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Pediatric Audiology > Chapter 1, 6, 7, 8, Case Studies, & ASHA > Flashcards

Chapter 1, 6, 7, 8, Case Studies, & ASHA Flashcards

1
Q

Prevalence

A

Refers to the number of children with hearing loss at a particular period of time.

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2
Q

Incidence

A

Number of new cases of children with hearing loss over a period of time.

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3
Q

Functionally Deaf

A

Describes a person who learned language primarily through a visual modality and who receives environmental information visually.

Visual inputs may be “Speech reading, cued speech, manual communication, lip reading, and sign language”

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4
Q

3-Pronged Approach to Pediatric Audiology

A

Diagnostician
Counselor
Audiologic Care Coordinator

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5
Q

Hearing loss definition:

A

Defined as a loss or deficit in hearing sensitivity due to auditory dysfunction in the peripheral or central auditory system.

Hearing loss exceeding 15dB HL may be considered hearing loss in children compared to 25 dB in adults.

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6
Q

Hearing handicap definition:

A

Impact of hearing loss on a person’s goals, responsibilities, and professional roles.

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7
Q

Hearing disability definition:

A

Describes the impact of the hearing loss on a person’s social functions and activities.

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8
Q

Hearing impairment:

A

Refers to any type or degree of hearing loss.

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9
Q

Functionally hard of hearing:

A

Describes an individual who learned language primarily auditorally and who receive information from the environment through the auditory modality.

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10
Q

Prevalence of congenital hearing impairment:

A

1 - 3 per 1,000 children are born with hearing loss, based on screening and/or medical records.

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11
Q

Etiology now vs. back in the day

A

There are 10x the number of children with mild/moderate hearing impairments compared to two decades ago. There are less than one-half the number of children with severe to profound hearing loss today than two decades ago.

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12
Q

What amt of infants are screened nationally?

A

97.7%

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13
Q

What amt of infants are screened in Michigan?

A

99.8%

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14
Q

Diagnostic Assessment Tools (Crumpton’s era vs. now)

A

*Crumptons Era
-BOA
-Calibrated noise makers
-Behavioral Threshold testing (VRA/CPA)
-Tympanometry using 226Hz and 660Hz probe tone
*Our Era
-Assessment protocols that are based on age and developmentally based.
-ABR, DPOAEs, and TEOAEs
-High Freq. Tympanometry
Auditory developmental check lists (LittlEars)

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15
Q

Age of intervention Crumpton’s Era vs. Now

A

Crumpton’s Era
-Intervention date was linked to age of diagnosis
-Diagnosis age was typically after the critical period for language development.
Now
-69% of infants w/ HL enrolled in intervention by 6mo
-30% are not, by 6 mo :(

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16
Q

Hearing Aid technology Then vs. Now

A

Then:
-HA technology was limited
-HA fitting was delayed because of late diagnosis
-When CI implants were first available (1990) it was limited to 2 year olds and up.
Now:
-Attempts should be made to fit HA w/in 1 mo of diagnosis.
-CI implants are allowed by 12 mo

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17
Q

Education Then vs. Now

A

Then:
-Prevalence of self contained classrooms for children who were deaf and hard of hearing
-Significant bias regarding communication and educational options.
Now:
-HoH and typically developing children are put into the same classrooms
-Family centered philosophy in determining communication and educational options.
-Laws and regulations that address needs in special education and general education.

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18
Q

How would you approach a counseling session?

A 
Family Centered approach
Be culturally sensitive
Natural Environment
Offer comprehensive services (diagnose and treat)
Evidence based
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19
Q

VRA specifics

A

Speakers at 90 or 45degree angle
Use instructions
-Don’t cue child
-Get their attention back to center
-Reinforce each time or intermittently
-Warble or Narrow band noise can be used (doesn’t matter)
-Reinforcer should be colorful and complex to keep attention
-Avoid habituation to be get most accurate results.
*Change stimulus and reinforcement

20
Q

WIPI stands for

A

Word Intelligibility by Picture Identification (Normed 5-6y/o)

21
Q

PBK stands for:

A

Phonetically balanced kindergarten (normed 5-7y/o)

22
Q

CPA (conditioned play) specifics

A
  • 3-5 years

- Most important Freq = .5 and 2kHz

23
Q

Etiology

A 
>5 days NICU
Genetics
Rubella
Measles
Meningitis
Hyperbilirubinemia
Intraventricular hemorrhage
Syndromic/non-syndromic 
Ototoxicity
Autosomal
Infection during pregnancy
24
Q

Genetics cause:

A

50-60% of all HL in children

25
Q

What percent of babies with genetic hearing loss have a syndrome?

