Exam 1 (Speech Audiometry) Flashcards
Discuss the importance of conducting speech audiometry in children.
Speech perception testing helps to determine how well the child uses hering for communicative function
The ability to understand speech is the primary goal of fitting Technology.
Speech perception testing is a critical component of the audiologic test battery. It provides information about how a child can be expected to function in daily listening situations.
without speech perception testing we cannot predict
What the child hears and does not
is there a change in auditory perception
How to improve auditory functioning
what are the essentials of speech perception testing
Measures their perception of phonetic segments, words, sentences, and connected discourse
Quantifies the benefits of amplification to guide audiological management decisions
Monitors their auditory progress & documents improvements over time
Assists in planning and implementing audiologic rehab, including speech reading and auditory training
Identifies abnormalities not predicted from PTA
what are the speech audiometry principles
Needs to match their capabilities (cognitive, motor, & attention)
Has to be interesting and motivating
Needs to match speech perception abilities in realistic scenarios
if a child isn’t repeating or identifying, is it because they cannot hear or because they do not understand the words or langauge
true
internal and external factors that can impact word recognition testing in children.
Internal factors
Vocab and language competency
Chronological age
Cognitive abilities
Alertness
Motivation
Fatigue
External factors
Designation of appropriate response task
Effective utilation of reinforcement
Controlling the memory load inherent in the task that can influence test performance
Not all speech perception tests are appropriate for children; some are too complex
true
Discuss the challenges associated with conducting speech audiometry in children
Language & vocabulary level of the child
Cognitive, motoric and attentional capabilities of the child
Articulation problems are common in children – may be difficult to score speech discrimination tests as w/adults
strategies to overcome Articulation problems are common in children – may be difficult to score speech discrimination tests as w/adults
picture pointing rather than requiring verbal responses; perform speech awareness instead of speech recognition (only have to detect presence of sound & not repeat it back)
strategies to overcome Cognitive, motoric and attentional capabilities of the child
break the test into shorter sessions or take breaks to keep them engaged and avoid fatigue ; use interactive and interesting gaims to keep their interest
strategies ot overcome Language & vocabulary level of the child
use words familiar to the child & that are within their vocabulary; incorporate pictures or objects to represent words or sounds being tested
what are the 6 ling sounds
[a], [i], [u], [∫], [m], and [s]
Provides frequency specific information telling us how a person ca be expected to perceive speech stimuli across the frequency range needed for speech
Can be compared directly to pure tone thresholds
shorter ling sounds
[ba] for assessing low-frequency information
[∫] for assessing mid- to high-frequency information
[s] for assessing high-frequency information.
Audibility of /a/, /u/, /i/ , and /m/ indicates useable hearing through
1000 Hz (low frequency)
Audibility of /∫/
hearing through 2000 Hz (mid-high frequency)
Audibility of /s/
hearing through 4000 Hz (high frequency)
describe NU CHIPS
Closed set of picture pointing word recognition test
closed set - using the booklet with pictures
open set - ask the child to repeat the words without the book and pictures
Scored as %
Children with language age 3-5 yrs
The test is made up of 50 monosyllabic PB words familiar to a 3 year old in four randomization called forms
describe the WIPI
Word Intelligibility by Picture Identification
Most common used
Takes into consideration those with restricted receptive vocan & cannot read
Has 6 pictures (4 are rhyming and 2 serve as distractors to reduce probability of correct guess)
Children language age between 5-8 yrs
WIPI-R is 5-10/11 yrs
Can be administered as an open-set measure by not using the picture book.
The test can be performed in an “auditory only” or “auditory and visual” (lip reading allowed) modality.
The test can be performed in an “auditory only” or “auditory and visual” (lip reading allowed) modality.
WIPI
ages 5-8 yrs
WIPI
ages 3-5 yrs
NU CHIPS
Closed set of picture pointing word recognition test
NU CHIPS
Takes into consideration those with restricted receptive vocan & cannot read
Has 6 pictures (4 are rhyming and 2 serve as distractors to reduce probability of correct guess)
WIPI
Discuss some of the factors when selecting speech audiometry tests.
cognitive and language level of the child is what we should be choosing the materials based on
Degree of hearing loss should not be a factor in selecting tests of speech perception.
Tests should be selected based on the individual child’s language abilities.
Profound hearing loss makes it harder for children with hearing aids to receive information through hearing, though this may not apply to children with cochlear implants.
true
ability to tell when a stimulus is present
detection
patient decides if it is there or not (any time you hear a sound let me know)
detection
ability to determine whether two stimuli are the same or different
discrimination
cat and hat - are these the same or different?
asking what is different and similar and asking for specific information
discrimination
Ability to recognize and label stimulus
identification
if you say apple, have to know it is an apple (given apple, orange, banana)
detect stim, hear it, identify, know what it is
labeling things
identication
ability to understand what the stimulus means
comprehension
most complex process
focusing on segment and phonetic information to differentiate (cat from hat), identify it and then comprehend
following, repeating, command
comprehension
what are speech detection thresholds
lowest level at which a person can detect the presence of the stimulus 50% of the time.
too young, delay, limited vocab, significant HL - when to use
Response can vary greatly from eye widening, head turn, or facial change
Stimuli can be the child’s name, nonsense words, or short phrases
Stimuli is presented typically via MLV and can be obtained in the SF (better ear response) or under headphone.
