Assessment and Scoring CAPD Flashcards

1
Q

CAPD Evaluation Team

A

Audiologist
speech and language pathologist
psychologist
social worker
parents
physician

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2
Q

What is a test battery?

A

includes a number of tests to diagnose a certain condition

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3
Q

why use test battery and not single sensitive diagnostic test to diagnose CAPD

A

CAPD is not unitary disorder
- clinical presentations vary from number of mechanisms and auditory processes affected

  • different measures are required for accurate assessment of central auditory processes
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4
Q

Test Battery Approach: questions asked to ensure diagnostic accuracy and usefulness

A

1) does the battery improve sensitivity and specificity over using individual tests
2) How many tests are needed to obtain optimal sensitivity and specificity
3) which combination if tests give the best sensitivity and specificity

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5
Q

how many tests can provide maximum sensitivity

A

2-3 tests in CAPD Battery or 4

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6
Q

lax criterion will yield better but poorer

A

better sensitivity but poorer specificity

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7
Q

strict criterion will yield better but poorer

A

better specificity but poorer sensitivity

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8
Q

reason behind lax criterion trend

A

as size of test battery increases greater probability that a patient will fail any single test

  • normal patients have increased change of being incorrectly identified
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9
Q

reason behind the strict criterion trend

A

as size of test battery increases, less probability that a patient will fail all tests

patient more likely to fail all tests when a battery has 2 to 3 tests compared to when it has 10 (more opportunities to pass)

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10
Q

Intermediate criterion

A

most reliable
abnormal performance on at least 2 tests (>2SD below mean)
-abnormal performance on at least 1 tests (>3SD below mean)

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11
Q

CAPD Test Battery Consideration

A

Test sensitivity
Test reliability
ease of administration
population characteristics

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12
Q

Tests sensitivity and specificity

A

tests with relatively low sensitivity/specificity are not useful diagnostic indicators of CAPD

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13
Q

Tests reliability

A

test should demonstrate test retest consistency and age appropriate norms

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14
Q

ease of demonstration

A

tests requiring extensive training, time and client practice are not appropriate for most clinical settings

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15
Q

population characteristics

A

age appropriate
location appropriate
cultural and linguistic diversity

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16
Q

symptom specific considerations

A

test battery process should not be test driven it should be motivated by the referring complaint and the relevant information available to audiologist

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17
Q

patient specific considerations

A

patient developmental maturity to complete auditory tasks
- language development, motivation level, attention and cognitive factors, cultural influences, native language

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18
Q

auditory processes umbrella terms

A

dichotic processes
temporal processes
binaural interaction

-monaural low redundancy speech auditory closure processes

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19
Q

examples of dichotic processes

A

dichotic digits
competing sentences
SSI - CCM
SSW

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20
Q

example of Temporal Processes

A

Gaps in noise
random gap detection test
duration pattern test
pitch pattern test

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21
Q

example of binaural interaction

A

auditory fusion
masking level difference

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22
Q

example of monaural low redundcy speech/auditory closure processes

A

Nu-6 filtered words
time compresses words
SSI-ICM
Speech in noise tests

23
Q

Dichotic processes test

A

different speech stimuli presented to each simultaneously (CVC or monosyllabic words, digits, or sentences)

24
Q

dichotic processes tests may assess either

divided attention:

Selective attention:

A

binaural integration or binaural separation

DA= repeat stimuli heard in both ears

SA = Ignore what is heard in one ear repeat what is heard in the target ear

25
Q

dichotic process

free call is used because and what it is

A

to prevent attention factors for contaminating results

  • repeating back words back without regard to which ear heard it
26
Q

Dichotic tests are sensitive to lesions of

A

Corpus callosum and cerebral cortex

27
Q

temporal processes and pattern tests

A

monotic presentation to assess each ear independently

stimulus is often tones rather than speech

28
Q

temporal processes and Patten tests

temporal pattern test assess pattern perception and temporal functioning abilities including

A

feature detection abilities
frequency/duration discrimination

  • acoustical pattern and contour recognition
29
Q

temporal pattern tests are more sensitive to a compromised

A

right hemisphere
if the test requires verbal response , it is sensitive to left hemisphere lesions

