Exam 1 (Part 1) Flashcards
The process by which the sounds of language are heard, interpreted, and understood. It describes the ability to perceive linguistic structure in the acoustic speech signal.
speech perception
what is speech perception
The process by which the sounds of language are heard, interpreted, and understood. It describes the ability to perceive linguistic structure in the acoustic speech signal.
process, when someone is talking how much of the speech you are perceiving
Communication of thoughts and feelings through a system of signals, such as voice sounds, gestures, or written symbols.
language
what is language
Communication of thoughts and feelings through a system of signals, such as voice sounds, gestures, or written symbols.
The act of expressing or describing thoughts, feelings, or perceptions by the articulation of words
speech
what is speech
The act of expressing or describing thoughts, feelings, or perceptions by the articulation of words
what is Apgar
Apgar is a tool for evaluating an infant’s condition in the delivery room
Completed in 1 min and again at 5 min following birth
Multiple exams all newborns receive after birth to detect abnormalities & determine need for immediate resuscitation
what are the 5 standardized observations in apgar
heart rate, respiratory effort, reflex irritability, muscle tone, and color
scoring of apgar
0 - absent
1 - slow/some/pink
2 - good
10 is the highest score possible
what is gesttional age
defined in weeks
duration of preganncy before birth
period of time bw conception and birth
how is gestational age estimated
from moms last menstrual period or
physical and neuromuscular characteristics of the fetus
or duration of pregnancy
how is physical and neuromuscular characteristics of the fetus used
can be comapred to birth weight to determine if it is small for gestional age (SGA), appropriate for gestational age (aga), OR large for gestational age (LGA)
prenatal
before birth
postnatal
after birth
perinatatl
period around time of birth from 28 wks of gestation through 7th day following delivery
time window up to 7 days after birth
embryonic period
first 8 wks
all major organs are formed
fetal period
remaining 30 wks
organs grow large and more complex
chronological age
age from actual day the child was born
actual birthday and correlates with how old you are
what is corrected or adjusted age
only used with premature babies
actual age in weeks minus the numbr of weeks baby was preterm
what is the calculation for corrected age
Corrected age (CA) = chronological age - # weeks or months premature
week child was born early minus 40 = the weeks born earlier than the full term
when is a baby premature
born before 37 weeks
Baby J was born at 28 weeks gestation
He was 12 weeks premature
Today it is 6 months past the day he was actually born
what is his corrected age
40 weeks - 28 weeks = 12 weeks = 3 months)
CA = 6 months - 3 months
Baby J is 3 months corrected age
born between 37- 42 ( typically 40) weeks from the mother’s last menstrual period.
full term
born less than 37 weeks gestation
premature
born after 42 weeks gestation
post term
infant during the first 4 weeks of life.
neonate
1 month to 1 year
infant
developmental age of the fetus when the cochlea begins to function.
ear starts developing by 3rd week of embryonic life
branchial arches form middle & external ear during 4th week and recognizable by 8th week
Inner ear structures mature 20-26 wks
AN working by 24-26 wks
mechanical & neural properties mature simultaneously
AS is under structural development during first 20 wks of gestation with initial neurosensory maturation after (even after birth)
AS is functional around 25 wks gestation
First communication signs occurs when
baby learns to cry
crying brings food, comfort and companionship
is language solely auditory?
no, also comes from face to face interactions
full term newborns have _____ auditory experience
more than 2 mos
when do babies have preferences?
why?
