Hearing Disorders in Children and AssessmentCauses of Hearing Disorders in ChildrenAcquired Hearing DisordersMyringotomy -Hearing LossLocation of damageCauses of Conductive and Sensorineural Hearing Loss in ChildrenDegree of Hearing Loss in ChildrenAuditory Processing DisorderEar Anatomy Review- Name the StructureHearing AssessmentHearing ScreeningGoals of Hearing AssessmentTerminologySlide 15Audiological AssessmentCase HistoryPhysical examinationSlide 19Equipment used for hearing testingPure Tone Hearing TestTwo Pathways of SoundSlide 23AudiogramSpeech BananaAudiogram- Normal HearingDisorders of HearingConductive Hearing LossSensorineural Hearing LossSeverity of Hearing LossPure Tone AssessmentAuditory Brainstem ResponseBehavioral ObservationVisual Reinforcements AudiometryConditioned Play AudiometryAdditional assessmentsImmittance testing-TympanometryImmittance testing- Acoustic ReflexSpeech Audiometry- SRTSpeech Audiometry- Word Recognition TestingElectrophysiological01/16/19 1Causes of Hearing Disorders in ChildrenCongenitalAcquiredHearing loss present at birthCan be geneticCan be a result of other factorsHearing loss after birth, at any time of lifeCan be the result of a disease, injury, or other conditionbacterial meningitisMumpsMeaslesViral infectionsOtitus mediaNoise exposure01/16/19 2Acquired Hearing DisordersOtitis MediaMost common cause of conductive hearing loss in childrenOften causes 25 to 30 dB lossIntermittent and variableResearch supports high correlation in chronic otitis media and speech/language problemsMay require frequent medical management01/16/19 3Myringotomy -Ear infection is result of eustachian tube swelling and not allowing drainageTubes in the ear with history of multiple ear infections and speech delayVideo of myringotomy:http://on.aol.com/video/learn-about-middle-ear-infections-114822081 01/16/19 4Hearing LossMild, moderate, severe, profoundTemporary or permanentOne ear or bothTreatmentMedicationSurgeryHearing aidCochlear implant01/16/19 5Location of damageConductiveSensorineuralDamage or blockage in outer or middle earCochlea is still functioning so some sound information is carried to the brainOften a temporary loss as it can be treated medically or surgicallyDamage to cochlea or the acoustic nerveMost common type of permanent hearing lossCan be treated effectively with amplification or implantable device01/16/19 6Causes of Conductive and Sensorineural Hearing Loss in ChildrenConductiveSensorineuralWax buildupInflammation of ear canalMalformations of the outer and middle earOtitis mediaHereditaryMaternal illness during pregnancy- STORCH infectionsComplicated birth process- low birth weight, hyperbilirubinemia, intercranial hemorrhageNoise exposureOtotoxic drugs01/16/19 7Degree of Hearing Loss in ChildrenHearing loss in children is defined as an average threshold of greater than 15 dB (adults are 25 dB)dB is loudness or intensity of signalStandard is lower for children because they are in the process of learning speech and language and are not able to “fill in the gaps” of conversation01/16/19 8Auditory Processing DisorderChild has normal hearing Disorder caused by inefficient/ineffective processing of auditory signal in the central nervous systemDiagnosed by an audiologist and treated by a speech-language pathologist01/16/19 9Ear Anatomy Review- Name the StructureProtects the ear drumConnects to the opening of the inner earAllows for drainage of fluid from the middle earProtects the middle earCarries nerve impulses from the cochlea to the brainFluid in the cochleaMove sin response to movement of endolymph and “talks” with auditory nerveWork together to boost and transmit pressure to the inner ear01/16/191001/16/1911Hearing ScreeningIdentify those at risk for hearing lossConducted by an audiologist, Speech-language pathologist or school nurseNewbornsInfants/Toddlers/Preschoolers who are at riskSchool age children- Grades: K,1,2,3,7,11 Adults- every decade through age 50 and then at 3 year intervals01/16/1912Goals of Hearing AssessmentIdentify any hearing lossUnderstand nature/severity of lossMonitor an already identified loss01/16/1913TerminologyFrequency is the number of cycles per second of a sound wave Pitch Hertz (Hz)01/16/1914TerminologyIntensity or loudness is a measure of the magnitude or pressure of a sound wave. decibels or dB0 dB is the minimum level of sound needed to stimulate the human ear at a particular frequencyNormal hearing at variety of frequencies Adults 0-25 dBChildren 0-15 dB01/16/1915Audiological Assessment1. Case history2. Physical examination of the ear3. Pure tone audiometry4. Speech audiometry5. Immitance measures01/16/1916Case HistoryNature of the problem Cause of the problemMedical historyFamily history related to hearing loss01/16/1917Physical examinationExamine the outer ear (pinna) for any malformationPictures of various malformationshttp://www.ghorayeb.com/CongenitalEar.htmlOtoscopic examination of the ear canal and ear drumvideohttp://www.youtube.com/watch?v=iIbaq15t1L001/16/1918Physical examinationExamine the outer ear (pinna) for any malformationhttp://www.ghorayeb.com/CongenitalEar.htmlOtoscopic examination of the ear canal and ear drumhttp://www.youtube.com/watch?v=iIbaq15t1L001/16/1919Equipment used for hearing testingAudiometer – tests sounds at different frequencies and intensitiesSchool and SLP screeningsSoundproof booth01/16/1920Pure Tone Hearing TestSingle frequency (pure tones) are testedThreshold is obtained- lowest level individual can reliably hear soundPure tones may be introduced through air or bone conduction01/16/1921Two Pathways of SoundAir conduction – tested by introducing sounds through ear canal, usually with headphonesBone conduction – tested by introducing vibrations through bone behind the ear. Sound bypasses middle ear and goes directly to cochlea.01/16/1922Two Pathways of Sound01/16/1923AudiogramGraph used for plotting responses to a pure tone hearing testFrequency is plotted on horizontal axisDecibel level responses plotted on vertical axisAir conduction and bone conduction can be plotted01/16/1924Speech Banana01/16/1925Audiogram- Normal Hearing01/16/1926Disorders of HearingConductive
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