Biomedical subjects

C Kiese-Himmel

Publications and source records attributed to C Kiese-Himmel.

17 recordsLinked to original sources

PubMed2000

[Acceptance of wearing a hearing aid by children].

BACKGROUND: Having one or 2 hearing aids is not a guarantee that a child will wear the instruments constantly. The purpose of this study was to evaluate the hearing aid acceptance by children (assessed using the daily wearing time). PATIENTS AND METHODS: A total of 116 parents of a patient population of persistent hearing-impaired children with a need for a hearing aid (average age 51.1 +/- 30.1 months) rated the wearing acceptance of their children on a 5-point-Likert-scale. This assessment was made after the child had received its individual hearing aid for its specific disorder (on average after 5 months). Hearing levels ranged from mild to profound. RESULTS: 58.6% of the children accepted their electroacoustic aids amplier "excellent" or "good", 18.1% did it "average", 23.3% "bad" to "miserable" or even "not at all". There was no significant difference between girls and boys. The wearing acceptance from children with unilateral hearing impairments was reduced, especially from those with chronic conductive disorders by malformations of the ears. Very young children (prelingual hearing impairments), mainly those with additional handicaps and/or not German speaking homes demonstrated a "bad" to missing wearing behaviour. Hearing acceptance did not correlate with the severity of the disorder. CONCLUSION: The wearing acceptance as one aspect of compliance should be rated before each regular hearing aid control. Finally it is an efficient and sensitive mean to detect faulty amplification and changed diagnosis.

Child↗

PubMed1999

[Haptic form discrimination. Group comparison of children with normal speech development and former speech development disordered patients].

The importance of the neurobiological basis of developmental language disorders includes somatosensory modalities. Twenty-five children were diagnosed as having specific language-impairment at preschool age. All were examined with regard to their manual haptic form discrimination without visual control at a mean age of 8.7 years +/- 7.1 months. This study group was compared to age- and gender-matched normal children of equal non-verbal intelligence (control group). Haptic discrimination was measured with the Seguin formboard on which the children were required to place ten geometrical forms in appropriate holes. Both groups differed significantly in their mean quantitative performances in favor of the control group (P < 0.05). The difference in their mean performance and their mean discrimination times did not reach statistical significance. All results were not age-dependent. The control group on average performed significantly better with their left hands than the study group (P < 0.05). Qualitative analysis revealed a significant difference in haptic discrimination of the pointed forms and was probably caused by inadequate exploration procedures and/or cognitive representation deficits. The results of the children with previous developmental language disorders were interpreted as an expression of an impaired cerebral maturation.

Child↗

PubMed1998

Psychological profiles of patients with laryngeal contact granulomas.

The association between laryngeal contact granuloma and demographic/psychological variables was examined by using a psychosomatic approach to health research. A stepwise procedure of logistic regression analyses was utilized to get a final multivariate model of variables associated with the clinical finding of a laryngeal contact granuloma. The subjects consisted of 47 patients with contact granulomas and 110 patients with voice disorders due to other causes. Our analysis of 22 variables uncovered the following statistically significant factors for developing a contact granuloma: male gender (P = 0.0001), low achievement orientation (P = 0.0007), fear of physical lesions (P = 0.0038), impulsiveness (P = 0.0016), age > 60 years (P = 0.0012), low extraversion (P = 0.004), high achievement orientation (P = 0.0079), fear of appearing in public (P = 0.0216) and strain (P = 0.03). These results show that a variety of variables are important for predicting the development of a laryngeal contact granuloma. The usefulness of this set of risk variables for predicting a contact granuloma remains to be proved in a prospective study. It is possible that not only the nature but the number of risk factors are the prime determinants of outcome.

Achievement↗

PubMed1998

[Higher touch and kinesthetic functions in children with former speech/language development disorders: a neuropsychological study].

Two groups of children took part in this study to test the hypothesis that children diagnosed in infancy as specific speech/language-impaired have deficits in tactile-kinesthetic functions: A formerly clinical group of 25 German-speaking pupils with a mean age of 8;7 years (SD 7.1 months) who have previously been identified as specific speech/language-impaired (on average at 4;11 years, SD 10.6 months) and a control group of 25 normal pupils in elementary school without a former or actual speech/language disorder (mean age: 9;2 years, SD 8.3 months). The control group was matched with the formerly clinical group for gender and age. Performance scores of both groups on a nonverbal intelligence test (the Raven's Matrices), on a tactile-kinesthetic subtest (Berliner-Luria-Neuropsychologisches Verfahren f¿r Kinder), and on a developmental language test (Heidelberger Sprachentwick- lungstest) were compared. There was a significant difference (p < 0.05) in the mean tactile-kinesthetic performance of both groups (3.1 vs. 4.0) who present a nearly identical nonverbal intelligence. Thirty-two percent of the formerly clinical group demonstrated a performance below the norm. Analysis of the laterality did not reveal significant differences in performance between left and right hand, neither in right-handers nor in left-handers of both groups. Nevertheless right-handers demonstrated on average a better somatosensory performance with their left hand. Mean language and tactile-kinesthetic performance correlate significantly in the formerly clinical group (r = 0.45, p < 0.05), but not in the control group (r = 0.08). The formerly clinical group was inferior in performance to the normal subjects especially in complex functions as in the tactile discrimination of sharp/blunt and in topognosia.