birth to 6 mos because they can hear before thye are even born
n utero acoustic environments shows frequencies >1 kHz are attenuated _____ dB in transmission to fetuses
20-30
what is suprasegmentals
Prosodic features include sound duration, intonation, syllables and stress
sounds of a language
phonology
what is phonology
sounds of a language
study of words and their meaning
semantics
what is semantics
study of words and their meaning
study of rules that governs morphemes
morphology
what is morphology
study of rules that governs morphemes
study of how people use language to communicate effectively
pragmatics
what is pragmatics
study of how people use language to communicate effectively
arrangement of words in sentences
syntax
what is syntax
arrangement of words in sentences
how do infants perceive suprasegmental information
early encoding - fetus access auditory input putting speech info into memory, distinguishing native from foreign, preferring mom over other voices, and prefer nursery rhymes over new ones
sensitivity to rhythm and intonation - infancts recognize these before and at birth
early speech processing - infants prefer IDS, intonation and emotional info and speech with positive effect
how do infants perceive segmental information
phoneme sensitivity - infants detect important phonetic properties to identify phonemes across languages, discriminate voicing place and manner of articulation
encoding phonemes into long term memory
language experience - infant speech discrim becomes more language specific with experience (focus on native sounds by 10-12 mos
what is segmental information
acoustic properties of speech that differentiate phonemes
what are segments
discrete units of speech that differentiate phonemes
Can infants encode phonemes into long-term memory?
hey encode into long term memory showing preferences for native language rhythms and phoneme inventories by 9 mos
when do infants focus on native sounds more
10-12 mos
how do the viewpoints of linguists and behavioralists differ
Behaviorists - believe all learning is acquired step by step through associations and reinforcements
Linguists - believe language is product of biology and is too complex to be mastered so early and easily by conditioning
Children who are spoken to more and praised by caregivers tend to develop language faster
true
why are parents great intuitive teachers
name items for infants and praise infants when they repeat our words.
Parents name the object and speak clearly and slowly, often using baby talk to capture the infant’s interest
ex: arents typically name each object when they talk to their child, “Here is your bottle”, “There is your foot”, “You want your juice?”
what is infant directed speech
Speak slowly and exaggerated changes in pitch and loudness and elongated pauses between utterances
Parentese, motherese, child-directed speech
why is IDS important
Helps infants perceive the sounds that are fundamental to their language
why does IDS attract infants attention mroe
due to the slower pace and accentuated changes that provide the child with more noticeable language cues
why do we start testing babies with speech first
Newborns prefer human voice and speech - this is why we start testing using speech with young children because they want this more in order to condition them and you get some information before they tap out, then switch to pure tones
crying phase
birth to 6 wks
cooing
7 wks to 3 mos
babbling
after 4 mos
first understanding of languagr
8-10 mos
first words
approx 12 mos
50 words
18 mos
vocab spurt
18-20 mos
two word sentences
24 mos
development of grammar
after 30 mos
all babies with different languages will make the same sounds and start babbling the same
true
what is meant by babbling is experience expected learning
all babies babble, all babies gesture, sounds they make are similar regardless of their native language
what is babbling
extended repetition of certain single syllables around 6-7 mos
what are babies born with that adults do not have
Born with ability to discriminate universal set of phonetic contrasts
Declines as they experience specific linguistic experiences
Not found in adults
Experience listening to a language may be necessary to facilitate perception of some phonetic distinctions
true
what are phonemes
Basic building blocks of language
Unique sounds that can be joined to create words
Ex: p in pin pet and pat or b in bed, bat and bird
Infants can distinguish between many sounds, even as early as
1 mos old
Able to distinguish sounds of phonemes from a foreign language
true
why do p,b,n,w,m sounds come early
because they are the most visible on the mouth and they can see them on the face
what sounds are developed first
p b n w m
which sounds come after p b n w m
t d ng k g y
which sounds come after t d ng k g y
f s z
what comes after f s z
sh, ch, l
what comes after sh ch l
j v
what are the last sounds to develop
r th
when do children start using symbols?
shortly before 1st birthday
what is meant by symbols
gestures
sometimes gestures pave the way for language
true
Gestures and words convey a message differently
false
equally well
describe the language spirt
Once an infant’s vocabulary reaches about 50 words it suddenly begins to build rapidly, at a rate of 50-100+ words per month, mostly nouns.
occurs around 18 months
naming explosion
language spirt that happens around 18 mos when vocab reaches 50 words and builds rapidly to 50-100 words/month
By about _____ years of age, children have the ability to produce more complex sentences (four or more words per sentence).
