Week 7.2 Pediatric Candidacy Flashcards
when did the FDA 1st approve CI’s for children
june 1990
AB audiometric threshold requirements for children
severe to profound bilateral sensorineural hearing loss (>70 dB HL)
AB auditory skills and speech recognition in younger children
<4 years of age: failure to reah developmentally appropriate auditory milestones (such as spontaneous response to name in quiet or to environmental sounds) measured using the infant-toddler meaningful auditory integration scale or meaningful auditory integration scale; or <20% correct on a simple open-set word recognition test (multisyllabic lexical neighborhood test (MLNT)) administered using monitored live voice (70 dB SPL)
AB auditory skills and speech recognition in older children
> 4 years of age: <12% on a difficult open-set word recognition (phonetically balanced kindergarten test) or <30% on an open-set sentences (hearing in noise test for children) administered using recorded materials in the sound field (70 dB SPL)
AB amplification requirements for children
use of appropriately fitted hearing aids for at least 6 months in children 2-17 years, or at least 3 months in children 12-23 months of age. The minimum duration of hearing aid use is waived in the presence of ossification concerns
cochlear audiometric threshold requirements in children
- 12-23 months: bilateral profound SNHL
* 24 months-18yrs: bilateral severe-to-profound SNHL
Cochlear auditory skills and speech recognition in younger children
lack of progress in the development of simple auditory skills as quantified an a measure such as the Meaningful Auditory Integration Scale or the Early Speech Perception test
cochlear auditory skills and speech recognition in older children
= 30% correct on MLNT or lexical neighborhood test (LNT), depending on the child’s cognitive and linguistic skills
cochlear amplification requirements for children
use of appropriate amplification and participation in intensive aural habilitation over a 3 to 6 month period
med-el audiometric threshold requirements
profound bilateral SNHL with thresholds of 90 dB HL or greater at 1000 Hz
med-el auditory skills and speech recognition in younger children
lack of progress in the development of simple auditory skills in conjunction with appropriate amplification
med-el auditory skills and speech recognition in older children
<20% correct on the MLNT or LNT depending on cognitive ability and linguistic skills
Mel-el amplification requirements for children
use of appropriate amplification and participation in intensive aural habilitation over a 3 to 6 month perios
*radiologic evidence of cochlear ossification may justify a shorter trial with amplification
when can you use conditioned play audiometry
24-30 months up to 6 yrs
CI criteria for children (audiometric thresholds)
- 12-24 months: bilateral profound SNHL
- > 24 months
- –cochlear= bilateral severe to profound SNHL
- –AB and Mel-el= bilateral profound SNHL
- can implant earlier then 12 months by decision of the CI team
different ways to assess hearing status of children
- objective testing
- –case history
- –tymps
- –acoustic reflex
- –OAE
- –ABR
- –EcochG (will tell you pre synaptic or post synaptic lesion)
- speech recognition testing
- accurate diagnosis (VRA or play audiometry is really helpful to know what is really going on, this is preferable)
when to use evoked potential testing for candadicy for children
- use on your itty bittys who cant give behavioral responses
* can also use to try and find the site of lesion
about what percent of children with HL have auditory neuropathy and what is the significance of this
- about 9% of kids with HL have AN
- this is important to know because it would affect the recommendations depending on type 1 or type 2
- –type 2 is more of damage to the synapse of the IHC
hearing aids eval in CI candidate for children
- testing conditions: the best-aided condition
- HA verification process
- –PMM or test box verification with pt specific real ear to coupler difference (RECD) corrections
- –DSL m[i/o] should be used
- –verify target at speech-input levels corresponsing to soft, average, and loud, such as 50, 60, and 70 dB SPL
speech recognition testing for children basic
materials and presentation level
- speech testing material
- –recorded is necessary for older children
- –some children only respond to MLV, but really need to do recorded
- —–use the multisyllabic lexical neighborhood test (MLNT) and monosyllabic lexical neighborhood test (LNT)- both are recorded
- presentation level
- –use 60 dB A
- amplification trial period
- –importance
- –6 months
- –shorter trial
speech recognition testing in younger children
- mainly looking at auditory skills development via questionnaires
- closed set tests are recommended for younger kiddos
- –Nu-chips
- –WIPI
- –CRISP Jr
NU-CHIPS
northwestern university children’s perception of speech
- picture booklet with 4 pics per page (25% chance)
- vocab level is 2.5-5 years
WIPI
word identification picture intelligibility
- picture booklet with 6 pictures per page (16.7% chance)
- vocab level is 3-5 years
CRISP Jr
children’s realistic intelligibility of speech perception (computer based)
- 16 words that are body parts or names of objects
- age group is 2.5-5 years
