Behavioral Observation Audiometry Flashcards
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
presence or absence of hearing loss
degree and configuaration of hearing loss
integrity of auditory system
a complete diagnostic evaluation includes
frequency and ear specific threshold information throughout the frequency range, using air and bone conduction procedures
most common test protocols for evaluating infants and young children include
acoustic immittance testing
ABR
Auditory steady state evoked potential
OAE
Behavioral testing
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
referral from newborn hearing screen
presence of risk factors
not startling to loud sounds
parental concern about hearing or speech delays
Crosscheck principle
employing multiple testing procedures is critical to
to accurately assess their hearing status
crosscheck principle
testing is predominantly performed in sound field conditions
which do not provide specific ear information
cross check principle
the responses are typically suprathreshold
complicating definitive conclusions about the presence of hearing loss
cross check principle
short attention span
behavioral assessment
behavioral evaluation is the
gold standard for evaluation of hearing in infants and children
Why do we need behavioral testing?
enables parents to participate in testing by allowing them to observe when the infant responds to sound and when he does not
why do we need behavioral testing?
allows for cross checking physiologic results with behavioral data by using a battery of tests to determine hearing sensitivity
why do we need behavioral testing?
can be used to monitor performance with technology
procedure selection
choosing the right method based on the child’s cognitive and physical development is crucial for accurate test results
influencing factors
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
sound field testing
will not provide ear specific information but will provide an indication as to whether or not hearing is sufficient to develop speech and language
response fatigue
younger or developmentally delayed children tire quickly, Individual ear testing may follow sound filed tests or be scheduled for another day
importance of setup
a proper testing setup is vital to ensure the assessments are reliable and precise
behavioral testing requires determining the child’s
cognitive age as a first step regardless of the child’s chronologic age
how can cognitive information be obtained
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
must estimate developmental age from development in other areas such as
motor and cognitive milestones can provide information
and help audiologists plan testing
4 months
6 months
9 months
12 months
- holds head without support
- rolls front to back; reaches for objects
-sits up independently; responds to name - waves, pulls to stand, walks with support
15 months
18 months
2 years
- takes independent steps; uses objects correctly
- walks independently, climbs, points to objects
- runs, kick balls, identifies body parts
unconditioned response
behavioral observation audiometry
conditioned response
visual reinforcement audiometry
conditioned play audiometry