2 ½
what are grammatical morphemes
words or endings of words that make sentences more grammatical
give an example of sentences bw a 1 1/2 yr old vs a 3 yr old
A 1 ½-year-old might say “kick ball” but a 3-year-old would be more likely to say “I am kicking the ball”
what is the rate of a child’s vocab development influenced by
the amount of talk they are exposed to
the more speech that is addressed to a toddler, the more rapidly the toddler will learn new words
what are early errors in language
underextension
overextension
overregularization
what is underextension and an example
using a word too narrowly
ex: using cat only to refer to the family cat or ball to refer only to their favorite toy ball
what is overextension and an ex
using a word in broader context than appropriate; the child uses the new word and applies to group of similar experiences
common bw 1-3 yrs
more common than underextension
A child might use the word “dog” to refer to all four-legged animals, including cats, cows, and horses.
A child might call all men “daddy” or all women “mommy.”
what is overregularization and ex
speech errors where they treat regular forms of words as if they were regular
leads children to talk about foots, tooths, sleeps, sheeps, mouses
ex: he goed, I catched it
is overregularization a good thing
yes, sign of verbal sophisticaton becuase it shows children are applying the rules to grammar
part of learning the language because they are paying attention
necessary for newborns to develop the ability to prefer their mother’s voice over other voices
extensive auditory experience
The infant auditory system must be ______ to various acoustic discriminations before making early distinctions.
preadapted
Infants and children with hearing loss undergo the same stages of auditory development as those with normal hearing, but their learning about sound is likely limited by their impairment
true
what is incidental learning? what % learn from this?
unintentional or passive acquisition of knowledge, often occurring through everyday experiences and interactions
90% of what normal hearing individuals learn is from overhearing conversations & only 10% from direct instruction
what are incidental experiences newborns experienc
hearing their moms voice and other environmental sounds
Infants and children with hearing loss may have limited opportunities for incidental learning due to their reduced ability to hear environmental sounds, affecting their overall auditory development
true
what is absolute sensitivity
ability todetect sound in quiet
what frequencies mature more rapidly for absolute sensitivity
HF than LF
when does absolute sensitivity reach adult like
10 yrs old
what is frequency resolution
ability of AS to distinguish bw different frequencies or pitches of sound
what is spectral representation of sound look like in 6 mos old
adult like in frequency resolution at all frequencies
what is spectral representation of sound look like in 3 mos old
mature frequency resolution at 500 and 1000 Hz but poorer than adults and older infants at 4000 Hz
what is the development of intensity discrimination of sounds
6 mos - range from 12 dB ot 4dB change in intensity
Ex: they would have to be 10 and 22
12 mos - 3dB
6 yrs - 1 to 2 dB
Adults - 1 dB
when are complex pitch close to adults
7 mos
what is temporal resolution
ability to hear changes in sound over time
what is gap detection maturing for temporal resolution
Adults can detect as short as 3 ms in some conditions
By 6 yrs, gap matures
Infants </= 12 mos - do not detect gaps shorter than about 30 ms
Preschool - gap threshold in 2000 Hz is about 12 ms
two sounds come from the same side but they are coming from different locations
can children tell the two apart
children do not do this well until they are coming from further apart differences
Localization abilities depends on head and ear size and changes with age
true
Infants and young children are as good as adults at identifying spatial location of a sound
false
what is used for sound localization and spatial haering development
ITD & ILD differences & by reference of the shape of a sound’s amplitude spectrum that is altered by the external ear are used for sound localization
MAA is ______ in adults
1°
Newborn infants cannot tell that a sound comes from the left or right
false
By 1 month, MAA is ______
27°
By 18 months, MAA improves to _____
5°
By age of ______, children can localize many sounds in the left-right dimension as well as adults
5
Human auditory development begins _______ and continues into ________.
before birth
adolescence
The basic auditory capacities, the spectral and temporal representations of sound, are
not completely mature at birth but are apparently adultlike by about 6 months of age
As children grow older, they become sensitive to aspects of sounds that they previously appeared not to notice.
true
The ability to use the information that the ear provides the brain develops over a much longer time course.
true
checklist for birth to 3 mos
Startles to loud sounds
Calms to familiar voices
Turns head to mother’s voice
Smiles when hears a new voice.