PTA is always better than SDT
false
what are speech reception thresholds
Lowest level at which a person can identify speech stimuli 50%of the time
No visual cues
what materials should be used for SRTs in younger children
Direct them to point at pictures or body parts, pick toys, or follow simple verbal instructions
what materials should be used for SRTs in older children
Older children: Ask them to repeat using standard tests; spondee words
use carrier phrase
show me _____
show me snowman
when do you use BC SRT
Helps to diagnose CHL in young children by comparing AC SRT
Can use in 2-4 yr old who has bilateral ear canal atresia or mocrotia to determine cochlea hearing status
helpful in determining if bone conduction devices would work for certain kids
what are the limititons of bc srt
Usually speech through this is not calibrated
Range is limited - volume for bone is limited when compared to air
closed set
limited # of items to choose from
can be numbers, body parts, pictures, or alphabet
guessing is a possibility
open set
offers no clues
more difficult
yeilds lower test results
offers more realistic p8icture of speech perception abilities in real conversaton
attempted by age 5
adv/dis of recorded and MLV
ecorded
Has the advantage of being more reliable and easily comparable test-retest but can be time-consuming and challenging for a child, requiring breaks between stimuli, repetitions due to distractions, and timeouts for encouragement.
MLV
According to AAA, MLV should be used only when recorded testing is not available/or possible to perform, as it can potentially
scores are not repeatable because we are all different and some differences can reach up to 80% just depending on who performs the tes
MLV
what are speech discrimination tests
evaluate a child’s ability to understand speech under different listening conditions.
Performed at suprathreshold levels at different intensities and under varying conditions of competing noise.
AKA word recognition, word discrimination testing, or speech intelligibility testi
how do you select the right word test
Depends on child’s vocab level, cooperation level
Degree of HL is not a factor when selecting
phoneme vs whole word scoring
Phoneme scoring: gives info on which frequencies are impaired perceptually
Vowel errors: insufficient LF info
Sibilants error: insufficient HF perception
Whole word scoring: most tests
Even if 1 phoneme in a word is wrong (ex: sox vs fox) the whole point is deducted.
vowel errors
insufficient LF info
sibilants error
insufficient HF percepton
full vs half list
Full: reduces scoring errors, increases reliability, but is time consuming
Half: only use when word list is validated ot use fewer
what is the procedure for speech test
typically with normal hearing present at 30 dB SL
so if HL is at 20, administer the test at 50 dB HL
if it is 10, intensity level is 40
if they have HL - 40 dB SL
sloping - make sure it is audible at 2000 and in HF
Can also be presented at MCL
WRS is a supra-threshold test, masking is, therefore, not indicated with an asymmetrical hearing loss
false
almost always
what is the pont of a carrier phrase
Alerts child to attend
Show me
Tell me
Say the word
Point to the
if hearing level is at 30 dB HL, what would you present WRS at
60 dB HL (30 dB SL)
if they have HL, what do you present speech at?
40 dB SL
what if they have sloping ehat is speech presented at
make sure it is audible at 2000 and in HF
how should speech testing be conducted
Testing should be conducted while the child uses his or her hearing technology (hearing aids, cochlear implants, osseointegrated implants, and remote microphone systems).
Testing should be conducted at normal and soft conversational levels in quiet and with competing noise
describe PBK-50
50 phonemically balanced monosyllabic word list selected from spoken vocab of normal hearing kindergarten children
5-8 yrs; cannot be used for younger than kindergarten because vocab is too hard
Only an open set; no pictures
Scored as %
Requires verbal response
5-8 yrs
PBK-50
50 phonemically balanced monosyllabic word list selected from spoken vocab of normal hearing kindergarten children
pbk-50
how many bablle talker is BKB sin
4
what is the BKBSIN
SIN tst using sentences recorded in 4 talker babble on the same channel of a CD
Contains 18 list pairs that are equated for difficulty; each list pair has two lists; both lists of the List Pair must be averaged to obtain score.
what is bkb SIN for
Used to estimate SNR loss in children 5+ yrs and adults for which the QuickSIN is too difficult
which BKB sin list is used for CI PTs or those with significant SNR loss
List Pairs 9-18
Children are more affected by SNR Loss than adults because
they are still developing their linguistic and world knowledge, essential for speech perception.
Test results for children should be interpreted individually, taking into account factors like the child’s speech, language, and academic abilities, as well as the learning environment, including class size, room acoustics, and teaching methods.
true
at what age can children use CNC or NU-6 normal lists
age 12 yrse
SRT tests
body parts or familiar objects - they point to them; used when other tests are too hard
spondee pictures/objects - point to them and repeat the word to increase attention; used when the language can identify the objects
CRISP/JR - cosed set of spondee using picture book or on a computer; with/without competing noise
ex of tests to use with profound HL with no amp
ANT
Early speech perception (ESP) test
Mr. Potato head task
Alphabet test
Minimal auditory capabilities (MAC) test
Test of auditory comprehension (TAC)
Importance of assessing hearing in young kids has been recognized for
over 80 yrs
Using age-appropriate (based on developmental age) test techniques with children fto oster efficiency and accuracy in audiologic measurement
true
Behavioral test outcomes provide audiologists with data that reflect
whta the child is actually hearing