Child↗

PubMed1998

[Psychological measurement of tactile-kinesthetic perception in early childhood].

The perception theory of Affolter (1987), the theory of sensory integration of Ayres (1979, 1984) as well as the development theory of Piaget (1973) consider sensorimotor experiences as a basis for the child's cognitive development. Tactile-kinesthetic perception has hereby a central position. In the German-speaking psychology, no standardized tests exist to measure the developmental age of tactile-kinesthetic perception in early childhood. The subtests of neuropsychological batteries have not been primarily constructed for young children, therefore they may not portray the age dependence of tactile-kinesthetic perception exactly. That is why we have collected a pool of items, empirically based descriptors of tactile-kinesthetic behavior, to test this perceptual modality. Then we proved it in a series of pretests. The resulting preliminary developmental test contains 7 functions: Localization of touch, pressure sensibility, two-point-discrimination, finger identification, object stereognosis, stereognosis of object properties, and graphesthesia. It was administered to 111 children aged from 3;2 to 6;5 years in kindergarten. Data of the item analysis demonstrated that many items proved to be to easy. Nevertheless, the instrument is useful and measures reliably. The deficits of the experimental test version will now be corrected by a revision. We will start a detailed analysis again using the revised test.

Child↗

PubMed1997

Identification and diagnostic evaluation of hearing impairments in early childhood in German-speaking infants.

The present study was devised to gather epidemiological information to aid in understanding the etiology, identification, and management of children with permanent hearing losses in Lower Saxony as a defined geographical area of Germany. All infants and preschool children were identified in the Department of Phoniatrics and Pediatric Audiology during a 1-year period (October 1994 until October 1995). Forty-four hearing-impaired children were identified, of whom 41 (93%) had sensorineural losses and 3 had pure conductive losses. Thirty-two children (73%) had bilateral hearing impairments. The causes of hearing loss were unknown in 17 children (39%). The median age of identification for the study group was 32 months, with a median age of 35.5 months when fitting hearing aids. Severity of hearing loss was inversely associated with age of identification. Prelingually deaf children had the worst comprehension levels of all children tested psychologically. Results were tabulated and special references to other studies were discussed. Our findings show again that the successful out-come of speech and language development depends on early identification and management of the hearing loss, and on continued assessment of the progress of habilitation. These require a basic assessment of the stage of language development (in perception and expression) as relevant rehabilitation measures. The next step is the treatment of existing linguistic deficits followed by retests at regular intervals.

Child, Preschool↗

PubMed1997

[Follow-up of patients with laryngeal contact granuloma].

A conservative approach (vocal rest, voice therapy, antibiotic treatment of infections and/or management of esophageal reflux) and microsurgery have been used to heal laryngeal contact granulomas. Unfortunately, recurrences have been found in most cases. In the present study we followed 45 patients after an initial diagnosis of a contact granuloma was made based on laryngoscopy and stroboscopy with video-documentation. All studies were conducted in the Department of Phoniatrics (University of Göttingen) during the past four years, with follow-ups made at 3 month-intervals up to 12 months after diagnosis. All patients were counselled using a focal psychosomatic approach. Follow-up was possible for 41 patients. Findings showed that 19 patients lost their contact granulomas completely without therapy, 12 of which occurred over a period to 13 months after diagnosis. Seven patients underwent microsurgery at their own requests, with 5 developing recurrences when compared with the first diagnosis, 15 patients still had a contact granuloma. Emotional strain in connection with specific personality traits seemed to operate as a significant variable in the remission of contact granulomas.

Adult↗

PubMed1997

[A rare case of psychogenic dysarthrophonia or a complex dyskinesia of the pharynx?].