30
Q

binaural interaction/fusion processes

A

test are binaural, stimuli presented to each ear at the same time

assess integration between to ears

31
Q

binaural interaction/fusion processes

A

unification of disparate information as a s single perceptual event takes place at the auditory brainstem

32
Q

monaural low redundancy speech/auditory closure processes

A
  • speech is redundant signal
    speech test involve modification (distortion) of acoustic signal to reduce amount of redundancy
33
Q

monaural low redundancy speech/ auditory closure processes

degraded speech stimuli are presented by modifying frequency, temporal, or intensity characteristic to reduce redundancy and are

A

sensitive to auditory closure abilities

moderately sensitive to cortical lesions

NOT BRAIN STEM LESIONS

34
Q

What is CDA and what does it include

A

statistical measures that can be applied to individual and combinations of tests to determine maximum diagnostic value of tests

  • sensitivity and specificity
  • receiver operant curves
  • factor analysis (reduce large number of variables into fewer numbers of factors)
35
Q

Recommended CAPD Evalution

A
  • Case history
  • pre test standardized questionnaires
  • behavioral measures
  • electrophysiologic measures
  • psychoeducational evaluation
  • speech and language evaluation
36
Q

case history components

A

Prenatal/postnatal
developmental
medical
academic
family
social
results of other evaluations
work history

37
Q

Screening tests Questionnaires
3 names

A

CHAPS (children’s auditory performance scale)

SIFTER (screening instrument for targeting educational risk)

Fishers Auditory Problem Checklist

38
Q

Screening tests typically have advantages over diagnostic tests

A
  • more accesible
    less invasive/dangerous
    less time consuming
    less expensive
    less physically and psychologically uncomfortable for patients
39
Q

CHAPS age range

A

7 years and older

40
Q

CHAPS items

A

36 item checklist divided into six listening conditions and functions
each item scores on a 7 point scale

41
Q

CHAPS objective (3) and used by

A

parents and teachers
- evaluates listening behaviors in diverse listening situations
- assess child’s ability in comparison to child’s peers
- used as part of screening process to identify children experiencing listening difficulties because of HL and CAPD

42
Q

CHAPS SCORING
- PASS
- AT RISK RANGE

A

+36 to -11
-12 to -130

43
Q

SIFTER
Screening Instrument for targeting educational risk

age range?
completed by?

A

first through 5t grade
teacher

44
Q

Items of SIFTER

(5)

A

15 questions three in each of five categorical areas

1) academics
2) Attention
3) communication
4) class participation
5) social behavior

45
Q

Objective of SIfter

A

educationally screening students with known or suspected hearing loss

classroom teacher compares childs functional ability to peers

can be used to track childs performance over time

46
Q

Fishers Auditory Problem Checklist

A

provides good information on children functional listening abilities in the classroom

47
Q

Itemized behaviors in fishers auditory checklist

A

failure to attend to instructions

need for repeated instructions

easy distraction by auditory stimuli

degrading processing in a competing acoustic environment

also addresses attention and memory issues

several questions related to language based deficits such as discrimination ability

48
Q

fishers checklist contains? with value of

how is it scored

A

25 items each with value of 4% each

items not selected are multiplied by 4 for total percentage

49
Q

fishers auditory problem checklist cut off score

A

72% at or below warrant a referral for further CAPD testing

50
Q

what should be used to highlight concerns about a child but not determine wether a diagnostic capd assessment is warranted

A

CHAPS
SIFTER
TAPS-R

51
Q

what tools from scan 3c screening test better predicted diagnosis of CAPD

A

Auditory figure ground
Competing words free recall
gap detection

52
Q

electrophysiologic tests

A

oae
immitance
ABR (early latency response)
Mid latency auditory evoked response

late latency auditory evoked response

53
Q

auditory evoked responses measures

A

neuromaturation and neuroplasticity of central auditory pathways

54
Q

electrophysiologic tests provide additional information about

A

integrity of the CNS