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PBL SEM 3 > 4 - hearing and speech development lecture > Flashcards

4 - hearing and speech development lecture Flashcards

1
Q

outline the embryology of the ear

A
  • structure of ear and neurosensory - 20 weeks gestation
  • 25 weeks - functional auditory system
  • 25 weeks gestation to 5-6 months - hear cells of the cochlea, axons of the auditory nerve, and the neurons of the temporal lobe auditory cortex are tuned to receive signals of specific frequencies and intensities
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2
Q

what does the auditory system require, unlike the visual system?

A

outside auditory stimulation — speech, music, meaningful sounds from the environment

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3
Q

what is the organ of hearing?

A

cochlea

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4
Q

label this tympanic membrane

A
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5
Q

what forms the medial wall of the middle ear?

A

cochlea/cochlear promontory

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6
Q

describe the chorda tympani

A
  • runs in middle ear
  • branch of facial nerve
  • innervates taste to the anterior 2/3 of the tongue
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7
Q

what are the roles of the middle ear?

A
  • conduction — conducts sound from the outer ear to the inner ear
  • protection — creates a barrier to protect middle and inner ear structures from foreign bodies
  • transducer — converts acoustic to mechanical energy and mechanical to hydraulic energy
  • amplifier — transformer action of middle ear

only about 1/1000 of the acoustic energy in air would be transmitted to the inner ear fluid (30dB loss) without middle ear function — seen in glue ear

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8
Q

where is the inner ear?

A

petrous part of temporal bone

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9
Q

what is the inner ear made up of?

A

cochlea and vestibular system

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10
Q

utricle and saccule vs semicircular canals

A

vestibule — aids in balance when stable/not moving

semicircular canals — aids in balance with movement

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11
Q

what semicircular canals are there?

A

posterior/inferior, lateral and anterior/superior

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12
Q

how many turns are there in the cochlea?

A

2.5

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13
Q

label this cochlea

A
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14
Q

what separates the vestibule from the middle ear?

A

oval window

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15
Q

what does the membranous labyrinth consist of?

A

cochlear duct, semicircular ducts and utricle and saccule

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16
Q

what is the membranous labyrinth filled with?

A

endolymph

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17
Q

what does the bony labyrinth consist of?

A

cochlea, vestibule, 3 semi circular canals

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18
Q

what propagates sound waves from the base?

A

cochlea

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19
Q

the scala vestibuli and scala tympani are _____ filled chambers

A

perilymph

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20
Q

inner vs outer hair cells in terms of Reissner’s membrane

A
  • hair on IHCs does not touch the membrane
  • hair on OHCs are embedded into this membrane
21
Q

what channel ends at the round window?

A

scala tympani

22
Q

what channel is located inferiorly to the cochlear duct?

A

scala tympani

23
Q

what channel is continuous with the vestibule?

A

scala vestibuli

24
Q

another name for Reissner’s membrane?

A

vestibular membrane

25
Q

what does movement of the tympanic membrane in response to impulses from the external ear cause?

A

vibration of ossicles — mechanical energy

26
Q

describe the tonotopic arrangement of the inner ear

A
  • hair cells are arranged along the basilar membrane according to what frequencies they pick up
  • base — higher frequencies picked up
  • apex — lower frequencies picked up
27
Q

briefly outline the auditory pathway from the cochlear nucleus

A

cochlear nucleus —> superior olivary nucleus —> inferior colliculus —> medial geniculate nucleus —> auditory cortex

28
Q

wernicke’s vs broca’s area

A

wernicke’s area — temporal lobe — speech comprehension
broca’s area — frontal lobe — production of speech

29
Q

how do you test children’s hearing?

