Audiology 2

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Audiology 2
2012-11-08 00:53:10

Audiology 2
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  1. unknown etiology
  2. % of babies every year with a major birth defect
  3. Approximately ___ in ____ people carry a recessive gene for hearing loss in the general population.
    1 in 8
  4. % of children born with SNHL have two biological parents with normal hearing
  5. % of the offspring of deaf biological parents have normal hearing
  6. % of genetic causes of hearing loss
  7. % of SNHL caused by syndromes
  8. most common syndromes involving SNHL
    • Waardenburg Syndrome
    • Branchio-Oto-Renal (BOR) Syndrome
    • Down Syndrome
    • Pendred Syndrome
  9. Contributes to a lot of biochemistry within cochlea
    Common cause of genetic hearing loss
    The Connexin Protein (Connexin 26)
  10. Popular philosophy in late 1800/ early 1900 that
    undesirable traits can be eliminated and desirable traits made more prominent through selective breeding of humans

    Approximately 95% of prenatal babies diagnosed
    with down syndrome in the U.S. are now “terminated”
  11. Anything that can assault the body

    A child is very susceptible from 3-9 weeks of gestational age (after conception) because of the formation of the organs at that time
  12. environmental teratogens
    • Syphilis
    • Toxoplasmosis
    • Other (polio, varicella, measles, and mumps)
    • Rubella
    • Cytomegalovirus (CMV)
    • Herpes simplex virus (HSV)
  13. Common virus that usually causes a small, harmless infection, except prenatally
    1 in 25 women will contract it while pregnant; 33% will pass it on to their baby
    Women who contract it before pregnancy only have a 1% chance of passing on the virus
    No vaccine or treatment 
    Prevention: good handwashing, esp. after exposure to small children and the sick
    cytomegalovirus (CMV)
  14. A screening test’s accuracy in correctly identifying those with the condition (alone it also identifies those without condition)
  15. A screening test’s accuracy in correctly identifying those without the condition
  16. % of children with some sort of hearing impairment have to repeat a grade
  17. People who adminster hearing screening
    An ASHA certified audiologist, An ASHA certified speech-language pathologist; or Support personnel under the supervisor of an ASHA certified audiologist
  18. -detects neural response of brain
    -Waves labeled I-VII     
    -Each wave represents a synapse through the brainstem     
    -Looking for presence or absence of wave V at the screening level
    -Only I, III, and V comes through for babies
    auditory brainstem response
  19. -Puts a sound in the ear with a probe and elicits an acoustic response in the ear
    -produced by outer hair cells
    -detects whether outer hair cells are working or not
    outacoustic emissions
  20. how much hearing is left without any sensory device
    residual hearing
  21. pediatric CI team
    • Surgeon (otologist) *
    • Audiologist *     
    • SLP  
    • Educational specialist      
    • Psychologist    
    • Social worker
  22. Teaching listening without lipreading
  23. Use hand shapes and hand positions accompanied by aural
    To assist with sounds that are hard to see
    Not sign language
    cued speech
  24. Don’t cover your mouth, includes lipreading skills
  25. Use anything and everything to communicate 
    total communication
  26. Reveals they have a hearing loss but they really don’t
    false positive
  27. Reveals they have a hearing loss and they really do
    true postive
  28. Reveals they don’t have a hearing loss but they really do
    false negative
  29. Reveals that they do not have a hearing loss and they really don’t
    true negative
  30. LSLS
    listening and spoken language specialist
  31. UNHS
    universal newborn hearing screening
  32. OAE
    otoacoustic emissions
  33. ABR
    auditory brainstem response
  34. 3 Key Components of Early Hearing Detection and
    Intervention Programs
    • Birth Administration Screening (Before 1 month of age)    
    • Follow-Up Screen and Dx (Before 3 months)
    • Early Intervention (Before 6 months)
  35. Unilateral or bilateral hearing loss (sensorineural or conductive) of greater than 20 dBHL in the frequencies of 500-4000 Hz
    hearing impairment
  36. develops speech and lan­guage skills primarily through the auditory mode and employs (or is capable of employing) a primarily auditory‑verbal system of communication. While many of these children may be depend­ent upon visual cues for interpersonal communication, vision is still a secondary channel compared to audition.
    more related to typical hearing children, but not treated that way, treated as high level deaf child
    hard of hearing
  37. any person whose development of communication skills occurred primarily through the visual channel and whose current mode of communication is primarily visually based.
  38. 5 communication options
    • Auditory-verbal     
    • Bilingual-bicultural   
    • Cued speech
    • Aural-oral
    • Total communication
  39. technology used to monitor the reliability of the intracochlear
    electrodes after being surgically implanted into the cochlea.  It is used to check that the internal components of a cochlear implant have not malfunctioned
  40. -Adjusting the level of electrical impulses
    -Audiologist sets minimal and maximal current for each electrode (unique and dynamic)
    -Initially  at 3-5 weeks post-surgery, then in 2 weeks, months (for 6 months), and then annually
    -T-level (threshold), C-level (comfort)
  41. 6 criteria for pediatric implant
    • 12 months or older
    • Profound SNHL (severe for > 24 months old)     
    • Lack of auditory development as indicated on IT-MAIS or MAIS using well fit HAs      
    • No medical contraindications       
    • High motivation and realistic expectations
    • Environment supporting acquisition of listening & verbal language
  42. 5 cochlear implant components
    • receiver
    • electrode array
    • microphone
    • speech processor
    • transmitter
  43. Receives signal from external components

