MOT SO VAN DE KHI DAY NGON NGII CHO TEE KHIEM THINH TS O O THj HI^N" Xahoi phat triSi, cudc song cua con ngudi cang dupc nang cao, tuy nhien, van ed mpt bd phan ngudi khuyet tat phai chju rat nhieu th[.]
MOT SO VAN DE KHI DAY NGON NGII CHO TEE KHIEM THINH TS O O THj H I ^ N " X ahoi phat triSi, cudc song cua ngudi cang dupc nang cao, nhien, van ed mpt bd phan ngudi khuyet tat phai chju rat nhieu thiet thdi cupc sd'ng Cd nhieu nguyen nhan dan den cac hien tupng nay, khoa hpc du rat phat trien cung khdngthebaibdhoan toan nhiing nguyen nhan dd Gan day, Nha nudc da trien khai thue hien nhieu chUPng trinh nh§m giup ngudi khuyet tat vupt len so phan, d'n djnh cudc sdng va hda nhap cdng ddng Tuy vay, ngudi khuyet tat van edn gSp nhieu khdkhSn ddi sdng vatchat l i t i n h than Giao due, nang cao trinh dovSn hoa vadao tao nghecho ngudi khuyet t^t dang duqc xem la nhdng glai phap hieu qua de mang den cho hpmpttupnglaitotdep hpn, dae bietvdiddi tupng la tre em Trong baiviet nay, ehung tdi dua mdt sdvan de CP ban lien quan den viec hinh ngdn ngu (NN) eho tre khiem thinh (TKT), dae biet la ngon ngQkihieu (NNKH) Dong thdi, gidi thieu mpt so khuynh hudng hien dang dupc mdtsdtmng tam giao due sddung de dayNNKHpVietNam I.Trekhlan thinh vangon ngucuaTKT TKT la tre ed susuy giam sdc nghe dcae mi^c d$ khac nhau, d i n den su khd khSn tri giac am thanh, dd cd am NN, lam han c h l kha nSng giao tiep (GT) b i n g Idi va anh hudng den qua trinh nhan thdc TKT ch? gap khd khan vdi viec nghe, ma khdng bj mdt khuyet tat nao khac ve tam than Vi vay, neu mpt dua TKT dupc phat hien sdm (trudc 18 thang tud'i) va dupc can thiep, tri lieu kjp thdi, thi tien trinh phattrien NN cua tre se gid'ng nhu tre binh thudng Ngupc lai, n i u ^Mdc phat hien sau ba tud'i, thi su phattrien sau cua dua tre dd se bi anh hudng rat nghiem trpng (vi day la gial doan CO y nghTa quyet dinh ctia qua trinh thiJ die NN) Dovay, nhiJng tre phat hien fr/?/emf/)/V?/?{KT) sau ba tud'i da bj bd Id mat CP hpi dupe can thiep, tre bjchSm phattrien v l NN, kTnang GT va nhan Mc{hinh1) 24 Tap chi Gido due so 306 IhingluJI _ WOdrn ?• T a n i n t p IU lhir>gruji Wxlm >• T IMnglgA u n I M P IU IMnglilSi Hinh TiSh Irinh phat then NN cua TKT dugc can thi^p dcae Ihdidiem khac so vditre binh thifdng Do khuy^tatdtai nen vieehinh NNcho TKT gap rat nhieu khd khan Kha nang nghe cua TKT kem, d i n den khanang ndi vahieu NN cung kem Vdinhdng tre diee nang, may trp thinh khdng giup nghevandidupc Nhung trenay, neu khdng dupc phat hien va cd bien phap can thiep tri lieu kjp thdi, edthlse bj cam Do dd, yeu cau dau tien viec hinh HHcholKJ)a\iephaidugcph^higns^vachinhxss mtiedoKTdeco nhdng blen phap trj lieu vacan thiep phuhpp d ngudi, tai la cp quan thinh giac, tat KT la nhungkhuyettatPtalgaynen.Tuynhien, khdng giong vdi n h i ^ g tat khac, rat it tre bj KT dupc phat hien kjp thdi, bPi vi tai ya CP che hoat dpng eua nd