lec 8

Question 1

T or F: hearing screenings identify type and degree of hearing loss by providing accurate individual ear info

Answer 1

false! they do none of these things

Question 2

what is sensitivity vs specificity of a screening?

Answer 2

• sensitivity: true positive rate
• specificity: true negative rate

Question 3

what is worse, false positives or false negatives?

Answer 3

false negatives!

Question 4

what is a problem with tests yielding too many false positives?

Answer 4

fatigues the referral system

Question 5

what can you say to clients instead of “your baby failed the hearing screening”?

Answer 5

“We did not get the response we were looking for. We are going to refer your baby for further testing.”

Question 6

why should we screen the hearing of babies?

Answer 6

• undiagnosed and untreated hearing loss impacts a child’s overall development.
• these negative consequences can be reduced or eliminated through early detection and intervention.

Question 7

what are the 2 steps of the ontario IHP screening?

Answer 7

1. blood-spot screen
2. OAE screen

Question 8

what does the blood-spot screen determine? (2)

Answer 8

• congenital cytomegalovirus
• inherited predisposition to hearing loss

Question 9

what causes false negatives vs false positives in OAE screens for newborns?

Answer 9

• false negatives: babies with mild loss or ANSD.
• false positives: human error, amniotic fluid in middle ear.

Question 10

explain what these results of infant screening entail:
a) pass
b) refer
c) high risk
d) diagnoses of hearing loss

Answer 10

a) discharged from system
b) rescreen in community. if second “refer” go to audiologist
c) straight to audiology
d) provide communication intervention + support services

Question 11

does canada pass based on SAC ratings? (reading 5)

Answer 11

• no; 6 provinces and 1 territory scored “insufficient”

Question 12

which babies are disproportionately not being screened?

Answer 12

indigenous babies, especially those living on reserves

Question 13

which province has highest screening rate in canada?

Answer 13

• northwest territories (99%)
• apparently yukon also has 99%? (see slide 23)

Question 14

describe nunavut’s infant hearing screening program

Answer 14

• they do not have one!
• widely dispersed population makes service difficult

Question 15

T or F: indigenous communities in canada have lower prevalence of OME than non-indigenous communities

Answer 15

• false (prevalence rates as high as 40x)

Question 16

what are some risk factors of OME in indigenous communities?

Answer 16

• crowded living conditions
• most babies are bottle fed
• cigarette smoke
• potential ET structure

Question 17

what is the rule of 1, 3, 6?

Answer 17

• hearing screening at age 1 month
• hearing loss diagnosis at 3 months
• hearing loss management at 6 months

Question 18

__% of the world has no infant screening

Answer 18

38

Question 19

__% of the world reports screening more than 85% of babies

Answer 19

33

Question 20

__% of children are lost in the follow-up between ID and intervention

Answer 20

17.2

Question 21

how do pure tone screenings work?

Answer 21

• tones presented at pre-determined frequencies + hearing level
• person responds or does not

Question 22

do people need to be alert for pure tone screenings? is there age requirements?

Answer 22

• yes need to be alert
• not recommended for children under 3

Question 23

T or F: the auditory threshold is determined by pure tone screenings

Answer 23

false

Question 24

what does a “pass” vs “refer” mean for pure tone screens?

Answer 24

• pass = no concern w/ hearing at present time, responded to 2/3 tones per frequency
• refer = potential hearing related issue (provide info on referral)

Question 25

why might the client respond during pure tone screens (besides actually hearing the tone)? (3)

Answer 25

• randomly responding
• responding to non-verbal cues
• long periods of silence

Question 26

why might the client NOT respond during pure tone screens (besides not hearing the tone)? (3)

Answer 26

• there is no sound
• faking hearing loss
• distractions/forgot instruction

Question 27

which frequencies are used in pure tone screens?

Answer 27

• 1000 Hz
• 2000 Hz
• 4000 Hz

Question 28

which hearing level is most often used in pure tone screens?

Answer 28

• 25 dB HL
• 40 for geriatric, 20 for peds in quiet room

Question 29

at its best, the human ear can hear between ____–____Hz.

standard audiological assessments test from _____–_____Hz.

Answer 29

• 20 to 20,000 Hz
• 250 to 8000 Hz

Question 30

A 66-year-old person who wears hearing aids comes to you for a screening.

What do you do?

Answer 30

• they do not need a screening because we already know they have hearing problems (purpose of screen)