Makes vowel sounds “ooh” and “ahh”
checklist for 3-6 mos
Makes a variety of sounds “ba-ba” and “ga-ba”
Enjoys babbling
Likes sound making toys
Turns eyes and head toward sounds
checklist for 6-9 mos
Responds to own name
Imitates speech with non-speech sounds
Plays with voice repetition “la-la-la”
Understands “no” and “bye-bye”
Says “da-da” or “ma-ma”
Listens attentively to music and singing
checklist for 9-12 mos
Responds differently to happy or angry talking
Turns head quickly toward loud or soft sounds
Jabbers in response to human voice
Uses two or three simple words correctly
Gives up toys when asked
Stops in response to “no”
Follows simple directions
checklist for 12-18 mos
Identifies people, body parts, and toys on request
Turns head briskly to source of sound in all directions
Can tell you what he or she wants
Talks in what sounds like sentences
Gestures with speech appropriately
Bounces in rhythm with music
Repeats some words that you say
checklist for 18-24 mos
Follows simple commands
Speaks in understandable two-word phrases
Recognizes sounds in the environment
Has a vocabulary of 20 words or more
Discuss the impact of parent-child interactions on the speech and language development of the child
Critical experience to sound is needed for auditory development
Frequent, rich, and responsive interactions provide the foundation for language acquisition.
Parents who frequently talk, read, and sing to their children expose them to a wider range of vocabulary.
Children learn new words and their meanings within the context of daily activities and routines.
Interactions help children understand non-verbal cues, such as facial expressions and body language.
Telling and listening to stories enhances children’s ability to understand and construct narratives.
how would you use this information to counsel parents of a child with a hearing impairment.
Encourage parents to engage in frequent, meaningful interactions with their child, using both auditory and visual cues.
Consistent interaction helps compensate for any delays caused by hearing impairment and supports overall language development.
Teach parents to use sign language, gestures, and visual aids to reinforce spoken language.
Enhances understanding and communication, providing alternative ways for the child to learn and use language.
Instruct parents on the importance of responding to their child’s attempts to communicate, whether through sounds, gestures, or expressions.
Validates the child’s efforts and encourages further communication attempts.
Guide parents to seek early intervention services, including speech therapy and audiology support, as soon as a hearing impairment is identified.
Provides professional support tailored to the child’s specific needs, optimizing their language development outcomes.
Recommend programs and resources that teach parents effective strategies for supporting their child’s language development.
Discuss the importance of consistent use of hearing aids or cochlear implants if prescribed, and ensure they are properly fitted and maintained.
Babbling is different in HL to those with hearing
false,
the same until age of 6 mos (less babble as they grow older due to the lack of auditory feedback)
how is rate of babbling impacted
Rate of babbling can increase if parents speech to them
Babbling of moderately impaired infants is closer to normal than those who are more severely affected
tru
Deaf infants and toddlers master sign language the same way and pace that hearing children master spoken language
true
Deaf 10-month-olds often “babble” in ______
signs: produce signs that are meaningless but resemble the tempo and duration of real signs
Describe the various strategies used by parents and caregivers to encourage language development
IDS - speaking slowly with exaggerated changes in pitch and loudness, and elongated pauses between utterances.
Attracts infants’ attention and helps them perceive and differentiate the sounds of their native language.
Regularly reading books, telling stories, and describing pictures in detail.
Enhances vocabulary, comprehension, and phonemic awareness.
Singing songs, reciting nursery rhymes, and engaging in rhythmic activities.
Develops phonological awareness and helps children recognize patterns in language.
Surrounding the child with diverse language experiences, such as conversations, books, music, and social interactions with peers and adults.
Consistently naming objects, actions, and emotions during daily interactions and providing detailed descriptions.