rat phuc tap, nhin bing m i t thudng, ehung ta khdng phat hien dupc tatKT Tai gom mdt vai bd phan d ngoai va mdt vai bp phan dtrong dau Bp phan eua tai nhin thay rd nhat la tai ngoai Talngoaiciu gom vanh tai va mdt phan eua ong tai Taingoaico nhiem vu thu nhan sdng am va chuyen vao tatgii/a Taigiila la mdt khoang dupc lap day khdng va cd ba xUdng nhd Sdng am dupc ehuyen td taingoaivao 1am cho cae xupng nhd chuyen dpng Neu tai 5'/(/a bi viem, se lam anh hudng den suhoatddng * Vien Ngba 901 bpc -(ki2-3/2013) cua ba xupng nay, gay khd khan eho viec ehuyen am vao tai Tuy nhien, nhimg benh p te/ ngoaiva tai giua cd the dupc dieu trj, neu dupc phat hl?n kjp thcrt Khitai giua binh thudng, sdng am duoc chuyen vao/a/7ro/7f? ra/fron(;la mdt dng cudn trdng gidng hinh ocnen dupc gpi la 6c tai NhCmg tdn thupng p te/fronpcdthe nhieu nguyen nhan khac nhau.Nguyen nhan trudc sinh cd thedo di truyen, n h i l m ddc bao thai, me bi sot rubela giaidoan dau thai ki, hoae bat dong nhdm mau me (nhdm Rh) Nhung nguyen nhan gayiJec nang sinh, thudng xay d nhung trudng hpp de th ieu dxi hoae bj Chan thupng Nhdng ngudi sau khisinh mdlbj die'c nang, thudng la bj n h i l m tmng vi rut hoae vl khuan nhu viem mang nao Cdn nhung td'n thuong dday than kinh giac quan thudng cd nguyen nhan la u than kinh Ddi khi, diee nang khdng xac dinh dupe nguyen nhan Khae vdi cac benh d tai ngoaiva taiglua, benh d (a/ fronykhdng the chua khdimdtcach dpn gian vaed the bjdIecvTnh viin Vi vay, viec xac djnhchinhxacmuc dp KT, thdi dilm bj KT cd y nghTa rat quan trpng viec giao due, phat trien N N cho ngudi KT Theo Nguyin Quang Uan (1), tat KT cd the dupe ehiathanhbamu'cddcPban:-£?/ecn/)e^20-'#0dB;: Nghe dupc nhdng am cd am lupng Idn hon binh thudng; - Diee trung binh (40 - 70dB):OW\ nghe dupe n h d may trp t h i n h ; - Diee nang, diee siu ^(3-50tfS/Chinghedupcratit,ducddeomaytrPthinh NhiJng tre d i i c n§ng, dlic sau, d i l e bam sinh la nhdng trebi diic cam Nhung tre dd mat sue nghe d ^ mdc mat ludn ca kha nang cam nhan NN tunhien Vdl nhiing tre dd, N NKH dUPc col nhu N N me de NN cdvai trd vd eung to Idn suhinh va phat trie'n cua mdt ngudi Nd la phUPng tien GT quan trpng nha't, dong thdi cung la cdng ey eua tuduy, la chia khoa cua nhan thuc va cua mpi cdng doivdi mdt dda tre Tre bj KT khdng la ngoai le Tham chi, vdi cac em, NN trdnen dae biet quan trpng, bdivi, ngudibinh thudng cdmptdci m i t , mpt ddi tai, mpt cai m i p n g d i G T vdi the gidi ben ngpai, cdn vdi TKT thi chl cdn ddi m i t Cf Viet Nam, ti le tre giam thinh Iyc v l n cdn ehilm mpt tile kha cap Thep thd'ng ke mdl nhat tai khoa Thinh hpc (Benh vien Tai Mui Hong TW), de'n h i t thang 11/2011,sd tre den kham ve thinh luc la 2057, so ire bj giam thinh luc la 1034; sdtre bj cam diic bam sinh la 218, s d ' c d n l a i l a b i m l c e a c b e n h l i k h a c , nhu viem tai ghJaeapvaman (ki2-3/2013)- Viec day N N eho eae em