity with deaf-dumbness is accompanied by malfunctioning of the vocal apparatus. Subsequently, this leads to morphological changes in the larynx - incomplete closure of the glottis, premature ossification of cartilage, etc. This makes it impossible to form the natural sound of speech even against the background of its maintenance and further development. The lack of full-fledged rehabilitation measures and training in specialized institutions makes it almost impossible for the patient to fully adapt to society.

Diagnostics

Diagnostics for deaf-dumbness consists in the study of sound-conducting and sound-perceiving devices, the study of the structure of the temporal and frontal regions of the cerebral cortex and the establishment of the etiological factor. The difficulty of examining children under 2 years old is that common tests using a tuning fork and an audiometer are incomprehensible to the child and do not provide an opportunity to obtain clear results. Thus, the diagnostic program includes:

• Study of sound perception.The otolaryngologist, when examining a patient, talks to him at different volumes, gives him sounding toys. To exclude tactile sensations from exhaled air or visual perception of lip movement, the doctor uses a mask or sheet of paper. With deafness, the child does not have any reaction to surrounding sounds.
• ABR-test.Allows you to assess the function of the conducting nerves and the auditory brain stem. When they are damaged, the nerve impulse from the inner ear is not transmitted or perceived by the structures of the central nervous system.
• Neuroimaging.CT of the skull, MRI of the temporal bones and MRI of the brain can reveal structural or inflammatory changes in the structure of the sound-conducting and sound-receiving systems, the cerebral cortex.
• DNA diagnostics.The study of the structure of DNA is used in the presence of other symptoms indicating the development of a particular genetic disease.

Deaf-dumbness treatment

In most cases, it is impossible to restore the normal level of hearing under the condition of already formed surdomutism. In the early stages of progressive deterioration in sound perception, medical or surgical treatment is carried out taking into account etiological factors. Children with congenital deafness are sent to specialized educational and educational institutions. With deaf-dumbness, formed at the age of 3-5 years, further development of speech is carried out with the help of classes with a deaf teacher. Rehabilitation measures include the use of hearing aids and cochlear implants. These devices are effective for deafness resulting from damage to the organs of the sound-conducting system or the inner ear.

Forecast and prevention

The prognosis for deaf-dumbness is unfavorable. In the vast majority of cases, hearing loss is a manifestation of the final stage of the disease, at which the changes are already irreversible. In the future, children undergo special training aimed at the development of partially formed speech or the study of articulation and sign language. Preventive measures include medical genetic counseling for married couples, pregnancy planning, prenatal fetal care, early diagnosis and treatment of diseases that can potentially lead to deafness.

The inability to speak is a difficult diagnosis, which, however, is successfully overcome in some cases.

In this article, we will discuss the main reasons why a person is dumb, as well as the types of dumbness.

The main causes of dumbness

Deafness

Basically, dumbness is a consequence of deafness. So, if a child was born deaf, he never heard the speech of people, therefore he cannot reproduce it; This type of dumbness is congenital and is called deaf-dumbness.

Cases of acquired deaf-dumbness are also possible. If a person loses hearing at an early age, when the vocabulary is still small (or absent), over time, the ability to speak is lost.

Mental problems

Certain psychological illnesses, shocks caused by tragic events in life, overexertion and stress can lead to dumbness. Silence, which is a symptom of psychomotor disorder, is called mutism and is treated with disinhibition.

Developmental deviations

Deep mental retardation in development (oligophrenia), that is, deviations in the development of intelligence, can also be the cause of dumbness. In children, dumbness can be caused by autism.

Brain dysfunctions

Another reason for dumbness (with normal hearing and a level of intelligence) is disturbances in the activity of the brain due to birth trauma or insufficient development of the brain centers responsible for speech. This kind of dumbness is called alalia. With alalia, a person may or may not understand the speech addressed to him, but he is not able to speak.

In addition, a person may lose the ability to speak in adulthood due to traumatic brain injury, inflammation, stroke or tumor. Also, a person may be dumb due to pathologies of the vocal cords, which are responsible for the formation of the voice.

13 facts about the deaf and everything connected with them that you did not know and never thought about.

First of all, I want to say that deaf people are absolutely the same people as everyone else. Let me explain with a clear example. We do not discriminate against Spaniards or Canadians because they are not Russians and were born in another country. So it is with the deaf. They seem to constitute a separate nation with their own language and traditions. Moreover, they perceive the world around us differently than we do, but they cannot imagine how it is possible to hear, and what it is. Something like this we cannot imagine, for example, the fourth dimension, living in three. They have hearing impairments, but other senses are extremely heightened, and so much so that we can only envy them. Despite this, we are all equally human, both from a biological and a psychological point of view, and we must treat the deaf as equals.

