Congenital Hearing Impairment- Management Flashcards
What is the UNHS?
It is the screening test to test for hearing impairment in babies.
What happens if a baby fails the UNHS?
There is a further diagnostic test to confirm deafness.
Sometime infants can pass the UNHS but…
Parents are concerned.
What is the subjective confirmation of thresholds?
Age appropriate audiometry.
What is the earliest age that age appropriate audiometry can be used?
From 8 months- turn and respond.
Once a child turns 2, how is age-appropriate audiometry performed?
Hear sound= stack a building block.
Up to ages 4, what is the problem with age appropriate audiometry?
It can only test the hearing of both ears.
Describe age-appropriate audimetry for 4+ year olds.
Headphones can be used
Can now test each ear individually- can indentify unilateral Hearing Loss.
What are some objective confirmation of thresholds?
Tympanometry (should have a nice peak, checks for middle ear fluid) Evoked Response Audiometry (electrodes- brain heard sound?) Otoacoustic Emissions (congestion)
What is Evoked Response Audiometry useful for?
Very useful for newborn babies- older kids would have to be sedates, wouldn’t stay still etc.
What must we consider when telling parents that their child is deaf?
- diagnosis of deafness is a “bad news” consultation
- may show denial or grief reaction
- time requires to accept diagnosis
- easier to break news when parents suspect.
________ is only part of the process, _______ occurs over the years.
amplification
rehabilitation
Name professionals involved in the team approach.
TOD- teachers of deaf
SALT
Education Audiologist
ENT (insert cochlear implant etc.)
Describe the characteristics of hearing aids.
- bilateral, behind the ears
- robust (kids tend to eat/stand on them)
- reliable- good repairs service
- powerful
- compatible with educational accessories (hooked up to teacher’s mic)
- Digital.
What are some tricks of the trade when it comes to HA’s?
- Change batteries weekly (means won’t run out)
- Disposable batteries
- Clip or toupee tape to keep in place
- Change moulds regularly
Apart from HA’s name some other aids and strategies.
- Radio Aids/ Induction Loops
- Lights for alarm clock, phone, doorbell
- Communication Strategies
- Signing (speaking better for employment etc.)
- Peer support- NDCS
Why are bone conduction aids used?
Can’t wear a conventional Hearing Aid due to:
- chronically discharging ears
- atresia (absence) of pinna and canal eg. parts missing
- abnormal ear shape.
- some get infection from conventional HA
How does the bone conduction aid?
There is a vibrator attached to the head band and applied to the skull.
What is a disadvantage to bone conduction aids?
they can be uncomfortable for user.
What do babies wear for bone conduction aids?
They wear a soft band around the head.
What are some pros of BAHA?
- Permanent
- skull vibrated directly via osseointegrated titanium screw
- excellent sound transmission (sound quality better than band)
- cosmetically acceptable (+ prothesis)
- comfortable
- clip on/off, don’t have to wear band
What does BAHA stand for?
Bone Anchored Hearing Aids.
Name some cons of BAHA.
- Limited power output, only for up to 40dB losses
- Not as powerful as conventional HA
- Easily Damaged
- Needs looking after
- Need a certain thickness of bone (age 2 years +)
How does a cochlear implant clip on?
Via a magnet.
What recieves the signals in a cochlear implant?
The reciever stimulator.
What sits in the cochlea?
22-electrode.
The magnet, antenna, reciever stimulator, 22-electrode and ball electrode make up the…
Internal component of the cochlear implant.
If a child has hearing loss worse than 90dB, what is normally done?
Cochlear Implant is normally inserted.
A cochlear implant is for the ________ ________ who aren’t progressing with HA’s.
Profoundly Deaf.
how does a cochlear implant work?
Electrode inserted directly into cochlea to stimulate auditory nerves.
What is needed before a cochlear implant is inserted?
Extensive pr-operation assessment.
After a cochlear implant is inserted, what is needed?
Rehabilitation- learn to hear from robotic voice.
The earlier the cochlear implant is inserted, the …
Better the speech and language.
For the profoundly deaf why is there less pressure in terms of surgery?
Because they can’y do anything to make hearing worse, they can only make it better really.
There are a wide range of _______ _____ available.
Hearing Aids.
What hearing aids are used for special circumstances?
Bone conductors and BAHA (Bone Anchored Hearing Aids).
____________ ____________ are for those not progressing with conventional aiding.
Cochlear Implants.