de eac em co CP hdi tiep eanvpihpetapvanhdabinh d i n g vdl eac tre khac ddi hdi suchung tay giup ddcua caedng dong xa hdi Tuy nhien, vdi nhimg trediee nang, diee sau, viee phue hdi chuc nang NN am cho cac em la mpt dieu h^suc khd khan Vay cd each nao dehinh NN cho cac em.mptcach hieu qua nha't? Khi GT, Chung t a c d the sudung cac dang NN Vhacnhau'.NN CO laivaNN khong lai.TK>ngd6,n\\ixn NN khong Idigom: NNKH, cuchlNN hinh afihHhom NNcolc^gotn: NNI^noi, NNdgeva NNviet Thdng thudng, ehung ta sudung mot loai NN sd'dd nhllu hpn cac dang cdn lai NN nd/la NN dupc dung bien nha't bdi tinh hieu qua eua nd, khicac dang N N khae ddng vai trd bd'trp Nhung khdng phat tat ea mpi ngudi deu cdthe hpc d e s d dyng NN ndi, nhat la dd'i vdi nhung ngudibiKT Mat khac, tK)ngGT, tateacae dang NN deu cd mattd'teho GT Vi dy, tre bj ddi, nao bp xuat hien thdng bao "doi" Lue dd, thupc vao kha nang sudyng cac dang NN cua chu the, thdng bao cdthe dupc gui dl dudi cac dang NN co /d?"va NN khong loi [hinh 2) Vdl mdi toai NN khae " ~ — M ^ nhau, can ed , i> mdt so "cdng cu" chinh de su dung: NN nd/dungmdi, ludi, vdm mieng, quan va phoi NN doc, viet "-i , | |—i;^—i *" "J Eli [^ dung thj giac " " „ o ^ " ^ , , « " H I * ^ ^ ^ ^ va su dieu khien tay NN hinh anh dung thi giac va su dilu khiln b ^ tay NN kihieu, ci/chidiing sudieu khien cua canh tay, ban tay va loan than Vi vay, ed t h i sd dung cac dang NN khac de day cho tre GT thdng thudng Tuy nhien, tai eac trudng hoc, trung tam giao dye tre KT,NN Idi nava NNKH van dupc sddung nhu mdtphUPng tien GTquan trpng Viec day NN am iianh ldi noi cho tre KT da dupc de cap dCTifrongnhieu tai fieu Dudiday, chiing tdi chi trinh bay mdt so blen phap day NNKH dang dupc sudung deday chp cac em NN ki hieula mpt NN nhan tap, nd la mot he thong euchiduge quy udc thong qua cac phuang tien (ban tay, dieu bg, net mat ) nham thehien su Tap chi Gido due so 306 25 vat hien tugng, hanh dgng tutuang tinh cam (2) Theo GS.TS Woodward JR Jame Clyde (3):/VA//(W la mgt thdNN hoan chinh, vdihe thong tii" vt/ng va nguphap neng biet (GV)vahpesinh (HS)chi sudyng NNKH de tmyen dat, tiep thu kien thuc va trao dd'i thdng tin Su'dyng Oianh thao NNKH, cac em tiep thu kien thue mdt each chu ddng sang tao.Theo eac G V day HS KT tai Vdi nhi/ng tre dile nang, diec sau, diee bam sinh, 'DiJ an giao due dai hge cho ngudi d'lec VietNam'?! NNKH dupe col nhu NN me de Cf nhdng nhdm tre Dal hpc Dong Nai, HS oday cdn sang tao nhihig ki Wiae, cd the mde cam nhan NN ndi tot hPn eae hieu mdl cd tinh tnjru tupng, khai quat, lam edng ey de em bj diee cam Tuy nhien, thyc t i e h o thay, khdng hpe tap va tiep thu nhihig dPn vj kiln thuc mpt the day NN Idi ndi cho tre KT, neu khdng k i t hpp vdi nang eao vlecsddyng NNKH Matkhac.quytrinh hpe NN cua Su hinh nhihig ki hieu mdi eung tuan theo tre phai tuan thu theo tdng budc mpt {hinh 2) nhung quytic nhatdjnh Do dae thucua