Builds vocabulary and helps children make connections between words and their meanings.
how would you use this information to counsel parents of a child with a hearing impairment.
Emphasize the Importance of Early Intervention:
Action: Highlight the need for early detection and use of hearing aids or cochlear implants if recommended.
Purpose: Ensure that the child has access to auditory information during critical periods of language development.
2. Adapt Infant-Directed Speech:
Action: Use clear, slow, and exaggerated speech patterns while ensuring visual cues are prominent (e.g., facial expressions, lip movements).
Purpose: Enhance the child’s ability to understand speech through both auditory and visual inputs.
3. Foster Visual Communication:
Action: Incorporate sign language, gestures, and visual aids (like pictures and written words) to support language development
limitations normal-hearing children face in complex environments and the implications for children with hearing loss.
Preschool and school-age children need higher SNR than adults to achieve similar levels of performance on speech recognition tests in presence of noise or speech maskers
Infants could recognize their name embedded in a background of competing speech but needed a higher SNR to do so, relative to adults
child w/ HL they naturally require higher SNR and now with HL, it is even worse
Identify the red flags indicating potential issues in speech and auditory development.
No babbling at 12 months
No gesturing (pointing, waving bye-bye) by 12 months
No single words by 16 months
No 2 words combination spontaneous phrases by 24 months
No 3 words combination by 3 years of age
Unintelligible speech at 3 years
Limited number of consonants at 2 years
Simplified grammar at 3 ½ years
Difficulty formulating ideas and using vocab at 4 years
Language not used communicatively
0-4 mos
moro reflex, eye blinking or widening, sucking
startle when there is a very loud noise
4-7 mos
head lateral turn towards the sound source
7-9 mos
good lateral localization in all directions
9-13 mos
sound localization in all directions
13> mos
excellent localization, child can also get distracted easily
Helps infants perceive the sounds that are fundamental to their language
infant directed speech
make sounds that are language based
2 mos
make speech-like sounds with no meaning (cooing turns to babbling)
5-6 mos
when does babbling happen
6-7 mos
what speech sounds are first to develop and last to develop
P,b,h,n,w,m → t,d,ng,k,g,y → f,s,z → sh,ch,l → j,v → r,th
what is an infant’s first communication
crying
what does crying do fora. child
helps them receive food, comfort, and companionship.
involves auditory and face-to-face interactions
language development
describe early encoding and sensitivity
Fetuses can access auditory input, store speech information, distinguish native from foreign languages, and show preferences for their mother’s voice and familiar nursery rhymes. Infants are sensitive to rhythm and intonation from birth.
describe speech processing
Infants prefer infant-directed speech (IDS) over adult-directed speech (ADS) due to its intonation and emotional content.
Language is biologically innate and complex.
linguists
Learning through associations and reinforcements
behaviorists
Infants are equipped for language before birth due to
brain readiness and prenatal auditory experiences. Newborns prefer human voices, which aids in early speech testing.
Infants can initially discriminate a universal set of phonetic contrasts, but this ability declines with exposure to specific languages.
true
quick checklist from birth to 3 mos
Startles to loud sounds
Calms to familiar voices
Turns head to mother’s voice
Smiles when hears a new voice.
Makes vowel sounds “ooh” and “ahh”
quick checklist from 3-6 mos
Makes a variety of sounds “ba-ba” and “ga-ba”
Enjoys babbling
Likes sound making toys
Turns eyes and head toward sounds
quick checklist from 6-9 mos
Responds to own name
Imitates speech with non-speech sounds
Plays with voice repetition “la-la-la”
Understands “no” and “bye-bye”
Says “da-da” or “ma-ma”
Listens attentively to music and singing
quick checklist from 9-12 mos
Responds differently to happy or angry talking
Turns head quickly toward loud or soft sounds
Jabbers in response to human voice
Uses two or three simple words correctly
Gives up toys when asked
Stops in response to “no”
Follows simple directions
quick checklist from 12-18 mos
Identifies people, body parts, and toys on request
Turns head briskly to source of sound in all directions
Can tell you what he or she wants
Talks in what sounds like sentences
Gestures with speech appropriately
Bounces in rhythm with music
Repeats some words that you say
quick checklist from 18-24 mos
Follows simple commands
Speaks in understandable two-word phrases
Recognizes sounds in the environment
Has a vocabulary of 20 words or more
Moro reflex, eye blinking or widening, sucking. Startle when there is a very loud noise.
