Audiology 4- Behavioural tests of hearing of Paeds Flashcards
What is behavioural observation audiometry (BOA)?
- the observation of a baby’s behaviour in the presence or absence of a sound stimulus
- stimulus presented through a loudspeaker and clinician looks for a change in behaviour, that implies the baby has heard a stimuli
- should be carried out in a rigorous manner, but test is of limited reliability
what types of responses would you expect on a behavioural observation audiometry?
Reflexive:
- auto- palpebral reflex
- startle- whole body
- arm or leg jerk
- slow limb movements
- change in sucking
- facial twitch
Orienting:
- quieting response
- breath holding/ change in breathing
- onset/offset of vocalisation
- starting or stopping crying
- eye- widening
- searching/ localising
- smiling/ frowning/ change of expression
what is visual reinforcement audiometry?
- requires involvement and co-operation of the child. Child must be able to sit unsupported/ minimal support and have good head control
- Child is trained to look towards a source.
- when the child gives a correct response, the child is rewarded though a visual reinforcement such as a toy that moves or an animated image
what is the procedure for visual reinforcement audiometry?
- signal, generally warble tones at 0.5, 1, 2, 4 kHz is presented for 2-3 seconds
- if the child responds, reinforced presented for 1-2 seconds
- track threshold in a similar way to pure tone audiometry
- can also be done with earphones to gain ear specific info
- accurate to within 10-15 dB of threshold
What is conditioned play audiometry?
- child is conditioned to wait for auditory stimulus and then respond using play activity
- stimulus= tone
- response= play activity
- reinforcement= social praise
- gain is to establish thresholds from 250- 4000 Hz in each ear but only gets 10-15 minutes before the child loses concentration
- start at 4-dB above expected threshold
- descend rapidly in large steps ( about 20 dB)
- accept 2 responses as threshold
what age do you conduct behavioural observation, visual reinforcement and conditioned play audiometry?
BOA- 0-6 months
VRA- 6- 30 months
CPA- 2.5- 5 years
Why are behavioural tests of hearing important?
- they show if the child has heard the sound stimulus
- test the whole auditory system