1.On December 30, 2012, the President of the Russian Federation signed the federal law “On Amendments to Articles 14 and 19 of the Federal Law“ On Social Protection of Disabled Persons ”, in accordance with which the status of the Russian sign language changed significantly from“ a means of interpersonal communication ”to“ a language of communication ”, There were opportunities for its study and development. Indeed, from the point of view of modern science, sign languages \u200b\u200bof the deaf are full-fledged natural languages.

2. Deaf and dumb people do not exist. All deaf people can make speech sounds, they just cannot learn to do it on their own - they do not hear a "sample" of speech. In the same way, Mowgli children who have not heard human speech are also unable to learn to speak on their own. On the other hand, deaf people have their own sign language, and they actively use it for communication.

3. Deaf people call us not “hearing”, but “speaking”, because from their perspective we differ from them only by the fact that we move our lips when communicating for some reason.

4. Tactile sensations are very important to all deaf people, and their sensitivity to them is increased. In the absence of hearing, they feel vibrations more sharply and react to them immediately. Also, the deaf have a very developed photosensitivity, so in the dark they notice even the slightest reflections of light. Thus, nature compensates for the lack of hearing and helps such people to adapt in the world.

5. Deafness is just a general definition. In fact, there are 3 degrees of hearing loss and 4 groups of deafness. Degrees of hearing loss differ in the number of perceived decibels (below 80 dB). According to the Neumann system, deafness begins when a person does not hear sounds below 90 dB, and its groups vary in the range of perceived frequencies (in hertz). People with group I of deafness perceive from 125 to 250 Hz, that is, a part of non-speech sounds: loud stomping, noise of cars, etc. Only 3% of deaf people hear nothing at all, and most often this is due to an anomaly in the structure of the auricle and / or inner ear.

6. In everyday life, the deaf are helped by various devices. For example, when you press the doorbell, lights start flashing throughout the apartment. And to look after a small child, vibrating radio nannies are used, notifying that the child is crying.

7. There are three types of translators working with deaf people. Dactyls - show words in letters using a special sign alphabet - "dactyl". RSL (Russian Sign Language) translators are full-fledged translators who translate from Russian into RSL (and vice versa) using gestures. Calculation translators - translators specializing in quick literal translation from Russian into RSL, ignoring grammar and features of sign language; this is called KZhR - tracing sign speech. Also, there used to be a profession "sign language interpreter", which combines a translator and a social worker. Now this profession has disappeared from the register of professions and positions, being replaced by a "translator of Russian sign language" and does not contain the functions of a social worker.

8. RSL, like any other language, has its own rules. Moreover, the RSL grammar is more like English than Russian.

9. There are two methods of teaching the deaf: the mimic (mimic-gestural) method and the pure oral method (without the use of gestures).

10. There is a disease called Usher syndrome. It is an inherited disorder characterized by hearing loss and progressive vision loss. That is, a deaf person gradually narrows the angle of view horizontally and vertically (in deaf people it is initially much wider than in healthy people) and by about 40 years of age he almost loses sight. This disease is diagnosed in the early stages, but, unfortunately, it is not treated. In such cases, people with this diagnosis are taught tiflosurd translation in advance. Such speech is also gestural, but it has no scope, and all gestures are shown with one hand, covered by the hand of the interlocutor.

11. Many healthy people believe that deaf people are poor, unhappy people with disabilities. But they themselves do not think so. They lead the fullest possible life, study, do business, drive a car (there is a special sign "deaf driver behind the wheel"), have families, raise children ... Young people often even go to discos. They do not hear (or hardly hear) the music, but they feel the vibrations of the beats, which just enter into a kind of trance of all party goers.

12. Deaf people have their own special culture and psychology. For example, they speak the truth directly, without flattery and avoiding a direct answer, unlike those who hear. This is considered completely natural, and they sincerely do not understand when speakers are offended by honest words, like "You got fat" or "This hairstyle does not suit you."

13. There is sign theater and even sign singing.

Sight, hearing, smell, touch - these are the qualities of the human body, without which ordinary everyday life cannot be imagined. Going to work, hugging loved ones, shopping at your favorite store and much more, most of these actions cannot be performed without relying on the capabilities of our body. But life is unpredictable. Sometimes, as a result of illness or an accident, people are born who have limited, or completely lack these opportunities. How do they cope in this world?

Deafblind people - one of the most difficult categories of such people. There are many patients with a wide variety of symptoms of this disease, but they can be conditionally divided into four types:

Totally deaf-blind-mute - these people are completely deaf and blind. In most cases, speech can be restored with special training.