NNKH, v i ^ Bit ^ Luan hinh va phat triln tdmdi, cd each rieng eua nd Nghe • -^ChaiHHiluH ^"^ chl phi6n Dau tien, GT, neu thay suvat ho^e khai niem nao Hinh Quy trinh hgc NN cua Ire thue te khach quan chua cd ki hieu bilu thi, nhihig ngudi KTse sudyng ehu cii ngon tay.H\\^g Theo quy trinh tren, nghe la mpt kT nang quan khai niem dd thudng la nhung khai niem thupc ITnh tnang de hpc NN, nhung P T K T , kTnang lai rat vuctnjru tucmg Dan dan, theo nguyen tae don gian, han che hoae khdng eo Vi vay, tre khdng the hoan ttit kiem, nhihig dau hieu de thupe, de nhd se dupe thien nhung kT n5ng tiep theo, nhuGT va tu Do giQ lai lam dau hieu chinh thiic do, vl^c d^y NN cho TKT ddi hdi tan dyng mpi loai Trong qua trinh hpe tap, chinh eac em da sang hinh NN, gliJp tre tang cudng vd'n tu, dae biet dd'i vdi Ida tud'imlm non, Ida Ujoi dupe cho la thich hpp nhat tao nhieu ki hieu mdi, giup cho hoat ddng day va hpc cua thay trd dat hieu qua cao Su hinh ki chp viec hpc tdmdi Cac khuynh hudng day hoc NNKH d hieu thue su b i t dau cac em hpe td mdi, hilu dupc y nghTa cua td, cam nhan dupe nd nhu the Vift Nam Tren thegidi, viec day hpe NNKH cd ljch sdxuat nao, rdl mdl sang tao dau hieu Dau hieu phal hien kha sdm, vdl nhieu cdng trinh nghi§n cdu eua dupc sudong y cua nhieu nguc^ diee cung hpc, cung cac nha khoa hoc Tieu bleu la cac tac pham kinh n l m dupc cal khai niem ma dau hi^u can bilu dat dien cua Charies Mtohel de L Epee (1712-1789) va Qua thdigian sddung, dan dan ki hieu ddmdi dupc William Stokoe (1965) trdthanh dau hieu ehinh thdccua NNKH Dudiday Viet Nam, NNKH dupe day eho ngudi KT td la mpt so ki hieu ma cac HS KT tai "Duan giao due n3m 1886, tai Trung tam Thuan An (cdn dupc gpi la dai hge eho ngudi diec VietNam'd Dai hpc Dong Tn/cmg Cim diec LaiThieu)\lnuoc\hh Binh DUPng Nai da sang tao qua trinh hpc tap: Toan, Tuy nhien chi den nhi/ng nam 2000, NNKH mdl Ham so Luy thua, Bic, Can, Sosanh, Tiep tuyen, dupc quan tam dung muc Hien nay, NNKH da dupc (mdn Toil)); Van, Tieng Viet, Ngif phap, Tha Hinh cpng dong ngudi KT sddung rdng rai va dupe nhieu vi Cau, Tu; Phin tich (mdn Ngd van); Dan ip vien cgng dong ngudi nghe ddn n h | n , No le, Boc tot, Cgng san, Xa hgi Tu ban Nghien nhieu kenh truyin hinh khdng ehi phat sdng nhihig ctiu, Ton giao (mdn Ljch si}i; Tam li Cam xtic, ban tin b i n g NNKH, ma cdn ed ehUPng trinh day Tim stf (mdn Tim li) NNKH cho ngudi KT khiln cho su hda nhap cua Viec tao nhihig ki hieu mdi da giup cho cac HS edng dong ngudi KT vdi xa hpi mdt gia tang Qua thuc t l , dieu tra thue trang NNKH tai cac KT dday cd the tiep thu dupc nhimg dPn vj kiln thiic ^ n g tam giao due TKT, ehung tdi nhan thay, hien cdtinh tnhj tupng khaiquatdnhihigehupng trinh cua dang cd hai khuynh hudng ehi phd'i phUPng phap eac bae hpe eao hpn Dd cung la ll khien Vt/an giao diJC Dai hoc cho nguoi Diec Viet Nam'aQa\hqc day NN eho TKT: 1) Day NNKH fchong feet hgp