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2011-12-08 18:02:39
Audiology SLP

Audiology Final Review
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  1. Testing young children - BOA
    Behavioral Observation Assessment (BOA)These tests are conducted by a specially trained audiologist who observes a child's body and head responses to sounds, including cessation of activity, body movement, eye widening, eye opening, or change in sucking rate.
  2. Testing young children - VRA
    Visual Reinforcement Audiometry (VRA)As children mature, so does their ability to respond to sounds. At about 6 to 7 months, normally developing children can turn toward a sound source. Children at this level are tested either with earphones or in a sound booth with speakers. Sounds for testing typically include low pitch to high pitch tones from the speech range. Turning toward the sound source is reinforced with a lighted toy. This testing is generally quite accurate in determining hearing levels.
  3. Testing young children - CPA
    Conditioned Play Audiometry By approximately 2 1/2 to 3 years most children can be tested using this technique. Earphones are placed on the child and he or she is conditioned to play various games when the test tone is heard.
  4. High Risk Register
    • 1. Family history of hearing loss
    • 2. Congenital infections (TORCH)
    • 3. Craniofacial anomalies
    • 4. Low birth weight
    • 5. Hyperbilirubinemia (might be related to auditory neuropathy)
    • 6. Ototoxic medications
    • 7. Bacterial meningitis
    • 8. Severe depression (not mental) - asphyxia at birth
    • 9. Prolonged mechanical ventilation (infant incubation)
    • 10. Stigmata associated with syndromes
  5. Testing young children - physiological tests
    • acoustic immittance
    • otoacoustic emissions
    • ABR
  6. Case management - case history
    • Info about hearing loss, hearing history, family history
    • info about problems with communication
  7. Case management - hearing evaluation
    • PT air and bone conduction thresholds
    • SRT
    • Word recognition
    • Tympanometry
    • Acoustic reflexes
    • ---For detailed - the above and the following included:
    • OAE
    • ABR
    • PI functions for word recognition
    • vestibular evaluation
    • Stenger test
  8. Case management - counseling
    • Explain results
    • Give a copy of audiogram
    • Explain implications for communication
  9. Case management - referral
    • For a hearing aid evaluation
    • to a physician (ENT)
    • for monitoring of hearing loss
  10. Case management - documentation (SOAP)
    • S-Subjective (background)
    • O-Objective (what did you find?)
    • A-Assessment (What did your test results mean?)
    • P-Plan (How will you follow up?)
  11. Assistive devices - hearing aid types
    • Conventional (single analog circuit)
    • Programmable (analog circuit programmed by computer according to the hearing loss)
    • Fully digital (digital circuit, usually programmable)
    • Disposable (used until battery dies)
    • Implantable
  12. Choosing a hearing aid based on many areas:
    • Cost
    • Cosmetics
    • Functions
    • Motivation to use
    • Medical contraindications
  13. Hearing aid evaluations - determining candidacy
    • Persons with hearing loss below 2000 Hz in one or both ears who report difficulty in hearing
    • Patients with auditory difficulties in communication
    • No medical contraindications (TM perf, draining ear, external otitis)
    • ENT approval
  14. Hearing aid evaluations - main points
    • Determmine candidacy
    • Select hearing aid(s)
    • Ear impression
  15. Hearing aid fitting and follow up
    • Match hearing aid response to hearing loss
    • Real ear measures of SPL in ear canal and functional gain (Measure appropriateness of fit)
    • Counseling regarding care of aid, 30 day trial, expectations
    • Follow-up appoinments as needed to make adjustments or assess satisfaction
  16. Assistive devices
    • Separate microphone, receiver
    • Isolates speaker (signal) from noise
  17. Cochlear Implant (Basics of Electrical Hearing)
    • Must have surviving neural units despite having a damaged cochlea
    • These 8th nerve fibers are capable of transmitting information about the auditory signal to the cortex
    • Electrical stimulation of nerve fibers causes the same type of percept of sound at the cortex as does sound transmitted through the standard auditory channel
  18. Insertion of Cochlear Prosthesis
    • Each electrode array is placed in the scala tympani
    • The electrodes are then close to the neural units in the modiolus
  19. The electrical analog of acoustic frequency is _________, not electrical ___________.
    • electrode position
    • frequency
  20. The dynamic range of electrical hearing is very narrow - approximately __________ dB. This contrasts to a dynamic range of ________ dB for acoustic hearing.
    • 5-30
    • 120
  21. Adult cochlear implant candidates
    Have severe to profound ____________ hearing loss in both ears.
    • 18 or older
    • sensorineural
  22. Adult cochlear implant candidates
    Receive little or no benefit from appropriate __________.
    i.e. score of ______ or less on _________ tests while wearing hearing aids.
    • hearing aids
    • 40%
    • sentence recognition tests
  23. Adult cochlear implant candidates
    Must desire to __________ and have no medical _________.
    • be a part of the hearing world
    • contraindications
  24. Child cochlear implant candidates
    Have ________(degree) _________ (type) hearing loss in both ears.
    • profound
    • sensorineural
  25. Child cochlear implant candidates
    No useful benefits from hearing aids in children ____________ is defined as lack of development of simple auditory skills.
    18 months to 5 years old
  26. Child cochlear implant candidates
    No useful benefits from hearing aids in children ____________ is defined asscoring less than 20% on speech perception tests.
    5 years and older
  27. Child cochlear implant candidates are in educational programs that _______________.
    support listening and speaking for communication
  28. Child cochlear implant candidates and their families should have high _____ and appropriate __________ as well as no medical _______.
    • motivation
    • expectations
    • contraindications