Hard of hearing visually impaired - this category of people retains residual vision and hearing, which help them navigate in space.

Visually impaired deaf - the patient is completely deaf, but residual vision is preserved.

Hearing impaired blind - a sick person has no vision, but there is a small opportunity to hear sounds.

It would seem that these people are doomed. And history often confirms with facts from life how such people became semi-idiots, whom the family hid in the farthest corners of the house, caring for them until the end of their lives. But no one tried to take their place.

Deafblind people are the loneliest people in this world. If a person sees, all colors are available to him, if he hears, then people can talk to him, but if he does not see and does not hear, then he is almost completely isolated from our life. In order for him to have the opportunity to develop and live, he needs to provide access to the information that those who can hear who can see, help him rebuild to the feelings that he has, and teach him to communicate.

How is this possible? After all, a person does not see what is shown to him and does not hear what is being said to him. But he can touch the necessary object with his hands, examine its smell and taste it. You just need to help him rebuild.

Any person gets used to relying on sight and hearing in life, sometimes forgetting that he has other opportunities. After the loss of the main senses of his own body, the psyche is disoriented, without the necessary support, a person stops developing, talking, problems arise with the vestibular apparatus. In this case, through special training, he can be taught to communicate using sign language, teach self-service skills based on the feelings that he has, even read and write in Braille. Some people, with the help of a teacher, were able to re-learn to speak, and understand what others were saying, putting their hands on the throat and lips of the interlocutor. The human body retains the ability to learn throughout life, if only there is a teacher who is ready to open the doors to another world for his student.

Having residual feelings complicates this learning. It's one thing when a person has completely lost his hearing and. Then he can, using previous life experience, rebuild to other feelings. But when there is residual hearing or vision, the body subconsciously tries to rely on them, ignoring the fact that they are no longer enough for a full life. With the help of a teacher, you can overcome this resistance, and teach a person new opportunities. And then the residual, when then the main feelings, will not become a hindrance, but a pleasant addition to such an unusual way of life.

But what about those who are born deaf-blind? Such children do not know what human speech is, for them objects do not exist at all as we imagine them. Their world is a world of darkness and silence, where there is nothing and no one.

But even such children can be helped. It is only important to start the learning process on time, without starting it until the moment the child grows up. Practice has shown that an adult is no longer able to assimilate as much information as a child can understand. And such a person is doomed to an animal existence on the floor, and a lifelong dependence on other people ...

Deaf people are not uncommon in the human community. According to statistics, 0.4 percent of the world's population suffers from this defect. Much less common are only dumb people who hear and understand speech, but are not able to answer. And this phenomenon is much more interesting than the lack of both the ability to hear and the ability to speak.

Deafness and related factors

From a medical point of view, it is wrong to be interested in those who are dumb. To put it exactly, all children are dumb - they cannot talk. And sounds are made by almost every living newborn. Speech is a secondary skill that develops as a result of information received through hearing. And if a child is born deaf, then as a result of her absence, over time, he becomes completely numb, that is, he stops making even meaningless sounds. Thus, dumb people are not born as such, but become them. But deafness can be congenital. Moreover, even if it cannot be cured, and the hearing aid is not able to compensate for the deafness, a person can still be taught to speak - there are special techniques.

Dumb people: reasons for the inability to speak

We have already come to the conclusion that muteness is always acquired. Moreover, it can overtake a person at any age. And different factors can cause it. Dumb people lose the ability to speak under the following circumstances.

1. Brain damage. It can be traumatic or physiological. Most often, dumbness is caused by a blow to the head in a certain area, brain cancer or hemorrhage into it. Patients with autism are often speechless, despite the fact that everyone can hear.
2. Defects in the organs responsible for speech. These can be ligament injuries or deformities due to some kind of disease. A real variant of paralysis of the tongue is enough to recall Sylvester Stallone, whose tongue is partially paralyzed, but his speech was very indistinct until the actor began to intensively develop it. It is probably not worth mentioning the deprivation of this organ - such an outcome is very unlikely.
3. Mutism. A psychomotor disorder that causes a person to stop speaking. It is caused by severe stressful situations or concussion. At the same time, dumb people understand the speech addressed to them and react to it, but they themselves are not able to overcome the silence. At the same time, muteness can be selective - for example, to touch only men, while a person speaks freely with women. It is treated with disinhibition techniques.

If the ability to speak is completely lost and cannot be restored, the letter and the language of the dumb can help a person in communication. True, the latter can only be understood by specially trained people.

for non-speaking

The language of the dumb is not at all the same as the gestures that people try to explain with foreigners. In this case, it is poor and narrowly functional, while those deprived of the ability to speak need a rich vocabulary that can convey both artistic images and mathematical terms.