Pediatric Audiology Flashcards
At what age does Pediatric Audiology begins?
Age 5 & under
At age 5, what type of testing can the child experience? & what type of cognitive function must be present?
Handing raising, button pressing etc for those with normal cognitive function
Hearing loss is the…
Sixth most prevalent chronic condition in the US
Since we can’t get a threshold as yet, what do we get?
A Minimum Response Level (MRL)
What is a minimum response level? & can it be above actual threshold?
Intensity at which reliable response is provided. Yes
What makes a Pediatric Audiologist?
- Flexibility
- Alert
- Engaging
What are the types of Newborn Hearing Screening?
- Universal Newborn Hearing Screening
2. Selective Screening Based on High-Risk Registry
What is Universal Newborn Hearing Screening?
Where every newborn is screened before leaving the hospital
What is Selective Screening based on High-Risk Registry?
Babies are screened based on a list of indicators for risk of hearing loss
What’s the issue with using Selective Screening based on High-Risk Registry?
If we use it alone, we’ll miss 50% of congenital hearing losses
What are the high-risk indictors?
- Concerns from parents
- Family history of permanent childhood HL
- NICU > 5days
- In utero infection
- Craniofacial abnormalities
- Syndromes associated with HL
- Neurodegenerative disorders
- Post-natal infections associated w/HL
- Head trauma
- Chemotherapy
When does the usage of High-Risk Registry come into play?
For those who have a progressive hearing loss
Newborn hearing screening is done by…
Trained technicians, nurses & audiologist oversees screening program
What is used for diagnostic purposes?
ABR & OAE
What is the concern with using ABR?
The stimulus is often a click so it’s not frequency specific
For newborns & using the ABR, what should we keep in mind?
When we should expect gestational norms and when we should expect chronological norms since the maturation of the auditory nervous system would differ in premature infants
What’s the best way to screen newborns for diagnostic?
Combination of OAE/ABR to ensure we don’t miss anything
What are some problems to consider for Newborn Hearing Screening?
- Method of screening/person performing screening
- Baby must be quiet
- Environment must be relatively quiet
- Conductive component can cause referral
- Four million infants born in US each year
- Four million infants born in US each year
- Who is telling parents results/what are they saying?
- Coordination of follow up appointments
When does a diagnostic of ABR/OAE occur?
After we identify someone that did not pass the screening
Why do we use a diagnostic ABR/OAE?
For children who have a hearing loss before they are old enough to participate in behavioral testing
When does a diagnostic ABR/OAE begins?
Usually, <6mos
Diagnostic ABR/OAE helps with
Identifying thresholds and type of hearing loss
What is behavioral Testing? & what ages can it be used on?
Behavioral Observation Audiometry (BOA) observes changes in child’s behavior with introduction to sound
Why isn’t BOA not commonly used?
It’s too subjective to be used clinically
With using BOA what should audiologist do?
Combine principles of BOA with other more proven methods to provide additional information
BOA should…
Never be used independently & should be reported with caution
What is another type of Behavioral Testing?
Visual Reinforcement Audiometry (VRA)
What is VRA
Trains child to turn their head towards a reinforcer
When do you know the child is able to use VRA?
If child can sit on parents lap (around 6 mos)
For VRA, what is the role of parent?
- Parent cannot give any cues
2. Dangling Task: Must redirect child to center to observe true head turns toward reinforcer
What is the concern with VRA’s?
After two years, kids are too old to hold attention to this task but are too young for conditioned play audiometry
What is another type of Behavioral Testing?
Conditioned Play Audiometry (CPA)
What is CPA?
A child is conditioned to perform a play task when a sound is heard
Which behavioral testing is common for Pediatric Audiology?
CPA for 2-5 years
What is another type of behavioral testing?
Speech Audiometry
For Speech Audiometry, what two are our focus?
- SRT - Speech Recognition Words (spondee words)
2. WRS - Monosyllabic words presented at supra-thresholds
What are non-behavioral measures?
Tympanometry & ABR & OAE (helpful for children that can’t be conditioned to behavioral responses)