0-4 mos
Lateral head turn towards sound source
4-7 mos
Good lateral localization skills & downwards
7-9 mos
Sound localization in all directions
9-13 mos
Excellent localization. Easily distracted
13+ mos
red flags indicating potential issues in speech and auditory development
No babbling at 12 months
No gesturing (pointing, waving bye-bye) by 12 months
No single words by 16 months
No 2 words combination spontaneous phrases by 24 months
No 3 words combination by 3 years of age
Unintelligible speech at 3 years
Limited number of consonants at 2 years
Simplified grammar at 3 ½ years
Difficulty formulating ideas and using vocab at 4 years
Language not used communicatively
Babbling is similar of normal hearing infants until the age of 6 months - less/decrease in babbling as they grow
true
deaf babies
Explain to parents, in general terms, how hearing loss can affect their child’s ability to communicate, learn, and interact with others
HL impacts speech, laguage, cognitive and psychosocial development
it affects vocab, sentence structure and speaking
Those with HL have issues in all areas of academics especially in reading and math
mild to mod HL achieve 1-4 grade levels lower than age matched peers (mild can miss up to 40% of class discussions); they feel isolated and unhappy becuase they are different and can not identify with normal hearing peers or with those that have hearing loss
severe to profound achieve no higher than 3-4th grade without appropriate educational intervention early; report isolation, no friends and unhappy i school because they feel left out or different and happens when they have limited socialization with other children with HL
what is minimal hearing loss in newborns
Normal 10-15
minimal/slight 15-25
Mild - 26-40
why are parameters different in infants than adults
they already have their s/l development but children have not so the loss really matters
Unilateral HL
PTA (.5, 1, 2 kHz) is >/= 20 dB HL with no more than dB ABG at 1, 2, & 4 kHz in the impaired ear & AC thresholds are 15 dB or better in the other ear
Bilateral SNHL: average AC thresholds are bw 20-40 dB HL and average ABG is </= 10 dB at 1, 2, & 4 kHz bilaterally
Bilateral SNHL
average AC thresholds are bw 20-40 dB HL and average ABG is </= 10 dB at 1, 2, & 4 kHz bilaterally
HF SNHL
AC thresholds > 25 dB HL at 2 or more frequencies above 2 kHz with no more than 10 dB ABGs at 3 and 4 kHz, can be unilateral or bilateral
Minimal HL prevalence increases at school age from
.03% to around 1-14%
Why is there such a large discrepancy in prevalence rates of minimal hearing loss from birth to school-aged children?
they do school screenings
could miss 60% of case with slight/minimal HL because we screen at 20/25dB because of the cut off
Why is identifying minimal HL in newborns difficult?
OAE & ABR technology cannot differentiate normal and mild HL at this time
Some loss configurations can result in ABR & OAE screening results to not be able to be differentiated from normal hearing ears
Pass/Fail criteria provided by manufacturers to decide if something is good or bad might not be good enough and cant always trust these rules to tell us if a product is actually up to standard or if the automated systems checking these rules are doing a good job. Sometimes, more thorough checks are needed to make sure everything is really working as it should.
Explain to parents, in general terms, how minimal hearing loss might affect their child’s daily listening and communication experiences
50% of children either repeat a grade or need resource support in school
Compared to hearing peers, HL more likely to have behavioral and linguistic difficulties
Children with minimal SNHL experienced more difficulty than NH children on a series of educational and functional test measures.
31% w/ minimal SNHL failed at least one grade
Children have a more critical need for hearing during their developmental and school years than do adults for understanding day speech - need higher SNRs
How can a 15dB hearing loss result in language delays?
