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Pediatric audiology > Behavioral Observation Audiometry > Flashcards

Behavioral Observation Audiometry Flashcards

1
Q

primary goal of an audiologic evaluation of an infant or young child is to determine wether the child has sufficent hearing (auditory brain access) to develop speech and language

A

presence or absence of hearing loss
degree and configuaration of hearing loss
integrity of auditory system

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2
Q

a complete diagnostic evaluation includes

A

frequency and ear specific threshold information throughout the frequency range, using air and bone conduction procedures

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3
Q

most common test protocols for evaluating infants and young children include

A

acoustic immittance testing
ABR
Auditory steady state evoked potential
OAE
Behavioral testing

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4
Q

comprehensive audiological evaluation are indicated by referrals from initial and secondary newborn hearing screens and the presence of risk factors for progressive or delayed onset hearing loss

A

referral from newborn hearing screen
presence of risk factors
not startling to loud sounds
parental concern about hearing or speech delays

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5
Q

Crosscheck principle

employing multiple testing procedures is critical to

A

to accurately assess their hearing status

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6
Q

crosscheck principle

testing is predominantly performed in sound field conditions

A

which do not provide specific ear information

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7
Q

cross check principle

the responses are typically suprathreshold

A

complicating definitive conclusions about the presence of hearing loss

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8
Q

cross check principle

A

short attention span

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9
Q

behavioral assessment

behavioral evaluation is the

A

gold standard for evaluation of hearing in infants and children

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10
Q

Why do we need behavioral testing?

A

enables parents to participate in testing by allowing them to observe when the infant responds to sound and when he does not

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11
Q

why do we need behavioral testing?

A

allows for cross checking physiologic results with behavioral data by using a battery of tests to determine hearing sensitivity

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12
Q

why do we need behavioral testing?

A

can be used to monitor performance with technology

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13
Q

procedure selection

A

choosing the right method based on the child’s cognitive and physical development is crucial for accurate test results

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14
Q

influencing factors

A

a childs response to sound during tests can be affected by their development stage, condition during the test (like being hungry or tired) and the experience of the audiologists

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15
Q

sound field testing

A

will not provide ear specific information but will provide an indication as to whether or not hearing is sufficient to develop speech and language

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16
Q

response fatigue

A

younger or developmentally delayed children tire quickly, Individual ear testing may follow sound filed tests or be scheduled for another day

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17
Q

importance of setup

A

a proper testing setup is vital to ensure the assessments are reliable and precise

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18
Q

behavioral testing requires determining the child’s

A

cognitive age as a first step regardless of the child’s chronologic age

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19
Q

how can cognitive information be obtained

A

case history

speech language or psychoeducational evaluations

if child has other developmental disabilities, cognitive levels will be harder to ascertain, results of specific developmental tests may be required

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20
Q

must estimate developmental age from development in other areas such as

A

motor and cognitive milestones can provide information

and help audiologists plan testing

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21
Q

4 months
6 months
9 months
12 months

A
  • holds head without support
  • rolls front to back; reaches for objects
    -sits up independently; responds to name
  • waves, pulls to stand, walks with support
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22
Q

15 months
18 months
2 years

A
  • takes independent steps; uses objects correctly
  • walks independently, climbs, points to objects
  • runs, kick balls, identifies body parts
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23
Q

unconditioned response

A

behavioral observation audiometry

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24
Q

conditioned response

A

visual reinforcement audiometry
conditioned play audiometry

25
Q

behavioral observation audiometry (BOA) is an unconditioned procedure used to test hearing in infants from

A

birth to 6 months of age

26
Q

what is the only behavioral test for 0-6 month

A

BOA
behavioral observation audiometry

27
Q

BOA is used for 0 to 6 months but also for children with

A

developmental delays or disorders such as cerebral palsy

28
Q

BOA involves presenting sounds to a baby who is not actively involved in the task and observing the response

A

eye widening, change in sucking rate

29
Q

what is being observed inBOA

A

observation for eye widening
quieting
eye shifting
head orienting
arousal
limb movement
respiration changes

30
Q

why was using the moro reflex or auro palpebral reflex a major problem

A

behaviors are not elicited to threshold stimuli but rather are responses to suprathreshold stimuli

31
Q

nosiemakers were the most common sound source employed for

A

early hearing tests

32
Q

noise makers advantages

A

readily available

simple and inexpensive

could be used in any setting (no sound room required)

believed that infants would respond more reliably to noise makers then to pure tone stimuli

33
Q

noise makers limitations

A

very broad frequency responses

intensity is not easy to control

34
Q

limitations of early methods

A

have not proven to be sufficiently repeatable

are not good indicators of threshold; typically reveal suprathreshold level

35
Q

ABR/ASSR/ DPOAES are considerably objective and reliable tests that provide important information about the status of the auditory status

Limitations:

A

not direct test of hearing

may not always be able to provide a complete and accurate assessment of hearing in early infancy

36
Q

information about an infants ability to hear and attend to auditory stimuli can be obtaiend with

A

behavioral testing

37
Q

BOA measures an infants awareness of sound but does not provide

A

threshold information

38
Q

children do not typically respond to sounds at threshold but only to sounds more clearly audible

A

minimum response levels

39
Q

higher inter and intra subject variability

A

unable to differentiate between mild and moderate HL

dependent on state, alertness, attention

infant habituation after only a few responses

40
Q

may be useful for corroboration of parent/ caregiver report but

A

should not be used to determine thresholds for purposes of hearing aid fitting

41
Q

what test is known to be a test of limited reliability?

A

BOA

42
Q

what is a reliable response for observing auditory behavior in infants younger than 6 months

A

cessation or initiation

43
Q

observation for sucking response

what is being observed ?

A

changes in the sucking in response to sounds
- observed with bottle, nursing, pacifier

44
Q

observation for sucking response

baby should be hungry but

A

not extremely

45
Q

what is likely to provide threshold responses?

A

a change in sucking pattern

  • can be present at suprathreshold levels

some infants will start sucking when a sound is presented

46
Q

how to detect a response

timing is key!
responses should be seen within

A

2 seconds of sound presentation

47
Q

Infants are usually consistent when it comes to their pattern of response

A

some will respond to the ON and some will respond to the OFF

48
Q

positioning the infant

infants needs to be resting in a comfortable position with full support of the head and torso and be visible to the tester

A

bottle or pacifier

nursing child

= let mother hold in arm

49
Q

positioning the infant

car seat
Advantage:

A

infant will not be receiving any “signals” from the mother when he/she hears the sound

50
Q

Minimum of two reaching a consensus

audiologist in
audiologist next to

A

(control room)
(next to the infant)

both need good visualization
consistency in what is being considered a response

51
Q

Role of parents

definitely not an observer

needs to remain silent and not react bodily to any sound because even

A

stiffening of the muscles especially for parents who are breast feeding could be transmitted to the infant

52
Q

role of parents

A

make baby comfortable

at least one parent should be in the room: assist and understand test procedure

53
Q

establishing response

infants provide only limited # of responses during session

REMEMBER: goal of testing =

A

to determine if the child has sufficient hearing to develop speech and language

54
Q

ear specific information may not be required for the initial visit, unless medical condition warrants ear specific info or hearing loss is detected

hearing is normal in general

A

then we can wait to get ear specific information

55
Q

Evidence of hearing loss

A

ear specific info is needed and need to test under earphones

56
Q

ear specific information

A

use supraaurals earphones

57
Q

what stimuli gives frequency specific information

A

pure tone/ warble (in sound field

58
Q

what will NOT give you frequency specific information

A

speech

59
Q
A

Pediatric audiology (5 decks)

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