-
amount spent annually on OME
3.5 billion
-
% of children with acute otitis media by one year of age
67%
-
-
symptoms of AOM
- crying
- pulling at ears
- not eating or sleeping
- red swollen ears
-
peak incidence age of OME
6-11 months
-
% of children with otitis media who have 3 epidodes by age 3
50%
-
rapid onset of signs
<3 weeks duration
AOM
-
otitis media for 3 weeks to 3 months
subacute OM
-
otitis media from 3 months or longer
chronic OM
-
after ____ OM, we need to screen children at least __ times with approximately ___ to ___ months in between
chronic, 2, 2, 3
-
how eustachian tube is opened
by contraction of palatal muscles
-
eustachian tubes in children are _____ and more _____ than adults
shorter, horizontal
-
functions of the eustachian tube
- protection from nasopharyngeal sound and secretions
- clearence of middle ear secretions
- ventilation (pressure regulation) of middle ear
-
eustachian tube acts as _____ pressure
negative
-
VLBW
very low birth weight
-
very low birth weight
<1500 grams
-
risk of VLBW decreases by race in this order
- american indians/eskimos
- hispanics
- whites
- blacks
-
intrinsic risk factores for chronic OME
- very low birth weight
- craniofacial anomalies
- family history
- first bout of OME before 6 months old
- sleep on stomach
- male
- immune system weakness
-
extrinsic (outside of body) risk factors for chronic OME
- season
- group day care
- sharing a pacifier
- allergens
- no breast milk
-
lowest time for OME
summer
-
average amount of hearing loss from OME
25 dB
-
what you look for in ear drum
- translucent
- PE tubes
- rupture
- white scare tissue
- cone of light
-
it takes _____ for tympanic membrane to heal after PE tube falls out
48 hours
-
caused from swimming in cold water a lot
results in bony growth
ear canal exotosis
-
-
inflammed mastoid
mastoiditis
-
smattering of scar tissue on the TM, but has no impact on hearing
tympanosclerosis
-
best practice for hearing screening:
- middle and outer ear screening done together
- must be both otherwise may miss up to 50% of children with otitis media
-
don't feed infant and the ____ position because if makes it easier for food to go to middle ear
supine
-
what you do during initial diagnosis of OME
- educate on parental control of environmental factors
- no myringotomy
- observation or antibiotics
-
do not soley perform _________ anymore because it does not allow for TM to stay open and dry out
myringotomy
-
what to do with OME for 3 months with HL of <20dBHL
- parental control of environment
- observation or antibiotics
-
what to do with OME for 3 months with HL of >20dBHL in both ears-chronic
- parental control of environment
- antibiotics or bilateral myringotomy with PE tubes
-
what to do with OME for 4-6 months with HL >20dBHL in both ears
- parental control of environment
- bilateral myringotomy with PE tubes
-
puts positive pressure in and negative pressure out
sends tone in and measures how much of tone comes back
tymponogram
-
static compliance needs to be
>.3 ml
-
tympanometric width needs to be
> 200 daPa
-
physical volume needs to be
<2.0
-
within normal limits
true peak, betwen positive 200 and negative 200
Type A tympanogram graph
-
negative tympanogram
true peak
less than -200
when your ear feels full
Type C tympanogram graph
-
flat- no true peak
concluded that there is fluid behind the ear
can't be on it's own as an indicator of OME
Type B tympanograph
-
OME progresses from __->___->___
A to C to B
-
recovery process for OME from __->__->__->
B to C to A
-
reasons for medical referral on screening
- 80% cerumen
- chrome OME (i.e. flat tymp with normal PV)
- flat tymp with high PV possible indicator of perforation of TM
-
school age students spend ___to___% of the school day in listening activities
45-60%
-
reasons for APD referals to audiologist
- difficulty following verbal instructions and answering questions
- difficulty with reading
-
% of SLPs who work with school age children regularly with APD
67%
-
argue that true perceptual dysfunctions are modality-specific
Cacase & McFarland
-
argues that APD often exists with more global dysfunction that may affect performance
ASHA
-
APD is not recognized by
IDEA and DSM
-
central auditory pathways travel through...
- brainstem (medulla,pons,midbrain)
- then to auditory cortex
-
65-70% of APD is caused by
neuromorphologic disorders
-
underdeveloped, misshapen, and misplaced cells usually in the left hemisphere and the auditory region of the corpus callosum
neruomorphologic disorders
-
25-30% of causes of APD
delayed maturation of the CANS
-
<5% of causes for APD
neurological disorders, diseases and insults
-
% of school age population with APD
2-5%
-
___to___% with LLD have APD
30 to 50%
-
ratio of boys to girls with APD
2:1
-
characteristics of school age with APD
- difficulty with speech understanding in adverse listening environments
- misunderstanding
- responding inconsistently or inappropriately
- frequently asking that information is repeated
- difficulty attending and avoiding distraction
-
Bellis' profiles of APD
- auditory decording deficit
- prosody weakness deficit
- integration weakness deficit
-
primary deficits in monaural serparation/auditory closure and phoneme discrim
auditory decoding deficit
-
difficulty with the perception of the intent of a message (sarcasm, humor)
prosody weakness deficit
-
inefficient communication between hemispheres
integration weakness deficit
-
SUNY-Buffalo Model
- CAPD
- decoding
- tolerance fading
- integration
- organization
-
decoding- SUNY
difficulty accurately/quickly processing speech
-
tolerance fading- SUNY
difficulty understanding adverse listening conditions
-
integration-SUNY
difficulty integrating linguistic with suprasegmental
-
Medwetsky Model
- spoken language processing
- intertwining of:
- auditory processes
- cognition
- receptive language
-
questionaire for grades k-6
fisher's problem checklist
-
questionnaire
-elementary and preschool versions: asks teachers to rate students in behavior, participation, academics, attendance, and communications
SIFTER
-
questionnaire that askes teachers and parents to compare a child's auditory functions in different environments
CHAPPS- auditory processing performance scare
-
screening for APD with diffierent numbers that go into the ear simultaneously, and child distinguishes
Dichotic digits test (DDT)
-
screening for 3-11 years
administered at MCL
appox 10-15 min
subtests- gap detection, auditory figure ground, competing words
SCAN 3-C
-
% of children with specific learning disablilty
43%
-
distribution of special ed categories
- 1- specific learning disability
- 2- speech and language impairment
-
other ways to classify APD to receive services
- other health impaired
- learning disability
- speech and langue impaired
- 504 plan
-
for students ineligible for special ed
disability is deficed as a mental or phyiscal impairment that substantially limits one of more major life activities (ex:hearing)
504 plan
-
doesn't believe APD exists
Kamhi
-
3 approaches to APD management
- environmental modification
- direct intervention
- compensatory strategies
-
what ASHA says S/N should be
>15 dB
-
teacher wears microphone, child wears earpiece
not much amplification
for people without SNHL
PhonakEduLink
-
using context to fill in missing pieces
auditory closure
-
using expectations and experiences to fill in message
schema induction
-
learning to key in to tag words and conjenctions
discourse cohesion devices
-
using rhythmic and melodic features of the message
prosody training
-
national acoustic classroom standard
- unoccupied ambient noise <35 dB
- T (Room reverberation) <.6 sec
- S/N ratio > +15dB
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