30 terms

Audiology: Testing for Infants and Toddlers

STUDY
PLAY

Terms in this set (...)

Technique (BOA)
1. Present a noise through sound field (warble tones, speech, noise makers)
2. Watch child and see what response they show
Strengths (BOA)
1. You get to see a behavioral response (ideal)
2. Non-invasive
3. Not time-intensive
Limits (BOA)
1. Can be very subjective
2. Up until 1.5 years, it is not good at giving definitive thresholds
3. Doesn't give you information for each individual ear
4. Kids fatigue quickly
BOA
• Age
• Ease:
• Client Cooperation Necessary?
• Client Response Necessary?
• Degree of HL:
• Frequency Specificity:
• Type:
Age: Any (newborntoddler)
• Ease: Poor (with infants) to Fair (with toddlers)
• Client Cooperation Necessary? Yes (Have to see a behavioral response)
• Client Response Necessary? Yes (Show an eye blink, startle reflex, localization response, etc.)
• Degree of HL: Poor (with infants) to Fair (with toddlers)
• Frequency Specificity: Good (can test individual frequencies)
• Type: Poor
Technique (VRA)
1. Present a noise through sound field or headphones (i.e. warble tones, speech instructions, noise makers like rattles).
2. Watch child and see what response they show.
3. Reinforce child's response by lighting up a toy
Strengths (VRA)
1. Keeps child engaged in task for longer period
2. More deliberate responses because they are reinforced
Limits (VRA)
1. Only testing better hearing ear (if done in sound field)
VRA:
-Ease
-Client Cooperation Necessary?
-Client Response Necessary?
-Degree of HL
-Frequency Specificity
-Type
• Ease: Good
• Client Cooperation Necessary? Yes (Have to see a behavioral response)
• Client Response Necessary? Yes (Show an eye blink, startle reflex, localization response, etc.)
• Degree of HL: Poor (with infants) to Good (with toddlers will reinforce their localization with toys)
• Frequency Specificity: Good (can test individual frequencies)
• Type: Fair (Toddler may let you do BC testing)
Technique (Play Audiometry)
1. Have child respond to stimulus by making a game out of it
♣ For example: Drop blocks in right or left bucket when they hear a tone
♣ Will want to practice this several times first, possibly with several children to reduce shyness
Strengths (Play Audiometry)
1. Typically, children enjoy participating, so their focus is enhanced
2. Consistent responses
3. Child will stay engaged for a longer period
4. Individual ear thresholds
5. Accurate threshold findings
6. Individual frequencies tested accurately
Limits (Play Audiometry)
Time Consuming
(Play Audiometry)
• Age
• Ease
• Client Cooperation Necessary?
• Client Response Necessary?
• Degree of HL
• Frequency Specificity
• Type: Good
• Age: Toddlers (3+)
• Ease: Good (very easy to perform)
• Client Cooperation Necessary? Yes
• Client Response Necessary? Yes
• Degree of HL: Good
• Frequency Specificity: Good (can test individual frequencies)
• Type: Good (headphones and BC)
Technique (Speech Audiometry)
1. Using words to get an idea of how they are hearing
♣ Could be localizing to sound, or following voiced instructions (because there is no context in the booth if they follow instructions it must be auditory).
2. Can be used in sound filed or under headphones.
Strengths (Speech Audiometry)
1. Test each ear
2. More engage for a longer period
3. Give good estimate of hearing for the speech frequencies
4. Very good idea of threshold levels.
Limits (Speech Audiometry)
1. If done in sound field- you're only testing better ear
2. No frequency specific thresholds
(Speech Audiometry)
• Age
• Ease
• Client Cooperation Necessary?
• Client Response Necessary?
• Degree of HL
• Frequency Specificity
• Type: Good
• Age: Toddlers (2+)
• Ease: Good
• Client Cooperation Necessary? Yes
• Client Response Necessary? Yes
• Degree of HL: Good
• Frequency Specificity: Fair (can at least tell you about the frequencies important for speech)
Type: Good (Can do headphones and BC testing)
Technique (ABR)
1. Electrodes are hooked up to the child's head.
2. A loud (around 80 dB) acoustic stimulus is presented to each ear.
3. As it travels up the auditory pathway, it creates an averaged evoked potential which we then measure. (Tells us about how the child is hearing).
4. You should get 7 peaks, but focus specifically on number 5.
5. Start to decrease the intensity of the tone presented until the peak disappears (latency and amplitude decrease).
Strengths (ABR)
1. Can test any age (even premature babies)
2. Child does not have to respond
3. It gives a good estimate of the degree of HL
4. Test individual ears
5. Can be presented through air or bone conduction (Ex: if ear canal is closed, you can do bone conduction)
Limits (ABR)
1. Not very frequency specific
2. Baby/child has to be completely still
♣ Must keep toddlers up all night so they'll sleep during it
3. Time-consuming to hook everything up
♣ 15-30 minutes just for screening
4. If they have any issues with the middle ear, it will really impact their results.
ABR
• Age
• Ease
• Client Cooperation Necessary?
• Client Response Necessary?
• Degree of HL
• Frequency Specificity
• Type
• Age: Any (newborntoddler)
• Ease: Fair (lots of prep)
• Client Cooperation Necessary? Yes (asleep or sitting still)
• Client Response Necessary? No
• Degree of HL: Good
• Frequency Specificity: Fair (can get an idea, but not very specific)
• Type: Good (Air or Bone)
Technique (DPOAE)
1. Before starting, you must control background noise, including being in a quiet room and having them sit very still.
2. Put probe tip in ear
♣ Probe tip has loudspeakers and microphone
3. Measure the echo produced by the cochlea
When is an echo produced by the cochlea?
1. When the outer hair cells are stimulated, it produces an echo that can range from -10 to 10 dB.
Which test should be done first for newborns?
1. Do DPOAE test first for newborns. If they fail this test, then they will do ABR.
Strengths (DPOAE)
1. Very frequency specific
2. Can test individual ears
3. Very quick and less expensive
4. Child doesn't have to respond.
Limits (DPOAE)
1. Does not give any estimation of degree of HL
♣ 30 dB or poorer = no echo
• Thus, they just "fail"
2. Child has to be 100% quiet
3. Any ME issues can cause test failure
♣ When child fails this test, do it again and then do tymp to see if ME issues are the cause.
DPOAE
• Age
• Ease
• Client Cooperation Necessary?
• Client Response Necessary?
• Degree of HL
• Frequency Specificity
• Type
• Age: Any (newborn-->toddler)
• Ease: Good (very quick and easy)
• Client Cooperation Necessary? Yes (asleep or sitting totally still)
• Client Response Necessary? No
• Degree of HL: Poor
• Frequency Specificity: Good (can test individual frequencies in each ear)
• Type: Poor
What percentage of children have profound HL? How long do you have to test HL in children?
3%, 10-15 minutes
What behavioral responses can children 4-7 months show?
Head turn laterally toward sound (speech detection)
Listening Attitude

Can do this at 51 dB HL (Warble tones)
21 dB HL (Speech)
40-50 dB SPL (Noisemaker)
What behavioral responses can children 16-21 months show?
Directly localizes to side/below/above ear level

Can do this at 25 dB HL (Warble tones)
5 dB HL (Speech)
25 dB SPL (Noisemaker)
When should peak V occur when doing ABR testing?
At 5.5-5.75 seconds