We present the symptomatology of a complex articulation-related dyskinesia of the pharynx with intermittent functional velopharyngeal insufficiency. It became permanent gradually after a writer's cramp had remitted without therapy. No final nosologic assignment can be made on the basis of the described observations in the individual case. The development of the disease in the 56-year old male patient ended in occupational disability. It suggests manifestation of psychopathological events in the patient's life history of threshold situations by premorbid psychic vulnerability. The possibility of the etiopathologic interaction of emotional and neurological factors cannot be excluded. However, therapy with local botulinum toxin injections proved to be just as unsuccessful as logopedic treatment.

Articulation Disorders↗

PubMed1997

[Vestibular function: a prerequisite for normal language development?].

BACKGROUND: First language acquisition depends on intermodal perception, especially auditive, tactile-kinesthetic, and partly visual in addition to sensomotoric integration. The influence of the vestibular function for a physiological language development is still unknown. PATIENT: A case history of a child with bilateral aplasia of all semicircular canals, normacusis in the right ear, and severe sensorineural hearing loss in the left (hearing aid supplied), without mental deficiency, allows us to draw initial conclusions. RESULTS: Logopedic diagnostics revealed only a mild articulation disorder (interdental sigmatism, inconstant gammacism) as a possible consequence of recurrent middle ear effusions since early childhood. Language development diagnostics did not demonstrate any significant norm deviation. CONCLUSIONS: In contrast to the statomotoric disorder, no evidence for a specific language impairment was found. Our report elucidates the importance of a selected diagnostic imaging (spiral CT and MIP MRI) in the phoniatric-ped-audiological field.

Articulation Disorders↗

PubMed1997

[Psychological classification of functional voice disorders].

In an explorative study the classification of a collective of patients with different voice disorders by discriminant and cluster analysis was tried. 21 variables, obtained from 128 patients with various diagnoses of voice disorders, were used. A first discriminant analysis on the basis of diagnoses-groups permitted no differentiation. A subsequent hierarchical cluster analysis indicated a four-cluster-solution. The clusters showed only little association with the phoniatric diagnoses. Cluster 1 is characterized by patients with non-organic voice disorders. Cluster 2 is marked by emotional unstable patients with organic dysphonia. Cluster 3 consists of patients with psychosomatic dysphonia by laryngeal contact granuloma, and cluster 4 contains emotional stable patients suffering from organic dysphonia and from spasmodic dysphonia. Thirteen psychological variables discriminated the clusters significantly: Anxiety about appearing in public, emotionality (neuroticism), life satisfaction, aggressiveness, anxiety, about physical injuries, extraversion.

Adult↗

PubMed1997

[Language development disorders in preschool children: almost 4 years later].

Twenty-five children with specific language impairments (15 boys, 10 girls) who were assessed initially at a mean age of 4 years 11 months were followed up 3 to 4 years later and were tested with standardized instruments (Coloured Progressive Matrices, Illinois Test of Psycholinguistic Abilities [ITPA, German version], Heidelberger Sprachentwicklungstest [H-S-E-T]). A control group of normal children matched for age and gender was also assessed. Nonverbal intelligence in both samples was average (mean T-score: 54). At follow-up 52% of the children who had been identified as having specific language disorders had mild speech articulation problems. Forty-two percent continued to show evidence of language disorders. The main outcome findings were linguistic deficiencies in automatic and sequential processes of language usage (serial auditory memory, imitation of grammatical structures), in the processing of morphological structures (derivation of adjectives) and in syntactic production. There were significant differences between the groups in imitation of grammatical structures, syntactic production and correction of semantically inconsistent sentences (H-S-E-T subtests), and in the subtest "auditory association" of the ITPA.

Articulation Disorders↗

PubMed1996

[Psychological factors in spasmodic dysphonia].

BACKGROUND: Spastic dysphonia has usually been thought as a form of psychogenic dysphonia. A considerable number of authors now feel that this voice disorder is caused by neurological factors. PATIENTS: This study evaluates several psychological factors in 18 patients (9 males, 9 females; mean age: 52.6 years) who had been phoniatrically diagnosed as suffering from adductor spasmodic dysphonia. RESULTS: In standardized psychometric tests, clinical performance of the patients as a group did not deviate from published test norms with respect to emotional instability, hypochondriasis, somatization, or depression. Many patients had been psychosocially stressed to a mild to moderate degree by life events in the two-year period prior to onset of spasmodic dysphonia. These events included severe illness of their own or of near relatives, or death in the family. The personality structure of nearly half of the patients showed a tendency toward increased achievement orientation and certain trait anxieties. CONCLUSIONS: In summary, spasmodic dysphonia remains a phonation disorder of uncertain nosologic classification. It is probable that the disorder is the result of a combination of largely unknown neurological and psychosocial factors.