A
  • 6-24 months — visual reinforcement audiometry
  • > 24 months — conditioned play audiometry
  • > 36 months — conventional audiometry
  • <6 months — objective measures
30
Q

describe visual reinforcement audiometry

A
  • 6-24 months
  • child needs to be able to independently turn their head
  • toy used to keep attention and focus
  • sound made to the side
  • +ve reinforcement (eg. toy lights up)
  • free-field testing — not ear specific
31
Q

describe conditioned play audiometry

A
  • > 24 months
  • conditioned to perform task when sound plays
  • ear specific
32
Q

describe conventional audiometry

A
  • > 36 months — may be more if child is not mature enough
  • patient presses button when they hear a noise
  • ear specific
33
Q

describe speech audiometry

A
  • tests the ability to recognise and understand speech
  • speech discrimination assessment measures functional hearing ability
  • hearing in noise test (HINT), speech recognition in noise test (SPRINT), words in noise test (WINT) — background noise
34
Q

describe the newborn hearing screening program

A
  • all newborns
  • automated otoacoustic emissions +/- auditory brainstem responses (ABR)
  • high failure rate in 1st 24 hours
  • can be hard in a noisy setting
  • have 2nd OAE if failed. if failed again —> ABR
35
Q

describe ABR

A
  • assesses brain’s response to sound
  • amplitude = no. of neurons firing
  • latency = speed of transmission
36
Q

speech vs language

A
  • speech is the way we say something
  • language is the form, meaning and use of words and utterance
37
Q

what is neuroplasticity?

A

the brain’s ability to change through experience

38
Q

speech under 6 months

A

PRE-VERBAL

  • crying, gestures (to get attention)
  • hungry, tired, cold, hot, pain
  • 2 months : coos and gurgles
  • 3 months : fixes on sound
  • calms to familiar voices
39
Q

speech 6-10 months

A

BABBLING

  • 6 months : able to express pleasure and displeasure
  • child can distinguish sounds of any language and reproduce this (lost by age 1)
  • communicates by sounds and intonations
40
Q

speech 6-12 months

A
  • begin by detecting very small differences between speech sounds (phenomes)
  • at 6 months they can contrast different vowel phenomes eg. a & i
  • by 11-12 months they can recognise consonants
  • as they get older they learn to ignore other non specific sounds
41
Q

speech at 1 year

A
  • one word stage — mainly morphemes
  • end of 1st year — should understand about 50 words, say about 5
  • one word to describe actions - “ball” = “get the ball” - semantics (understanding) develops before word
  • learn words which produce effects - “again” “more”
42
Q

speech at 18 months

A

= two word phrases
- should have about 20-50 words
- naming
- demanding
- questioning

43
Q

speech at 2.5 years

A
  • simple sentences
  • lacks tenses
  • errors in syntax (order of words wrong)
  • recognition of rhyme and intonation
  • 200-300 words
44
Q

speech in preschool 2.5-5 years

A
  • improvement in phenomes
  • development of pronunciation and articulation
45
Q

speech in primary school 6-10 years

A

master syllable stress to distinguish between similar words

46
Q

what are some of the lifelong consequences someone can face if as a child they fail to get support as a language learner?

A
  • aggressive behaviours
  • withdrawn into silence
  • reading and educational difficulties

language affects both cognitive growth and social competence!

47
Q

what are the advantages and disadvantages of multi-lingual children?

A

advantages:
- greater cognitive flexibility
- better perceptual skills
- divergent thinkers
- better understanding of syntax and language
- delay in dementia onset by almost 5 years

disadvantages:
- smaller vocabulary than peers
- delays in general learning milestones eg. maths and reading in primary school years

48
Q

who benefits from a cochlear implant?

A

—> pre-lingually deaf children — prescribe hearing aids before age 3 months. implant before age 4 years, ideally at 12 months

—> post lingually deafened adults — have sound memory. have used hearing aids to optimise hearing. already know how to speak and use language

49
Q

cochlear implantation does not improve hearing or speech after what period?

A

the period of neuroplasticity — pathway lost

PBL SEM 3 (49 decks)

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