Quiz 3 Flashcards
hearing thresholds are the same by air and bone conduction
normal or sensorineural loss
hearing thresholds by bone conduction are normal but air conduction thresholds shoe hearing loss
conductive loss
hearing thresholds show loss by both air and bone conduction thresholds. but bone conduction thresholds are better than air conduction thresholds
mixed loss
hearing thresholds show hearing loss for both air and bone conduction thresholds. hearing loss is the same for both air and bone conduction thresholds
sensorineural loss
hearing thresholds are better for bone conduction than air conduction
conductive or mixed loss
hearing thresholds are within normal limits and are the same by both air conduction and bone conduction
normal hearing
why is masking used?
it is used to eliminate the NON-TEST ear form participation in the measurement of hearing thresholds in the TEST ear
what kind of testing is masking used for?
both air and bone conduction testing
what kind of masking band is used to mask noise and why?
narrow band because it is more comfortable
what type of masking band is louder and more uncomfortable?
broad band “white” noise
how is hearing tested in infants and young children?
look for BEHAVIORAL response to sounds ex: eyes widening, arousal from sleep, cessation of activity, and HEAD TURN
how is hearing tested in 2-5 year olds?
from CONDITIONED responses through PLAY, head turn, raised hand (CONVENTIONAL AUDIOMETRY) and/or speech results
part of the tympanometer that introduces tones into the ear canal
pure tone generator (loudspeaker)
part of the tympanometer that changes the air pressure in the ear canal
air pump
part of the tympanometer that measures the pressure change
manometer
part of the tympanometer that measures the amount of sound that is reflected back from the tympanic membrane in response to air pressure changes
measure device (microphone)
what does a tympanogram measure?
the MOBILITY of the tympanic membrane and air pressure in the middle ear from +200 daps to -400 daPa
tympanograms that peak at less than or equal to -150 suggest malfunction of what part of the ear?
the middle ear pressure equalizing system (eustachian tube)
what do tympanograms measure?
immittance (general term for impedance or admittance) of the TM
what are pure tone hearing thresholds?
the LOWEST level at which the client responds correctly 50% of the time
PTA and SRT should be what?
equal
what are speech recognition thresholds? (SRTS)
the LOWEST level at which the client can correctly repeat the words 50% of the time
what are spondaic words used for?
to measure the SRTs. 2 syllable words are used (ex: football, playground)
what is the standard STARTING LEVEL for pure tone audiometry?
30 dB HL
what is the standard procedure for finding threshold?
Down 10dB UP in steps of 5 dB
what do we use when testing for air conduction?
headphones
what do we use when testing for bone conduction?
bone conduction vibrator
what are the ABR primary waveforms?
I, II, III, IV and V
what is an ABR?
auditory brainstem response
what is ABR testing used for?
to predict hearing SENSITIVITY in young infants, or in children or adults who are DIFFICULT to test
what is the primary waveform used for ABR testing?
Wave V
what does wave V do?
arises from the inferior colliculus
in ABR testing, wave I does what?
arises from the COCHLEAR portion of the auditory nerve before it enters the brainstem
in ABR testing, wave II does what?
it is generated by the BRAINSTEM segment of the auditory nerve and the cochlear nucleus
in ABR testing, wave III does what?
arises mostly from the SUPERIOR OLIVARY COMPLEX
in ABR testing, wave IV does what?
originated from ascending fibers in the LATERAL LEMMINISCUS just below the inferior colliculus
in ABR testing, wave V does what?
arises from the INFERIOR COLLICULUS
what is the most common clinical application of OAEs?
universal screening of newborn hearing
what are phonetically balanced (PB) word lists used for?
speech testing for supra threshold speech recognition
phonetic composition of all lists are what?
equivalent and are representative of everyday ENGLISH speech. single syllable
in closed set lists (multiple choice) the phonetically balanced choices will vary by what?
only one speech sound ex: rain-pain, him-hit
a 10 dB air-bone gap at 2 or more frequencies indicates what?
a conductive loss, even if hearing thresholds are in the NORMAL range and requires a MEDICAL referral
standard audiometric test battery tests what 3 things?
pure tone air and bone conduction testing, speech audiometry, and imminence testing (tympanometry)
what measuring auditory function what is essential?
test battery approach because it shows the best information
what is auditory processing disorder? (APD)
the dysfunction in the auditory portions of the CNS
who coordinates and supervises hearing screening programs?
professionals trained in audiology
who are the personnel designated to conduct the screening tests in speech and hearing, and even volunteers and and secretaries
nurses, audiologists, speech-language pathologists and graduate students
what are the two tests most commonly used in the USA?
otoacoustic emission (OAEs) and auditory brainstem response (ABRs)
why do we screen newborns for hearing loss?
children who receive EARLY INTERVENTION from the age of 3 years or younger show significantly better SPEECH AND LANGUAGE outcomes later in life
ASHA recommendations for screening for middle ear disease include:
case history, visual inspection of ear canal and eardrum, and tympanometry with a low frequency probe tone
ASHA guidelines for school age children include screening annually from when?
preschool through grade 3 and then in year intervals (except for 3-4 year individuals)
ASHA guidelines for school age children include testing where?
in a quiet room
ASHA guidelines for school age children include testing at what levels?
20 dB HL at 1000, 2000, 4000 Hz
ASHA guidelines for school age children include doing what to failures?
rescreening
at risk school age children require what?
more attention than routine hearing screening
who are considered at risk school children?
children with delayed or defective speech, having academic difficulties, suddenly being failing academically, or with frequent cold and ear infections
screening is a common healthcare practice that contributes _____.
to the high cost of health care in the US
define reliability
consistent results. if you retest the same person, you get the same results
define validity
measuring what we think we are measuring
a test must have high of what two things?
sensitivity and specificy
validity and reliability ___
do not go hand in hand. a test may be reliable but not valid and vice-versa
prevalence of a disorder is what?
how frequently a disorder occurs in a population. 100 x (A+C/A+B+C+D)
what is the relationship between sensitivity and specificity of a test and prevalence of a disorder
sensitivity and specificity of a test are NOT affected by the prevalence of a disorder
define sensitivity
identifying the abnormal; those with the disorder; TRUE POSITIVES (group A); has hearing loss and failed the screening. 100 x A/A+C
define specificity
identifying the normal; those without the disorder; TRUE NEGATIVES (group D); has normal hearing and passed the screening. 100 x D/B+D
Group B are what?
false POSITIVES; has normal hearing but failed the screening
Group C are what?
false NEGATIVE; has hearing loss but passed the screening
an acceptable screening test for a disorder should be what 5 things?
reliable, valid, cost effective, easy to administer and safe
screening is of little value is what?
if follow-up is not provided for children who FAIL the screening
children who fail the screening need what?
comprehensive audio logic evaluation as soon as possible, parent counseling and referral to educational services for planning and placement
there is no national program for screening of adults other than what?
the military
what increased with age?
the prevalence of hearing loss – but there is no screening programs for the elderly in the US
how many people over the age of 12 in the US have significant hearing loss?
1 in 5, which is about 48 million people