Adult↗

PubMed1996

["Specific" versus "audiogenic" speech development disorder. Quantitative speech development index in a controlled group comparison].

The language development of hearing-impaired children is disordered, especially in children with impairment before starting linguistic development. Binaural sensorineural-impaired children are likely to acquire a deficient oral vocabulary. Two population samples between the ages of 2 and 5 years (n = 110 specific language-impaired children vs. n = 34 bilateral sensorineural-impaired children with individual hearing aids) were compared with 66 normal children of similar age with respect to their expressive vocabulary. All groups were tested with a nonverbal intelligence test and reached average or better scores. The two clinical samples showed no significant difference in their lexical performance, but there was a difference in comparison with the normal children. The results are discussed on the background of degree, onset of hearing impairment and attending kindergarten. It is suggested that specific language impairment is a more serve development disorder than audiogenic language impairment because it seems to be neurobiologically founded. Early diagnosis by a phoniatrician is important.

Child, Preschool↗

PubMed1995

Sociodemographic variables of a German sample of patients with contact granuloma.

We report 28 German patients with contact granuloma (27 male, 1 female). Their mean age was 52 years (ranging from 35 to 70). Thirty-two percent were retired. The occupations of the others represented a wide range of different jobs. The majority of the sample had a middle educational level. Most patients lived with their family or with a partner. According to self-assessments, 68% had average daily strain on their speaking voice. All patients were nonsmokers. The patients felt themselves more disturbed by somatic troubles as the general population. Heartburn was felt by nearly half of the patients. A little more than half of the patients suffered from globus sensation. Thus, it is not possible at present to explain the laryngeal contact granuloma by sociodemographic data, vocal stress, or special somatic complaints in this sample. Therefore a multifactorial etiology should be supposed.

Adult↗

PubMed1995

[Expressive vocabulary: comparison of 2 psychological test procedures in kindergarten children].

Fifty-five subjects were drawn from a population of average kindergarden children. Their ages ranged between 3; 4 and 4; 11 years. Two vocabulary tests were administered individually in a quiet room to each subject. A new instrument for testing the active vocabulary (Subtest "vocabulary" of the K-ABC, 1991) was compared with an established one (AWST 3-6, 1979) to see whether they agree sufficiently for the new to replace the old. Raw scores were computed according to the test instructions for each correct response and transformed into normscores. These were compared, and both tests correlated with r = 0.69 (p = 0.0001). So, the K-ABC-Subtest "vocabulary" may be administered in the first diagnostic setting. The mean of the differences of both vocabulary tests is 0.1; yet, in some cases large differences between the results of both vocabulary tests are to be expected, because the differences vary in the broad range from -15.5 to +15.7 (= +/- 2 SD). Therefore the more detailed AWST 3-6 should be used to assess the amount of active vocabulary in children with a low norm score in the K-ABC-Subtest "vocabulary".

Child, Preschool↗

PubMed1994

[Laryngeal contact granuloma--a psychosomatic disorder?].

In a multidimensional design using the hypothesis of a psychosomatic genesis, 28 patients (1 female, 27 male) showed, in their personality profile, increased scores in 'impulsiveness', 'emotionality (neuroticism)', 'strain' and 'inhibition'. In addition to the voice disorders other somatic symptoms were observed, especially general symptoms as dysthymia, depression and excessive vegetative stimulation. Their social competence was reduced by the fear of making contacts and the inability 'to say no'. Also psychosocial stress factors were registered due to loss of a loved one with feelings of an existential danger. Thus, contact granuloma can be considered as a secondary reaction to a specific combination of personal disposition and social life situation. Lastly a causal model is presented, which can be used as a diagnostic criterion.

Adult↗

PubMed1993

[Psychosocial problems and coping with illness by patients with defective healing after facial paralysis].

Twenty patients with defective healing following idiopathic or infection-induced facial paralysis (group 1) and 14 patients with defective healing after excision of an acoustic neuroma and subsequent hypoglossal-facial nerve anastomosis (group 2) were questioned as to their psychosocial conditions. The principle gueries involved the impact of facial impairment on social activities, behavior in public, professional performance and communication, as well as strategies in coping with disfigurement. One third of the patients (with a majority in group 2) experienced stigmatization and a feeling of embarrassment or anxiety in public. Many patients minimized facial expressions and communication in order to hide their paralyses. In particular, patients in group 2 frequently had to change their employment and had great problems in accepting their conditions. Additional problems had with a clinical diagnosis of "acoustic neuroma" involved greater stress and more pronounced social withdrawal than experienced by the patients with idiopathic pareses.

Adaptation, Psychological↗