Rouke Baby Record - Physical examination - Hearing Flashcards
Which three things should prompt a rapid referral for a hearing assessment in an infant/toddler
3
- delayed speech
- delayed language development
- parental concerns
Language Delay:
Delayed speech or language development is often an early indicator of hearing loss. Examples: Limited babbling, lack of response to sounds, or delayed ability to form words.
Parental Concerns:
Parents may notice signs of poor hearing, such as lack of reaction to their voice or loud noises, which should always be taken seriously.
What infants should undergo formal audiology testing regardless of if symptoms of hearing impairment are present
high risk infants
at increased risk for later-onset or progressive hearing loss.
even if they passed universal newborn hearing screening
Which infants are at high risk
5
- family hx hearing loss
- NICU stay > 5 days
- congenital infections (rubella, CMV, toxoplasmosis)
- carniofacial anomalies
- neurodegenerative disorders or syndromes assocaited with hearing loss (usher syndrome, waardenbyrg syndrome)
What are indications to refer an older child for audiology testing
3
- parent/teacher concerns
- behaviours like speaking loudly, turning one ear towards the sound, asking for repetition
- hx OM
How is the universal newborn hearting screening performed
shortly after birth (24-48 hours)
There are two common methods used for UNHS:
A. Otoacoustic Emissions (OAE)
Purpose: Tests the function of the cochlea (inner ear).
How It's Done:
A small, soft ear probe is placed in the baby’s ear canal.
The probe emits soft clicking or tonal sounds.
A microphone in the probe detects "echoes" or otoacoustic emissions produced by the cochlea in response to sound.
Results:
Pass: If emissions are detected, it indicates the cochlea is functioning normally.
Refer: No emissions are detected, suggesting further testing is needed.
B. Auditory Brainstem Response (ABR)
Purpose: Tests the entire auditory pathway, including the auditory nerve and brainstem.
How It's Done:
Small sensors (electrodes) are placed on the baby’s head and near the ears to measure brain activity.
Soft sounds (clicks or tones) are played through earphones or ear probes.
The equipment records the brain’s electrical responses to these sounds.
Results:
Pass: Normal neural responses are recorded.
Refer: Abnormal or absent responses require further evaluation.
What is the expected language milestones at newborn-1wk?
2
- cries with discomfort
- calms to adult voice
What is the expected language milestones at 1 month
2
- alerts to unexpected sound
- makes brief short noises
What is the expected language milestones at 2 months old
2
- makes sounds other than crying
- reacts to loud sounds
What is the expected language milestones at 4 months old
- cooing
- makes sounds back at you when you talk
What is the expected language milestones at 6 months
3
- takes turns making sounds with you
- blows raspberries (sticks tongue out and blows)
- makes squealing noises
What is the expected language milestones at 9 months
2
- makes different sounds “mamamama, babababa”
- lifts arms to be picked up
What is the expected language milestones at 12 months
3
- waves byebye
- mama, dada
- understands no
What is the expected language milestones at 15 months
4
- 1-2 words
- looks at familiar object when you name it
- followed directions when given with both a gesture and words (he gives you a toy when you hold out your hand and say, “Give me the toy.” )
- points to ask for something or get help
What is the expected language milestones at 18 months
2
- tries to say 3+ words besides mama, dada
- follows 1 step directions without gestures
What is the expected language milestones at 2 years old
4
- points to things in a book when cued (“where is the bear”)
- says at least 2 words together (“more milk”)
- points to at least 2 body parts
- uses more gesutres than just waving and pointing (like blowing a kiss or nodding yes)
