Intro_Advanced Assessment Flashcards
What was the goal of diagnostic behavioural site-of-lesion assessments?
To distinguish sensory (cochlear) vs neural (retrococochlear vs CANS (central auditory nervous system)) lesions
- prior to ABR and OAE
What was peripheral auditory assessment originally designed for?
To differentiate cochlear from retrocochlear “neural” disorders
What were some of the things Central Auditory Processing Assessment was used to detect?
Lesions affecting the central auditory system
- mass lesions
- degenerative disorders
- vascular lesions
- demyelinating disorders
Name 2 types of peripheral auditory assessments, and what they were used for
SISI (short increment sensitivity index) - detecting cochlear dysfunction
TD (tone decay) - detecting neural dysfunction
ABLB (alternate binaural loudness balance) - testing for pattern of results and site of lesion
What are some of the central auditory processing assessments?
- MLD, Binaural fusion, gap detection tasks - used to detect brainstem dysfunction
- dichotic listening tests, pitch patterns - used to detect cortical dysfunction
- SSW - used to detect multiple levels of CANS (central auditory nervous system)
Name 3 things that have replaced advanced behavioural tests for “site-of-lesion” determination
Imaging: CT, MRI
Physiologic measures: OAE, AEP
Name one example of how advanced behavioural tests might still be used today
- assessing perceptual abnormalities in patients with unusual complaints (worse than expected performance with standard treatment plan, more difficulty hearing “real world” sound than expected from pure tone audiogram)
- new tests and adaptations of older tests for CAP assessments
When might we document a hearing deficit (suprathreshold levels)? What can we use this information for?
- difficulty hearing in noise
- difficulty localizing sound
- levels of comfort/discomfort
- reduced speech perception
- differences in speech/language development
Useful information for hearing aid fitting (dynamic range, MCL)
What are some possible explanations for why suprathreshold perception might vary across subjects with the same audiogram?
- amount and pattern of OHC loss
- amount and pattern of IHC loss
- other types of cochlear damage
- retrocochlear neural damage
- variable brain plasticity
What types of populations might we use these advanced behavioural tests on?
- elderly: deficits of peripheral and central origin
- noise exposed
- patients with peripheral neural dysfunction that includes auditory nerve (e.g. Auditory Neuropathy Spectral Disorder)
- patients with CANS lesions
- patients with (C) Auditory Processing Disorder
Name 3 signs of Auditory Processing Disorder
Difficulty
- hearing in noise
- following long conversations
- hearing on phone
- learning foreign language/challenging vocab
- remembering spoken info
- taking notes
- maintaining focus with other sounds present
- with organization
- following multi-step directions
- directing, sustaining, or dividing attention
- reading and/or spelling
- processing nonverbal info (e.g. music)
What protocols do we have for advanced behavioural assessments (e.g. types of assessments)?
- loudness perception
- extended frequency PT audiometry
- SIN assessment
- auditory adaptation
- CAP Battery
Name 3 of the tests we have for loudness perception (based on the changes in loudness perception that accompany different auditory disorders)
- MCL and UCL (speech or non-speech stimuli)
- ABLB and AMLB (loudness scaling and balance tests use pure tone stimuli)
- SISI (detection of small intensity increments)
What 2 things might affect the type of protocol we use to assess a hearing deficit?
- hearing threshold of the patient (conventional audiometry)
- focus of the test (towards a specific site of dysfunction or to assess a particular auditory function)
Why is it important to understand what a test is used for and how it is supposed to work?
To properly interpret it and determine if it is a worthwhile test to perform (especially if it costs money)