A

20%

26
Q

CMV (Cytomegalovirus) infection is the second leading cause of hearing loss? T/F

A

False, it is the number one leading cause.

27
Q

1 in how many infants with low birth weight have HL?

A

1 in 4

28
Q

What % of children with HL have one or more other developmental disabilities?

A

25%

29
Q

Environmental Etiology

A

50% Environmental

  • CMV
  • Meningitis
  • Rubella
  • Prematurity
  • Ototoxicity
  • TORCHs
30
Q

Genetic/syndromic/non-syndromic Etiology

A

(Genetic - 50%)/(Environmental - 50%)
Genetic:
Syndromic - 30%
Non-syndromic - 70%

31
Q

Audiologist as diagnostician:

A

The establishment of an accurate diagnosis of hearing status.

32
Q

Audiologist as counselor:

A

Effective family counseling conducted in parallel with the diagnostic process.

33
Q

Audiologist as case manager/audiologic care coordinator

A

Timely service coordination

34
Q

An Audiologist (and SLP) must:

A

Demonstrate interpersonal skills that promote effective communication with children, their families, and fellow professionals in healthcare, early intervention, and educational communities.

35
Q

1-3-6 Rule:

A

(EHDI)
Screen by 1 month of age
Diagnose by 3 months of age
Intervention by 6 months of age

36
Q

EHDI background

A

Early Hearing Detection and Intervention Programs
Since late 80’s/early 90’s
Improved screening rates
Screened with OAE or AABR
If in NICU, ABR is recommended to rule out neural HL

37
Q

What should be included in a case history?

A

Observing the parent and child together
Case History
NBHS results
Risk factors (Also include late-onset or progressive HL risk factors)
Developmental observation of cognitive, vision & motor development
Emerging communication milestones
Parents impression of infant/child responsiveness to sound
(Possibly interpreter)

38
Q

Comprehensive Aud Assessment Birth - 4mo

A

Case history
Otoscopy
ABR (click stimulus) (Tone burst only if behavioral pure tone approximation is needed Frequency specific)
ASSR/Auditory Steady State Response
DPOAEs/TEOAEs (DPOAEs filter out noise better than TEOAEs)
Tympanometry (1000Hz)
Acoustic reflexes
**Cross check with behavioral assessment)

39
Q

Comprehensive Aud Assessment 6 - 36mo

A 
Behavioral assessment 
-VRA or CPA (inserts, get MRL down to 20, alternating freq.)
-Soundfield or ear specific 
Speech Aud
-SDT or SAT
-SRT for spondees or body part identification
DPOAE/TEOAE
Tymp @ 226 Hz
Acoustic Reflexes
ABR (IF VRA IS Abnormal!)
40
Q

What takes the place of word recognition testing for young child?

A

WIPI

41
Q

For children with limited hearing -problems with speech perception, we would use (severe - profound HL)

A

ESP (early speech perception test)
and
GASP (Glendonald auditory screening procedure)

42
Q

Purpose of OAEs

A

Assesses auditory function though the level of the cochlea but DOES NOT tell you degree of loss.

  • Sensitive to OHC damage
  • Helps find malingering
  • Can be used in well-child screenings (NOT NICU)
43
Q

ABR stimulus types and Polarity

A

Click: Broadband signal - Provides estimate of hearing sensitivity in the 2-4 kHz regions
Tone Bursts: Frequency specific stimuli - Must be used to estimate hearing thresholds at specific frequencies. (Minimally 500 Hz- 4kHz)
Stimulus Polarity: Rarefaction, condensation, or Alternating - Used to rule out neuropathology.
If clicks are abnormal, then use tone burst.

44
Q

Pioneer of pediatric audiology:

A

Marion Downs

45
Q

Chronological age:

A

How old they are.

46
Q

Developmental age:

A

What age level they function at (regardless of chronological age)

Pediatric Audiology (2 decks)

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