    Implanted just below the skull within the
    temporal bone
  44. Part that’s implanted
    Between 18 and 24 electrodes

    Inserted within the cochlear

    Want them to be as close to the nerve fibers
    as possible
    electrode array
  45. Body worn or Head worn

    Mini computer

     takes sound from microphone and converts it into the key features that the brain needs to comprehend the sounds they are listening to.  The code is going to the auditory nerve.  The electrodes are representing the hair cells.  The pattern that is coded comes through the electrodes and sent to the auditory nerve.
    speech processor
  46. A magnet and a this, signal this by radio frequency

    Magnet to keep it on the head

    Receives coded signal
  47. CI manufacturers
    • Cochlear (Nucleus 5)      
    • Med-El (Pulsar and Sonata)
    • Advanced Bionics (Harmony HiResolution)
  48. 3 components of hearing aid
    • Microphone- picks up sound from the environment and converts it into an electrical signal, which it sends to the amplifier.
    • Amplifier- increases the volume of the sound and sends it to the receiver.
    • Receiver/speaker - changes the electrical signal back into sound and sends it into the ear. Then those impulses are sent to the brain.
  49. part of HA that picks up sound from the environment and converts it into an electrical signal, which it sends to the amplifier.
  50. part of HA that increases the volume of the sound and sends it to the receiver.
  51. part of HA that changes the electrical signal back into sound and sends it into the ear. Then those impulses are sent to the brain.
  52. S/N
    Relationship between the intensity of signal and intensity of background noise at the child’s ear
  53. SN
    signal to noise
  54. _____ S/N ratio adversely affects speech recognition
  55. Typicainsurance coverage of hearing aids for children 
    • Typically cover <18 yrs old  
    •      -Range = <16 to <24)       
    • Typical amount of coverage: $1400 per HA
    •        -Range= $ 1000/HA to all costs    
    • Typical benefit period: every 3 years
    •         -Range- every 2 years to every 5 years
  56. 70% of speech between 500-2000 Hz

    Reason why PTA is 500,100 and 2000 Hz
    speech banana
  57. 4 components of an FM system
    • Microphone  
    • Transmitter     
    • Receiver   
    • Hearing aid
  58. Before the sound is sent to the receiver, it transmitter ensures that no part of the sound signal is greater than 70dB SPL. This is achieved through compression of the incoming
    sound waves.
    The sound is sent from it to the receiver that is attached to the child's hearing aids, by radio frequency waves.
    FM transmitter
  59. converts the radio waves back to electrical energy which is sent to the hearing aid for amplification.
    FM receiver
  60. 3 types of genetic transmission
    • Autosomal dominant
    • Autosome recessive
    • Sex or X-linked
  61. 20% of genetic etiologies
    family history (each generation)
    50% chance each conception
    autosomal dominant
  62. 80% of genetic etiologies
    No family history
    25% chance each conception
    autsomal recessive
  63. <1% of genetic etiologies
    Son has 50% chance of inheriting gene from
    mother each conception
    Daughters unaffected
    sex or x-linked