A lot of speech energy is in the voiced vowels and consonants
Unvoiced consonants (s, p, t, k, th, f, sh) contain little speech energy so they fall below even normal hearing thresholds in average rapid converstions
Describe how to position infants and young children for otoscopy.
Under 3 yrs
Child sits on parents lap, parent comfort holds the side of the head against their chest
Over 3 yrs
Invite them to play with the otoscope
Show them how it works & explain why they need to stay still and how
Attach largest speculum the ear accommodates
how do you choose a speculum size
select size based on external eare, slightly smaller in diameter to insert into the canal and provides max lumen for visualization
pick the largest tip you can fit into the child’s ear in order to get the best view of the ear canal
Pediatric audiologist need to
Communicate on their level and be creative
Engage the parents
Build trust
Make sure that you have the temperament, personality, and dedication required!
how do you straighten an infants ear canal
pull back and down
Inspect the ear canal to ensure
Clear enough to allow the insertion of an admittance probe tip
Free from excessive cerumen
Free from other obstructions such as PE tubes that have been extruded from the tympanic membrane
Not draining excessively so as to plug the probe
what are we looking for in otoscopy
Foreign object
Redness
Swelling
Cerumen impaction
Bony growth
what are we looking for in otoscopy in regards to the TM
Inflammation, retracted, bulging
Perforation
PE tube is in place or extruded
Scarring or tympanosclerosis of the tympanic membrane.
what is a case history
planned professional conversation enabling PT to communicate symptoms, feelings and fear to the clinican to obtain insight into the nature of the PTs illness and their attitude towards them
Obtaining a case history enables the audiologist to
learn about the child and to understand the parents’ concerns and assessment expectations.
also facilitates the development of a rapport between the audiologist and the family that will be invaluable when counseling about test results
Identify reasons for taking a case history. Importance of a case history
may reduce the quantity and quality of data obtained from the evaluation and diminishes the role of both the assessment and the audiologist to a technical one rather than a professional and diagnostic one.
Accurate diagnosis of hearing loss relies on interpretation of a test battery within the context of the child‘s medical and/or developmental history.
Understanding the Child: Provides essential information about the child’s development and health, offering insights into their cognitive and developmental status and helping estimate their auditory skills.
Understanding the Family: Enables the audiologist to understand the parents’ concerns, needs, and assessment expectations, and helps build rapport with family and caregivers, which is crucial for effective counseling.
Observational Opportunities: Allows the audiologist to observe the child’s behavior and note interactions with family members and others.
Guidance for Assessment: Informs the audiologist about the nature of auditory complaints (e.g., unilateral/bilateral, acute/chronic), assists in formulating clinical testing strategies, and highlights possible contributing factors to hearing disorders.
A good case history is a valuable tool and an often-overlooked part of an audiologic evaluation.
Failure to obtain sufficient history information may reduce the quantity and quality of data obtained from the evaluation and diminishes the role of both the assessment and the audiologist to a technical one rather than a professional and diagnostic one.
Accurate diagnosis of hearing loss relies on interpretation of a test battery within the context of the child‘s medical and/or developmental history.
Key differences in case history between pediatric and adult patients.
peds
-Emphasizes developmental milestones - motor skills, language acquisition & social development
-Asking about prenatal and birth hx
Provided by parents/guardians & accuracy depends on their observations and knowledge of the child’s history
-Family hx looking for hereditary factors; social hx including child’s environment, school performance and interactions w/ peers
-Behavioral issues and emotional development; focus on conditions like ADHD, autism, anxiety disorders etc.
adults
-Focuses on PT’s medical hx, lifestyle factors, chronic conditions
-PT usually provides the information directly allowing firsthand reporting of symptoms and concerns
-Family hx is important; social hx includes lifestyle factors like smoking, alcohol use, occupation and living situation
-Behavioral and emotional health - focus on mental health conditions like depression or anxiety in the context of life stressors
