Hearing Screenings Flashcards
portable audiometers: transducers
- supra-aural headphones
- insert headphones
- bone conduction vibrators/oscillators
- speakers
before you begin…
complete a listening check on the audiometer
listening check
- ensure transducers are working
- everything is plugged in and set appropriately
- done prior to seeing patient
why should you complete a listening check?
avoid misdiagnosis
how do you complete a listening check?
turn the intensity dial to 25 dB and listen to each headphone/speaker
conditioning
- young children may need to be conditioned to testing
- practice a couple of times without the headphone
- supra-aural threshold
preparing for screening
- find location of screening
- ensure child is faced away from you
find location of screening
- move desks/chairs into proper position close to an outlet
- complete a listening check
- be sure to bring a pen/pencil
- do not bring food or drink with you
- turn off phone
ensure child is faced away from you
- give instructions prior to placing the headphones
- have the child remove glasses, hats, and large earrings (only if pinching)
- tuck hair behind the ears (do not place headphones over hair)
- place headphones on child from the front and secure the headband for proper fit
hearing screenings in the schools
- Pennsylvania requires 25 dB with threshold search if no response at 25 dB
- if you are screening in a school, always follow the state’s requirements
recording results, Pennsylvania schools
- when doing a hearing screening for PA schools, you will not be using an audiogram
- you will be given a form by the school district from which you are providing screenings
- the form will have boxes for results (250-500-1000-2000-4000 [8000]) for each ear
- if the child responds at 25 dB, then you will mark a + sign in the box with the corresponding frequency
- if the child does not respond at 25 dB, present again
- if they still do not respond, begin a threshold search and record the threshold
recording results: mark “refer” when…
- child has a threshold of 30 dB at 2 or more frequencies
- child has a threshold of 35 dB at 1 frequency
PA hearing screenings: pupils in…
- kindergarten
- special un-graded classes
- grades 1, 2, 3, 7, and 11
screening practitioners
school nurse and properly trained medical technicians (SLPs)
clinical process
- pure tone audiometer approved by the Department of Health
- 250, 500, 1000, 2000, and 4000 Hz
- 25 dB pass, threshold search if no response at 25 dB
follow up
- refer by personal contact with parent, followed by written notification
- completion of report from physician or hearing specialist following assessment
purpose of hearing screening
to detect those individuals who demonstrate a greater probability for having a disease or condition so they may be referred for further evaluation
ASHA guidelines for preschool children: goal
to identify the preschool children most likely to have a peripheral hearing impairment that may interfere with communication, development, health, or future academic performance
peripheral hearing impairment
impairment occurring in the ear and not in the brain
ASHA guidelines for preschool children: who can administer?
- audiologists CCC-A and state licensure
- speech-language pathologists with CCC-SLP and state licensure
- support personnel under supervision of certified audiologist
preschool children are screened…
- as needed, requested, or mandated, or when they have conditions that place them at risk for hearing impairment
- parent/care provider concerns
- family history
- disorders, trauma, etc.
preschool: clinical process ASHA
- obtained informed parental/legal guardian permission
- condition child to motor response (hand raise, tapping, etc.)
- administer 2 conditioning trials
- headphones
- pass/refer
- acceptable modifications
- follow up
ASHA guidelines for school-age children: goal
identification of school children at risk for hearing impairment that may affect adversely education, health, development, or communication
ASHA guidelines for school-age children: who can administer?
- audiologists CCC-A and state licensure
- speech-language pathologists with CCC-SLP and state licensure
- support personnel under supervision of certified audiologist
clinical indications ASHA: school-aged children are screened…
- on initial entry to school
- annually in kindergarten through 3rd grade
- annually in 7th and 11th grades
- as needed, requested, or mandated
otoacoustic emissions screening
- place probe in ear canal
- deliver screening
- room should be quiet and free of ambient noise
- patient should be still and quiet
- screening equipment will state “pass” or “refer”
- if they did not pass, refer for an audiological work up
tympanometry screening
- place probe into ear canal
- client needs to be still, but room does not have to be quiet
- screeners have a box on the screen
- if the tymp falls within the box, it is within normal limits
additional considerations
use terminology “did not pass” or “refer” instead of “fail”
can I send the results home?
- if you work in a school, you may be required to send it through the school nurse
- it may be the screening form or a summary letter