vaiNN noi (nhin Dong Nai da dat dupe mdt so ket qua kha quan Cy khauhmh)L Vdi khuynh h u m g nay, du eac tilt thl.Pday da dao tao dupe 11 em tot nghiep taing cap hpc vdn hda ndi rieng, GT ndi ehung, giap vien su pham Hien tai, a trung tam dang ed 18 em theo 26 T a p chi G i d e due so -(ki2-3/2013) hpc chuong trinh cao (JSng su pti^m, Irong 46, co em chuan bj tn/dng, em m di vao nam thu nhat 2) Day NNKH kSt hop vol NN noi (dgc khau /i»i/i|-Khuynli hudng xuat pliattiJquan diem la can tan dung toi da sue nghe lai cua nguoi KT de day cac em hpc tap va GT, Trpng sp cac tnjng tam day hpc ya giap due nguoi KT ma chiJng loi da tien hanh dieu Ira lim hieu (tai Ha Npi va TP Ho Chi Minh)tnj "DuangiaoducdaihocchongaditJiec Viet Nam''aBm hpc Ocng Nai, iai deu Ihuc hien thep l(huynh huong Ngucfi KT den hpc a cac trung tam tnJong hpc chuyen biet cc su chenh lech ve lua tuSi tuong do! Ion Vol nhOng be d tuoi m l u giao, hau h§'l cac gia dinh deu chp cac em su dung cac thiS bi tro Ihinti Vi vay, mdi den Imng tam, hlunhucac em chldupc day G T b J n g N N n a Nhung den nhOng bae hpc cac hon, nhu cau hpc lap va GT mpt cac, dpi hpi trinh dp si) dung NN cua cac em cung phai duoc nang cap cave so lupng l l n chat lupng Trong do, may trp thinh hau nhu khong dap ling dupc nhiJng nhu c l u do, do, viec sudgng NNKH la l i t y§'u Do do, gicrhpc ciing n h u G T Ihong thuong, cac em si} dung NNKH ket hpp vdj v'tec doc hinh mieng Qua sutiep xuc true tiep vol ngudi KT ocac Injng lam Irudng hpc, ehung tdi nhan thay, du gid hpc tren Idp cc dupc day b i n g phuong phap nap, nhung GT vdi trpng sinh hpat ddi thudng, ngudi KT v l n Sl} dyng NNKH mpt each tu nhien, thac, giong nhu ngudi nghe sudung NN noi cua minh Cu the, neu Ire dliia tud'i mam non, la tuoi thich quan sat, kham pha the gidi xung quanh, Ihi nen sudung phuong phap day NNKH ket hop NN ndi, hay nhin /f/jai//i/n/?./C/7ao/j/n/r khidd dupe eoi nhula phuong tien can ngcn (paralingguistics) phu Iro them chp NNKH, giiJp cac em phal Irien ven tiimpt each nhanh chong Vdi nhiing Ire d bae hpc eao hpn, nen de Ire Sli dung NNKH lam cong eu de lu va GT Co nghTa la, day NNKH khdng ket hpp vdi NN noi Lijc dd NNKH dupc coi nhu mpt NN dich thuc, cd he thong Id vung va ngd phap dpc lap Cd nhu vay, Ire mdi dien dat S^iqc nhiing y ludng phiic lap, nhdng don vj kien thiic ma tinh tniu tuong, khai puat mdt gia tang 2)Sifhan che've khanang NN khieh TKT gap nhieu kho khan viec hinh nhung ki nang xa hgi, anh huang tan den tuang iai cila cac em Be nang cac hieu qua trpng viec day NN chp Ire, dpi hpi mdi GV khdng ehi nang cao nang luc chuyen men, ma quan trpng hon la e l n ed su cam thdng, chia se, Idn trpng, yeu thuong Nhiing tinh cam dp se xda nhda khpang each, giiip cac em s i n sang ddn nhan bai hpe, du ehp nd la rat khd khan vdi cac em a (1) NguySn Quang Uln "Nhung ddc diim tdm If ctia tri khi^m tinh" (T$p b^i giang) Tnrdng D